Year 2021 Vol. 29 No 6

GENERAL & SPECIAL SURGERY

E.A. ILYICHEVA 1, D.A. BULGATOV 1, T.A. ROY 1, D.V. LEBEDEVA 2

CHANGES OF QUALITY OF LIFE AFTER SURGICAL TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPY WITH HEMODIALYSIS

Irkutsk Scientific Center of Surgery and Traumatology 1,
Irkutsk State Medical University 2, Irkutsk,
The Russian Federation

Objective. To assess quality of life (QoL) using the Short Form Medical Outcomes Study (SF-36) questionnaire before and after surgical treatment of secondary hyperparathyroidism (SHPT) in patients undergoing renal replacement therapy.
Methods. QoL was assessed before surgery and in the period from 4 to 30 months after surgical treatment of SHPT. Twenty patients were questioned according to SF-36 questionnaire in a longitudinal study and in comparison, with the population indicators of the Irkutsk region residents. The median age before surgery was 53 years, the median level of PTH before surgery was 1715 pg/ml. After surgical treatment, the median of PTH was 12.9 pg/ml, calcium – 1.99 mmol/l; phosphorus – 1.72 mmol/l within 6-12 months.
Results. An unfavorable effect of SHPT on QoL of patients receiving hemodialysis was shown in comparison with population indicators. Evaluation of the effectiveness of surgical treatment of SHPT in relation to changes in the quality of life of patients is given. A statistically significant increase in QoL indicators after surgical treatment was proved for all the studied scales (pW<0.05). In the long term after the operation, QoL of patients receiving hemodialysis exceeds the population indicators on the scales of the psychological component of health, pain intensity, social and role functioning.
Conclusion. The SHPT in patients receiving hemodialysis is the cause of a decrease in QoL in comparison with population indicators was shown for the first time. Surgical remission of the disease leads to a statistically significant improvement in QoL, and on the scales of the psychological component of health, intensity of pain, social and role functioning, the quality of life of patients exceeds population indicators in a similar age group. The data obtained allow us to consider postoperative hypoparathyroidism as one of the favorable factors in course of postoperative period and criterion for remission of the disease.

Keywords: parathyroidectomy, secondary hyperparathyroidism, quality of life, SF-36, chronic kidney disease, postoperative hypoparathyroism, PTH
p. 654-661 of the original issue
References
  1. Andrusev AM, Tomilina NA, Peregudova NG, Shinkarev MB. Renal replacement therapy for end stage renal disease in Russian Federation, 2014-2018. Russian National renal replacement therapy Registry report of Russian public organization of nephrologists “Russian Dialysis Society. Nefrologiia i Dializ. 2020;22(S1):1-71. doi: 10.28996/2618-9801-2020-1suppl-1-71(In Russ.)
  2. Bikbov BT, Tomilina NA. The contingent and treatment quality indicators in patients on replacement therapy of end stage renal disease in the Russian Federation in 1998-2013 years. Nefrologiia i Dializ. 2016;18(2):98-164. http://journal.nephro.ru/index.php?r=journal/articleView&articleId=1952(In Russ.)
  3. Dedov II, Mel’nichenko GA, red. Endokrinologiia: nats ruk. 2-e izd., pererab. i dop. Moscow, RF: GEOTAR-Media; 2019: 1112 p. https://www.rosmedlib.ru/book/ISBN9785970450833.html (In Russ.)
  4. Volgina G.V. Secondary hyperparathyroism in patients with chronic renalfailure. The treatment with active metabolites of vitamin D. Nefrologiia i Dializ. 2004;6(2):116-26. http://journal.nephro.ru/index.php?r=journal/issueView&journalId=46 (In Russ.)
  5. Assotsiatsiia nefrologov. Nauchnoe obshchestvo nefrologov Rossii. Mineral‘nye i kostnye narusheniia pri khronicheskoi bolezni pochek (Natsional‘nye rekomendatsii) [Elektronnyi resurs]. 2015. 26 s. [data obrashcheniia: 2020 Sent 22]. Rezhim dostupa: http://www.nephro.ru/content/files/recomendations/ckdmbdNationalGuidelines.pdf (In Russ.)
  6. Gerasimchuk RP, Zemchenkov AIu, Novokshonov KIu, Sleptsov IV, Kislyi PN, Karelina IuV, Chernikov RA, Fedotov IuN. The impact of parathyroidectomy on the dynamics of CKD-MBD laboratory parameters and survival of dialysis patients in St.-Petersburg. Nefrologiia i Dializ. 2016;18(1):40-49. http://journal.nephro.ru/index.php?r=journal/issueView&journalId=76 (In Russ.)
  7. Bikbov B, Bieber B, Andrusev A, Tomilina N, Zemchenkov A, Zhao J, Port F, Robinson B, Pisoni R. Hemodialysis practice patterns in the Russia Dialysis Outcomes and Practice Patterns Study (DOPPS), with international comparisons. Hemodial Int. 2017 Jul;21(3):393-408. doi: 10.1111/hdi.12503
  8. Kosenkova OI, Makarova VI. Problem of quality of life in present-day medicine. Ekologiia Cheloveka. 2007;(11):29-34. (In Russ.)
  9. Amirdzhanova VN, Goriachev DV, Korshunov NI, Rebrov AP, Sorotskaia VN. Populiatsionnye pokazateli kachestva zhizni po oprosniku SF-36 (rezul’taty mnogotsentrovogo issledovaniia kachestva zhizni «MIRAZh»). Nauch-Prakt Revmatologiia. 2008;(1):36-48. doi: 10.14412/1995-4484-2008-852. (In Russ.)
  10. Elkinton JR. Medicine and the quality of life. Ann Intern Med. 1966 Mar;64(3):711-14. doi: 10.7326/0003-4819-64-3-711
  11. Martyshenko SN. Kontseptual‘nye modeli upravleniia kachestvom zhizni. Analiticheskii obzor. Regional Ekonomika i Upravlenie: [Elektronnyi nauch zhurn]. 2014;(2):80-92. https://eee-region.ru/article/3806/ (In Russ.)
  12. Khetogurova AK. Palliativnaia pomoshch‘, mediko-sotsial‘nye, organizatsionnye i eticheskie printsipy. Moscow, RF: VUNMTs; 2003. 160 p. In Russ.)
  13. Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res. 1994 Oct;3(5):329-38. doi: 10.1007/BF00451725
  14. Vasil’eva IA. Rossiiskaia versiia oprosnika kidney disease and quality of Life Short Form (KDQOL-SF) - tsennogo diagnosticheskogo instrumenta dlia otsenki kachestva zhizni bol’nykh na dialize. Nefrologiia. 2007;11(1):64-70. doi: 10.24884/1561-6274-2007-11-1-64-70. In Russ.)
  15. van der Plas WY, Dulfer RR, Engelsman AF, Vogt L, de Borst MH, van Ginhoven TM, Kruijff S; Dutch Hyperparathryoid Study Group (DHSG). Effect of parathyroidectomy and cinacalcet on quality of life in patients with end-stage renal disease-related hyperparathyroidism: a systematic review. Nephrol Dial Transplant. 2017 Nov 1;32(11):1902-1908. doi: 10.1093/ndt/gfx044
  16. Ware JE, Kosinski M, Keller SD. SF-36 Physical and Mental Health Summary Scales: A User’s Manual. 5th printing. Health Assessment Lab, New England Medical Center, Boston, MA; 1994 Dec. https://www.researchgate .net/profile/ John_Ware/publication/292390260_SF17._Physical_and_Mental_Health_Summary_Scales_a_User’s_Manual/links/5af580264585157136caee31/SF-36-Physical-and-Mental-Health-Summary-Scales-a-Users-Manual.pdf
  17. Il’icheva EA, Roi TA, Mikhlina IA. Pokazateli anketirovaniia po standartnomu oprosniku SF-36 vzroslykh lits, prozhivaiushchikh na territorii g. Irkutska i Irkutskoi oblasti. Svidetel’stvo gos. reg. bazy dannykh ¹2015620339 ot 20.02.2015. Pravoobladatel’ FGBU «NTsRVKh» SO RAMN. https://www.elibrary.ru/item.asp?id=39328850 (In Russ.)
  18. Komaba H, Taniguchi M, Wada A, Iseki K, Tsubakihara Y, Fukagawa M. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 2015 Aug;88(2):350-59. doi: 10.1038/ki.2015.72
  19. El-Kholey MMAE, Ibrahim GES, Elshahat OI, El-Kannishy G. Impact of Subtotal Parathyroidectomy on Clinical Parameters and Quality of Life in Hemodialysis Patients with Secondary Hyperparathyroidism. Endocrinol Metab (Seoul). 2019 Dec;34(4):367-73. doi: 10.3803/EnM.2019.34.4.367
  20. Gu C, Ye Z, Wang Y, Wang Q, Qi J, Chen J, Chen S, Xu Z. Therapeutic efficacy of two surgical methods on the secondary hyperparathyroidism. Gland Surg. 2020 Apr;9(2):321-28. doi: 10.21037/gs.2020.03.08
Address for correspondence:
664003, Russian Federation,
Irkutsk, Borcy Revoljucii Str., 1,
Irkutsk Scientific Center of Surgery
and Traumatology
tel.: 8(3952)40-78-28,
å-mail: lena_isi@mail.ru
Ilyicheva Elens A.
Information about the authors:
Ilyicheva Elena A., MD, Professor, Head of the Research Department of Clinical Surgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-2081-8665
Bulgatov Dmitry A., Senior Researcher of the Research Department of Clinical Surgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-2440-0813
Roy Tatyana A., Senior Researcher of the Research Department of Clinical Surgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-3273-774X
Lebedeva Darya V., Day Time Post-Graduate Student of the Hospital Surgery DEpartment, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0001-7388-1679
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