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Long‐Term Outcomes of Total Parathyroidectomy With or Without Autoimplantation for Hyperparathyroidism in Chronic Kidney Disease: A Meta‐Analysis
Author(s) -
Jia Xiaoyan,
Wang Rong,
Zhang Chengyin,
Cui Meiyu,
Xu Dongmei
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12310
Subject(s) - medicine , autotransplantation , parathyroidectomy , hyperparathyroidism , surgery , secondary hyperparathyroidism , odds ratio , kidney disease , retrospective cohort study , confidence interval , parathyroid hormone , transplantation , calcium
The aim of the present study was to compare total parathyroidectomy without autotransplantation ( TPTX ) versus total parathyroidectomy with autotransplantation ( TPTX + AT ) for renal hyperparathyroidism ( RHPT ) with respect to long‐term outcomes. A literature search was undertaken using Medline and EMBASE from inception to D ecember 2013. Data were analyzed using Review Manager version 5.0. A total of seven cohort studies comprising 931 patients were identified. Compared with TPTX + AT , patients in the TPTX group have lower “recurrence” (odds ratio ( OR ) 0.08, confidence interval ( CI ) 0.03 to 0.21; P < 0.00001), lower “recurrence or persistence”( OR 0.11, 95% CI 0.05 to 0.25; P < 0.00001), lower “requiring reoperation because of recurrence or persistence” ( OR 0.17, CI 0.06 to 0.54; P = 0.002), and higher “hypoparathyroidism” ( OR 2.97, CI 1.09 to 8.08; P = 0.03). None of the patients in these seven studies were recorded as having severe hypocalcemia or adynamic bone disease. Compared with TPTX + AT , TPTX is associated with lower “requiring reoperation because of recurrence or persistence” and without severe hypocalcemia or adynamic bone disease.