Gender differences among patients with secondary hyperparathyroidism undergoing parathyroidectomy.

OBJECTIVE

Female gender is associated with an increased risk of parathyroid nodular hyperplasia and parathyroidectomy rate in dialysis patients. The purpose of this study was to assess differences between women and men undergoing parathyroidectomy for secondary hyperparathyroidism.

METHODS

We reviewed 121 consecutive patients with end-stage renal disease and advanced secondary hyperparathyroidism who underwent parathyroidectomy between 2004 and 2007. Preoperative characteristics and short-term outcome of these patients were evaluated.

RESULTS

Compared with men (n = 43), women (n = 78) had lower preoperative bone mineral density (both T-scores and Z-scores) as well as lower preoperative hemoglobin levels. The cause of renal failure was also different between the two groups. No differences in preoperative calcium-phosphorus product, alkaline phosphatase, or parathyroid hormone levels were observed. Follow-up analysis showed that biochemical improvement and 1-y recurrence rate was similar between genders.

CONCLUSION

Women with secondary hyperparathyroidism had worse bone mineral metabolism before parathyroidectomy. Additional research regarding target organ susceptibility to hyperparathyroidism in different genders is warranted.