Novosti
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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.
- Golokhvastov NN., red. Giperkal'tsiemiia. Pervichnyi giperparatireoz: ucheb [Hypercalcemia. Primary hyperparathyroidism]. posobie dlia vrachei. SPb, RF: Gippokrat; 2003. 136 p.
- Shchegolev AA, Filiptsev PIa, Larin AA, Piashin VV, Sokol'skii AS. Kogan MA, i dr. Vtorichnyi giperparatireoz pri khronicheskoi pochechnoi nedostatochnosti [Secondary hyperparathyroidism in chronic kidney failure]. Lechebnoe Delo. 2009;(3):75-79.
- Samokhvalova NA, Maistrenko NA, Romashchenko PN. Programmnyi podkhod k lecheniiu vtorichnogo giperparatireoza pri khronicheskoi bolezni pochek [The program approach to the treatment of secondary hyperparathyroidism in chronic kidney disease]. Vestn khirurgii im II Grekova. 2013;172(2):43-46.
- Voronenko IV, Mokrysheva NG, Rozhinskaia LIa, Syrkin AL. Narusheniia uglevodnogo i zhirovogo obmena pripervichnom giperparatireoze [Disturbances of carbohydrate and fat metabolism in primary hyperparathyroidism]. Ozhirenie i Metabolizm. 2008;(4):18-24.
- Dedov II, Rozhinskaia LIa, Mokrysheva NG, Vasil'eva TO. Etiologiia, patogenez, klinicheskaia kartina, diagnostika i lechenie pervichnogo giperparatireoza [Etiology, pathogenesis, clinical presentation, diagnosis and treatment of primary hyperparathyroidism]. Osteoporoz i Osteopatii. 2010;(1):13-18.
- Kaji1 H, Nomural N, Yamauchi M, Chihara1 K, Sugimoto T. The usefulness of bone metabolic Indices for the prediction of changes in Bone mineral density after parathyroidectomy in patients with primary hyperparathyroidism. Horm Metab Res. 2006 Jun;38(6):411-16.
- Bart LC, editor. Primary Hyperparathyroidism and Hypoparathyroidism. Endocrinology. 2000;2(Pt 1):2-12.
- McCormick R. Osteoporosis: Integrating biomarkers and other diagnostic correlates into the management of bone flagility. Altern Med Rev. 2007 Jun;12(2):113-27.
- K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003 Oct;42(4 Suppl 3):S1–201.
- Rozhinskaia LIa. Vtorichnyi giperparatireoz i pochechnye ostaopatii pri khronicheskoi pochechnoi nedostatochnosti [Secondary hyperparathyroidism and renal osteopathy with chronic renal failure]. Nefrologiia i Dializ. 2000;2(4):241–47.
- Egshatian LV, Rozhinskaia LIa, Kuznetsov NS, Kim IV, Artemova AM, Mordik AI, i dr. Lechenie vtorichnogo giperparatireoza, refrakternogo k al'fakal'tsidolu, u patsientov, poluchaiushchikh zamestitel'nuiu pochechnuiu terapiiu programmnym gemodializom [Treatment of secondary hyperparathyroidism refractory to alfacalcidol in patients receiving renal replacement therapy by program hemodialysis]. Endokrin Khirurgiia. 2012;(2):27-41.
- Samokhvalova NA, Romanchishen AF, Gerasimchuk RP, Grinev KM, Zemchenkov AIu. Vtorichnyi giperparatireoz: chastota, klinicheskie proiavleniia, lechenie [Secondary hyperparathyroidism: incidence, clinical manifestations, treatment]. Vestn Khirurgii im II Grekova. 2007;166(5):78-81.
- Vetchinnikova ON. Giperparatireoz pri khronicheskoi bolezni pochek. Effektivnaia farmakoterapiia [Hyperparathyroidism in chronic kidney disease. Effective pharmacotherapy]. Urologiia i Nefrologiia. 2013;44:26-39.
- Okabe R, Nakatsuka K, Inaba M, Miki T, Naka H, Masaki H, et al. Clinical evaluation of the elecsys β-CrossLaps Serum assay, new assay for degradation products I type collagen C-telopeptides. Clin Chem. 2004 Aug;47(8):1410-14.
- Samokhvalova HA. Vtorichnyi giperparatireoz. Paratireoidektomiia kak metod profilaktiki destruktsii kostei u bol'nykh vtorichnym giperparatireozom [Secondary hyperparathyroidism. Parathyroidectomy as a method of preventing bone destruction in patients with secondary hyperparathyroidism]. V: Romanchishen AF, red. Khirurgiia shchitovidnoi i okoloshchitovidnoi zhelez. SPb, RF: Vesti; 2009. p. 434-60.
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
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 №2 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 №2 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''.