ArticleLangenbeck's archives of surgery2025
A retrospective analysis of the management of renal hyperparathyroidism; evaluating changes in practice and outcome in an era of calcimimetics.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Pre-Parathyroidectomy PTH as an Integrated Biomarker of Glandular Remodeling and Skeletal Turnover in Secondary Hyperparathyroidism.International journal of molecular sciences · 2026Review
- Outcomes of renal hyperparathyroidism following parathyroidectomy in kidney replacement therapy patients at a tertiary centre in South Africa: A retrospective cohort study.Journal of the colleges of medicine of South Africa · 2026Article
Corrections and comments
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHyperparathyroidism (HPT) is a common and significant complication of chronic kidney disease (CKD). Both parathyroidectomy and cinacalcet, are used routinely in an effort to manage this cohort. Unfortunately, there remains no guideline consensus on how best to combine these treatments into an effective strategy. We look to assess the efficacy of these interventions and identify factors predicting recurrence and the development of post-operative complications. We also examine changes in our practice nationally following the arrival of cinacalcet as an alternative or an abridge to definitive surgical management.
methodsThis was a nationwide study. We conducted a retrospective analysis of a prospectively maintained database. All patients who underwent a parathyroidectomy as management of secondary or tertiary HPT between 1999 and 2023 were included. A control group of patients managed with cinacalcet were also included.
resultsOur cohort included 155 patients managed with parathyroidectomy and 203 patients treated with cinacalcet. Pre-operative Alkaline phosphatase > 200 IU/L was predictive of hungry bone syndrome (HBS) on univariate (P = 0.003) and multivariate (P = 0.002) analysis, whilst a PTH > 1000 pg/ml (P = 0.012) was also predictive of HBS on univariate analysis. In an attempt to identify an optimal PTH cut off to trigger surgical referral we found mean serum PTH levels were significantly higher at 5 years in the cohort of patients who had a PTH > 1000 pg/ml prior to surgical intervention (39 ± 32 Vs 374 ± 544, P = 0.045).
conclusionsOur findings re-emphasise the efficacy and safety of parathyroid surgery in the management of renal HPT and suggest earlier surgical referral may improve the incidence of post-operative HBS and recurrent HPT.
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