Hormona paratiroidea en suero indicadora de muerta temprana en artroplastia.

El bajo nivel en suero de la hormona paratiroidea es una pronosticador de la muerte temprana posterior a la artroplastia de cadera en pacientes de diálisis.

T. Nakai, K. Masuhara, S. Yamasaki, T. Fuji, N. Kanbara.
A high mortality rate after hip arthroplasty has been reported in hemodialysis patients; however, there has been no previous study on predictors of mortality after hip arthroplasty so far.

Objectives: The purpose of the present study was to identify any risk factors associated with early death in hemodialysis patients undergoing hip arthroplasty.

Methods: We retrospectively reviewed 34 patients on hemodialysis who underwent hip arthroplasty between 1994 and 2001. The average age was 60 years, and the average hemodialysis duration was 116 months at the time of operation. Body mass index (BMI), operating time, and total blood loss were reviewed. Serum levels of albumin (Alb), calcium (Ca), phosphorus (P), alkaline phosphatase (Alp), and intact parathyroid hormone (PTH) were measured preoperatively.

Results: Of these 34 patients, 9 died (26%). There were 2 perioperative deaths and 7 during follow-up period between 2 and 19 months. No significant difference was found with respect to patient age, hemodialysis duration, Alb, Ca, P, Alp, operating time, and total blood loss. Patients with lower BMI and PTH levels had an earlier mortality than patients with higher BMI and PTH levels (p < 0.05 and p < 0.01).

Conclusion: We conclude that despite an intensive care directed to our hemodialysis patients, the incidence of early death after hip arthroplasty is still high. If low BMI and serum levels of low PTH were detected before operation, we should pay special attention to early mortality after hip arthroplasty.

Hemodialysis International Volume 8 Issue 1 Page 89 - January 2004