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2015 ; 2015
(ä): 639587
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Parathyroidectomy Is Associated with Reduced Mortality in Hemodialysis Patients
with Secondary Hyperparathyroidism
#MMPMID26064934
Ma TL
; Hung PH
; Jong IC
; Hiao CY
; Hsu YH
; Chiang PC
; Guo HR
; Hung KY
Biomed Res Int
2015[]; 2015
(ä): 639587
PMID26064934
show ga
Secondary hyperparathyroidism increases morbidity and mortality in hemodialysis
patients. The Kidney Disease Outcomes Quality Initiative Guidelines recommend
parathyroidectomy for patients with chronic kidney disease and parathyroid
hormone concentrations exceeding 800?pg/mL; however, this concentration
represents an arbitrary cut-off value. The present study was conducted to
identify factors influencing mortality in hemodialysis patients with parathyroid
hormone concentrations exceeding 800?pg/mL and to evaluate the effects of
parathyroidectomy on outcome for these patients. Two hundred twenty-one
hemodialysis patients with parathyroid hormone concentrations > 800?pg/mL from
July 2004 to June 2010 were identified. 21.1% of patients (n = 60) received
parathyroidectomy and 14.9% of patients (n = 33) died during a mean follow-up of
36 months. Patients with parathyroidectomy were found to have lower all-cause
mortality (adjusted hazard ratio [aHR]: 0.34). Other independent predictors
included age ? 65 years (aHR: 2.11) and diabetes mellitus (aHR: 3.80). For
cardiovascular mortality, parathyroidectomy was associated with lower mortality
(HR = 0.31) but with a marginal statistical significance (p = 0.061). In
multivariate analysis, diabetes was the only significant predictor (aHR: 3.14).
It is concluded that, for hemodialysis patients with parathyroid hormone
concentrations greater than 800?pg/mL, parathyroidectomy is associated with
reduced all-cause mortality.