Evidence map›Paper›PMID 30729318›Full record

ArticleLangenbeck's archives of surgery2019

Parathyroidectomy versus cinacalcet for tertiary hyperparathyroidism; a retrospective analysis.

R R Dulfer, E Y Koh, W Y van der Plas, A F Engelsman, E J M Nieveen van Dijkum, R A Pol, L Vogt, M H de Borst, S Kruijff, A Schepers and 7 more

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Langenbeck's archives of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 1 country.

R R DulferDepartment of Surgery, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. roderickdulfer@gmail.com.
E Y KohDepartment of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
W Y van der PlasDepartment of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
A F EngelsmanDepartment of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
E J M Nieveen van DijkumDepartment of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
R A PolDepartment of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
L VogtDepartment of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
M H de BorstDepartment of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
S KruijffDepartment of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
A SchepersDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
N M Appelman-DijkstraDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
J I RotmansDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
D A HesselinkDepartment of Internal Medicine, Division of Nephrology and Kidney Transplantation, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
C H J van EijckDepartment of Surgery, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
E J HoornDepartment of Internal Medicine, Division of Nephrology and Kidney Transplantation, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
T M van GinhovenDepartment of Surgery, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Dutch Hyperparathyroid Study Group
University Medical Center Groningen · NLErasmus MC · NLLeiden University Medical Center · NLAmsterdam UMC Location University of Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTertiary hyperparathyroidism (tHPT), i.e., persistent HPT after kidney transplantation, affects 17-50% of transplant recipients. Treatment of tHPT is mandatory since persistently elevated PTH concentrations after KTx increase the risk of renal allograft dysfunction and osteoporosis. The introduction of cinacalcet in 2004 seemed to offer a medical treatment alternative to parathyroidectomy (PTx). However, the optimal management of tHPT remains unclear.

methodsA retrospective analysis was performed on patients receiving a kidney transplantation (KT) in two academic centers in the Netherlands. Thirty patients undergoing PTx within 3 years of transplantation and 64 patients treated with cinacalcet 1 year after transplantation for tHPT were included. Primary outcomes were serum calcium and PTH concentrations 1 year after KT and after PTx.

resultsSerum calcium normalized in both the cinacalcet and the PTx patients. PTH concentrations remained above the upper limit of normal (median 22.0 pmol/L) 1 year after KT, but returned to within the normal range in the PTx group (median 3.7 pmol/L). Side effects of cinacalcet were difficult to assess; minor complications occurred in three patients. Re-exploration due to persistent tHPT was performed in three (10%) patients.

conclusionIn patients with tHPT, cinacalcet normalizes serum calcium, but does not lead to a normalization of serum PTH concentrations. In contrast, PTx leads to a normalization of both serum calcium and PTH concentrations. These findings suggest that PTx is the treatment of choice for tHPT.

Indexed as

Kidney TransplantationParathyroidectomyAdultCalcimimetic AgentsCinacalcetFemaleHumansHyperparathyroidismMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeCalcimimetic AgentsCinacalcetCinacalcetCKD-BMDParathyroidectomyTertiary hyperparathyroidism

Identifiers

PMID30729318
PMCPMC6394681
OpenAlexW2913586125

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.