[A ten-year follow-up study of a patient with chronic renal failure and metastatic pulmonary calcification after parathyroidectomy and review of the literature].

Objective: To analyze whether parathyroidectomy can prevent the progress of metastatic pulmonary calcification (MPC) in patients with chronic renal failure (CRF). Methods: A male patient with CRF complicated with MPC who underwent parathyroidectomy for secondary hyperparathyroidism and parathyroid adenoma was followed up for 10 years. The changes of MPC and the levels of blood calcium and phosphorus were measured. We searched the relevant literatures in PubMed and Wanfang databases with the key words of "metastatic pulmonary calibration" and "parathyroidectomy". Then, we manually retrieved the references of the literatures. A total of 18 patients (17 patients from 14 publications as well as the present case) were analyzed. By comparing the characteristics of MPC improvement group and MPC progression group, the factors affecting the prognosis of MPC after parathyroidectomy were explored. Results: After parathyroidectomy, the thoracic CT images of the patient gradually worsened from normal to diffuse ground glass opacity of both lungs, which indicated that parathyroidectomy did not prevent the progression of MPC in this patient. Among the 18 MPC patients who underwent parathyroidectomy, 10 patients had improved MPC, three had CRF, and two received peritoneal dialysis or hemodialysis respectively; eight patients had progressed MPC, all of the patients were CRF patients, one patient received peritoneal dialysis, and other patients received hemodialysis. Compared between the two groups, the proportion of CRF patients (P=0.004) and hemodialysis patients (P=0.003) in the progression group were significantly higher than those in the improvement group. Conclusion: Parathyroidectomy cannot prevent the progression of MPC in hemodialysis patients with CRF.