{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T22:46:05Z","timestamp":1782773165521,"version":"3.54.5"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong Research","doi-asserted-by":"crossref","award":["200004576"],"award-info":[{"award-number":["200004576"]}],"id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010988","name":"Hong Kong Society of Nephrology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010988","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hong Kong Kidney Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This trial aimed to evaluate oral cinacalcet versus total parathyroidectomy (PTx) with forearm autografting on cardiovascular surrogate outcomes and health-related quality of life (HRQOL) measures in dialysis patients with advanced secondary hyperparathyroidism (SHPT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>In this pilot prospective randomized trial conducted in two university-affiliated hospitals, 65 adult peritoneal dialysis patients with advanced SHPT were randomized to receive either oral cinacalcet or PTx. Primary endpoints were changes in left ventricular (LV) mass index by cardiac magnetic resonance imaging and coronary artery calcium scores (CACS) over 12 months. Secondary endpoints included changes in heart valves calcium scores, aortic stiffness, biochemical parameters of chronic kidney disease-mineral bone disease (CKD-MBD) and HRQOL measures over 12 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Changes in LV mass index, CACS, heart valves calcium score, aortic pulse wave velocity and HRQOL did not differ between groups or within groups, despite significant reductions in plasma calcium, phosphorus and intact parathyroid hormone in both groups. Cinacalcet-treated patients experienced more cardiovascular-related hospitalizations than those who underwent PTx (P\u00a0=\u00a0.008) but the difference became insignificant after adjusting for baseline difference in heart failure (P\u00a0=\u00a0.43). With the same monitoring frequency, cinacalcet-treated patients had fewer hospitalizations due to hypercalcemia (1.8%) than patients who underwent PTx (16.7%) (P\u00a0=\u00a0.005). No significant changes were observed in HRQOL measures in either group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Both cinacalcet and PTx effectively improved various biochemical abnormalities of CKD-MBD and stabilized but did not reduce LV mass, coronary artery and heart valves calcification, or arterial stiffness, or improve patient-centered HRQOL measures in PD patients with advanced SHPT. Cinacalcet may be used in place of PTx for treating advanced SHPT. Long-term and powered studies are required to evaluate PTx versus cinacalcet on hard cardiovascular outcomes in dialysis patients.<\/jats:p>\n                  <jats:p>Trial registration: ClinicalTrials.gov identifier: NCT01447368.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfad043","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T22:15:23Z","timestamp":1677708923000},"page":"1823-1835","source":"Crossref","is-referenced-by-count":22,"title":["Parathyroidectomy versus oral cinacalcet on cardiovascular parameters in peritoneal dialysis patients with advanced secondary hyperparathyroidism (PROCEED): a randomized trial"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-7117","authenticated-orcid":false,"given":"Angela Yee-Moon","family":"Wang","sequence":"first","affiliation":[{"name":"University Department of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Kei","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tung Wah Hospital , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Chi-Wai","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Queen Mary Hospital , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tak-Ka","family":"Tang","sequence":"additional","affiliation":[{"name":"University Department of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yat-Yin","family":"Yau","sequence":"additional","affiliation":[{"name":"Biomedical Imaging Center , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Hung-Hin","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"key":"2023073100372031000_bib1","first-page":"2208","article-title":"Mineral metabolism, mortality, and morbidity in maintenance hemodialysis","volume":"15","author":"Block","year":"2004","journal-title":"J Am Soc\u00a0Nephrol"},{"key":"2023073100372031000_bib2","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/01.ASN.0000038685.95946.83","article-title":"Cardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: a prospective study","volume":"14","author":"Wang","year":"2003","journal-title":"J Am Soc 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