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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31072

    標題: The Risk of Peripheral Arterial Disease after Parathyroidectomy in Patients with End-Stage Renal Disease
    作者: Hsu, Yueh-Han
    Yu, Hui-Yi
    Chen, Hsuan-Ju
    Li, Tsai-Chung
    Hsu, Chih-Cheng
    Kao, Chia-Hung
    貢獻者: China Med Univ, Dept Hlth Serv Adm
    Ditmanson Med Fdn Chia Yi Christian Hosp, Dept Internal Med, Div Nephrol
    Min Hwei Jr Coll Hlth Care Management, Dept Nursing
    Ditmanson Med Fdn Chia Yi Christian Hosp, Div Endocrinol & Metab, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Sports Management
    China Med Univ Hosp, Management Off Hlth Data
    China Med Univ, Coll Med
    China Med Univ, Coll Publ Hlth, Grad Inst Biostat
    Asia Univ, Coll Hlth Sci, Dept Healthcare Adm
    Natl Hlth Res Inst, Inst Populat Hlth Sci
    China Med Univ, Coll Med, Grad Inst Clin Med Sci
    China Med Univ, Coll Med, Sch Med
    關鍵字: chronic kidney-disease
    ankle-brachial index
    dialysis patients
    secondary hyperparathyroidism
    bone turnover
    日期: 2016-06
    上傳時間: 2018-01-18 11:41:07 (UTC+8)
    出版者: Public Library Science
    摘要: Purpose The changes of the risk of peripheral arterial disease (PAD) in patients with end-stage renal disease after parathyroidectomy are scant. Methods We used a nationwide health insurance claims database to select all dialysis-dependent patients with end-stage renal disease aged 18 years and older for the study population in 2000 to 2006. Of the patients with end-stage renal disease, we selected 947 patients who had undergone parathyroidectomy as the parathyroidectomy group and frequency matched 3746 patients with end-stage renal disease by sex, age, years since the disease diagnosis, and the year of index date as the non-parathyroidectomy group. We used a multivariate Cox proportional hazards regression analysis with the use of a robust sandwich covariance matrix estimate, accounting for the intra-cluster dependence of hospitals or clinics, to measure the risk of peripheral arterial disease for the parathyroidectomy group compared with the non-parathyroidectomy group after adjusting for sex, age, premium-based income, urbanization, and comorbidity. Results The mean post-op follow-up periods were 5.08 and 4.52 years for the parathyroidectomy and non-parathyroidectomy groups, respectively; the incidence density rate of PAD in the PTX group was 12.26 per 1000 person-years, significantly lower than the data in the non-PTX group (24.09 per 1000 person-years, adjusted HR = 0.66, 95% CI = 0.46-0.94). Conclusion Parathyroidectomy is associated with reduced risk of peripheral arterial disease in patients with end-stage renal disease complicated with severe secondary hyperparathyroidism.
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