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BioMed Research International
Volume 2017, Article ID 6934706, 7 pages
https://doi.org/10.1155/2017/6934706
Research Article

Impact of Different Levels of iPTH on All-Cause Mortality in Dialysis Patients with Secondary Hyperparathyroidism after Parathyroidectomy

1Department of Nephrology, China-Japan Friendship Hospital, Beijing, China
2Department of Nephrology, Nanchong Central Hospital, Second Clinical Medical Institution of North Sichuan Medical College, Nanchong, China
3Department of Nephrology, Aerospace Center Hospital, Beijing, China
4School of Social Development and Public Policy, Beijing Normal University, Beijing, China
5School of Management Beijing University of Chinese Medicine, Beijing, China
6Department of Nephrology, Dalian University Affiliated Xinhua Hospital, Dalian, China
7Department of Nephrology, The Fourth Hospital of Jilin University, Changchun, China
8Department of Nephrology, Cangzhou People’s Hospital, Cangzhou, China

Correspondence should be addressed to Ling Zhang; nc.moc.liamdem@5gnilgnahz

Received 3 December 2016; Revised 7 February 2017; Accepted 13 March 2017; Published 5 June 2017

Academic Editor: Wen-Chin Lee

Copyright © 2017 Qiu Ping Xi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Secondary hyperparathyroidism (SHPT) usually required parathyroidectomy (PTX) when drugs treatment is invalid. Analysis was done on the impact of different intact parathyroid hormone (iPTH) after the PTX on all-cause mortality. Methods. An open, retrospective, multicenter cohort design was conducted. The sample included 525 dialysis patients with SHPT who had undergone PTX. Results. 404 patients conformed to the standard, with 36 (8.91%) deaths during the 11 years of follow-up. One week postoperatively, different levels of serum iPTH were divided into four groups: A: ≤20 pg/mL; B: 21–150 pg/mL; C: 151–600 pg/mL; and D: >600 pg/mL. All-cause mortality in groups with different iPTH levels appeared as follows: A (8.29%), B (3.54%), C (10.91%), and D (29.03%). The all-cause mortality of B was the lowest, with D the highest. We used group A as reference (hazard ratio (HR) = 1) compared with the other groups, and HRs on groups B, C, and D appeared as 0.57, 1.43, and 3.45, respectively. Conclusion. The all-cause mortality was associated with different levels of iPTH after the PTX. We found that iPTH > 600 pg/mL appeared as a factor which increased the risk of all-cause mortality. When iPTH levels were positively and effectively reducing, the risk of all-cause mortality also decreased. The most appropriate level of postoperative iPTH seemed to be 21–150 pg/mL.