Parathyroidectomy for secondary hyperparathyroidism (SHPT) is an uncommon procedure among patients receiving dialysis in the United States, investigators concluded in a report published in BMC Nephrology.
In a retrospective cohort study of 3008 patients (2749 on hemodialysis and 259 on peritoneal dialysis) using US Renal Data System data from 2015 to 2018, Mark D. Danese, PhD, MHS, of Outcomes Insights, Inc. in Agoura Hills, California, and colleagues found that the rate of parathyroidectomy, per 1000 person-years, decreased from 6.5 in 2016 to 5.3 in 2018.
By the second month after parathyroidectomy, 58% of patients had a corrected calcium level (less than 8.5 mg/dL). In the year after the procedure, the hospitalization rate and hospital days increased significantly by 1.4 and 12.1 per person-year, respectively, compared with the year before the surgery. Dialysis visits and office visits decreased significantly by 5.2 and 1.3 per person-year, respectively.
The incremental increase in 12-month cost after parathyroidectomy, compared with before, was $25,314. “The incremental cost of parathyroidectomy was mostly attributable to the cost of the parathyroidectomy hospitalization,” Dr Danese’s team reported.
“This study presents the most current parathyroidectomy rates to date and is the first to provide detailed cost, utilization, and laboratory information for the year before and after parathyroidectomy,” the investigators wrote.
They concluded, “Clinicians, payers, and patients should understand the potential clinical and economic outcomes when considering parathyroidectomy.”
Danese MD, Fox KM, Duryea JL, Desai P, Rubin RJ. The rate, cost, and outcomes of parathyroidectomy in the United States dialysis population from 2016-2018. BMC Nephrol. 2022;23:220. doi:10.1186/s12882-022-02848-x