ИЗМЕНЕНИЕ КАЧЕСТВА ЖИЗНИ ПОСЛЕ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ВТОРИЧНОГО ГИПЕРПАРАТИРЕОЗА У ПАЦИЕНТОВ, ПОЛУЧАЮЩИХ ЗАМЕСТИТЕЛЬНУЮ ПОЧЕЧНУЮ ТЕРАПИЮ ГЕМОДИАЛИЗОМ

Abstract

Objective. To assess quality of life (QoL) using the Short Form Medical Outcomes Study (SF-36) questionnaire before and after surgical treatment of secondary hyperparathyroidism (SHPT) in patients undergoing renal replacement therapy. Methods. QoL was assessed before surgery and in the period from 4 to 30 months after surgical treatment of SHPT. Twenty patients were questioned according to SF-36 questionnaire in a longitudinal study and in comparison, with the population indicators of the Irkutsk region residents. The median age before surgery was 53 years, the median level of PTH before surgery was 1715 pg/ml. After surgical treatment, the median of PTH was 12.9 pg/ml, calcium - 1.99 mmol/l; phosphorus - 1.72 mmol/l within 6-12 months. Results. An unfavorable effect of SHPT on QoL of patients receiving hemodialysis was shown in comparison with population indicators. Evaluation of the effectiveness of surgical treatment of SHPT in relation to changes in the quality of life of patients is given. A statistically significant increase in QoL indicators after surgical treatment was proved for all the studied scales (pW<0.05). In the long term after the operation, QoL of patients receiving hemodialysis exceeds the population indicators on the scales of the psychological component of health, pain intensity, social and role functioning. Conclusion. The SHPT in patients receiving hemodialysis is the cause of a decrease in QoL in comparison with population indicators was shown for the first time. Surgical remission of the disease leads to a statistically significant improvement in QoL, and on the scales of the psychological component of health, intensity of pain, social and role functioning, the quality of life of patients exceeds population indicators in a similar age group. The data obtained allow us to consider postoperative hypoparathyroidism as one of the favorable factors in course of postoperative period and criterion for remission of the disease. What this paper adds It has been shown that the secondary hyperparathyroidism in patients undergoing hemodialysis is the cause of a decrease in life of quality in comparison with population indicators. Surgical remission of the disease leads to a statistically significant improvement the quality of life. The data obtained allow considering postoperative hypoparathyroidism as one of the favorable factors in the course of the postoperative period and criteria for remission of the disease.