Efficacy analysis of medical and surgical treatments in chronic kidney disease patients with secondary hyperparathyroidism.

Abstract

PURPOSE\nTo investigate the effects of surgical and medical treatments on chronic kidney disease (CKD) patients with secondary hyperparathyroidism (SHPT).\n\n\nMATERIALS AND METHODS\nA total of 198 CKD patients with SHPT were identified at Tongji Hospital from January 2013 to June 2017.\n\n\nRESULTS\nSurgical group (53 patients) received maintenance dialysis for 78.0\u202f±\u202f4.9\u202fmonths, while medical group (84 patients) for 62.0\u202f±\u202f6.4\u202fmonths. The serum intact parathyroid hormone (iPTH) in surgical group reduced apparently compared with medical group (P\u202f=\u202f0.015) and maintained satisfied result during three years of follow-up (67.4\u202f±\u202f7.4\u202fpg/ml). The recurrence rate in surgical group was 7.5% and in medical group was 15.5% (P\u202f=\u202f0.024). Beyond that, 5 (5.9%) patients suffered persistent hyperparathyroidism in medical group.\n\n\nCONCLUSION\nAlthough the progress of medical treatment is changing rapidly, surgical treatment is still an effective way to control serum iPTH and calcium chronically for SHPT patients. Complex SHPT patients can also receive satisfied effect by surgical treatment, without apparently increasing the risk of complications.