The Risk of Peripheral Arterial Disease after Parathyroidectomy in Patients with End-Stage Renal Disease

doi:10.1371/journal.pone.0156863

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Title:	The Risk of Peripheral Arterial Disease after Parathyroidectomy in Patients with End-Stage Renal Disease
Authors:	Hsu, Yueh-Han Yu, Hui-Yi Chen, Hsuan-Ju Li, Tsai-Chung Hsu, Chih-Cheng Kao, Chia-Hung
Contributors:	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
Keywords:	chronic kidney-disease ankle-brachial index hemodialysis-patients dialysis patients secondary hyperparathyroidism cardiovascular-disease bone turnover vitamin-d hormone calcification
Date:	2016-06
Issue Date:	2018-01-18 11:41:07 (UTC+8)
Publisher:	Public Library Science
Abstract:	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.
Relation:	Plos One, v.11 n.6, e0156863
Appears in Collections:	[Dept. of Sports Management] Periodical Articles

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