https://scholars.lib.ntu.edu.tw/handle/123456789/578457
標題: | Parathyroidectomy is associated with reduced mortality in hemodialysis patients with secondary hyperparathyroidism | 作者: | Ma T.-L. Hung P.-H. Jong I.-C. Hiao C.-Y. Hsu Y.-H. Chiang P.-C. Guo H.-R. KUAN-YU HUNG |
公開日期: | 2015 | 出版社: | Hindawi Publishing Corporation | 卷: | 2015 | 起(迄)頁: | 639587 | 來源出版物: | BioMed Research International | 摘要: | Secondary hyperparathyroidism increases morbidity and mortality in hemodialysis patients. The Kidney Disease Outcomes Quality Initiative Guidelines recommend parathyroidectomy for patients with chronic kidney disease and parathyroid hormone concentrations exceeding 800 pg/mL; however, this concentration represents an arbitrary cut-off value. The present study was conducted to identify factors influencing mortality in hemodialysis patients with parathyroid hormone concentrations exceeding 800 pg/mL and to evaluate the effects of parathyroidectomy on outcome for these patients. Two hundred twenty-one hemodialysis patients with parathyroid hormone concentrations > 800 pg/mL from July 2004 to June 2010 were identified. 21.1% of patients (n = 60) received parathyroidectomy and 14.9% of patients (n = 33) died during a mean follow-up of 36 months. Patients with parathyroidectomy were found to have lower all-cause mortality (adjusted hazard ratio [aHR]: 0.34). Other independent predictors included age ? 65 years (aHR: 2.11) and diabetes mellitus (aHR: 3.80). For cardiovascular mortality, parathyroidectomy was associated with lower mortality (HR = 0.31) but with a marginal statistical significance (p = 0.061). In multivariate analysis, diabetes was the only significant predictor (aHR: 3.14). It is concluded that, for hemodialysis patients with parathyroid hormone concentrations greater than 800 pg/mL, parathyroidectomy is associated with reduced all-cause mortality. ? 2015 Tsung-Liang Ma et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929643536&doi=10.1155%2f2015%2f639587&partnerID=40&md5=e36a7971729ce61b1725f079b24dc4d2 https://scholars.lib.ntu.edu.tw/handle/123456789/578457 |
ISSN: | 2314-6133 | DOI: | 10.1155/2015/639587 | SDG/關鍵字: | parathyroid hormone; parathyroid hormone; aged; Article; cardiovascular mortality; diabetes mellitus; female; follow up; hemodialysis patient; human; major clinical study; male; mortality; parathyroidectomy; predictive value; risk factor; secondary hyperparathyroidism; treatment outcome; blood; hemodialysis; Hyperparathyroidism, Secondary; Kidney Failure, Chronic; middle aged; pathology; Aged; Female; Humans; Hyperparathyroidism, Secondary; Kidney Failure, Chronic; Male; Middle Aged; Parathyroid Hormone; Parathyroidectomy; Renal Dialysis; Treatment Outcome |
顯示於: | 醫學系 |
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