Clinical characteristics of 496 secondary hyperparathyroidism patients undergoing parathyroidectomy

Objective To retrospectively analyze the characteristics of age distribution and clinical nutritional parameters in secondary hyperparathyroidism (SHPT) patients undergoing parathyroidectomy (PTX). Methods Clinical data of 496 SHPT patients undergoing PTX from 2011 to 2015 in the First Affiliated Hospital with Nanjing Medical University were collected and recorded. Age stratification of SHPT patients was observed. The levels of nutritional parameters in different age groups were compared using ANOVA analysis. The relationship between intact parathyroid hormone (iPTH) and nutritional parameters was explored using Spearman's correlation. Results There were 274 males in 496 SHPT patients who were aged (46.0±11.4) years. Chronic glomerulonephritis was the major primary cause of patients (92.1%). Their dialysis vintage was (7.7±3.6) years. The proportion of SHPT patients receiving hemodialysis was 92.9%. In SHPT patients serum levels of calcium, phosphorus, iPTH and alkaline phosphatase (ALP) were (2.6±0.2) mmol/L, (2.2±0.5) mmol/L, (2290.0± 1294.2) ng/L, and (564.7 ±537.8) U/L, respectively. Levels of serum albumin (Alb) in all age groups were lower than the reference range. Serum calcium, ALP, and iPTH levels among age groups were different with statistical significance, while serum phosphorus levels among age groups shown no statistically significant difference. Compared with patients aged ≤18 years old and 19~30 years old, the level of ln[ALP] was lower in patients aged 61-70 years old (P <0.05). Conclusions Severe SHPT patients are mainly receiving hemodialysis and aged between 30 and 60 years old. Chronic glomerulonephritis is a primary cause of SHPT patients. In order to increase the patients' endurance of operations and reduce the occurrence of postoperative complications, malnutrition in SHPT patients is to be alleviated before PTX. Key words: Hyperparathyroidism, secondary; Renal osteodystrophy; Age factors; Parathyroidectomy