Effect of Calcitriol Shock Therapy Combined with Total Parathyroidectomy on the Efficacy and Calcium and Phosphorus Metabolism in Renal Failure Patients with Secondary Hyperparathyroidism

LIU Shujuan; LIU Yating; HU Yating

doi:10.3969/j.issn.1002-3429.2024.20.020

Abstract：Objective To explore the effect of calcitriol shock therapy combined with total parathyroidectomy(tPTx)on efficacy and calcium(Ca)and phosphorus(P)metabolism in renal failure patients with secondary hyperparathyroidism,and to observe the safety of drug therapy.Methods Between January 2020 and September 2022,90 renal failure patients with secondary hyperparathyroidism were selected and randomly divided into two groups:the control group(n=45)and the observation group(n=45)according to random number table method.The control group was treated with tPTx,and the ob-servation group was supplemented with calcitriol shock therapy on the basis of the control group.The total effective rate,pre-operative and postoperative Ca and P metabolism,inflammatory indicators and nutrition status indicators,hemoglobin,erythro-poietin(EPO)dosage,and safety were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group after treatment(93.33%vs.77.78%,P＜0.05).At 6 and 12 months after treatment,serum intact parathyroid hormone(iPTH)levels were significantly lower,and serum Ca and Ca×P levels were significantly higher in both groups compared with those before treatment(P＜0.05),At 1 month after treatment,the blood Ca levels in both groups significantly increased compared with those before treatment(P＜0.05).At 12 months af-ter treatment,the iPTH level in the observation group was significantly lower than that in the control group,while the levels of blood Ca and Ca×P were significantly higher than those in the control group(P＜0.05).Serum ferritin(SF)and albumin(ALB)levels increased significantly in both groups at 1 and 12 months after treatment,and reached the highest value at 6 months after treatment(P＜0.05).C reactive protein(CRP)decreased in both groups at 1 and 12 months after treatment,with a significant decrease at 6 months after treatment(P＜0.05).SF and ALB were significantly higher in the observation group than in the control group(P＜0.05).Hemoglobin increased significantly in both groups at 6 and 12 months after treat-ment,which was significantly higher in the observation group than in the control group(P＜0.05).The dosage of EPO began to decrease in both groups at 6 and 12 months after treatment,which was significantly lower in the observation group than in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Calcitriol shock therapy combined with tPTx can improve the Ca and P metabolism and nutritional status of renal failure patients with secondary hyperparathyroidism,and decrease EPO dosage,without any significant impact on the safety of drug therapy.