Postoperative Serum Changes in Calcium, Phosphorus, iPTH, CRP, IL-6, and TNF-β Levels in Patients with Secondary Hyperparathyroidism

Postoperative Serum Changes in Calcium, Phosphorus, iPTH, CRP, IL-6, and TNF-β Levels in Patients with Secondary Hyperparathyroidism

  • Wenjing Feng Department of General Surgery, Third Hospital of Hebei Medical University A Breast Hernia (General Surgery), Shijiazhuang, Hebei 050000, China
  • Runtao Xu Department of General Surgery, Third Hospital of Hebei Medical University A Breast Hernia (General Surgery), Shijiazhuang, Hebei 050000, China
  • Jinghui Mu Department of General Surgery, Third Hospital of Hebei Medical University A Breast Hernia (General Surgery), Shijiazhuang, Hebei 050000, China
  • Jie Li Department of General Surgery, Third Hospital of Hebei Medical University A Breast Hernia (General Surgery), Shijiazhuang, Hebei 050000, China
  • Mingjing Cheng Department of General Surgery, Third Hospital of Hebei Medical University A Breast Hernia (General Surgery), Shijiazhuang, Hebei 050000, China
Keywords: Serum changes , calcium , blood phosphorus levels, immune reactive parathyroid hormone (iPTH) level, serum CRP, IL-6, and TNF-β levels ,Secondary hyperparathyroidism; Fast track surgery; Food structure intervention; Nutritional status; Immune stress

Abstract


Aim: This research attempted to clarify clinical impact of food structure intervention based on the concept of fast track surgery on postoperative nutritional status, Serum changes in calcium and blood phosphorus levels, immune reactive parathyroid hormone (iPTH) level, serum CRP, IL-6, and TNF-β levels and rehabilitation outcomes of patients with secondary hyperparathyroidism.

Methods: Fifty patients who underwent surgery in our hospital from January 2024 to December 2024 received selection and random division into control group and observation group. The control group received conventional nursing for patients and observation group received food structure intervention based on fast track surgery concept.

Results: After intervention, hemoglobin and albumin levels were higher in observation group than control group; blood calcium level and calcium-phosphorus product were also higher; blood phosphorus and immune reactive parathyroid hormone levels were lower; C-reactive protein C-reactive protein, interleukin-1, tumor necrosis factor-β levels were lower; Visual Analog Scale scores were lower, medication regimen complexity scores were higher; incidence of complications was lower. To sum up, fast track surgery fast track surgery nursing can ameliorate nutritional status of patients with secondary hyperparathyroidism, facilitate postoperative recovery, attenuate postoperative complications, and ensure patients' prognosis.

Conclusion: This research provides a novel insight for excellent process and model for perioperative nursing of patients with secondary hyperparathyroidism, facilitating further development of fast track surgery.

References

1. Li D, Guo B, Liang Q, Liu Y, Zhang L, Hu N, et al. Tissue-engineered parathyroid gland and its regulatory secretion of parathyroid hormone. Journal of tissue engineering and regenerative medicine. 2020;14(10):1363-77.
2. Liu Y, Zhang L, Hu N, Shao J, Yang D, Ruan C, et al. An optogenetic approach for regulating human parathyroid hormone secretion. Nature communications. 2022;13(1):771.
3. Rodríguez-Ortiz ME, Rodríguez M. Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease. F1000Research. 2020;9.
4. Chowdhary R, Khan RB, Masarkar N, Malik R, Goel SK. An association of VDR gene polymorphism in hypovitaminosis D mediated secondary hyperparathyroidism in adolescent girls; a tertiary hospital study in central India. Steroids. 2022;185:109054.
5. Levy AR, Xing S, Brunelli SM, Cooper K, Finkelstein FO, Germain MJ, et al. Symptoms of Secondary Hyperparathyroidism in Patients Receiving Maintenance Hemodialysis: A Prospective Cohort Study. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2020;75(3):373-83.
6. D'Marco L, Checa-Ros A, Gamero D, Soto C, Salazar J, Nava M, et al. Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation. Healthcare (Basel, Switzerland). 2022;11(1).
7. Bozic M, Diaz-Tocados JM, Bermudez-Lopez M, Forné C, Martinez C, Fernandez E, et al. Independent effects of secondary hyperparathyroidism and hyperphosphataemia on chronic kidney disease progression and cardiovascular events: an analysis from the NEFRONA cohort. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2022;37(4):663-72.
8. Chen CL, Chen NC, Wu FZ, Wu MT. Impact of denosumab on cardiovascular calcification in patients with secondary hyperparathyroidism undergoing dialysis: a pilot study. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2020;31(8):1507-16.
9. Gong W, Xie Y, Lin Y, Meng Z, Wang Y. [Risk factors affecting graft survival after parathyroidectomy and parathyroid autotransplantation in patients on maintenance hemodialysis]. Nan fang yi ke da xue xue bao = Journal of Southern Medical University. 2021;41(6):947-52.
10. Sari R, Yabanoglu H, Hargura AS, Kus M, Arer IM. Outcomes of Total Parathyroidectomy with Autotransplantation versus Subtotal Parathyroidectomy Techniques for Secondary Hyperparathyroidism in Chronic Renal Failure. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 2020;30(1):18-22.
11. He H, Yang G, Wang S, Han X, Li J. Fast-track surgery nursing intervention in CRC patients with laparotomy and laparoscopic surgery. Medicine. 2022;101(37):e30603.
12. Wu Y, Xu M, Ma Y. Fast-track surgery in single-hole thoracoscopic radical resection of lung cancer. Journal of BUON : official journal of the Balkan Union of Oncology. 2020;25(4):1745-52.
13. Wang W, Liu P, Zhang Q, Jiang G, Zheng H, Zhang W. Effect of high-quality nursing on orthopedic trauma based on a fast-track surgery model. American journal of translational research. 2022;14(7):4812-20.
14. Maurer T, Belau MH, von Grundherr J, Schlemmer Z, Patra S, Becher H, et al. Randomised controlled trial testing the feasibility of an exercise and nutrition intervention for patients with ovarian cancer during and after first-line chemotherapy (BENITA-study). BMJ open. 2022;12(2):e054091.
15. Lewis JD, Sandler RS, Brotherton C, Brensinger C, Li H, Kappelman MD, et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease. Gastroenterology. 2021;161(3):837-52.e9.
16. Luyao H, Xiaoxiao Y, Tianxiao F, Yuandong L, Ping W. Management of Cervical Spondylotic Radiculopathy: A Systematic review. Global spine journal. 2022;12(8):1912-24.
17. Schreiber-Katz O, Siegler HA, Wieselmann G, Kumpe M, Ranxha G, Petri S, et al. Improvement of muscle strength in specific muscular regions in nusinersen-treated adult patients with 5q-spinal muscular atrophy. Scientific reports. 2023;13(1):6240.
18. Bover J, Gunnarsson J, Csomor P, Kaiser E, Cianciolo G, Lauppe R. Impact of nutritional vitamin D supplementation on parathyroid hormone and 25-hydroxyvitamin D levels in non-dialysis chronic kidney disease: a meta-analysis. Clinical kidney journal. 2021;14(10):2177-86.
19. Bellone F, Cinquegrani M, Nicotera R, Carullo N, Casarella A, Presta P, et al. Role of Vitamin K in Chronic Kidney Disease: A Focus on Bone and Cardiovascular Health. International journal of molecular sciences. 2022;23(9).
20. Grifka J, Greimel F, Maderbacher G. [Day-case outpatient endoprosthetics-"Ultra-Fast-Track"]. Der Orthopade. 2022;51(5):380-4.
21. Fazzalari A, Srinivas S, Panjwani S, Pozzi N, Friedrich A, Sheoran R, et al. A Fast-Track Pathway for Emergency General Surgery at an Academic Medical Center. The Journal of surgical research. 2021;267:1-8.
22. Maderbacher G, Meyer M, Grifka J, Holzapfel D, Greimel F. [Results and lessons learned in fast-track arthroplasty]. Der Orthopade. 2022;51(5):374-9.
23. Goodson KM, Kee JR, Edwards PK, Novack AJ, Stambough JB, Siegel ER, et al. Streamlining Hospital Treatment of Prosthetic Joint Infection. The Journal of arthroplasty. 2020;35(3s):S63-s8.
24. McCarthy C, Fletcher N. Early Extubation in Enhanced Recovery from Cardiac Surgery. Critical care clinics. 2020;36(4):663-74.
25. Zhao JH, Zhang L, Liu Y, Cheng QL. Effect of Shexiang Baoxin Pill () in Alleviating Early Hypertensive Renal Injury in Rats. Chinese journal of integrative medicine. 2021;27(1):47-53.
Published
2025/04/17
Section
Original paper