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| Effect of Parathyroidectomy Combined with Autotransplantation on Klotho and FGF23 in Maintenance Hemodialysis Patients |
| TONG Chang-jun, LIU Yong, ZHOU Jia-jun, et al |
| Yijishan Hospital of Wanna Medical College,WUhu Anhui,241001 |
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Abstract 【Objective】 To evaluate the efficacy of parathyroidectomy combined with anterior wall autotransplantation (tPTX+AT) in the treatment of maintenance hemodialysis (MHD) patients with severe secondary hyperparathyroidism (SPTH), and investigate the effect on soluble Klotho protein and fibroblast growth factor 23 (FGF23) levels. 【Methods】 Ninety patients complicated with MHD and SPTH, who underwent tPTX+AT treatment, were enrolled in the study. The incidence of complications, biochemical parameters, Klotho and FGF23 levels before and 1, 3, 6 and 12 months after treatment were recorded. 【Results】 All patients underwent successful operation. There were 3 cases of postoperative hemorrhage, 2 cases with postoperative infection, 1 case with laryngeal nerve injury, 1 case with arrhythmia, 4 cases with hypocalcemia, and 1 case with high potassium. All of them got improved after active treatment. The levels of serum calcium, blood phosphorus, calcium and phosphorus product, iPTH and ALP at 1, 3, 6 and 12 months after surgery were lower than those before treatment (P<0.05). At 3, 6, and 12 months after surgery, Hb, Hct, and SF were higher than those before surgery (P<0.05). While the dose of rHuEPO and CRP were lower than those before surgery (P<0.05). There was no significant difference in Kt/V (urea clearance index) before and after surgery (P>0.05). FGF-23 in patients at 1, 3, 6 and 12 months after surgery was lower than that before surgery, and Klotho was higher than that before surgery (P<0.05). 【Conclusion】 tPTX+AT has less complication in MHD with SPTH patients and high safety. It can improve calcium metabolism, correct nutrition and inflammation status, and can reduce FGF-23 and increase Klotho level.
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Received: 24 September 2019
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2020, Vol. 37 
