Evaluation of malnutrition and inflammation after total parathyroidectomy in patients on maintenance dialysis

Int Urol Nephrol. 2023 May;55(5):1301-1309. doi: 10.1007/s11255-022-03436-6. Epub 2022 Dec 12.

Abstract

Purpose: To evaluate the effect of total parathyroidectomy (tPTx) on malnutrition and inflammation in patients on maintenance dialysis (MHD) having secondary hyperparathyroidism (SHPT).

Methods: Twenty-five patients on MHD having SHPT who were being treated with tPTx were selected, and changes in their general condition (dry body mass), parathyroid hormone (PTH) and calcium levels, nutrition state (hemoglobin, hematocrit, serum albumin, and total iron binding capacity), and inflammatory status [serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and the malnutrition-inflammation score (MIS)] were observed at 12, 24, and 36 months postoperatively.

Results: Compared with the preoperative period, the dry body mass increased at 12, 24, and 36 months postoperatively (P < 0.01), hemoglobin, hematocrit, and serum albumin increased significantly (P < 0.01), whereas calcium, phosphorus, and PTH levels decreased significantly (P < 0.01). Serum CRP, IL-6, and TNF-α levels were significantly decreased at 12, 24, and 36 months after surgery (P < 0.01). Furthermore, MIS was reduced as well but to a lesser extent (P < 0.01).

Conclusion: tPTx effectively reduced MIS in maintenance dialysis patients, and the alleviated malnutrition and improved inflammatory status may contributed to improving the quality of life of patients on MHD with SHPT.

Keywords: Inflammation; Maintenance hemodialysis; Malnutrition; Secondary hyperparathyroidism; Total parathyroidectomy.

MeSH terms

  • C-Reactive Protein
  • Calcium
  • Hemoglobins
  • Humans
  • Hyperparathyroidism, Secondary* / complications
  • Hyperparathyroidism, Secondary* / surgery
  • Inflammation / complications
  • Interleukin-6
  • Kidney Failure, Chronic* / surgery
  • Kidney Failure, Chronic* / therapy
  • Malnutrition* / complications
  • Malnutrition* / etiology
  • Parathyroid Hormone
  • Parathyroidectomy
  • Quality of Life
  • Renal Dialysis
  • Serum Albumin
  • Tumor Necrosis Factor-alpha

Substances

  • Calcium
  • Tumor Necrosis Factor-alpha
  • Interleukin-6
  • Parathyroid Hormone
  • C-Reactive Protein
  • Hemoglobins
  • Serum Albumin