Abstract: FR-PO0251
Parathyroidectomy and Survival Among Patients on Dialysis Receiving Calcimimetics
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Komaba, Hirotaka, Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
- Okada, Manabu, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
- Hiramitsu, Takahisa, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
- Abe, Masanori, Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
- Hanafusa, Norio, Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
- Tominaga, Yoshihiro, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
- Ichimori, Toshihiro, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
Background
Calcimimetics are effective treatments for secondary hyperparathyroidism (SHPT), but adequate control is not achieved in a subset of patients. The impact of parathyroidectomy (PTX) on survival among patients receiving calcimimetics remains unclear.
Methods
This study used registry data from the Parathyroid Surgeons’ Society of Japan (PSSJ) and the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR). Patients who underwent initial PTX for SHPT between 2010 and 2021 and had been treated with calcimimetics prior to surgery were identified from the PSSJ database. To obtain longitudinal laboratory and mortality data, these patients were linked to the JRDR using birth year, sex, year and month of dialysis initiation, and prefecture. Separately, patients receiving calcimimetics on December 31, 2009 or 2019 were identified from the JRDR. PTX patients and calcimimetic-treated patients were matched using propensity scores at a 1:3 ratio. Mortality follow-up began on the date of surgery for PTX patients and on December 31, 2009 or 2019 for calcimimetic-treated patients, and continued until the end of 2021.
Results
Of 1,216 PTX patients identified from the PSSJ database, 786 had received calcimimetics prior to surgery, and 381 were successfully linked to patients in the JRDR. Propensity score matching was conducted with 92,635 calcimimetic-treated patients from the JRDR, resulting in 269 PTX patients and 807 calcimimetic-treated patients included in the analysis. Median baseline intact PTH levels were 485 pg/mL (interquartile range [IQR], 331–749 pg/mL) in the PTX group and 500 pg/mL (IQR, 241–746 pg/mL) in the calcimimetic group. After PTX, intact PTH levels decreased substantially to 26 pg/mL (IQR, 11–104 pg/mL). In the calcimimetic group, intact PTH levels also declined to 230 pg/mL (IQR, 133–461 pg/mL), possibly due to dose adjustments, switching of calcimimetic agents, or other treatment modifications. During a median follow-up of 7.7 years, 52 PTX patients and 314 calcimimetic-treated patients died. PTX was associated with a significantly lower risk of death compared with calcimimetic therapy (hazard ratio, 0.52; 95% confidence interval, 0.39–0.70).
Conclusion
Among dialysis patients with SHPT receiving calcimimetics, PTX was associated with improved survival.