Measurement of Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism and End Stage Renal Disease.

BACKGROUND: Surgery is the definitive treatment of secondary hyperparathyroidism (2HPT) and end stage renal disease patients. The aim of this study to assess the impact of surgery on the evolution of quality of life (QoL) in patients with 2HPT, and to identify the variables that influence this evolution.

METHODS: A series of 85 consecutive unselected patients underwent total parathyroidectomy for 2HPT in our clinic. QoL was measured using the Short-Form Health Survey(SF-36) and alleviation of symptoms was documented using an outcome tool (PAS score), based on visual analog scales, preoperatively, postoperatively and at 6 months.

RESULTS: Preoperatively, patients had lower SF-36 scores than the general population in all 8 individual and 2 component summary scales, with significant decrease in the physical health scales(p 0.0001). Patients improved in all ten scales at 6 months follow-up, most significant being: Body Pain (45.02‚+-5.52 vs 33.12‚+-8.82, p 0.0001), Role-physical (41.00‚+-7.43 vs 33.46‚+-8.54, p 0.0001), Physical functioning (40.06 ‚+-7.77 vs 33.36 ‚+-10.84, p 0.0001). PAS Scores decreased from preoperatory levels of 569.99 ‚+- 136.45 to 372.20 ‚+- 104.62 at 7 days after surgery and furthermore at 292.64 ‚+- 85.16 at 6 months follow-up (p 0.0001).

CONCLUSIONS: We found no correlation between preoparatory PTH or Calcium levels and clinical symptoms. Parathyroidectomy clearly alleviates symptomatology and improves QoL in 2HPT patients, with durable effect at 6 months.