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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Evidence regarding the influence of parathyroidectomy (PTX) on long-term prognosis is conflicting, especially concerning its association with established CKD-MBD target ranges. We analyzed the long-term outcomes of PTX for secondary hyperparathyroidism (SHPT) in dialysis patients and evaluated the association between hard endpoints and the dynamics of CKD-MBD parameters.
A prospective cohort study included all patients who underwent parathyroidectomy (PTX) for SHPT between 2011 and 2019 at a single tertiary endocrinology center and who had follow-up data available for at least two years. We calculated the long-term trends in MBD-CKD parameters following PTX using a linear regression model for each patient over the entire observation period.
The analysis included 548 patients (54.4%) from the 1,008 who underwent PTX, representing 39 dialysis centers. The median [Q1-Q3] age and the duration of dialysis therapy prior to PTX were 41 [50-41] years and 83 [53-126] months, respectively. There were 50.1% women in cohort. Prior to PTX, 10.3% of patients had undergone a functioning kidney transplant for a period of 32 [9-82] months). Cinacalcet was administered to 37% of patients at averaged dose (SD) of 48 (24) mg/day.
Subtotal PTX was performed on 34% of patients and total PTX with autotransplantation of parathyroid gland tissue, was performed on 66% of patients.
The baseline levels of calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and alkaline phosphatase were 2.45 (0.23) mmol/L, 1.02 (0.04) mmol/L, 1.98 (0.51) mmol/L, 134 pmol/L [95-204], and 220 [160-471] IU, respectively. The median of PTH level after PTX was 3 [1.4-9.1] pmol/l. During the follow-up period, 198 patients (40.8%) died, 36 patients (7.4%) underwent a kidney transplant, and 250 patients remained alive at the end of the follow-up after 34 [24-67] months following PTX. Long-term changes in CKD-MBD parameters are presented in Figure 1.
The relationship between the dynamic changes in MBD-CKD parameters and patient survival was examined using Cox regression analysis. Of them, long-term trends in PTH (OR=1.41 [95% CI 1.026 - 1.938], p=0.034) and serum phosphorus (OR=1.162 [95% CI 1.03 - 1.31], p=0.014) were independent predictors of all-cause mortality (Tab.1).
Parameter
р
OR
95% CI
PTH trend, +10 pmol/l per year
0.034
1.41
1.026 - 1.938
Phosphatemia trend, +0.1 mmol/l per year
0.014
1.162
1.03 - 1.31
Calcemia trend, +0.1 mmol/l per year
0.565
0.95
0.8 - 1.13
Age, +1 year
0.902
0.998
0.97 - 1.027
Gender, male
0.227
0.631
The long-term effect of parathyroidectomy (PTX) on hard endpoints is influenced by the future trajectory of mineral and bone disease parameters. Physicians should consider this when making a prognosis and planning the extent of the surgery.
