title: Epidemiology and mortality among dialysis patients with parathyroidectomy: Taiwan  National Cohort Study.
abstract: OBJECTIVE
  Parathyroidectomy (PTx) is usually necessary in patients with end-stage renal disease (ESRD) on dialysis. Risk factors for higher PTx rates are controversial. The objectives of this study were to identify the risk factors for PTx in patients on dialysis and evaluate the mortality after PTx.
  
  
  METHODS
  We analyzed data obtained from the National Health Insurance Research Database and included 35,162 ESRD dialysis patients. Kaplan-Meier method was used to calculate the incidence of PTx and survival rate after PTx. Cox proportional hazards models were used to identify the risk factors.
  
  
  RESULTS
  The PTx rate was 8.09 per 1,000 patient-years. Stratified on the basis of gender and diabetic mellitus (DM), the highest incidence rate of PTx was in females without DM. Stratified by age and DM, the highest incidence rate of PTx was in those aged 18-44 years without DM. The significant risk factors for PTx were younger age, female (hazard ratio (HR) 1.409, 95% confidence interval (CI): 1.257-1.580), DM (HR 0.479, 95% CI: 0.413-0.555), peritoneal dialysis (HR 1.657, 95% CI: 1.418-1.938) and hypertension (HTN) (HR 1.317, 95% CI: 1.162-1.492). The cumulative survival rates after PTx were 97.1%, 94.5%, 82.8% and 77.4% at the first, second, fifth and seventh year, respectively. Only age was significantly associated with higher mortality after PTx.
  
  
  CONCLUSIONS
  Higher PTx rates were found in dialysis patients who were female and younger, did not have DM, were on peritoneal dialysis and had HTN. Advanced age was associated with a higher mortality after PTx.
authors.affiliation: Department of Pediatrics, Taichung Veterans General Hospital, Taichung - Taiwan.
authors.forename: Chi-Hsi
authors.initials: CH
authors.lastname: Chuang
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Kun-Ming
authors.initials: KM
authors.lastname: Chung
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Chen
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Yang
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chien
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000401:mortality* / Q000706:statistics & numerical data; D010530:Peritoneal Dialysis / Q000401:mortality; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult