title: Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study.
abstract: OBJECTIVE
  We evaluated whether parathyroidectomy (PTX) was associated with survival of dialysis patients.
  
  
  METHODS
  In a cohort study with one year follow-up, data from 146 haemodialysis patients from a hospital were analyzed. We compared the baseline data between patients receiving PTX surgery and those who had not undergone PTX. The Cox proportional hazards regression was used to examine the effect of PTX.
  
  
  RESULTS
  Patients who had received PTX surgery were more likely to be older, have longer duration of dialysis, higher ultrafiltration rate, C-reactive protein (CRP), alkaline phosphatase (ALP), and lower albumin compared with those who had not receive PTX. During 1 year follow-up, 21 (17.1%) patients died, of whom seven died from cerebrovascular events, 10 died from cardiovascular disease, and four died from infection. The mortality was 9.4% in the PTX group and 17.3% in the control group. The PTX group had a significantly lower risk of all-cause mortality than the control group (P = 0.005). There was a significantly lower risk of all-cause mortality in the PTX group compared with the non-PTX group (HR = 0.93, 95%CI: 0.89-0.97). The lower risk (HR = 0.92, 95%CI: 0.85-0.98) of PTX group was not changed after adjusting potential factors. Our results also suggested that this relationship was independent of many potential confounding factors.
  
  
  CONCLUSIONS
  Parathyroidectomy was related to significant reduction in all-cause among patients with severe SHPT. PTX may be considered as a matter of priority, from which dialysis patients would benefit.
authors.affiliation: Department of Thyroid Breast Surgery, Cangzhou People's Hospital, Cangzhou, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Thyroid Breast Surgery, Cangzhou People's Hospital, Cangzhou, China.
authors.forename: Manli
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Cangzhou People's Hospital, Cangzhou, China.
authors.forename: Shutong
authors.initials: S
authors.lastname: Du
authors.affiliation: Department of Thyroid Breast Surgery, Cangzhou People's Hospital, Cangzhou, China.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Endoscopy Center, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016105:Parathyroidectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: end-stage renal disease; haemodialysis; hyperparathyroidism