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Khirurgii

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Year 2016 Vol. 24 No 1

GENERAL & SPECIAL SURGERY

A.V. VELICHKO1, Y.I. YARETS 1, S.L. ZYBLEV2, Z.A. DUNDAROV2,
V.V. POKHOZHAY 2

EFFECT OF PARATHYROIDECTOMY ON THE BONE METABOLISM INDICATORS IN PATIENTS WITH SECONDARY HYPERPARATHYROIDISM AGAINST THE BACKGROUND OF CHRONIC RENAL DISEASE

SE ''Republican Research Center for Radiation Medicine and Human Ecology''1,
EE ''Gomel State Medical University bone'' 2
The Republic of Belarus

Objectives. To examine the effect of parathyroidectomy on the bone metabolism and remodeling bone in patients with the secondary parathyroidectomy against the background of chronic renal desease (CRD).
Methods. The diagnostic and treatment results of patients (n=19) with the secondary hyperparathyroidism had been examined; the patients received medical treatment at the surgery department (a department of transplantation, reconstructive and endocrine surgery) of SE "The Republican Research Center for Radiation Medicine and Human Ecology". The patients’ age ranged from 23 to 66 years. There were 12 males (63%) and 7 females (37%). All the patients were subjected to parathyroidectomy (PTE) accompanied by the determination of parathyroid hormone concentration in venous blood 30 minutes prior to operation and 20 minutes after it. The study examined level indicators of β2-microglobulin (B2MG), cystatin C, osteocalcin and β-Cross laps prior surgery and 3 months after it.
Results. Efficacy of parathyroidectomy was confirmed by the considerable reduction of parathyroid hormone concentration in 20 minutes after the operation. The total and ionized calcium level reduced after the surgical operation. The study showed that the level of bone resorption markers was decreasing during the incisional period. The considerable reduction of osteocalcin and β-Cross laps concentration had been registered in comparision with that was done prior to operation. The considerable decrease of β2-microglobulin and cystatin C level was indicated the efficiency of parathyroidectomy performance in improving indicators of the nephrone functional activity.
Conclusion. The surgical correction of hyperparathyroidism is an efficient treatment method of metabolic bone disease at chronic renal disease. The parathyroidectomy is considered to be a surgical operation of choice in patients with chronic renal disease for arrest disease progression and hypercalcemia consequences. With a view to cupping the metabolic disorders in secondary hyperparathyroidism due to chronic kidney disease the surgical correction of hyperparathyroidism is quite justified.

Keywords: secondary hyperparathyroidism, chronic renal failure, parathyroidectomy, parathyroid hormone concentration, bone metabolism, remodeling bone, hypercalcemia consequences
p. 32-39 of the original issue
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Address for correspondence:
246040, Republic of Belarus,
Gomel, ul. Ilicha, d. 290,
GU ''Respublikanskiy nauchno-prakticheskiy
tsentr radiatsionnoy meditsinyi i ekologii cheloveka'',
khirurgicheskoe otdelenie
(transplantatsii, rekonstruktivnoy i endokrinnoy khirurgii),
tel. mob.: 375 29 656-57-11, e-mail: velichkoav@rambler.ru,
Velichko Alexander Vladimirovich
Information about the authors:
Velichko A.V. PhD, an associate professor, a head of the surgery department (transplantation, reconstructive and endocrine surgery) of SE ''The Republican Research Center for Radiation Medicine and Human Ecology''.
Yarets Y.I. PhD, an associate professor, a head of the clinical and diagnostics laboratory of SE ''The Republican Research Center for Radiation Medicine and Human Ecology''.
Zyblev S.I. PhD, an assistant of the chair of surgical diseases ¹2 with the course of pediatric surgery, anesthesiology and reanimatology of EE ''Gomel State Medical University''.
Dundarov Z.A. MD, professor, a head of the chair of surgical diseases ¹2 with the course of pediatric surgery, anesthesiology and reanimatology of EE
''Gomel State Medical University''.
Pokhozhay V.V. An assistant of the oncology chair with the course of radiation diagnosis and radiotherapy of EE ''Gomel State Medical University''.
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