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Parathyroidectomy (PTX) becomes necessary when medical therapy fails, thus highlighting the interest to compare biochemical and clinical outcomes of patients receiving either medical treatment or surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We aimed to compare overall survival and biochemical control of hemodialysis patients with severe hyperparathyroidism, treated by surgery or medical\u00a0therapy\u00a0followed-up for 36\u00a0months.\u00a0Inclusion criteria were age older than 18\u00a0years, renal failure requiring dialysis treatment (hemodialysis or peritoneal dialysis) and ability to sign the consent form. A control group of\u00a0418 patients treated in the same centers,\u00a0who did not undergo parathyroidectomy was selected after matching\u00a0for\u00a0age, sex, and dialysis vintage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 82 Dialysis units in Italy, we prospectively collected data of 257 prevalent patients\u00a0who underwent parathyroidectomy (age\u00a058.2\u2009\u00b1\u200912.8 years; M\/F: 44%\/56%, dialysis\u00a0vintage: 15.5\u2009\u00b1\u20098.4 years) and of 418 control patients who did not undergo parathyroidectomy (age\u00a060.3\u2009\u00b1\u200914.4 years; M\/F 44%\/56%; dialysis vintage 11.2\u2009\u00b1\u20097.6 y). The survival rate was higher in the group\u00a0that underwent\u00a0parathyroidectomy (Kaplan\u2013Meier log rank test\u2009=\u20090.002). Univariable analysis (HR 0.556, CI: 0.387\u20130.800,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and multivariable analysis (HR 0.671, CI:0.465\u20130.970,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034), identified parathyroidectomy as a\u00a0protective factor of overall survival. The prevalence of patients at KDOQI targets for PTH was lower in patients\u00a0who underwent parathyroidectomy\u00a0compared to controls (PTX vs non-PTX: PTH\u2009&lt;\u2009150\u00a0pg\/ml: 59% vs 21%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; PTH at target: 18% vs 37%\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; PTH\u2009&gt;\u2009300\u00a0pg\/ml 23% vs 42%\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). The control group received more intensive medical treatment\u00a0with higher prevalence of vitamin D (65% vs 41%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001), calcimimetics (34% vs 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001) and phosphate binders (77% vs 66%,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data suggest that parathyroidectomy is associated with survival rate\u00a0at 36 months, independently of biochemical control. Lower exposure to high PTH levels could represent an advantage in the long term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-023-01658-0","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T16:30:50Z","timestamp":1687537850000},"page":"1947-1955","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Parathyroidectomy and survival in a cohort of Italian dialysis patients: results of a multicenter, observational, prospective study"],"prefix":"10.1093","volume":"36","author":[{"given":"Lida","family":"Tartaglione","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silverio","family":"Rotondi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Aucella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Bonomini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosa","family":"Caruso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Casino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Cuzziol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Farcomeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Filippini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Lomonte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Marinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Rolla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Rubino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Seminara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Pasquali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-1893","authenticated-orcid":false,"given":"Sandro","family":"Mazzaferro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of The Italian Study Group on Mineral Metabolism of the Italian Society of Nephrology","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bagnis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bisegna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"F. 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