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World Journal of Surgery
Published in: World Journal of Surgery 9/2017

Open Access 01-09-2017 | Original Scientific Report

The Effect of Parathyroidectomy on Risk of Hip Fracture in Secondary Hyperparathyroidism

Authors: Elin Isaksson, Kerstin Ivarsson, Shahriar Akaberi, Andreas Muth, Gunnar Sterner, Prütz Karl-Göran, Naomi Clyne, Martin Almquist

Published in: World Journal of Surgery | Issue 9/2017

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Abstract

Background

Secondary hyperparathyroidism increases the risk for fractures. Despite improvement in medical therapy, surgical parathyroidectomy (PTX) often becomes necessary, but its effect on risk of fractures is not clear. Our aim was to study the effect of parathyroidectomy on the risk of hip fractures in patients on dialysis or with a functioning renal graft at time of parathyroidectomy.

Design

In a cohort of 20,056 patients on dialysis or with functioning renal allograft, we identified 590 patients who underwent parathyroidectomy between 1991 and 2009. Of these, 579 were matched with 1970 non-PTX patients on age, sex, cause of renal disease and functioning renal allograft or not at the time of PTX or at the corresponding time for non-PTX patients (t). We calculated the risk for hip fracture after PTX using crude and adjusted Cox proportional hazards regressions, adjusting for time in renal replacement therapy before t, time with functioning renal allograft before and after t, comorbidity at t and a hip fracture before t.

Results

The adjusted hazard ratio (95% confidence interval) for hip fracture was 0.40 (0.18–0.88) for PTX patients, compared to non-PTX patients. When analyses were performed separately for sex, only women had a lower risk of hip fracture after PTX compared to non-PTX patients. The risk of hip fracture after PTX was similar in patients with or without functioning renal allograft at time for PTX.

Conclusion

Parathyroidectomy is associated with a lower risk of hip fracture in female patients with secondary hyperparathyroidism.
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Metadata
Title
The Effect of Parathyroidectomy on Risk of Hip Fracture in Secondary Hyperparathyroidism
Authors
Elin Isaksson
Kerstin Ivarsson
Shahriar Akaberi
Andreas Muth
Gunnar Sterner
Prütz Karl-Göran
Naomi Clyne
Martin Almquist
Publication date
01-09-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 9/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4000-0

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