Jones, Scott A., Hegerty, Katharine, Scuderi, Carla, Eglington, Jessica, Green, Ben, and Mallett, Andrew (2020) Clinical and healthcare utilization outcomes of parathyroidectomy in CKD and dialysis patients. Kidney International Reports, 5 (7). pp. 1086-1089.

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Abstract

[Extract] Secondary hyperparathyroidism is common among patients with CKD and those with end-stage kidney disease (ESKD) receiving dialytic renal replacement therapy.1,2 Cohort studies have suggested an association between elevated parathyroid hormone levels and adverse patient outcomes.2, 3, 4 Current guidelines suggest that patients with CKD stages 3–5D with severe hyperparathyroidism who fail to respond to medical therapy should consider surgical parathyroidectomy.4

Ishani et al.2 report 2% mortality among 4435 patients within 30 days following parathyroidectomy. Within 30 days of discharge, 23.8% of patients were rehospitalized. Similar 30-day mortality was shown by Kestenbaum et al.5 with 30-day postoperative mortality of 3.1% in a cohort of 4558 patients. Ishani et al.2 found a 1-year mortality of 9.8%. Further, 7571 hospitalizations (excluding those for outpatient renal replacement therapy) occurred among 2832 unique individuals in the year after parathyroidectomy, and an average of 2.7 hospitalizations per person among those hospitalized. All-cause hospitalizations were 39% higher, and admissions for hypocalcemia were 17-fold higher.

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