THE EFFECT OF PARATHYROIDECTOMY ON HEMATOCRIT AND ERYTHROPOIETIN DOSEIN PATIENTS ON HEMODIALYSIS

Hyperparathyroidism has been implicated as a cause for resistance to e rythropoietin therapy, based on a limited number of studies. The autho rs retrospectively surveyed the effects of parathyroidectomy on hemato crit and erythropoietin dose in patients with end-stage renal disease. The study group included 10 patients (4 men, 6 women) on long-term he modialysis, 9 of whom were receiving erythropoietin intravenously duri ng dialysis. Parathyroidectomy resulted in a decrease in mean parathor mone levels from 15 times normal preoperatively to 2.3 times normal at follow-up. The hematocrit values increased, and the weekly erythropoi etin dose decreased significantly when values 1 month before surgery w ere compared with those 6 months after surgery. From this, the authors conclude that secondary hyperparathyroidism is a cause of worsening a nemia and increased erythropoietin requirements in patients on hemodia lysis, and that parathyroidectomy is effective in reversing these abno rmalities.