Abstract:

ABSTRACT Objective： To observe the effect of total parathyroidectomy with forearm autograft (PTX+AT) on blood pressure in patients with secondary hyperparathyroidism(SHPT) of chronic kidney disease(CKD). Methodology： Between February 2011 and March 2013, in 41 cases of secondary hyperparathyroidism (SHPT) of chronic kidney(CKD) patients were treated with PTX+AT,35 cases with hypertension.The follow-up period was more than 3 months. The change of serum iPTH, blood pressure, calcium, and phosphorus were observed in the preoperative, postoperative and follow-up periods. Results：(1) 41 patients successfully underwent surgery, 35 patients had their 4 parathyroid glands removed, in 5 patients only 3 parathyroid glands were discovered and removed, and in 1 patient 2 parathyroid glands were found and removed.(2) Postoperative serum iPTH,calcium，phosphate，and the blood pressure decreased significantly compared with the preoperative. In 28 cases with hypertension,, blood pressure was effectively controlled after surgery. Conclusion： In patients with secondary hyperparathyroidism and hypertension, total parathyroidectomy with forearm autograft can significantly improve hypertension control rates, which is meaningful for reducing cardiovascular complications in patients with CKD.

Key words: Chronic kidney disease, Secondary hyperparathyroidism, Total parathyroidectomy with forearm autograft, Hypertension