{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:42:04Z","timestamp":1770813724388,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:00:00Z","timestamp":1452643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:00:00Z","timestamp":1452643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Parathyroidectomy is recommended by the clinical guidelines for dialysis patients with unremitting secondary hyperparathyroidism (SHPT). However, the survival advantage of parathyroidectomy is debated because of the selection bias in previous studies. To minimize potential bias in the present nationwide cohort study, we enrolled only dialysis patients who had undergone radionuclide parathyroid scanning to ensure all patients had severe SHPT. The parathyroidectomized patients were matched with the controls based on propensity score for parathyroidectomy. Mortality hazard was estimated using multivariate Cox proportional hazard models adjusting for comorbidities before scanning (model 1) or over the whole study period (model 2). Our results showed that among the 2786 enrolled patients, 1707 underwent parathyroidectomy and the other 1079 were controls. The crude mortality rates were lower in the parathyroidectomized patients than in the controls. In adjusted analyses for the population matched on propensity score, parathyroidectomy was associated with a significant 20% to 25% lower risk for all-cause mortality (model 1: hazard ratio 0.76, 95% confidence interval 0.61 to 0.94; model 2: hazard ratio 0.80, 95% confidence internal 0.64 to 0.98). We concluded that parathyroidectomy was associated with a reduced long-term mortality risk in dialysis patients with severe SHPT.<\/jats:p>","DOI":"10.1038\/srep19150","type":"journal-article","created":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T11:42:09Z","timestamp":1452685329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Parathyroidectomy Associates with Reduced Mortality in Taiwanese Dialysis Patients with Hyperparathyroidism: Evidence for the Controversy of Current Guidelines"],"prefix":"10.1038","volume":"6","author":[{"given":"Li-Chun","family":"Ho","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Yuan","family":"Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsi-Hao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Te-Hui","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Tzu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Chung","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Ling","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yi","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Der","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yau-Sheng","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junne-Ming","family":"Sung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Tainan RENal Disease Study (TRENDS) group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junne-Ming","family":"Sung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Der","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yi","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Chung","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Tzu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Te-Hui","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsi-Hao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Chun","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Ling","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Cheng","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao-Fen","family":"Yen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Lien","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping-Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Huang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ting","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,1,13]]},"reference":[{"key":"BFsrep19150_CR1","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","volume":"69","author":"S Moe","year":"2006","unstructured":"Moe, S. et al. Definition, evaluation and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 69, 1945\u20131953 (2006).","journal-title":"Kidney Int."},{"key":"BFsrep19150_CR2","doi-asserted-by":"publisher","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","volume":"15","author":"GA Block","year":"2004","unstructured":"Block, G. A. et al. Mineral metabolism, mortality and morbidity in maintenance hemodialysis. J. Am. Soc. Nephrol. 15, 2208\u20132218 (2004).","journal-title":"J. Am. Soc. Nephrol."},{"key":"BFsrep19150_CR3","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.1093\/ndt\/gfq219","volume":"26","author":"J Floege","year":"2011","unstructured":"Floege, J. et al. Serum iPTH, calcium and phosphate and the risk of mortality in a European haemodialysis population. Nephrol. Dial. Transplant. 26, 1948\u20131955 (2011).","journal-title":"Nephrol. Dial. Transplant."},{"key":"BFsrep19150_CR4","first-page":"iii23","volume":"18","author":"M Fukagawa","year":"2003","unstructured":"Fukagawa, M. & Nakanishi, S. Role of parathyroid intervention in the management of secondary hyperparathyroidism. Nephrol. Dial. Transplant. 18 Suppl 3, iii23\u201326 (2003).","journal-title":"Nephrol. Dial. Transplant."},{"key":"BFsrep19150_CR5","doi-asserted-by":"crossref","unstructured":"National Kidney, F. K\/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am. J. Kidney Dis. 42, S1\u2013201 (2003).","DOI":"10.1016\/S0272-6386(03)00905-3"},{"key":"BFsrep19150_CR6","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/1471-2369-14-100","volume":"14","author":"JP Lafrance","year":"2013","unstructured":"Lafrance, J. P. et al. Effect of cinacalcet availability and formulary listing on parathyroidectomy rate trends. BMC Nephrol. 14, 100 (2013).","journal-title":"BMC Nephrol."},{"key":"BFsrep19150_CR7","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/1471-2369-15-75","volume":"15","author":"S Akaberi","year":"2014","unstructured":"Akaberi, S. et al. Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population\u2014a nationwide, population-based study 1991\u20132009. BMC Nephrol. 15, 75 (2014).","journal-title":"BMC Nephrol."},{"key":"BFsrep19150_CR8","doi-asserted-by":"publisher","first-page":"e1001436","DOI":"10.1371\/journal.pmed.1001436","volume":"10","author":"SC Palmer","year":"2013","unstructured":"Palmer, S. C. et al. Cinacalcet in patients with chronic kidney disease: a cumulative meta-analysis of randomized controlled trials. PLoS Med. 10, e1001436 (2013).","journal-title":"PLoS Med."},{"key":"BFsrep19150_CR9","doi-asserted-by":"publisher","first-page":"2482","DOI":"10.1056\/NEJMoa1205624","volume":"367","author":"ET Investigators","year":"2012","unstructured":"Investigators, E. T. et al. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N. Engl. J. Med. 367, 2482\u20132494 (2012).","journal-title":"N. Engl. J. Med."},{"key":"BFsrep19150_CR10","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1111\/j.1523-1755.2004.00972.x","volume":"66","author":"B Kestenbaum","year":"2004","unstructured":"Kestenbaum, B. et al. Survival following parathyroidectomy among United States dialysis patients. Kidney Int. 66, 2010\u20132016 (2004).","journal-title":"Kidney Int."},{"key":"BFsrep19150_CR11","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1093\/ndt\/gfh018","volume":"19","author":"FH Jorna","year":"2004","unstructured":"Jorna, F. H. et al. Early identification of risk factors for refractory secondary hyperparathyroidism in patients with long-term renal replacement therapy. Nephrol. Dial. Transplant. 19, 1168\u20131173 (2004).","journal-title":"Nephrol. Dial. Transplant."},{"key":"BFsrep19150_CR12","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/j.1542-4758.2007.00155.x","volume":"11","author":"Y Slinin","year":"2007","unstructured":"Slinin, Y., Foley, R. N. & Collins, A. J. Clinical epidemiology of parathyroidectomy in hemodialysis patients: the USRDS waves 1, 3 and 4 study. Hemodial. Int. 11, 62\u201371 (2007).","journal-title":"Hemodial. Int."},{"key":"BFsrep19150_CR13","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.5301\/jn.5000286","volume":"26","author":"CH Chuang","year":"2013","unstructured":"Chuang, C. H. et al. Epidemiology and mortality among dialysis patients with parathyroidectomy: Taiwan National Cohort Study. J. Nephrol. 26, 1143\u20131150 (2013).","journal-title":"J. Nephrol."},{"key":"BFsrep19150_CR14","doi-asserted-by":"publisher","first-page":"S97","DOI":"10.1046\/j.1523-1755.63.s85.23.x","volume":"63","author":"R Jofre","year":"2003","unstructured":"Jofre, R. et al. Parathyroidectomy: whom and when? Kidney Int. Suppl. 63, S97\u2013100 (2003).","journal-title":"Kidney Int. Suppl."},{"key":"BFsrep19150_CR15","doi-asserted-by":"publisher","first-page":"755","DOI":"10.5301\/jn.5000056","volume":"25","author":"N Iwamoto","year":"2012","unstructured":"Iwamoto, N. et al. Total parathyroidectomy improves survival of hemodialysis patients with secondary hyperparathyroidism. J. Nephrol. 25, 755\u2013763 (2012).","journal-title":"J. Nephrol."},{"key":"BFsrep19150_CR16","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.surg.2007.06.015","volume":"142","author":"V Costa-Hong","year":"2007","unstructured":"Costa-Hong, V. et al. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery 142, 699\u2013703 (2007).","journal-title":"Surgery"},{"key":"BFsrep19150_CR17","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1111\/cen.12333","volume":"80","author":"HC Lin","year":"2014","unstructured":"Lin, H. C. et al. Parathyroidectomy improves cardiovascular outcome in nondiabetic dialysis patients with secondary hyperparathyroidism. Clin. Endocrinol. 80, 508\u2013515 (2014).","journal-title":"Clin. Endocrinol."},{"key":"BFsrep19150_CR18","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1007\/s00268-006-0693-1","volume":"31","author":"A Trombetti","year":"2007","unstructured":"Trombetti, A. et al. Survival after parathyroidectomy in patients with end-stage renal disease and severe hyperparathyroidism. World J. Surg. 31, 1014\u20131021 (2007).","journal-title":"World J. Surg."},{"key":"BFsrep19150_CR19","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1186\/1471-2482-13-S2-S4","volume":"13","author":"G Conzo","year":"2013","unstructured":"Conzo, G. et al. Impact of parathyroidectomy on cardiovascular outcomes and survival in chronic hemodialysis patients with secondary hyperparathyroidism. A retrospective study of 50 cases prior to the calcimimetics era. BMC Surg. 13 Suppl 2, S4 (2013).","journal-title":"BMC Surg."},{"key":"BFsrep19150_CR20","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/j.jamcollsurg.2011.12.046","volume":"214","author":"J Sharma","year":"2012","unstructured":"Sharma, J. et al. Improved long-term survival of dialysis patients after near-total parathyroidectomy. J. Am. Coll. Surg. 214, 400\u2013407 (2012).","journal-title":"J. Am. Coll. Surg."},{"key":"BFsrep19150_CR21","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1038\/ki.2015.72","volume":"88","author":"H Komaba","year":"2015","unstructured":"Komaba, H. et al. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 88, 350\u2013359 (2015).","journal-title":"Kidney Int."},{"key":"BFsrep19150_CR22","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1038\/ki.2015.123","volume":"88","author":"JJ Scialla","year":"2015","unstructured":"Scialla, J. J. & Wolf, M. When there will never be a randomized controlled trial. Kidney Int. 88, 220\u2013222 (2015).","journal-title":"Kidney Int."},{"key":"BFsrep19150_CR23","first-page":"1","volume":"30","author":"F Locatelli","year":"2013","unstructured":"Locatelli, F. et al. What can we learn from a statistically inconclusive trial? Consensus conference on the EVOLVE study results. G. Ital. Nefrol. 30, 1\u20139 (2013).","journal-title":"G. Ital. Nefrol."},{"key":"BFsrep19150_CR24","doi-asserted-by":"publisher","first-page":"836","DOI":"10.2215\/CJN.02910707","volume":"3","author":"P Raggi","year":"2008","unstructured":"Raggi, P. & Kleerekoper, M. Contribution of bone and mineral abnormalities to cardiovascular disease in patients with chronic kidney disease. Clin. J. Am. Soc. Nephrol. 3, 836\u2013843 (2008).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"BFsrep19150_CR25","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1053\/j.ajkd.2013.10.013","volume":"63","author":"HH Wang","year":"2014","unstructured":"Wang, H. H., Hung, S. Y., Sung, J. M., Hung, K. Y. & Wang, J. D. Risk of stroke in long-term dialysis patients compared with the general population. Am. J. Kidney Dis. 63, 604\u2013611 (2014).","journal-title":"Am. J. Kidney Dis."},{"key":"BFsrep19150_CR26","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1111\/j.1523-1755.2004.00368.x","volume":"65","author":"B Kestenbaum","year":"2004","unstructured":"Kestenbaum, B. et al. Parathyroidectomy rates among United States dialysis patients: 1990-1999. Kidney Int. 65, 282\u2013288 (2004).","journal-title":"Kidney Int."},{"key":"BFsrep19150_CR27","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1681\/ASN.V1261242","volume":"12","author":"F Malberti","year":"2001","unstructured":"Malberti, F. et al. Parathyroidectomy in patients on renal replacement therapy: an epidemiologic study. J. Am. Soc. Nephrol. 12, 1242\u20131248 (2001).","journal-title":"J. Am. Soc. Nephrol."},{"key":"BFsrep19150_CR28","doi-asserted-by":"publisher","first-page":"90","DOI":"10.2215\/CJN.03520414","volume":"10","author":"A Ishani","year":"2015","unstructured":"Ishani, A. et al. Clinical outcomes after parathyroidectomy in a nationwide cohort of patients on hemodialysis. Clin. J. Am. Soc. Nephrol. 10, 90\u201397 (2015).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"BFsrep19150_CR29","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/1471-2369-13-43","volume":"13","author":"CC Chien","year":"2012","unstructured":"Chien, C. C. et al. Long-term survival and predictors for mortality among dialysis patients in an endemic area for chronic liver disease: a national cohort study in Taiwan. BMC Nephrol. 13, 43 (2012).","journal-title":"BMC Nephrol."},{"key":"BFsrep19150_CR30","unstructured":"Cormen, T. H., Leiserson, C. E., Rivest, R. L. & Stein, C. Greedy Algorithms. In Introduction to Algorithms (MIT Press and McGraw-Hill, 1990)."},{"key":"BFsrep19150_CR31","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1093\/aje\/kwm324","volume":"167","author":"S Suissa","year":"2008","unstructured":"Suissa, S. Immortal time bias in pharmaco-epidemiology. Am. J. Epidemiol. 167, 492\u2013499 (2008).","journal-title":"Am. J. Epidemiol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep19150","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep19150.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep19150.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T23:22:08Z","timestamp":1672874528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep19150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,13]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,5,10]]}},"alternative-id":["BFsrep19150"],"URL":"https:\/\/doi.org\/10.1038\/srep19150","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,13]]},"assertion":[{"value":"29 June 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19150"}}