 |
||||
| 2008 JASN IMPACT FACTOR 7.505 | HOME AUTHOR INFO EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP | |||
| CURRENT ISSUE | ARCHIVES | JASN Express | ONLINE SUBMISSION | |
|
||||
| 2008 JASN IMPACT FACTOR 7.505 | HOME AUTHOR INFO EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP | |||
| CURRENT ISSUE | ARCHIVES | JASN Express | ONLINE SUBMISSION | |
Registro Lombardo Dialisi e Trapianto, Milano, Italy.
Correspondence to Dr. Fabio Malberti, Servizio Dialisi, I-26900 Lodi, Italy. Phone: +39-0371-372731; Fax: +39-0371-372105; E-mail: nefrodialisilodi{at}pmp.it
Abstract. Secondary hyperparathyroidism is a frequent complication of long-term dialysis treatment, and despite recent advances in medical therapy, surgical parathyroidectomy (PTx) is necessary in a considerable number of uremic patients. A prevalence of PTx of 22% was reported in Europe in 1988 in patients on dialysis from 10 to 15 yr, but no large-scale epidemiologic study has been published since then. The aim of the study was to evaluate the prevalence, incidence, and risk factors for PTx in patients on renal replacement therapy (RRT) in Lombardy and to determine whether the incidence has changed over time. The study involved 14,180 patients included in the Lombardy Registry of Dialysis and Transplantation who received RRT for end-stage renal disease (ESRD) between 1983 and 1996. Cox-proportional hazards regression models were used to evaluate the risk factors of PTx, the explanatory covariates being age on admission to RRT, gender, underlying renal disease (nondiabetic or diabetic nephropathy), and dialysis modality (peritoneal dialysis or hemodialysis). The prevalence of PTx in the 7371 ERSD patients who were alive on December 31, 1996, was 5.5% and increased with the duration of RRT (9.2% after 10 to 15 yr, 20.8% after 16 to 20 yr). Similarly, the incidence of PTx increased from 3.3 per 1000 patient-years in patients who had been on RRT for <5 yr to 30 per 1000 patient-years in those receiving RRT for >10 yr. The Cox regression models showed that the relative risk for PTx was significantly higher in women and lower in elderly and diabetic patients. The relative risk for PTx (adjusted for gender, age, and nephropathy) was higher in the patients on peritoneal dialysis than in those on hemodialysis and decreased after transplantation. During the course of a follow-up of 7 yr, the incidence of PTx in patients who started RRT between 1990 and 1992 was no different from that observed in patients who started RRT between 1983 and 1985. In conclusion, the prevalence and incidence of PTx in patients receiving RRT in Lombardy is lower than that in Europe and Italy as a whole, as reported by the 1988 European Dialysis and Transplantation Association Registry; its frequency has not changed significantly during the past few years. The need for PTx decreases markedly after successful transplantation. The epidemiologic finding that the rate of PTx is greater in women, young patients, and individuals who do not have diabetes suggests the need for a more aggressive medical treatment of secondary hyperparathyroidism particularly in such patients.
This article has been cited by other articles:
 |
|
 |
|
  M. Hori, Y. Ubara, S. Nakanishi, N. Inosita, and K. Takaichi Hyperparathyroidism in a diabetic patient on dialysis NDT Plus, October 1, 2008; 1(5): 361 - 362. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lomonte, L. Vernaglione, D. Chimienti, A. Bruno, S. Cocola, A. Teutonico, F. Cazzato, and C. Basile Does Vitamin D Receptor and Calcium Receptor Activation Therapy Play a Role in the Histopathologic Alterations of Parathyroid Glands in Refractory Uremic Hyperparathyroidism? Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 794 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lomonte, M. Antonelli, N. Losurdo, G. Marchio, B. Giammaria, and C. Basile Cinacalcet is effective in relapses of secondary hyperparathyroidism after parathyroidectomy Nephrol. Dial. Transplant., July 1, 2007; 22(7): 2056 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Evenepoel, K. Claes, D. R. Kuypers, F. Debruyne, and Y. Vanrenterghem Parathyroidectomy after successful kidney transplantation: a single centre study Nephrol. Dial. Transplant., June 1, 2007; 22(6): 1730 - 1737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Koiwa, T. Kakuta, R. Tanaka, and S. Yumita Efficacy of percutaneous ethanol injection therapy (PEIT) is related to the number of parathyroid glands in haemodialysis patients with secondary hyperparathyroidism Nephrol. Dial. Transplant., February 1, 2007; 22(2): 522 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Basile, C. Lomonte, L. Vernaglione, F. Casucci, D. Chimienti, A. Bruno, S. Cocola, E. A. Verrelli, and F. Cazzato A high body mass index and female gender are associated with an increased risk of nodular hyperplasia of parathyroid glands in chronic uraemia Nephrol. Dial. Transplant., April 1, 2006; 21(4): 968 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Lorenzo, A. Martin-Malo, R. Perez-Garcia, J. V. Torregrosa, N. Vega, A. L. M. de Francisco, and A. Cases Prevalence, clinical correlates and therapy cost of mineral abnormalities among haemodialysis patients: a cross-sectional multicentre study Nephrol. Dial. Transplant., February 1, 2006; 21(2): 459 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Shiizaki, S. Negi, I. Hatamura, T. Sakaguchi, F. Saji, K. Kunimoto, M. Mizobuchi, I. Imazeki, A. Ooshima, and T. Akizawa Biochemical and Cellular Effects of Direct Maxacalcitol Injection into Parathyroid Gland in Uremic Rats J. Am. Soc. Nephrol., January 1, 2005; 16(1): 97 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. N. Foley, S. Li, J. Liu, D. T. Gilbertson, S.-C. Chen, and A. J. Collins The Fall and Rise of Parathyroidectomy in U.S. Hemodialysis Patients, 1992 to 2002 J. Am. Soc. Nephrol., January 1, 2005; 16(1): 210 - 218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Cohen The need for parathyroidectomy Nephrol. Dial. Transplant., September 1, 2004; 19(9): 2417 - 2417. [Full Text] [PDF]
|
|
|
|
|
|
F. Jorna Reply Nephrol. Dial. Transplant., September 1, 2004; 19(9): 2417 - 2417. [Full Text] [PDF]
|
|
|
|
|
|
F. H. Jorna, T. J. M. Tobe, R. M. Huisman, P. E. de Jong, J. T. M. Plukker, and C. A. Stegeman Early identification of risk factors for refractory secondary hyperparathyroidism in patients with long-term renal replacement therapy Nephrol. Dial. Transplant., May 1, 2004; 19(5): 1168 - 1173. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Edevanilson de Barros Gueiros, M. C. Chammas, R. Gerhard, C. F. Dente da Silva Dias Boilesen, I. R. Souza de Oliveira, R. M. Affonso Moyses, and V. Jorgetti Percutaneous ethanol (PEIT) and calcitrol (PCIT) injection therapy are ineffective in treating severe secondary hyperparathyroidism Nephrol. Dial. Transplant., March 1, 2004; 19(3): 657 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Locatelli, J. B. Cannata-Andia, T. B. Drueke, W. H. Horl, D. Fouque, O. Heimburger, and E. Ritz Management of disturbances of calcium and phosphate metabolism in chronic renal insufficiency, with emphasis on the control of hyperphosphataemia Nephrol. Dial. Transplant., May 1, 2002; 17(5): 723 - 731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. H. Horl Secondary hyperparathyroidism: present and future therapeutic implications Nephrol. Dial. Transplant., May 1, 2002; 17(5): 732 - 733. [Full Text] [PDF]
|
|
|
HOME
CURRENT ISSUE
ARCHIVES
JASN Express
ONLINE SUBMISSION
AUTHOR INFO
EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP |
Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673
