Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study

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Abstract

Aim:

We evaluated whether parathyroidectomy (PTX) was associated with survival of dialysis patients.

Methods:

In a cohort study with one year follow-up, data from 146 haemodialysis patients from a hospital were analyzed. We compared the baseline data between patients receiving PTX surgery and those who had not undergone PTX. The Cox proportional hazards regression was used to examine the effect of PTX.

Results:

Patients who had received PTX surgery were more likely to be older, have longer duration of dialysis, higher ultrafiltration rate, C-reactive protein (CRP), alkaline phosphatase (ALP), and lower albumin compared with those who had not receive PTX. During 1 year follow-up, 21 (17.1%) patients died, of whom seven died from cerebrovascular events, 10 died from cardiovascular disease, and four died from infection. The mortality was 9.4% in the PTX group and 17.3% in the control group. The PTX group had a significantly lower risk of all-cause mortality than the control group (P= 0.005). There was a significantly lower risk of all-cause mortality in the PTX group compared with the non-PTX group (HR = 0.93, 95%CI: 0.89–0.97). The lower risk (HR = 0.92, 95%CI: 0.85–0.98) of PTX group was not changed after adjusting potential factors. Our results also suggested that this relationship was independent of many potential confounding factors.

Conclusion:

Parathyroidectomy was related to significant reduction in all-cause among patients with severe SHPT. PTX may be considered as a matter of priority, from which dialysis patients would benefit.

SUMMARY AT A GLANCE

This paper confirmed the JSDT data on the effect of PTX on survival, which was published recently (Epub on March 18, 2015). However, the reasons are not clear. Further studies are required on the effects of CKD-MBD and other factors on survival.

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