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Secondary hyperparathyroidism is a common complication of chronic kidney disease-mineral and bone disorders (CKD-MBD) among patients who undergo dialysis. When adequate doses of dialysis and directed medical treatment fail to manage it, parathyroidectomy is recommended. In this study, we evaluated the correlation between pre-operative PTH levels and the duration of hospital stay for patients with end-stage kidney disease (ESKD) on dialysis.
We performed a retrospective cohort study, including patients with ESKD on hemodialysis (HD) or peritoneal dialysis (PD) who underwent total or subtotal parathyroidectomy between January 2022 and January 2023 at a Brazilian reference center for CKD-MBD treatment. We used Shapiro-Wilk's test to determine the normality distribution of continuous variables. Correlation coefficients were considered as per Cohen’s assessment. Statistical analyses were done with SPSS Statistics version 25.
A total of 55 patients were included in this study. The mean age was 48.2 (+-1.50), and 25 patients were male (45.5%). As for the kidney replacement therapy (KRT), most patients were on HD (n = 49, 89.1%). The median time on KRT was 9 (6.75-12) years.
The mean PTH was 1945 (+-675.5). The median duration of stay post-parathyroidectomy was 7 days. We found a moderate correlation between the pre-operative PTH levels and the length of hospital stay among patients on dialysis who underwent parathyroidectomy (ρ = 0.344, p = 0.028).
In conclusion, patients with higher PTH levels experience longer hospital stays. This fact must be related to the severity of bone hunger, with an impact on the cost of treatment and exposure of the patient to various complications.