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  • Editor in Chief: Prof. Giovanni Gambaro
  • Co-Editor: Benedetta Bussolati
  • Current issue: Vol. 26 issue Suppl. 22 , 2013 (November-December)

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Vol. 26 - Issue 6 (November-December 2013)

Epidemiology and mortality among dialysis patients with parathyroidectomy: Taiwan 
National Cohort Study

Epidemiology and mortality among dialysis patients with parathyroidectomy: Taiwan 
National Cohort Study

J Nephrol 2013; 26(6): 1143 - 1150

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jn.5000286

Authors

Chi-Hsi Chuang, Jhi-Joung Wang, Shih-Feng Weng, Kun-Ming Chung, Ya-Ping Chen, Chien-Cheng Huang, Chun-Ming Yang, Chih-Chiang Chien

Abstract

Background and objectives: Parathyroidectomy (PTx) is usually necessary in patients with end-stage renal disease (ESRD) on dialysis. Risk factors for higher PTx rates are controversial. The objectives of this study were to identify the risk factors for PTx in patients on dialysis and evaluate the mortality after PTx.  
Methods: We analyzed data obtained from the National Health Insurance Research Database and included 35,162 ESRD dialysis patients. Kaplan-Meier method was used to calculate the incidence of PTx and survival rate after PTx. Cox proportional hazards models were used to identify the risk factors.  
Results: The PTx rate was 8.09 per 1,000 patient-years. Stratified on the basis of gender and diabetic mellitus (DM), the highest incidence rate of PTx was in females without DM. Stratified by age and DM, the highest incidence rate of PTx was in those aged 18-44 years without DM. The significant risk factors for PTx were younger age, female (hazard ratio (HR) 1.409, 95% confidence interval (CI): 1.257-1.580), DM (HR 0.479, 95% CI: 0.413-0.555), peritoneal dialysis (HR 1.657, 95% CI: 1.418-1.938) and hypertension (HTN) (HR 1.317, 95% CI: 1.162-1.492). The cumulative survival rates after 
PTx were 97.1%, 94.5%, 82.8% and 77.4% at the first, second, fifth and seventh year, respectively. Only 
age was significantly associated with higher mortality 
after PTx.
Conclusions: Higher PTx rates were found in dialysis 
patients who were female and younger, did not have DM, were on peritoneal dialysis and had HTN. Advanced age was associated with a higher mortality after PTx.

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Authors

  • Chuang, Chi-Hsi [PubMed] [Google Scholar]
    Department of Pediatrics, Taichung Veterans General Hospital, Taichung - Taiwan
  • Wang, Jhi-Joung [PubMed] [Google Scholar]
    Department of Medical Research, Chi-Mei Medical Center, Tainan - Taiwan
  • Weng, Shih-Feng [PubMed] [Google Scholar]
    Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
  • Chung, Kun-Ming [PubMed] [Google Scholar]
    Department of General Medicine, Chi-Mei Medical Center, Tainan - Taiwan
  • Chen, Ya-Ping [PubMed] [Google Scholar]
    Department of Management in Medical Records and Information, Chi-Mei Medical Center, Tainan - Taiwan
  • Huang, Chien-Cheng [PubMed] [Google Scholar]
    Department of Emergency Medicine, Chi-Mei Medical Center, Tainan - Taiwan
  • Yang, Chun-Ming [PubMed] [Google Scholar]
    Department of Neurology, Chi-Mei Medical Center, Tainan - Taiwan
  • Chien, Chih-Chiang [PubMed] [Google Scholar]
    Department of Nephrology, Chi-Mei Medical Center, Tainan - Taiwan; and Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan - Taiwan

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