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The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
by
Duryea, Jennifer L.
, Danese, Mark D
, Desai, Pooja
, Rubin, Robert J
, Fox, Kathleen M
in
Age
/ Analysis
/ Calcium phosphates
/ Care and treatment
/ Chronic kidney failure
/ Comorbidity
/ Confidence intervals
/ Cost estimates
/ Costs
/ Diagnosis
/ End-stage kidney disease (ESKD)
/ End-stage renal disease
/ Health aspects
/ Hematoma
/ Hemodialysis
/ Hyperparathyroidism
/ Hypocalcemia
/ Internal Medicine
/ Kidney diseases
/ Laboratories
/ Measurement
/ Medical care, Cost of
/ Medicare
/ Medicine
/ Medicine & Public Health
/ Mineral and bone disorder (MBD)
/ Mortality
/ Nephrology
/ Outcomes
/ Paralysis
/ Parathyroid glands
/ Parathyroid hormone
/ Parathyroidectomy
/ Patients
/ Peritoneal dialysis
/ Peritoneum
/ Risk factors
/ Secondary hyperparathyroidism (SHPT)
/ Surgery
/ Vitamin D
2022
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The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
by
Duryea, Jennifer L.
, Danese, Mark D
, Desai, Pooja
, Rubin, Robert J
, Fox, Kathleen M
in
Age
/ Analysis
/ Calcium phosphates
/ Care and treatment
/ Chronic kidney failure
/ Comorbidity
/ Confidence intervals
/ Cost estimates
/ Costs
/ Diagnosis
/ End-stage kidney disease (ESKD)
/ End-stage renal disease
/ Health aspects
/ Hematoma
/ Hemodialysis
/ Hyperparathyroidism
/ Hypocalcemia
/ Internal Medicine
/ Kidney diseases
/ Laboratories
/ Measurement
/ Medical care, Cost of
/ Medicare
/ Medicine
/ Medicine & Public Health
/ Mineral and bone disorder (MBD)
/ Mortality
/ Nephrology
/ Outcomes
/ Paralysis
/ Parathyroid glands
/ Parathyroid hormone
/ Parathyroidectomy
/ Patients
/ Peritoneal dialysis
/ Peritoneum
/ Risk factors
/ Secondary hyperparathyroidism (SHPT)
/ Surgery
/ Vitamin D
2022
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The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
by
Duryea, Jennifer L.
, Danese, Mark D
, Desai, Pooja
, Rubin, Robert J
, Fox, Kathleen M
in
Age
/ Analysis
/ Calcium phosphates
/ Care and treatment
/ Chronic kidney failure
/ Comorbidity
/ Confidence intervals
/ Cost estimates
/ Costs
/ Diagnosis
/ End-stage kidney disease (ESKD)
/ End-stage renal disease
/ Health aspects
/ Hematoma
/ Hemodialysis
/ Hyperparathyroidism
/ Hypocalcemia
/ Internal Medicine
/ Kidney diseases
/ Laboratories
/ Measurement
/ Medical care, Cost of
/ Medicare
/ Medicine
/ Medicine & Public Health
/ Mineral and bone disorder (MBD)
/ Mortality
/ Nephrology
/ Outcomes
/ Paralysis
/ Parathyroid glands
/ Parathyroid hormone
/ Parathyroidectomy
/ Patients
/ Peritoneal dialysis
/ Peritoneum
/ Risk factors
/ Secondary hyperparathyroidism (SHPT)
/ Surgery
/ Vitamin D
2022
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The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
Journal Article
The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
2022
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Overview
Background
In end-stage kidney disease, patients may undergo parathyroidectomy if secondary hyperparathyroidism cannot be managed medically. This study was designed to estimate the parathyroidectomy rate in the United States (US) and to quantify changes in costs and other outcomes after parathyroidectomy.
Methods
This was a retrospective observational cohort study using US Renal Data System data for 2015–2018. Parathyroidectomy rates were estimated for adult hemodialysis and peritoneal dialysis patients alive at the beginning of 2016, 2017, and 2018 who were followed for a year or until parathyroidectomy, death, or transplant. Incremental differences in economic and clinical outcomes were compared before and after parathyroidectomy in adult hemodialysis and peritoneal dialysis patients who received a parathyroidectomy in 2016 and 2017.
Results
The rate of parathyroidectomy per 1,000 person-years decreased from 6.5 (95% CI 6.2-6.8) in 2016 to 5.3 (95% CI 5.0-5.6) in 2018. The incremental increase in 12-month cost after versus before parathyroidectomy was $25,314 (95% CI $23,777-$27,078). By the second month after parathyroidectomy, 58% of patients had a corrected calcium level < 8.5 mg/dL. In the year after parathyroidectomy (versus before), hospitalizations increased by 1.4 per person-year (95% CI 1.3-1.5), hospital days increased by 12.1 per person-year (95% CI 11.2-13.0), dialysis visits decreased by 5.2 per person-year (95% CI 4.4-5.9), and office visits declined by 1.3 per person-year (95% CI 1.0-1.5). The incremental rate per 1,000 person years for hematoma/bleed was 224.4 (95% CI 152.5-303.1), for vocal cord paralysis was 124.6 (95% CI 59.1-232.1), and for seroma was 27.4 (95% CI 0.4-59.0).
Conclusions
Parathyroidectomy was a relatively uncommon event in the hemodialysis and peritoneal dialysis populations. The incremental cost of parathyroidectomy was mostly attributable to the cost of the parathyroidectomy hospitalization. Hypocalcemia occurred in over half of patients, and calcium and phosphate levels were reduced. Clinicians, payers, and patients should understand the potential clinical and economic outcomes when considering parathyroidectomy.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
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