title: Long-Term Outcomes of Total Parathyroidectomy With or Without Autoimplantation for Hyperparathyroidism in Chronic Kidney Disease: A Meta-Analysis.
abstract: The aim of the present study was to compare total parathyroidectomy without autotransplantation (TPTX) versus total parathyroidectomy with autotransplantation (TPTX + AT) for renal hyperparathyroidism (RHPT) with respect to long-term outcomes. A literature search was undertaken using Medline and EMBASE from inception to December 2013. Data were analyzed using Review Manager version 5.0. A total of seven cohort studies comprising 931 patients were identified. Compared with TPTX + AT, patients in the TPTX group have lower "recurrence" (odds ratio (OR) 0.08, confidence interval (CI) 0.03 to 0.21; P < 0.00001), lower "recurrence or persistence"(OR 0.11, 95% CI 0.05 to 0.25; P < 0.00001), lower "requiring reoperation because of recurrence or persistence" (OR 0.17, CI 0.06 to 0.54; P = 0.002), and higher "hypoparathyroidism" (OR 2.97, CI 1.09 to 8.08; P = 0.03). None of the patients in these seven studies were recorded as having severe hypocalcemia or adynamic bone disease. Compared with TPTX + AT, TPTX is associated with lower "requiring reoperation because of recurrence or persistence" and without severe hypocalcemia or adynamic bone disease.
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Jia
authors.affiliation: Provincial Hospital Shandong University, Jinan, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Yidu Central Hospital Affiliated to Weifang Medical College, Weifang, China.
authors.forename: Chengyin
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Meiyu
authors.initials: M
authors.lastname: Cui
authors.affiliation: Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000637:transplantation*; D016105:Parathyroidectomy; D012008:Recurrence; D012086:Reoperation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Chronic kidney disease; Outcomes; Parathyroidectomy; Renal hyperparathyroidism