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2015 ; 94
(23
): e936
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Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease: A 13-Year
Population-Based Cohort Study
#MMPMID26061321
Hsu YH
; Chen HJ
; Shen SC
; Tsai WC
; Hsu CC
; Kao CH
Medicine (Baltimore)
2015[Jun]; 94
(23
): e936
PMID26061321
show ga
Research information on the risk of stroke in patients with dialysis-dependent
end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is
scant. We used a nationwide health insurance claims database to select all
patients with dialysis-dependent ESRD age 18 years and older for the study
population. Of the patients with ESRD, we selected 1083 patients who had
undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083
patients with ESRD by sex, age, years since the disease diagnosis, and the year
of undergoing PTX as the non-PTX group. We used a multivariate Cox proportional
hazards regression analysis to measure the risk of stroke for the PTX group
compared with the non-PTX group after adjusting for sex, age, premium-based
income, urbanization, and comorbidity. The mean follow-up periods were 6.08 and
5.38 years for the PTX and non-PTX groups, respectively. After adjusting for
previously mentioned variables, significant risk reductions of stroke (adjusted
hazard ratio?=?0.57, 95% confidence interval?=?0.41-0.79), particularly those of
hemorrhagic stroke (adjusted hazard ratio?=?0.34, 95% confidence
interval?=?0.20-0.57), with PTX were observed. Chronologically, the risk of
stroke in the PTX group decreased in the second year after PTX and persisted for
>3 years. PTX reduces the risk of stroke, particularly that of hemorrhagic
stroke, in patients with dialysis-dependent ESRD. Other factors for risk
reduction include sex (females), an age <65 years, and the presence of
comorbidity.