title: Long-term mortality after parathyroidectomy among chronic kidney disease patients with secondary hyperparathyroidism: a systematic review and meta-analysis.
abstract: Parathyroidectomy (PTx) and medical treatments are both recommended for reducing serum intact parathyroid hormone (iPTH) and curing secondary hyperparathyroidism (sHPT) in patients with chronic kidney disease (CKD), but their therapeutic effects on long-term mortality are not well-known. Thus, we aim to assess such therapeutic effect of PTx. Electronic literatures published on Pubmed, Embase, and Cochrane Central Register of Controlled Trials in any language until 27 November 2015 were systematically searched. All literatures that compared outcomes (survival rate or mortality rate) between PTx-treated and medically-treated CKD patients with sHPT were included. Finally, 13 cohort studies involving 22053 patients were included. Data were extracted from all included literatures in a standard form. The outcomes of all-cause and cardiovascular mortalities were assessed using DerSimonian and Laird's random effects model. We find PTx-treated versus medically-treated patients had a 28% reduction in all-cause mortality and a 37% reduction in cardiovascular mortality. Thus, PTx versus medical treatments might reduce the risks of all-cause and cardiovascular mortalities in CKD patients with sHPT. Further studies with prospective and large-sample clinical trials are needed to find out the real effect of PTx and to assess whether mortality rates differ among patterns of PTx.
authors.affiliation: a Department of Endocrinology, Yantai Hospital of Traditional Chinese Medicine , Shandong University of Traditional Chinese Medicine , Yantai , Shandong , PR China ;
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.affiliation: b Department of Interventional Vascular Surgery, Yantai Hospital of Traditional Chinese Medicine , Shandong University of Traditional Chinese Medicine , Yantai , Shandong , PR China ;
authors.forename: Kongbo
authors.initials: K
authors.lastname: Wang
authors.affiliation: c Endoscopy Room, Yantai Hospital of Traditional Chinese Medicine , Shandong University of Traditional Chinese Medicine , Yantai , Shandong , PR China ;
authors.forename: Shanlan
authors.initials: S
authors.lastname: Yu
authors.affiliation: d Department of Cardiology , People's Hospital of Shouguang , Weifang , Shandong , PR China ;
authors.forename: Liping
authors.initials: L
authors.lastname: Lai
authors.affiliation: e Department of the PLA , Jinan Military Region Air Force Aftermath Work Office of out-Patient, ENT , Jinan , Shandong , PR China ;
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Zhang
authors.affiliation: f Department of Endocrinology , The People's Liberation Army 107th Hospital , Yantai , Shandong , PR China ;
authors.forename: Jingjing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: g Department of Periphery Vascular Surgery, Yantai Hospital of Traditional Chinese Medicine , Shandong University of Traditional Chinese Medicine , Yantai , Shandong , PR China.
authors.forename: Weifeng
authors.initials: W
authors.lastname: Duan
mesh_terms: D057966:Calcimimetic Agents / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D000069449:Cinacalcet / Q000627:therapeutic use; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D057966:Calcimimetic Agents; D010281:Parathyroid Hormone; D002118:Calcium; D000069449:Cinacalcet
keywords: Chronic kidney disease; outcomes; parathyroidectomy; secondary hyperparathyroidism