Impact of Different Levels of iPTH on All-Cause Mortality in Dialysis Patients with Secondary Hyperparathyroidism after Parathyroidectomy
| Autor: | Lin Wang, Cheng Gang Jin, Ling Zhang, Qiu Ping Xi, Xi Sheng Xie, Xiao Xuan Zhang, Yan Bo Li, Rui Zhang, Yue Fei Xiao, Shu Tong Du |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Parathyroidectomy
Male medicine.medical_specialty endocrine system Article Subject endocrine system diseases medicine.medical_treatment 030232 urology & nephrology Urology lcsh:Medicine Parathyroid hormone 030204 cardiovascular system & hematology Dialysis patients General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Renal Dialysis medicine Humans Aged Retrospective Studies Hyperparathyroidism General Immunology and Microbiology business.industry lcsh:R Hazard ratio Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Parathyroid Hormone Kidney Failure Chronic Secondary hyperparathyroidism Female Hyperparathyroidism Secondary business Cohort study Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2017 (2017) |
| ISSN: | 2314-6141 2314-6133 |
| Popis: | Background. Secondary hyperparathyroidism (SHPT) usually required parathyroidectomy (PTX) when drugs treatment is invalid. Analysis was done on the impact of different intact parathyroid hormone (iPTH) after the PTX on all-cause mortality. Methods. An open, retrospective, multicenter cohort design was conducted. The sample included 525 dialysis patients with SHPT who had undergone PTX. Results. 404 patients conformed to the standard, with 36 (8.91%) deaths during the 11 years of follow-up. One week postoperatively, different levels of serum iPTH were divided into four groups: A: ≤20 pg/mL; B: 21–150 pg/mL; C: 151–600 pg/mL; and D: >600 pg/mL. All-cause mortality in groups with different iPTH levels appeared as follows: A (8.29%), B (3.54%), C (10.91%), and D (29.03%). The all-cause mortality of B was the lowest, with D the highest. We used group A as reference (hazard ratio (HR) = 1) compared with the other groups, and HRs on groups B, C, and D appeared as 0.57, 1.43, and 3.45, respectively. Conclusion. The all-cause mortality was associated with different levels of iPTH after the PTX. We found that iPTH > 600 pg/mL appeared as a factor which increased the risk of all-cause mortality. When iPTH levels were positively and effectively reducing, the risk of all-cause mortality also decreased. The most appropriate level of postoperative iPTH seemed to be 21–150 pg/mL. |
| Databáze: | OpenAIRE |
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