Nephrology (Carlton, Vic.) · 2016
Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Li Weidong, Zhang Manli, Du Shutong, Yu Yanjie, Liu Jianfeng, Zhang Ling, Yao Li
Аннотация
AIM: 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.
CONCLUSION: 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.
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.
CONCLUSION: 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.
Предметные рубрики MeSH
AdultAgedCause of DeathChi-Square DistributionFemaleHumansHyperparathyroidism, SecondaryKaplan-Meier EstimateKidney Failure, ChronicMaleMiddle AgedMultivariate AnalysisParathyroidectomyProportional Hazards ModelsProspective StudiesRenal DialysisRisk FactorsSeverity of Illness IndexTime FactorsTreatment Outcome