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Nitta Kosaku
Department Other, Other Position |
|
| Article types | Original article |
| Language | English |
| Peer review | Non peer reviewed |
| Title | Parathyroidectomy vs Cinacalcet Among Patients Undergoing Hemodialysis. |
| Journal | Formal name：The Journal of clinical endocrinology and metabolism Abbreviation：J Clin Endocrinol Metab ISSN code：19457197/0021972X |
| Volume, Issue, Page | 107(7),pp.2016-2025 |
| Author and coauthor | Komaba Hirotaka, Hamano Takayuki, Fujii Naohiko, Moriwaki Kensuke, Wada Atsushi, Masakane Ikuto, Nitta Kosaku, Fukagawa Masafumi |
| Publication date | 2022/06 |
| Summary | CONTEXT:Parathyroidectomy (PTx) and cinacalcet are both effective treatments for secondary hyperparathyroidism in hemodialysis patients, but limited data exist comparing the long-term outcomes of these interventions.OBJECTIVE:We aimed to compare the risk of mortality among hemodialysis patients who underwent PTx and those who started treatment with cinacalcet.METHODS:In this prospective cohort study, comprising patients from the Japanese Society for Dialysis Therapy Renal Data Registry, patients who had intact parathyroid hormone (PTH) levels ≥ 300 pg/mL in late 2007 and underwent PTx or started treatment with cinacalcet in 2008 to 2009 were matched by propensity score at 1:3. PTx and cinacalcet were compared for all-cause mortality within 6 years.RESULTS:Among eligible patients, 894 patients who underwent PTx were matched with 2682 patients who started treatment with cinacalcet. The median baseline intact PTH levels were 588 pg/mL and 566 pg/mL in the PTx and cinacalcet groups, respectively. PTx resulted in greater reductions in intact PTH, calcium, and phosphorus levels compared with cinacalcet. During the 6-year follow-up period, 201 patients (22.5%) in the PTx group and 736 patients (27.4%) in the cinacalcet group died. PTx was associated with a lower risk of mortality compared with cinacalcet (hazard ratio, 0.78 [95% CI, 0.67-0.91]; P = 0.002). This association was more pronounced in patients with intact PTH levels ≥ 500 pg/mL and in patients with serum calcium levels ≥ 10.0 mg/dL (both P for interaction < 0.001).CONCLUSION:PTx compared with cinacalcet is associated with a lower risk of mortality, particularly among patients with severe secondary hyperparathyroidism. |
| DOI | 10.1210/clinem/dgac142 |
| PMID | 35277957 |