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- Title
Parathyroidectomy Improves Survival In Patients with Severe Hyperparathyroidism: A Comparative Study.
- Authors
Goldenstein, Patricia Taschner; Elias, Rosilene Motta; do Carmo, Lilian Pires de Freitas; Coelho, Fernanda Oliveira; Magalhães, Luciene Pereira; Antunes, Gisele Lins; Custódio, Melani Ribeiro; de Menezes Montenegro, Fábio Luiz; Titan, Silvia Maria; Jorgetti, Vanda; Moysés, Rosa Maria Affonso
- Abstract
Background and objectives: Secondary hyperparathyroidism (SHPT) in CKD is associated with an increased risk for mortality, but definitive data showing that parathormone control decreases mortality is still lacking. This study aimed to compare the mortality of patients with severe SHPT submitted to parathyroidectomy(PTX) with those who did not have access to surgery. Methods: This is a retrospective study in a cohort of 251 CKD patients with severe SHPT who were referred to a CKD-MBD Center for PTX from 2005 until 2012. Results: Most of our patients had indication of PTX, but only 49% of them had access to this surgical procedure. After a mean follow-up of 23 months, 72 patients had died. Non-survivors were older; more often had diabetes, lower serum 25 vitamin D and mostly had not been submitted to surgery. The relative risk of death was lower in the PTX patients (0.428; 95% CI, 0.28 to 0.67; p<0.0001). After adjustments, mortality risk was dependent on age (1.04; 95% CI, 1.01 to 1.07; p = 0.002), 25 vitamin D (0.43; 95% CI, 0.24 to 0.81; p = 0.006) and no access to PTX (4.13; 95% CI, 2.16 to 7.88; p<0.0001). Results remained the same in a second model using the PTX date as the study start date for the PTX group. Conclusions: Our data confirms the benefit of PTX on mortality in patients with severe SHPT. The high mortality encountered in our population is significant and urges the need to better treat these patients.
- Subjects
KIDNEY disease risk factors; PARATHYROIDECTOMY; HYPERPARATHYROIDISM; MORTALITY; FOLLOW-up studies (Medicine); MEDICAL statistics; COMPARATIVE studies; RETROSPECTIVE studies
- Publication
PLoS ONE, 2013, Vol 8, Issue 8, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0068870