Efecto de la paratiroidectomía en los niveles de PTH, calcio y fósforo de pacientes con hiperparatiroidismo asociado a enfermedad renal crónica

Abstract

There is controversy about the benefit of parathyroidectomy in patients with renal insufficiency and severe hyperparathyroidism, with little information available. Objective: To evaluate the effect of parathyroidectomy on the levels of parathyroid hormone (PTH), phosphorus and calcium in patients with hyperparathyroidism associated with chronic kidney disease with PTH greater than 800 pg / ml, seen at a peruvian reference hospital in the period 2000-2015. Methods: Retrospective analytical historical cohort study that included patients with hyperparathyroidism with surgical indication (PTH> 800). Baseline PTH, calcium and phosphorus levels were compared at 3, 6 and 12 months of patients, sometimes parathyroidectomy with respect to non-parathyroidectomized patients. Results: We included 84 patients, followed during 3606 people-month, of which 24 (28.57%) were parathyroidectomized. During the follow-up showed statistically significant reduction in the levels of parathyroid hormone at 3 (p < 0.001), 6 (p < 0.001) and 12 months (p < 0.001) follow-up in the group of parathyroidectomized patients compared with those not parathyroidectomized, as well as in calcium levels at 3 (p < 0.001), 6 (p < 0.001) and 12 months (p < 0.001) and phosphorus at 3 (p <0.03), 6 (p <0.001) and 12 months (p <0.001). Conclusions: Patients undergoing parathyroidectomy showed significant reductions in levels of PTH, calcium and phosphorus compared to those not paratiroidectomizados, achieving the levels recommended by the KDIGO Guide at 3, 6 and 12 months of follow.