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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/29577

    標題: Parathyroidectomy Is Associated with Reduced Mortality in Hemodialysis Patients with Secondary Hyperparathyroidism
    作者: Ma, Tsung-Liang
    Hung, Peir-Haur
    Jong, Ing-Ching
    Hiao, Chih-Yen
    Hsu, Yueh-Han
    Chiang, Pei-Chun
    Guo, How-Ran
    Hung, Kuan-Yu
    貢獻者: 生活應用與保健系
    關鍵字: Stage renal-disease
    Dialysis patients
    日期: 2015
    上傳時間: 2016-04-19 19:00:51 (UTC+8)
    出版者: Hindawi Publishing Corporation
    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.
    Appears in Collections:[生活應用與保健系] 期刊論文

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