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Multicenter study on parathyroidectomy (PTX) in Italy: preliminary results

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Abstract

Background

When medical therapy is unable to achieve biochemical control of secondary hyperparathyroidism, parathyroidectomy (PTX) is indicated, fortunately in a minority of patients. Thus, data on PTX prevalence and biochemical control are limited and, in particular in Italy, date back to 1999.

Methods

We designed a prospective, observational and multicenter study to collect data from dialysis units distributed throughout the Italian regions. Clinical data were collected with a dedicated data sheet.

Results

From January to December 2010, 149 Centers serving a total of 12,515 patients provided data on 528 living PTX cases (PTX prevalence = 4.2%). Prevalence was higher in hemo- than in peritoneal dialysis (4.5 vs. 1.9%, X2 = 21.52; p < 0.001), with non-significant regional differences (range 0.8–7.4%). PTX patients were younger (57.6 ± 12.5 vs. 67.1 ± 14.5 years; p < 0.001), more frequently female (56 vs. 38%, X2 = 68.05, p < 0.001) and had been on dialysis for a longer time (14.63 ± 8.37 vs. 4.8 ± 6.0 years, p < 0.001) compared to the 11,987 who did not undergo neck surgery. Median time since surgery was 6.0 years (3.0–9.0; 50%, IQR). The most frequent type of surgery was subtotal PTX (sPTX = 55.0%), significantly higher than total PTX (tPTX = 38.7%) or total PTX plus auto-transplantation (aPTX = 6.3%) (X2 = 5.18; Bonferroni post-hoc test, sPTX vs. tPTX + aPTX = p < 0.05). As for parathyroid hormone (PTH), calcium and phosphate control, cases targeting the KDOQI ranges were 18, 50.1 and 54.4%, respectively. The most prevalent biochemical condition was low PTH (62.7%).

Conclusion

PTX prevalence in Italy is stable compared to previous observations, is higher in hemodialysis than in peritoneal dialysis and results in a suboptimal biochemical control.

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Funding

This study was funded with an unrestricted grant by Amgen.

Author information

Authors and Affiliations

  1. Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Sandro Mazzaferro & Lida Tartaglione

  2. Nephrology Unit, Azienda Policlinico Umberto I, Rome, Italy

    Sandro Mazzaferro & Marzia Pasquali

  3. Nephrology Unit, Ospedale Ca’Foncello, Treviso, Italy

    Carmelo Cascone

  4. Nephrology and Dialysis Unit, Policlinico Tor Vergata, Rome, Italy

    Nicola Di Daniele

  5. Division of Nephrology and Dialysis, Azienda Ospedaliera G. Brotzu, Cagliari, Italy

    Antonello Pani

  6. Nephrology Unit, G.B. Grassi Hospital, Rome, Italy

    Massimo Morosetti

  7. Nephrology and Dialysis Unit, Ospedale Civile di Ivrea, Turin, Italy

    Marco Francisco

  8. Nephrology and Dialysis Unit, Provincial Hospital, Camposampiero, Padua, Italy

    Maurizio Nordio

  9. Nephrology and Dialysis Unit, Ospedale Santa Maria Goretti, Latina, Italy

    Maria Leonardi

  10. Nephrology and Dialysis Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio S. Salvatore, Pesaro, Italy

    Mauro Martello

  11. Nephrology Unit, Firenze 1 ed Empoli, Florence, Italy

    Cristina Grimaldi

  12. Nephrology and Dialysis Unit, ASST Santi Paolo e Carlo, Presidio San Paolo, Milan, Italy

    Mario Cozzolino

  13. Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, Rome, Italy

    Sandro Mazzaferro & Silverio Rotondi

Authors
  1. Sandro Mazzaferro
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  2. Lida Tartaglione
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  3. Carmelo Cascone
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  6. Massimo Morosetti
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  7. Marco Francisco
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  8. Maurizio Nordio
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  9. Maria Leonardi
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  10. Mauro Martello
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  11. Cristina Grimaldi
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  13. Silverio Rotondi
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  14. Marzia Pasquali
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Consortia

The Italian Study Group on Mineral Metabolism

Corresponding author

Correspondence to Sandro Mazzaferro.

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Conflict of interest

SM received honoraria for Congress presentations by Vifor Fresenius; LT, CC, NDD, AP, MM, MF, MN, ML, MM, CG, SR and MP declare no CoI. MC gave lectures for Amgen, Abbvie, Shire, Vifor Fresenius, Baxter.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on welfare of animals

This article does not contain any studies with animals performed by any of the authors.

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Mazzaferro, S., Tartaglione, L., Cascone, C. et al. Multicenter study on parathyroidectomy (PTX) in Italy: preliminary results. J Nephrol 31, 767–773 (2018). https://doi.org/10.1007/s40620-018-0527-x

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  • DOI: https://doi.org/10.1007/s40620-018-0527-x

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