Evidence map›Paper›PMID 37351832›Full record

Observational studyJournal of nephrology2023

Parathyroidectomy and survival in a cohort of Italian dialysis patients: results of a multicenter, observational, prospective study.

Lida Tartaglione, Silverio Rotondi, Filippo Aucella, Mario Bonomini, Maria Rosa Caruso, Francesco Casino, Carlo Cuzziol, Alessio Farcomeni, Armando Filippini, Carlo Lomonte and 7 more

Open access · hybridAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
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 8 institutions in 1 country.

Lida Tartaglione *Nephrology Unit, Azienda Policlinico Umberto I, Rome, Italy.
Silverio Rotondi *Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Filippo AucellaNephrology Unit, Casa Sollievo della Sofferenza, Monte Rotondo, Italy.
Mario BonominiDepartment of Medicine and Aging Sciences, G. D'annunzio University, Chieti, Italy.
Maria Rosa CarusoPapa Giovanni XXIII Hospital, Bergamo, Italy.
Francesco CasinoNephrology Unit, Matera, Italy.
Carlo CuzziolNephrology Unit ARS Medica Rome, Rome, Italy.
Alessio FarcomeniDepartment of Economics and Finance, Tor Vergata University Rome, Rome, Italy.
Armando FilippiniCasilino Hospital Rome, Rome, Italy.
Carlo LomonteNephrology Department, Ospedale Generale Regionale "F. Miulli", Acquaviva delle Fonti, Italy.
Rocco MarinelliNephrology Unit, Madonna della Fiducia, Rome, Italy.
Davide RollaSant'Andrea Hospital La Spezia, La Spezia, Italy.
Filomena RubinoNephrology Unit Sora Hospital, Sora, Italy.
Giuseppe SeminaraAgrigento Hospital Agrigento, Agrigento, Italy.
Marzia PasqualiNephrology Unit, Azienda Policlinico Umberto I, Rome, Italy.
Sandro MazzaferroNephrology Unit, Azienda Policlinico Umberto I, Rome, Italy. sandro.mazzaferro@uniroma1.it.ORCID http://orcid.org/0000-0003-3071-1893
Italian Study Group on Mineral Metabolism of the Italian Society of Nephrology
Policlinico Umberto I · ITCasa Sollievo della Sofferenza · ITMedica (Italy) · ITOspedale Papa Giovanni XXIII · ITPoliclinico Casilino · ITUniversity of Chieti-Pescara · ITOspedale Generale Regionale Francesco Miulli · ITUniversity of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere secondary hyperparathyroidism (SHPT) is associated with mortality in end stage kidney disease (ESKD). Parathyroidectomy (PTX) becomes necessary when medical therapy fails, thus highlighting the interest to compare biochemical and clinical outcomes of patients receiving either medical treatment or surgery.

methodsWe aimed to compare overall survival and biochemical control of hemodialysis patients with severe hyperparathyroidism, treated by surgery or medical therapy followed-up for 36 months. Inclusion criteria were age older than 18 years, renal failure requiring dialysis treatment (hemodialysis or peritoneal dialysis) and ability to sign the consent form. A control group of 418 patients treated in the same centers, who did not undergo parathyroidectomy was selected after matching for age, sex, and dialysis vintage.

resultsFrom 82 Dialysis units in Italy, we prospectively collected data of 257 prevalent patients who underwent parathyroidectomy (age 58.2 ± 12.8 years; M/F: 44%/56%, dialysis vintage: 15.5 ± 8.4 years) and of 418 control patients who did not undergo parathyroidectomy (age 60.3 ± 14.4 years; M/F 44%/56%; dialysis vintage 11.2 ± 7.6 y). The survival rate was higher in the group that underwent parathyroidectomy (Kaplan-Meier log rank test = 0.002). Univariable analysis (HR 0.556, CI: 0.387-0.800, p = 0.002) and multivariable analysis (HR 0.671, CI:0.465-0.970, p = 0.034), identified parathyroidectomy as a protective factor of overall survival. The prevalence of patients at KDOQI targets for PTH was lower in patients who underwent parathyroidectomy compared to controls (PTX vs non-PTX: PTH < 150 pg/ml: 59% vs 21%, p = 0.001; PTH at target: 18% vs 37% p = 0.001; PTH > 300 pg/ml 23% vs 42% p = 0.001). The control group received more intensive medical treatment with higher prevalence of vitamin D (65% vs 41%, p = 0.0001), calcimimetics (34% vs 14%, p = 0.0001) and phosphate binders (77% vs 66%, p = 0.002).

conclusionsOur data suggest that parathyroidectomy is associated with survival rate at 36 months, independently of biochemical control. Lower exposure to high PTH levels could represent an advantage in the long term.

Indexed as

Hyperparathyroidism, SecondaryKidney Failure, ChronicParathyroidectomyAdolescentAgedHumansMiddle AgedParathyroid HormoneProspective StudiesRenal DialysisParathyroid HormoneCKD-MBDHemodialysisMortalityParathyroidectomy

Identifiers

PMID37351832
PMCPMC10543527
OpenAlexW4381716295

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.