Parathyroidectomies In Patients With Renal Failure: The Hull Experience

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 234-256-Bone & Calcium Metabolism: Clinical Trials & Case Series
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-251
Rishi Srivastava*1, Sebastien Wallis2, Archie Lamplugh2, Victoria Allgar3, Sunil Bhandari2 and James England1
1Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom, 2Hull Royal Infirmary, 3Hull and York Medical School
ABSTRACT TITLE

 Parathyroidectomies in patients with renal failure: The Hull Experience

OBJECTIVES

Most patients with chronic renal failure will have secondary or tertiary hyperparathyroidism. If they meet the criteria, they are referred to the ENT department for a parathyroidectomy. We present our parathyroidectomy series and compared mortality rates and survival times with non-parathyroidectomised patients.

METHODS

 The renal database here at Hull Royal Infirmary, UK, was retrospectively analysed. Our parathyroidectomy series covers an 8 year period (2004 to 2011 inclusive). Patients with chronic renal failure who had not received a parathyroidectomy and were on the database during this time period were included for comparison.

RESULTS

112 cases of parathyroidectomy and 1442 non surgical cases were identified.

 In the surgical group, there were 69 males and 43 females. The mean age was 51.6 years and the number of deaths in our series was 24 (21.4%) with a mean annual mortality of 3 (2.7%). In the non-surgical group, there were 925 males and 517 females. The mean age was 64.1 years and the number of deaths was 678 (47.0%) with a mean annual mortality of 84.6 (5.9%).

 Survival function estimates based on the Kaplan Meier curve showed the cumulative survival is greater in the surgical group as compared with the non-surgical group. Patients were followed up from the date of surgery or first dialysis (in the non surgical group) to the date of death or censorship. The log-rank test was used and showed a significant difference (0.019) between those who had surgery and those who did not. A Cox Regression analysis was used; and when adjusted for age and sex it was found there was no significant difference between the groups.

CONCLUSIONS

 In our series, we found the mortality rates were lower and survival times higher as compared to the non surgical group in the same time period. The literature on the influence of parathyroidectomy on survival times in chronic renal failure patients is scarce. Various studies have suggested that this could be related to the number and severity of associated co-morbidities.

1.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 May;31(5):1014-21.   2.Kestenbaum B, Seliger SL, Gillen DL, et al. Survival following parathyroidectomy among United States dialysis patients. Kidney Int 2004;66:2010-2016

Nothing to Disclose: RS, SW, AL, VA, SB, JE

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm