PHOEBE TIN1, YI ZHI CHEONG1, SHAUN CHANDLER1, CARMEL HAWLEY2, ELAINE PASCOE3, DAVID JOHNSON2, DHARMENAAN PALAMUTHUSINGAM1, MAGID FAHIM2
1Metro North Kidney Health Service, Royal Brisbane and Women’s Hospital, Herston, Australia, 2Metro South Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Australia, 3Centre for Health Services Research, University of Queensland, St Lucia, Australia
Biography:
Bio to come
Aim:
To estimate the incidence of parathyroidectomy surgery in patients receiving chronic kidney replacement therapy (KRT) and post-operative mortality rates over a 15-year period in Australia and New Zealand.
Background:
Patients on KRT undergo parathyroidectomy to improve calcium and parathyroid hormone metabolism, as well as bone health.
Methods:
All patients receiving chronic KRT who underwent a parathyroidectomy were identified from a bi-national data linkage study between the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and jurisdictional hospital admission datasets between 2000 and 2015. Patients were categorised by different KRT modalities (haemodialysis [HD], home haemodialysis [HHD], peritoneal dialysis [PD] and kidney transplant [KT]). Incidence rate was estimated using Poisson models and 30-day mortality risk was estimated using logistic regression.
Results:
Of 46,791 patients receiving chronic KRT, 3,692 underwent parathyroidectomy (53% total parathyroidectomy). Median age was 53.1 years [42.2–62.9] and 52% were male. Incidence rate was 37 per 1,000 patient-years on dialysis (HD, HHD, PD) and 1 per 1,000 patient-years for KT. HHD had the highest incidence rates (16 per 1,000 patient-years). Parathyroidectomy rates were lowest between 2009-2013 (25 – 31 per 1,000 years) followed by a modest rebound in subsequent years. Thirty-day mortality rates were highest in PD (5.0%, 95%CI 4.9-5.1) and lowest in KT (1.9%, 95%CI 1.8-1.9).
Conclusions:
The trend is characterized by an initial escalation in rates, peaking mid-decade, followed by a steady decline and then a modest resurgence. This pattern likely mirrors broader key policy changes, the introduction of new therapies, and guideline updates during the study period. Further investigation into long-term clinical outcomes following parathyroidectomy, stratified by KRT modality, is warranted to better inform patient care.
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