Safety and efficacy of subtotal or total parathyroidectomy for patients with secondary or tertiary hyperparathyroidism in four academic centers in the Netherlands
| Autor: | Plas, W.Y. van der, Dulfer, R.R., Koh, E.Y., Vogt, L., Appelman-Dijkstra, N.M., Schepers, A., Rotmans, J.I., Pol, R.A., Ginhoven, T.M. van, Hoorn, E.J., Dijkum, E.J.M.N. van, Engelsman, A.F., Borst, M.H. de, Kruijff, S., Dutch Hyperparathyroidism Study Gr |
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| Přispěvatelé: | Surgery, Internal Medicine, Groningen Kidney Center (GKC), Lifestyle Medicine (LM), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Institute for Organ Transplantation (GIOT), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), APH - Health Behaviors & Chronic Diseases, Nephrology, ACS - Amsterdam Cardiovascular Sciences, AGEM - Digestive immunity, ACS - Microcirculation |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Parathyroidectomy
Adult Male medicine.medical_specialty Cinacalcet medicine.medical_treatment Population 030232 urology & nephrology Outcomes Tertiary hyperparathyroidism End stage renal disease 03 medical and health sciences End-stage renal disease 0302 clinical medicine Postoperative Complications Interquartile range Internal medicine medicine Humans education Kidney transplantation Netherlands Retrospective Studies education.field_of_study Hyperparathyroidism business.industry Patient Selection Middle Aged medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Kidney Failure Chronic Surgery Female Hyperparathyroidism Secondary Original Article business medicine.drug |
| Zdroj: | Langenbecks Archives of Surgery, 403(8), 999-1005. Springer-Verlag Langenbeck's Archives of Surgery, 403(8), 999-1005 Langenbeck's Archives of Surgery Langenbecks Archives of Surgery, 403(8), 999-1005. SPRINGER Langenbeck s archives of surgery / Deutsche Gesellschaft fur Chirurgie, 403(8), 999-1005. Springer Verlag |
| ISSN: | 1435-2443 |
| Popis: | PURPOSE: Hyperparathyroidism (HPT) is a common abnormality in patients with end-stage renal disease (ESRD). Since the introduction of cinacalcet in 2004, a shift from surgery toward predominantly medical treatment has occurred. Surgery is thought to be associated with more complications than oral medication. The aim of this retrospective study was to evaluate 30-day outcomes and effectiveness of parathyroidectomy (PTx) in ESRD patients in the Netherlands.METHODS: A national database containing data from four academic medical centers in the Netherlands of patients with ESRD-related HPT, who had undergone PTx and kidney transplantation between 1994 and 2015, was established. Primary endpoints were 30-day mortality and complication rate. Secondary endpoints were biochemical measurements.RESULTS: We identified 187 HPT patients undergoing PTx, with a median age of 46 years. Median preoperative PTH level was 866 pg/mL (interquartile range [IQR] 407-1547 pg/mL). At 3 months, the median PTH drop from baseline was 93% (IQR, 71-98%) to a median of 61 pg/mL (IQR, 23-148 pg/mL, p CONCLUSIONS: PTx is a safe and effective procedure in the frail ESRD population. These data show that there should be no reluctance for surgical intervention and when indicated, nephrologists can safely refer these patients for PTx. |
| Databáze: | OpenAIRE |
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