American journal of surgery · 2026
Underutilization of parathyroidectomy among dialysis patients with tertiary hyperparathyroidism.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Moreno Natalie A, Abreha Fasika M, Lindpere Vanda, Arain Muhammad Abdullah, Kuzomunhu Lovemore, Yenokyan Gayane, Rudin Anatoliy V, Morris-Wiseman Lilah F, Mathur Aarti
Аннотация
INTRODUCTION: Tertiary hyperparathyroidism (THPT) is often diagnosed post-kidney transplant (KT); Parathyroidectomy is curative. Pre-KT THPT increases post-KT THPT risk; however, epidemiology among dialysis patients remains unknown. We examined THPT prevalence, risk factors, and treatment among dialysis patients.
METHODS: We identified THPT patients using the United States Dialysis Outcomes and Practice Patterns Study phases 4-7, defining THPT as multiple calcium levels>10 mg/dL with PTH≥70 pg/mL. We identified THPT and calcimimetic treatment risk factors using adjusted multivariable logistic regression.
RESULTS: Out of 79,624 patients, 442(0.6%) had THPT. Compared to non-THPT patients, THPT patients were frequently Black (45.3%vs36.4%), on dialysis>5 years (36.7%vs22.6%), and receiving calcimimetics (48.6%vs29.2%)(p < 0.001); parathyroidectomy was underutilized in both groups (0%vs0.7%). THPT risk factors included dialysis>5 years (aOR1.43,95%CI:1.10-1.83) and PTH>300(aOR1.87,95%CI:1.36-2.56). Calcimimetic risk factors included vitamin D use (aOR1.31,95%CI:1.39-8.13),>5 dialysis years (aOR2.56,95%CI:1.57-7.63) and PTH>300(aOR3.37,95%CI:1.57-7.62).
CONCLUSION: THPT is rare and frequently managed with calcimimetics among dialysis patients. Guidelines are needed to ensure earlier parathyroidectomy.
METHODS: We identified THPT patients using the United States Dialysis Outcomes and Practice Patterns Study phases 4-7, defining THPT as multiple calcium levels>10 mg/dL with PTH≥70 pg/mL. We identified THPT and calcimimetic treatment risk factors using adjusted multivariable logistic regression.
RESULTS: Out of 79,624 patients, 442(0.6%) had THPT. Compared to non-THPT patients, THPT patients were frequently Black (45.3%vs36.4%), on dialysis>5 years (36.7%vs22.6%), and receiving calcimimetics (48.6%vs29.2%)(p < 0.001); parathyroidectomy was underutilized in both groups (0%vs0.7%). THPT risk factors included dialysis>5 years (aOR1.43,95%CI:1.10-1.83) and PTH>300(aOR1.87,95%CI:1.36-2.56). Calcimimetic risk factors included vitamin D use (aOR1.31,95%CI:1.39-8.13),>5 dialysis years (aOR2.56,95%CI:1.57-7.63) and PTH>300(aOR3.37,95%CI:1.57-7.62).
CONCLUSION: THPT is rare and frequently managed with calcimimetics among dialysis patients. Guidelines are needed to ensure earlier parathyroidectomy.