Long–term mortality after parathyroidectomy among chronic kidney disease patients with secondary hyperparathyroidism: a systematic review and meta-analysis

Figures & data

Figure 1. Flow-diagram of study selection.

Table 1. Detailed characteristics of studies included in the meta-analysis.

Study	Country	Design	Sample size (PTx/medical treatment)	Mean age (years)	Sex (% female)	Dialysis status	Dialysis duration (months)	Mean duration of follow-up (months)	Duration of inclusion (year to year)	Diabetes (%)	Serum iPTH (pg/ml)	Method for HR extraction^a	Adjusted covariates in the model (yes or no)
Hong et al (2007)^19	Brazil	PCS	50/68	44.1	44.1	HD	82.7	30	NR	0	1258.8	1	Yes
Sharma et al (2012)^20	USA	RCS	150/1044	42.0	53.0	PD and HD	86.4	43.2	1993–2009	22	1770.0	1	Yes
Dussol et al (2007)^21	France	CS	23/74	56.0	45.4	PD and HD	91.0	96	1994–2002	14.1	190	3	Yes
Goldenstein et al (2013)^22	Brazil	RCS	123/128	48.0	45.7	HD	72.0	23	2005–2012	12.6	1455.1	1	Yes
Iwamoto et al (2012)^23	Japan	RS	88/88	60.5	46.6	Dialysis	139.2	52.8	1998–2009	9.1	541.7	1	No
Kestenbaum et al (2004)^24	USA	OS	4558/4558	47.6	57.5	PD and HD	40.2	36	1994–2001	19.4	NRA	1	Yes
Ivarsson et al (2015)^25	Sweden	RCS	423/1234	55.8	50.4	PD and HD	NR	56.3	1991–2009	15.4	NR	1	Yes
Komaba et al (2015)^26	Japan	RCS	4428/4428	59.2	44.3	HD	150.5	12	2004–2005	11.4	382.5	1	Yes
Trombetti et al (2007)^27	Switzerland	OS	40/80	50.9	50.8	PD and HD	105.6	NR	1977–2002	5.0	NR	3	Yes
Ma et al (2015)^28	Taiwan	RCS	60/161	59.0	58.4	HD	95.7	36	2004–2010	44.3	1137.5	1	Yes
Li et al (2015)^29	China	PCS	53/92	58.2	40.1	HD	45.5	12	2012–2013	12.4	363.7	1	Yes
Conzo et al (2013)^30	Italy	RCS	30/20	52.9	62.0	HD	140.9	60	2004–2006	NR	463.9	2	No
Moldovan et al (2015)^31	Romania	PCS	26/26	50.6	38.5	HD	73.5	24	2007–2013	26.9	1659.7	1	Yes

PCS : prospective cohort study; RCS: retrospective cohort study; CS: cross-sectional study; RS: retrospective study; OS: observational study; HD: hemodialysis; PD: peritoneal dialysis; NR: not reported.

^a1 denoted as COX HR: reported in paper; 2 denoted as calculating HRs from the total number of deaths and its p values; 3 denoted as extracting HRs from Kaplan–Meier plots and number at risk .

Figure 2. Funnel plot for all-cause mortality.

Figure 3. Forest plot for all-cause mortality.

Figure 4. Forest plot for all-cause mortality, according to duration of follow-up.

Figure 5. Forest plot for all-cause mortality, according to deadline of inclusion.

Costa-Hong V, Jorgetti V, Gowdak LH, Moyses RM, Krieger EM, De Lima JJ. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery. 2007;142:699–703.

 PubMed Web of Science ®Google Scholar

Sharma J, Raggi P, Kutner N, et al. Improved long-term survival of dialysis patients after near-total parathyroidectomy. J Am Coll Surg. 2012;214:400–407.

 PubMed Web of Science ®Google Scholar

Dussol B, Morand P, Martinat C, et al. Influence of parathyroidectomy on mortality in hemodialysis patients: A prospective observational study. Ren Fail. 2007;29:579–586.

 PubMed Web of Science ®Google Scholar

Goldenstein PT, Elias RM, de Freitas do Carmo LP, et al. Parathyroidectomy improves survival in patients with severe hyperparathyroidism: A comparative study. PLoS One. 2013;8:e68870.

 PubMed Web of Science ®Google Scholar

Iwamoto N, Sato N, Nishida M, et al. Total parathyroidectomy improves survival of hemodialysis patients with secondary hyperparathyroidism. J Nephrol. 2012;25:755–763.

 PubMed Web of Science ®Google Scholar

Kestenbaum B, Andress DL, Schwartz SM, et al. Survival following parathyroidectomy among United States dialysis patients. Kidney Int. 2004;66:2010–2016.

 PubMed Web of Science ®Google Scholar

Ivarsson KM, Akaberi S, Isaksson E, et al. The effect of parathyroidectomy on patient survival in secondary hyperparathyroidism. Nephrol Dial Transplant. 2015;30:2027–2033.

 PubMed Web of Science ®Google Scholar

Komaba H, Taniguchi M, Wada A, Iseki K, Tsubakihara Y, Fukagawa M. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 2015;88:350–359.

 PubMed Web of Science ®Google Scholar

Trombetti A, Stoermann C, Robert JH, et al. Survival after parathyroidectomy in patients with end-stage renal disease and severe hyperparathyroidism. World J Surg. 2007;31:1014–1021.

 PubMed Web of Science ®Google Scholar

Ma TL, Hung PH, Jong IC, et al. Parathyroidectomy is associated with reduced mortality in hemodialysis patients with secondary hyperparathyroidism. Biomed Res Int. 2015;2015:639587.

 PubMedGoogle Scholar

Li W, Zhang M, Du S, et al. Impact of parathyroidectomy on survival among hemodialysis patients: A prospective cohort study. Nephrology (Carlton). 2016;21:133–138.

 Web of Science ®Google Scholar

Conzo G, Perna AF, Savica V, et al. Impact of parathyroidectomy on cardiovascular outcomes and survival in chronic hemodialysis patients with secondary hyperparathyroidism. A retrospective study of 50 cases prior to the calcimimetics era. BMC Surg. 2013;13:S4–S24268127.

 PubMed Web of Science ®Google Scholar

Moldovan D, Racasan S, Kacso IM, et al. Survival after parathyroidectomy in chronic hemodialysis patients with severe secondary hyperparathyroidism. Int Urol Nephrol. 2015;47:1871–1877.

 PubMed Web of Science ®Google Scholar