{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:35:46Z","timestamp":1794047746875,"version":"4.8.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>Limited evidence supports kidney dysfunction as an indication for parathyroidectomy in asymptomatic primary hyperparathyroidism (PHPT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate the natural history of kidney function in PHPT and whether parathyroidectomy alters renal outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Matched control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>A vertically integrated health care system serving 4.6 million patients in Southern California.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>6058 subjects with PHPT and 16 388 matched controls, studied from 2000 to 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Exposures<\/jats:title>\n                  <jats:p>Biochemically confirmed PHPT with varying serum calcium levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcomes<\/jats:title>\n                  <jats:p>Estimated glomerular filtration rate (eGFR) trajectories were compared over 10 years, with cases subdivided by severity of hypercalcemia: serum calcium 2.62-2.74 mmol\/L (10.5-11 mg\/dL), 2.75-2.87 (11.1-11.5), 2.88-2.99 (11.6-12), and &amp;gt;2.99 (&amp;gt;12). Interrupted time series analysis was conducted among propensity-score-matched PHPT patients with and without parathyroidectomy to compare eGFR trajectories postoperatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Modest rates of eGFR decline were observed in PHPT patients with serum calcium 2.62-2.74 mmol\/L (\u22121.0 mL\/min\/1.73 m2\/year) and 2.75-2.87 mmol\/L (\u22121.1 mL\/min\/1.73 m2\/year), comprising 56% and 28% of cases, respectively. Compared with the control rate of \u22121.0 mL\/min\/1.73 m2\/year, accelerated rates of eGFR decline were observed in patients with serum calcium 2.88-2.99 mmol\/L (\u22121.5 mL\/min\/1.73 m2\/year, P &amp;lt; .001) and &amp;gt;2.99 mmol\/L (\u22122.1 mL\/min\/1.73 m2\/year, P &amp;lt; .001), comprising 9% and 7% of cases, respectively. In the propensity score\u2013matched population, patients with serum calcium &amp;gt;2.87 mmol\/L exhibited mitigation of eGFR decline after parathyroidectomy (\u22122.0 [95% CI: \u22122.6 to \u22121.5] to \u22120.9 [95% CI: \u22121.5 to 0.4] mL\/min\/1.73 m2\/year).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions and relevance<\/jats:title>\n                  <jats:p>Compared with matched controls, accelerated eGFR decline was observed in the minority of PHPT patients with serum calcium &amp;gt;2.87 mmol\/L (11.5 mg\/dL). Parathyroidectomy was associated with mitigation of eGFR decline in patients with serum calcium &amp;gt;2.87 mmol\/L.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad081","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T20:26:32Z","timestamp":1689193592000},"page":"115-122","source":"Crossref","is-referenced-by-count":12,"title":["Long-term effects of primary hyperparathyroidism and parathyroidectomy on kidney function"],"prefix":"10.1093","volume":"189","author":[{"given":"Catherine Y","family":"Zhu","sequence":"first","affiliation":[{"name":"Section of Endocrine Surgery, Department of Surgery, UCLA David Geffen School of Medicine , Los Angeles, CA 90095 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui X","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California , Pasadena, CA , United States"},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. 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