Effect of parathyroidectomy on NLR and PLR in patients with renal secondary hyperparathyroidism

Objective To explore the effects of parathyroidectomy on neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in patients with renal secondary hyperparathyroidism(SHPT).Also the correlation was made between NLR、PLR and anemia,calcium and phosphorus,which provides clinical basis for improving anemia,mineral and bone disorder(MBD)and quality-of-life in SHPT patients.Methods A total of 151 patients with renal SHPT undergoing parathyroidectomy from January 2013 to January 2019 were recruited.According to the postoperative level of intact parathyroid hormone(iPTH),they were divided into two groups of successful and persistent or recurrent SHPT.The postoperative changes of NLR/PLR and other parameters were compared between two groups.Results Spearman’s correlation analysis indicated that preoperative NLR was positively correlated with white blood cell count,hypersensitive C-reactive protein,phosphorus,calcium and phosphorus product(P<0.05).Preoperative PLR was correlated positively with phosphorus,serum calcium and phosphorus product(P<0.05)and negatively with hemoglobin(P<0.05).In successful group,as compared preoperatively,serum levels of calcium,phosphorus,NLR/PLR,platelet count and iPTH decreased markedly while hemoglobin,red blood cell count and lymphocyte count rose obviously(P<0.05).In persistent or recurrent SHPT group,postoperative serum levels of calcium and iPTH decreased as compared preoperatively(P<0.05).No statistically significant difference existed in NLR/PLR,hemoglobin or other parameters before and after operation(P>0.05).Multi-factorial regression analysis revealed that preoperative NLR/PLR could predict the variations of NLR(ΔNLR)and PLR(ΔPLR).Conclusions Successful parathyroidectomy decreases NLR/PLR.And the modulatory effects of parathyroidectomy on systemic inflammation may improve the symptoms of anemia and MBD in patients with renal SHPT.