Hyperparathyroidism Clinical Trial
The impact of parathyroidectomy (PTX) on the bone mineral parameters in dialysis patients with secondary hyperparathyroidism (SHPT) remains unclear. The investigators performed this study to present the short- and long-term impact of PTX on calcium, phosphorus and intact parathyroid hormone control in dialysis patients with severe SHPT after operation. In particular, the investigators evaluate the impact based on the achievement of recommendations of the current clinical practice guidelines for bone and mineral parameters in dialysis patients after PTX.
1. A retrospective chart review of dialysis patients including referred cases, receiving
surgical PTX, which was performed by one surgeon at the Far Eastern Memorial Hospital,
a 1084-bed tertiary-care medical center in northern Taiwan will be performed.
2. Serum levels of calcium, phosphorus and intact parathyroid hormone were routinely
measured for three consecutive post-operative days and subsequent laboratory values
were checked during out-patient follow-up period. Patients with postoperative 6-month
laboratory data are included in the short-term group and those with more than 6-month
available data are in the long-term one.
3. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI™)
Clinical Practice Guidelines provided recommended target values for serum intact
parathyroid hormone (iPTH)(150-300 pg/ml), phosphorus (3.5-5.5 mg/dl), calcium (8.4-9.5
mg/dl) and the calcium-phosphorus product (<55 mg2/dl2). The Kidney Disease: Improving
Global Outcomes (KDIGO) Clinical Practice Guidelines suggested maintaining serum
calcium in the reference range (8.5-10.5 mg/dl), phosphorus (2.7-4.5 mg/dl) and PTH
values in the range of two to nine times the upper reference limit (130 - 585 pg/ml) in
dialysis patients.
4. The investigators evaluated the impact of subtotal PTX on the control of bone and
mineral parameters in dialysis patients with secondary HPT as the percentages of cases
achieving the recommended K/DOQI and KDIGO targets.
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Observational Model: Cohort, Time Perspective: Retrospective
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