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Year 2010 Vol. 18 No 6
GENERAL AND SPECIAL SURGERY
KHRYSHCHANOVICH V.YA., TRETYAK S.I., MOKHORT T.V., BOGOMAZOVA E.V.
WELL–BEING AND CALCIUM-PHOSPHORUS HOMEOSTASIS IN PATIENTS WITH HYPOPARATHYROIDISM RECEIVING STANDARD TREATMENT WITH CALCIUM AND VITAMIN D
Objectives. To study calcium homeostasis and well-being of the patients with hypoparathyroidism by comparison of the obtained results with those in the patients who underwent thyroid surgery but with saved parathyroid function.
Methods. Cross-sectional controlled study in 69 patients with the postsurgical hypoparathyroidism (the period of the postoperative observation made up 38,7±10,3 months (S.D.) on stable treatment with calcium and vitamin D (or analogs) and in 26 control patients with a history of thyroid surgery but saved parathyroid function, who were matched for sex, age and time since surgery. Assessment of well–being and parathyroid homeostasis were studied using validated questionnaires (SF–36 v. 2ÔÌ, NAIF), serum calcium/phosphorus homeostasis, and in the hypoparathyroid patients also screening for secondary disease by means of kidney ultrasound and ophthalmological split lamp examination.
Results. Serum calcium was in the accepted therapeutic range in 10 of hypoparathyroid patients, in the majority cases calcium/phosphorus homeostasis was clearly non–physiological. Nephrolithiasis was detected in 6 and cataracts in 3 of 69 hypoparathyroid patients. As compared with controls, hypoparathyroid patients had signicantly lower parameters of quality of a life in SF–36 v. 2ÔÌ (ð < 0,05), NAIF (ð = 0,048) with predominant decreases in the scale scores for vitality, physical and social functioning, role–physical/emotional functioning.
Conclusions. Current standard treatment in hypoparathyroidism is not only associated with an altered calcium/phosphorus homeostasis but also fails to restore well–being in these patients. Future studies need to address the impact of more physiological treatment options like parathyroid hormone (1–34) or parathyroid transplantation on well–being and mood in these patients.
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