Total parathyroidectomy improves survival of hemodialysis patients with secondary hyperparathyroidism
| Autor: | Tetsuya Hashimoto, Yuu Okamoto, Mayuko Murakawa, Satoru Yamasaki, Toshihiko Ono, Hisao Mabuchi, Hiroyuki Kobayashi, Masaya Nishida, Tsuneyuki Nakanouchi, Toshiko Tokoro, Kanji Ninomiya, Masato Nishimura, Kunitoshi Iseki, Naoto Adachi, Noriyuki Iwamoto, Ryo Imai, Koji Okino, Nodoka Sato, Chikako Sakoda, Masaki Koyama |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Parathyroidectomy medicine.medical_specialty Time Factors medicine.medical_treatment Urology Kaplan-Meier Estimate Risk Assessment Disease-Free Survival Renal Dialysis Risk Factors medicine Humans Survival rate Serum Albumin Dialysis Aged Retrospective Studies Hyperparathyroidism business.industry Atrial fibrillation Retrospective cohort study Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Cardiovascular Diseases Parathyroid Hormone Nephrology Multivariate Analysis Calcium Female Hyperparathyroidism Secondary Secondary hyperparathyroidism Hemodialysis business Biomarkers |
| Zdroj: | Journal of Nephrology. 25:755-763 |
| ISSN: | 1121-8428 |
| DOI: | 10.5301/jn.5000056 |
| Popis: | Background and aims To compare the prognosis of chronic hemodialysis patients with or without parathyroidectomy. Methods Among 158 chronic hemodialysis patients who underwent total parathyroidectomy between July 1998 and April 2009, 88 patients were matched with 88 controls for sex, age, underlying disease and prior dialysis history. Then a retrospective evaluation of their prognosis was performed over a median observation period of 4.41 years. Results The overall survival rate was 90.4% in the parathyroidectomy group and 67.4% in the control group. The cardiovascular death-free survival rate was 94.6% in the parathyroidectomy group and 76.3% in the control group. During observation, intact parathyroid hormone was measured every 6 months, and its average serum level was 37 ± 92 ng/L in the total parathyroidectomy group versus 274 ± 233 ng/L in the control group (p=0.0001). The total parathyroidectomy group had a significantly lower corrected calcium level and higher serum albumin level. Multivariate analysis revealed that parathyroidectomy, atrial fibrillation and serum albumin were significant factors for both total and cardiovascular mortality. Conclusion Total parathyroidectomy was associated with better survival, probably due to decreased cardiovascular mortality. |
| Databáze: | OpenAIRE |
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