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Longitudinal study of bone mass in end‐stage renal disease patients: Effects of parathyroidectomy for renal osteodystrophy
Author(s) -
Copley John B.,
Hui Siu L.,
Leapman Stephen,
Slemenda Charles W.,
Johnston Conrad C.
Publication year - 1993
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.5650080405
Subject(s) - renal osteodystrophy , medicine , parathyroidectomy , end stage renal disease , secondary hyperparathyroidism , bone disease , surgery , urology , hyperparathyroidism , hemodialysis , bone mass , osteodystrophy , kidney disease , parathyroid hormone , osteoporosis , calcium
The effectiveness of parathyroidectomy (PTHX) for the control of secondary hyperparathyroidism was assessed in 46 adult end‐stage renal disease (ESRD) patients whose bone mineral content at the midshaft and distal radius was measured using single‐photon absorptiometry (SPA) every 6 months before and after the surgery. They were compared to 46 age‐, race‐, and sex‐matched ESRD patient controls who had not undergone surgery but who had had at least five SPA studies at similar intervals. Presurgery midradius bone mass was significantly lower for PTHX patients compared to controls. Comparing changes in bone mass of PTHX patients across surgery to controls in comparable time periods showed that PTHX patients lost significantly less bone mass after surgery. Similar results were obtained when rates of change in bone mass were evaluated. When patient characteristics were examined, the effect of surgery was found to be diminished in elderly patients and in oophorectomized patients. It is concluded that PTHX can have a salutary effect on renal osteodystrophy in the appendicular skeleton, but factors other than bone mass also need to be considered in identifying those patients who will benefit from surgery.