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| 標題: | Parathyroidectomy Improves the Consumption of Erythropoiesis-Stimulating Agents in Hemodialysis Patients |
| 作者: | Lee, Yu-Ting
Tu, Chi-Wen
Kam, Kam-Hong
Ma, Tsung-Liang
Kuo, Chin-Ho
Lee, Ming-Yang
Hsiao, Chih-Yen
Chan, Michael W. Y.
Hung, Peir-Haur |
| 貢獻者: | Chia-Yi Christian Hospital
National Chung Cheng University
National Chung Cheng University
National Chung Cheng University
Chia-Yi Christian Hospital
Chia-Yi Christian Hospital
Chia-Yi Christian Hospital
Chia Nan University of Pharmacy & Science
Chia Nan University of Pharmacy & Science |
| 關鍵字: | renal-disease patients
bone-marrow fibrosis
anemia
hormone
therapy |
| 日期: | 2022 |
| 上傳時間: | 2023-12-11 14:00:00 (UTC+8) |
| 出版者: | MDPI |
| 摘要: | Secondary hyperparathyroidism (SHPT) is common in end-stage renal disease (ESRD) patients, and it can suppress erythropoiesis. We aimed to investigate the relationship between the consumption of erythropoiesis-stimulating agents (ESAs) and parathyroidectomy (PTX) in ESRD patients with SHPT and to determine the predictors for anemia improvement. The current standard of chronic kidney disease anemia therapy relies on the prescription of iron supplementation, and ESA. We retrospectively analyzed 81 ESRD patients with PTX at Ditmanson Medical Foundation Chiayi Christian Hospital from July 2004 to Dec 2018. The requirement of ESA therapy markedly declined from a dose of 41.6 (interquartile range [IQR], 0-91.2) to 10.3 (IQR, 0-59.5, p = 0.001) unit/kg/week. In addition, 63.7% of patients required iron replacement therapy preoperatively and the proportion reduced to 52.5% after PTX (p < 0.001). The hemoglobin (Hb) level showed an insignificant change from a median value of 10.7 g/dL (9.5-11.6 g/dL) before PTX to 10.5 g/dL (9.6-11.2 g/dL) at 6 months after PTX. A preoperative Hb level <= 10 mg/dL (odds ratio [OR], 20.1; 95% confidence interval [CI], 4.71-125, p < 0.001) and transferrin saturation (TSAT) < 25% (OR, 12.8; 95% CI, 2.51-129, p < 0.001) were predictors for anemia improvement. Our study demonstrated that PTX markedly decreased the requirement of ESA. Patients with a low preoperative Hb level or low TSAT showed an increase in the Hb level after PTX. PTX may be considered not only for SHPT with refractory anemia but also for high ESA-dependent patients. |
| 關聯: | INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, v.23, n.CB2, pp.CC2, pp.-, |
| 顯示於類別: | [行政單位] 123
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