Influence of dialysis modalities on patients undergoing parathyroidectomy for renal hyperparathyroidism

SummaryBackground/IntroductionDialysis modalities may influence parathyroid hormone (PTH) levels and renal osteodystrophy patterns. To date, no study has compared the effects of dialysis modality on surgical patients with renal hyperparathyroidism.Purpose/AimThis study evaluated the influence of different dialysis modalities on perioperative features among patients undergoing parathyroidectomy.MethodsOverall, 386 patients who underwent initial parathyroidectomy for renal hyperparathyroidism were recruited. Biochemical data and relevant symptoms were compared between hemodialysis and peritoneal dialysis patients.ResultsCompared with the hemodialysis patients, the 40 (10%) peritoneal dialysis patients were younger (p = 0.002) and had a shorter duration of dialysis (p < 0.001). The peritoneal dialysis patients had lower hemoglobin (p = 0.006), albumin (p = 0.040), and intact PTH levels (p = 0.039) prior to surgery but had higher serum aluminum levels (p = 0.039). During follow-up, the peritoneal dialysis patients tended to have higher calcium–phosphorus product levels and more severe residual symptoms of bone pain (p = 0.080), mood swings (p = 0.053), and pruritus (p = 0.094).ConclusionPatients on different dialysis modalities had similar decreases in intact PTH and alkaline phosphatase levels after surgery. However, the peritoneal dialysis patients had higher postoperative calcium–phosphorus product levels and more severe residual symptoms