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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/29631


    標題: Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease A 13-Year Population-Based Cohort Study
    作者: Hsu, Yueh-Han
    Chen, Hsuan-Ju
    Shen, Szu-Ching
    Tsai, Wen-Chen
    Hsu, Chih-Cheng
    Kao, Chia-Hung
    貢獻者: 醫務管理系
    關鍵字: chronic kidney-disease
    incident dialysis patients
    hemodialysis-patients
    secondary hyperparathyroidism
    ischemic-stroke
    maintenance hemodialysis
    myocardial-infarction
    atrial-fibrillation
    nationwide cohort
    single-center
    日期: 2015-06
    上傳時間: 2016-04-19 19:02:40 (UTC+8)
    出版者: Lippincott Williams & Wilkins
    摘要: Research information on the risk of stroke in patients with dialysis-dependent end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is scant.We used a nationwide health insurance claims database to select all patients with dialysis-dependent ESRD age 18 years and older for the study population. Of the patients with ESRD, we selected 1083 patients who had undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083 patients with ESRD by sex, age, years since the disease diagnosis, and the year of undergoing PTX as the non-PTX group.We used a multivariate Cox proportional hazards regression analysis to measure the risk of stroke for the PTX group compared with the non-PTX group after adjusting for sex, age, premium-based income, urbanization, and comorbidity.The mean follow-up periods were 6.08 and 5.38 years for the PTX and non-PTX groups, respectively. After adjusting for previously mentioned variables, significant risk reductions of stroke (adjusted hazard ratio=0.57, 95% confidence interval=0.41-0.79), particularly those of hemorrhagic stroke (adjusted hazard ratio=0.34, 95% confidence interval=0.20-0.57), with PTX were observed. Chronologically, the risk of stroke in the PTX group decreased in the second year after PTX and persisted for >3 years.PTX reduces the risk of stroke, particularly that of hemorrhagic stroke, in patients with dialysis-dependent ESRD. Other factors for risk reduction include sex (females), an age <65 years, and the presence of comorbidity.
    Appears in Collections:[醫務管理系(所)] 期刊論文

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