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Start Over Author "Celsi S" Journal journal of nephrology
2 results on '"Celsi S"'

1. Parathyroidectomy improves the quality of sleep in maintenance hemodialysis patients with severe hyperparathyroidism

Author

Mg, Esposito, Cm, Cesare, Rm, Santo, Cice G, Alessandra PERNA, Violetti E, Conzo G, Bilancio G, Celsi S, Annunziata F, Iannelli S, Ng, Santo, Cirillo M, Livrea A, Esposito, Mg, Cesare, Cm, DE SANTO, Rm, Cice, G, Perna, Alessandra, Violetti, E, Conzo, Giovanni, Bilancio, G, Celsi, S, Annunziata, F, Iannelli, S, DE SANTO, Ng, Cirillo, M, Livrea, A., De Santo, Rm, Perna, Af, Conzo, G, Bilancio, Giancarlo, De Santo, Ng, and Cirillo, Massimo

Subjects
Adult, Male, Insomnia, Time Factors, Blood Pressure, Severity of Illness Index, Phosphates, Renal Dialysis, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Humans, Prospective Studies, Aged, Parathyroidectomy, Sleep disorder, Hyperparathyroidism, Middle Aged, Alkaline Phosphatase, Treatment Outcome, Parathyroid Hormone, Calcium, Female, Hyperparathyroidism, Secondary, Hemodialysi, Sleep, PTH
Abstract

Sleeping disorders are very common in patients with chronic kidney disease on dialysis (CKD5D) and are an emerging risk factor able to predict mortality. Parathyroid hormone (PTH) although considered a pivotal uremic toxin has rarely been associated with sleep disorders in uremia. In a study from our laboratory PTH concentrations failed to distinguish patients with sleep disorders from those without. In a study performed by Chou et al a 97% prevalence of insomnia was found in patients undergoing hemodialysis requiring parathyroidectomy. Surgery reduced PTH and increased sleeping hours within 3 months. The aim of this study was to study the effects of parathyroidectomy on the sleep disorders of insomniacs on maintenance hemodialysis. The study was performed in 16 insomniac patients on maintenance hemodialysis who successfully underwent surgery with autotransplantation of autologous parathyroid tissue (40 mg) under the skin of the forearm. Patients (5 F and 11 M) were studied from 1 month before surgery to 1 year after. Sleep disorders were assessed by means of a 27-item questionnaire--Sleep Disorder questionnaire (SDQ)--that identified sleeping disorders according to Diagnostic and Statistical Manual of Mental Disorders - IV Edition (DSM-IV) criteria. The Charlson Comorbidity Index (CCI) was also measured along with systolic and diastolic blood pressure, Hb, PTH, Ca, P. A 95.5% prevalence of sleep disorders was found pre operatively. Patients slept 4.90+/-1.2 hours, Ca averaged 10.09+/-0.54 mg/dL, Phosphate 5.5+/-1.93, CCI 9.8+/-1.1, PTH 1498+/-498 ng/mL. After 1 year follow-up 2 out 16 patients had normal sleep, 6 out 16 patients had subclinical sleep disorders and 8 remained insomniacs (p=0.008, Mc Nemar Test for paired data, insomniacs vs. no disturbance + subclinical disorders). Sleeping hours increased up to 6.0+/-1.24 (p

Published
2008

2. Parathyroidectomy improves the quality of sleep in maintenance hemodialysis patients with severe hyperparathyroidism.

Author

Esposito MG, Cesare CM, De Santo RM, Cice G, Perna AF, Violetti E, Conzo G, Bilancio G, Celsi S, Annunziata F, Iannelli S, De Santo NG, Cirillo M, and Livrea A

Subjects
Adult, Aged, Alkaline Phosphatase blood, Blood Pressure, Calcium blood, Female, Humans, Hyperparathyroidism, Secondary complications, Hyperparathyroidism, Secondary etiology, Hyperparathyroidism, Secondary metabolism, Hyperparathyroidism, Secondary physiopathology, Male, Middle Aged, Parathyroid Hormone blood, Phosphates blood, Prospective Studies, Severity of Illness Index, Sleep, Sleep Initiation and Maintenance Disorders etiology, Sleep Initiation and Maintenance Disorders metabolism, Sleep Initiation and Maintenance Disorders physiopathology, Surveys and Questionnaires, Time Factors, Treatment Outcome, Hyperparathyroidism, Secondary surgery, Parathyroidectomy, Renal Dialysis adverse effects, Sleep Initiation and Maintenance Disorders prevention & control
Abstract

Sleeping disorders are very common in patients with chronic kidney disease on dialysis (CKD5D) and are an emerging risk factor able to predict mortality. Parathyroid hormone (PTH) although considered a pivotal uremic toxin has rarely been associated with sleep disorders in uremia. In a study from our laboratory PTH concentrations failed to distinguish patients with sleep disorders from those without. In a study performed by Chou et al a 97% prevalence of insomnia was found in patients undergoing hemodialysis requiring parathyroidectomy. Surgery reduced PTH and increased sleeping hours within 3 months. The aim of this study was to study the effects of parathyroidectomy on the sleep disorders of insomniacs on maintenance hemodialysis. The study was performed in 16 insomniac patients on maintenance hemodialysis who successfully underwent surgery with autotransplantation of autologous parathyroid tissue (40 mg) under the skin of the forearm. Patients (5 F and 11 M) were studied from 1 month before surgery to 1 year after. Sleep disorders were assessed by means of a 27-item questionnaire--Sleep Disorder questionnaire (SDQ)--that identified sleeping disorders according to Diagnostic and Statistical Manual of Mental Disorders - IV Edition (DSM-IV) criteria. The Charlson Comorbidity Index (CCI) was also measured along with systolic and diastolic blood pressure, Hb, PTH, Ca, P. A 95.5% prevalence of sleep disorders was found pre operatively. Patients slept 4.90+/-1.2 hours, Ca averaged 10.09+/-0.54 mg/dL, Phosphate 5.5+/-1.93, CCI 9.8+/-1.1, PTH 1498+/-498 ng/mL. After 1 year follow-up 2 out 16 patients had normal sleep, 6 out 16 patients had subclinical sleep disorders and 8 remained insomniacs (p=0.008, Mc Nemar Test for paired data, insomniacs vs. no disturbance + subclinical disorders). Sleeping hours increased up to 6.0+/-1.24 (p<0.05), PTH was normalized, the Charlson Comorbidity Index was reduced (p<0.05) as were plasma calcium and phosphate (p<0.01). The study indicates that insomnia in patients with severe hyperparathyroidism on maintenance hemodialysis is ameliorated by parathyroidectomy.

Published
2008

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