The Effects of Parathyroidectomy vs Medical Treatments for Secondary Hyperparathyroidism in Patients Undergoing Dialysis: A Meta-Analysis
Pooled result · All-cause mortalityResult — go to the resultHazard ratio 0.47 95% CI 0.35–0.61Authors' conclusion
Parathyroidectomy may offer a survival advantage compared to medical management in patients with severe secondary hyperparathyroidism.
Study context
- Population
- Patients undergoing dialysis with secondary hyperparathyroidism; history of kidney transplant excluded
- Participants
- 24,398 patients23 studies
- Comparison
- Parathyroidectomy vs medical treatments
- Outcome
- All-cause mortality
Pooled result
As reported in the abstract
Hazard ratio
0.47
95% CI 0.35–0.61
Parathyroidectomyvs Medical treatment
HR 0.47 (95% CI 0.35–0.61)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| Cardiovascular mortality | 0.58 (0.40–0.84) | |
| Mortality, subgroup with PTH >585 pg/mL | 0.37 (0.24–0.58) | |
| Mortality, subgroup where all medical-group patients received cinacalcet plus standard treatmentNo mortality difference | 1.02 (0.49–2.11) | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | WMD (pg/mL) (95% CI) | |
|---|---|---|
| Decrease in PTHLarger decrease with parathyroidectomy | 1078 (587–1569) | |
| −1000010002000Difference, pg/mL (linear scale) |
| Outcome | WMD (mg/dL) (95% CI) | |
|---|---|---|
| Decrease in calciumLarger decrease with parathyroidectomy | 0.86 (0.43–1.28) | |
| Decrease in phosphateLarger decrease with parathyroidectomy | 0.74 (0.32–1.16) | |
| −1012Difference, mg/dL (linear scale) |
Original publication
The Effects of Parathyroidectomy vs Medical Treatments for Secondary Hyperparathyroidism in Patients Undergoing Dialysis: A Meta-Analysis. Endocr Pract. Published 5 April 2024. doi:10.
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