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




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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.



Author: Yueh-Han Hsu , Hui-Yi Yu , Hsuan-Ju Chen, Tsai-Chung Li, Chih-Cheng Hsu, Chia-Hung Kao

Source: http://plos.srce.hr/



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