Jab for kidney patients: Less scarring, faster recovery

Dr Jeremy Ng, consultant at the SGH department of general surgery, performing a check on Mr Ho Peng Fun, 65, who underwent the injection-based treatment in February.
Dr Jeremy Ng, consultant at the SGH department of general surgery, performing a check on Mr Ho Peng Fun, 65, who underwent the injection-based treatment in February.ST PHOTO: MATTHIAS HO

One side effect of kidney dialysis is overactive parathyroid glands, which are found in the neck. This could lead to a loss of calcium, resulting in bones becoming soft and deformed.

Now, a local study has found a better answer to the problem than traditional surgery - injecting minced tissue into the patient's shoulder.

Typically, dialysis patients with overactive parathyroid glands get them removed. A tiny portion is then implanted into an arm muscle to restore some of the gland's function.

Surgeons at Singapore General Hospital (SGH), however, mince the tissue finely and inject it into the fat just under the skin instead. This not just shortens the time for the surgery but also improves the patient's recovery process.

It took patients who had undergone the injection method just two months for the tissue to start functioning normally, compared to nine months for the other method. "There is also a lower likelihood of bleeding or scarring," said Dr Jeremy Ng, a consultant at the SGH department of general surgery.

Added Dr Gopal Iyer, a senior consultant at the National Cancer Centre Singapore (NCCS) department of surgical oncology: "Injection worked even better than the previous method."

The findings, the result of a joint study by SGH and NCCS, was published in international journal Surgery this month.

It compared the recovery of 132 patients who had undergone either the conventional surgery or the injection method.

Overactive parathyroid glands affect an estimated three in 10 dialysis patients. Left untreated, the condition can clog blood vessels and cause heart disease.

However, it can be controlled with medication and proper diet management. Surgery is often seen as a last resort, with about 5 per cent to 15 per cent of sufferers eventually having to undergo surgery.

One patient who underwent the injection-based procedure was 65-year-old retiree Ho Peng Fun, who has been on dialysis for 20 years. He decided to go under the knife in February because his bones hurt and he felt he had "no choice".

"After the operation I asked the doctor if he did the procedure," he said. "I didn't even know because there was no wound."

LINETTE LAI