Back to Search Start Over

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
Source :
PLoS ONE; Aug2013, Vol. 8 Issue 8, p1-8, 8p
Publication Year :
2013

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19326203
Volume :
8
Issue :
8
Database :
Complementary Index
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
90070371
Full Text :
https://doi.org/10.1371/journal.pone.0068870