1. The Risk of Peripheral Arterial Disease after Parathyroidectomy in Patients with End-Stage Renal Disease.
- Author
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Hsu, Yueh-Han, Yu, Hui-Yi, Chen, Hsuan-Ju, Li, Tsai-Chung, Hsu, Chih-Cheng, and Kao, Chia-Hung
- Subjects
ARTERIAL diseases ,PARATHYROIDECTOMY ,CHRONIC kidney failure complications ,HEALTH insurance ,DIAGNOSIS ,DISEASE risk factors - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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