Abstract:

This study was conducted to investigate the survival rate of grafts after total parathyroidectomy with autotransplantation (PTX+AT) and its impacts on prognosis and quality of life in maintenance hemodialysis（MHD） patients with secondary hyperparathyroidism (SHPT).
Ｍｅｔｈｏｄｏｌｏｇｙ：160 MHD patients underwent PTX+AT were recruited from Second Affiliated Hospital of Anhui Medical University between February 1th,2011 and November 30th,2015. 2 weeks after operation,the allograft function was evaluated via comparing serum intact parathyroid hormone (iPTH) levels between implanted and nonimplanted arm. Biochemical parameters were detected pre and 1 month,3 month,6 month,9 month,12 month postoperation. Clinical symptoms and complications were collected.
Ｒｅｓｕｌｔｓ：1. The grafts survival rate was 6625%.Bone pain and pruritus were remarkably improved in both groups after operation.2.Compared with the preoperative parameters,the levels of Ca,P,iPTH and alkaline phosphatase（ALK）dropped significantly in both groups (P<005),and the hemoglobin（Hb），albumin（Alb）and total protein（TP）levels increased markedly in both groups (P<005).Serum levels of Ca at 3 month and 12 month postoperation in survival group were significantly higher than that of compared group.Serum iPTH level at 12 month postoperation in survival group was also dramatically higher than nonsurvival group.There were no significant differences in other indicators between the two groups.Although slightly more patients readmitted due to hypocalcemia in graft nonsurvival group,severe hypocalcemia was more common in the patients with longer dialysis vintage,higher PTH value and severer bone pain preoperation in both groups.3.The recurrence rate of survival group was higher (10/106 vs. 2/54，P<005).
Ｃｏｎｃｌｕｓｉｏｎ：
There were no significant differences on prognosis and quality of life among two groups after PTX+AT. The occurrence of hypocalcemia was positively correlated with the severity of SHPT before operation.