1989 Volume 22 Issue 12 Pages 1337-1340
Patients with severe renal hyperparathyroidism resistant to medical treatment almost always have several subjective symptoms, and after parathyroidectomy the patients are free of such symptoms. Since renal osteodystrophy is complicated, some symptoms may continue postoperatively. We investigated the symptoms of 79 patients who received parathyroidectomies for severe renal hyperparathyroidism before and after the parathyroidectomy, in order to evaluate their nursing care. The kind, degree and course of symptoms were evaluated by questions asked the patients.
Over 80% of the patients had several symptoms before parathyroidectomy and in 93% of them the symptoms improved after parathyroidectomy. The symptoms were complicated, but could be divided into 2 types. The first type was associated with bone disorders. Bone pain, arthralgia, muscle weakness and gait disturbance belonged to this types. The second type was not directly associated with bone disorders. Itching, irritability and disturbance of sleep belonged to the second type. The first type of symptoms occured a long time after the beginning of hemodialysis treatment and improved postoperatively. Almost two weeks were needed.
Recurrence of these types of symptoms was rare except for the patients with dialysis amyloidosis. The second type of symptoms occurred from an earlier period after the beginning of hemodialysis and rapidly improved after parathyroidectomy. In about 30% of the patients there was a recurrence of these symptoms. On the basis of these results, it became obvious that it is important for us to do two things. The first is to provide individualized nursing care for each patient and the second is to give accurate information about the symptoms of renal hyperparathyroidism before parathyroidectomy.
