title: Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population - a nationwide, population-based study 1991 - 2009.
abstract: BACKGROUND
  Many patients on renal replacement therapy (RRT) require parathyroidectomy (PTX). Trends and current rates of PTX on a national level are not known. Furthermore, it is not completely clear which factors influence rates of PTX. Thus, our aim was to investigate the incidence, regional distribution and factors associated with PTX as well as possible temporal changes, in the Swedish RRT population.
  
  
  METHODS
  From the Swedish Renal Registry we extracted data on 20 015 patients on RRT between 1991 and 2009. In these, 679 incident PTX (3.4%) were identified by linkage with the National Inpatient Registry, and the Scandinavian Quality Registry for Thyroid Parathyroid and Adrenal Surgery. Poisson models were used to estimate rates per calendar year, adjusted for risk factors such as gender, age, time with renal transplant, and underlying cause of renal disease.
  
  
  RESULTS
  The PTX rate was 8.8/1 000 person-years. There was a significant increase 2001-2004 after which the rate fell, as compared with year 2000. Female gender, non-diabetic cause of renal disease and age between 40-55 were all associated with an increased frequency of PTX.
  
  
  CONCLUSIONS
  The rise in PTX rates after year 2000 might reflect increasing awareness of the potential benefits of PTX. The introduction of calcimimetics and paricalcitol might explain the decreased rate after 2005.
authors.affiliation: Department of Nephrology, Clinical Sciences Lund, Lund University, Alwallhuset, Barngatan 2A, Lund 221 85, Sweden. shahriar.akaberi@med.lu.se.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Akaberi
authors.forename: Naomi
authors.initials: N
authors.lastname: Clyne
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sterner
authors.forename: Bengt
authors.initials: B
authors.lastname: Rippe
authors.forename: Eva
authors.initials: E
authors.lastname: Reihnér
authors.forename: Philippe
authors.initials: P
authors.lastname: Wagner
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rylance
authors.forename: Karl Göran
authors.initials: KG
authors.lastname: Prütz
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
mesh_terms: D000328:Adult; D017677:Age Distribution; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology* / Q000601:surgery*; D015994:Incidence; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000401:mortality / Q000706:statistics & numerical data*; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000601:surgery*; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome