Abstract: FR-PO296

Correlates and Outcomes Related to Parathyroidectomy in Veterans Who Transition to Maintenance Dialysis: A Transition of Care in CKD Study

Session Information

Category: Mineral Disease

  • 1202 Mineral Disease: Vitamin D, PTH, FGF-23

Authors

  • Ravel, Vanessa A., UC Irvine, Orange, California, United States
  • Streja, Elani, UC Irvine, Orange, California, United States
  • Soohoo, Melissa, UC Irvine, Orange, California, United States
  • Obi, Yoshitsugu, UC Irvine, Orange, California, United States
  • Lau, Wei Ling, UC Irvine, Orange, California, United States
  • Rhee, Connie, UC Irvine, Orange, California, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States
Background

Parathyroidectomy in the form of an elective, surgical resection of the parathyroid glands occurs less frequently since approved use of calcimimetics in 2004. Among patients who transition to ESRD, the correlates and consequences of parathyroidectomy are not known. We hypothesized that parathyroidectomy would be associated with better outcomes in incident dialysis patients.

Methods

Data of almost 80,000 US veterans who transitioned to dialysis between 10/2007 and 3/2014 were examined to identify those with documented parathyroidectomy prior to transition. The likelihood of parathyroidectomy was estimated via adjusted logistic regression odds ratios and the outcome of 1-year mortality via adjusted Cox regression hazard ratio.

Results

Out of 79,331 veterans who transitioned to dialysis, we identified 179 who had undergone parathyroidectomy prior to transition. Patients were 71±12 years old and included 11% women, 25% blacks and 7% Hispanics. Odds ratios (and 95% confidence intervals) of parathyroidectomy are shown in Table 1. The death hazard ratios (95% confidence interval bars) are shown in Figure 1. Case-mix adjustment included gender, race/ethnicity, comorbid states, and Malnutrition-Inflammation-Cachexia Syndrome (MICS) which includes additional laboratory variables and BMI.

Conclusion

Parathyroidectomy is performed more frequently among older veterans, women, and those with COPD, cancer, or hyperlipidemia, and those with higher serum levels of phosphorus, calcium or PTH. A consistent trend of 15-20% better survival was observed among those who underwent parathyroidectomy prior to transition.

Funding

  • NIDDK Support