{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:46:20Z","timestamp":1782902780510,"version":"3.54.5"},"reference-count":25,"publisher":"Royal College of Surgeons of England","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Renal hyperparathyroidism is a common complication of chronic kidney disease, often requiring parathyroidectomy (PTX) when medical therapy fails. Following surgical intervention, recurrence and postoperative complications, in particular hypocalcaemia, are variable. This study compares post-PTX outcomes between two UK centres, focusing on recurrence rates, length of stay (LOS) and factors influencing postoperative intravenous (IV) calcium administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted across two centres from 2008\u20132022. Demographic, biochemical, and clinical factors were analysed, with primary outcomes being disease recurrence and postoperative IV calcium requirement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 114 patients were included: 66 from centre A and 48 from centre B. Some 65.2% underwent total parathyroidectomy in centre A vs 60.4% in centre B. The remainder were subtotal parathyroidectomies. Total recurrence was higher in centre A (34.8%) than centre B (20.8%) and a longer LOS was seen in centre A (median 5.5 days vs 3 days, p = 0.007). IV calcium use was higher in centre B (35.4% vs 24.2%, p = 0.194), although not statistically significant. Predictors of recurrence were limited, with preloading with alfacalcidol being protective in a univariate model (hazard ratio [HR] 0.33, p = 0.005). Higher postoperative phosphate, parathyroid hormone and alkaline phosphate levels were significant predictors of postoperative IV calcium in multivariate analysis (p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant differences in recurrence and LOS suggest that preoperative disease burden and perioperative management strategies influence outcomes. The higher recurrence at centre A may be linked to disease severity, while the shorter LOS and higher IV calcium use at centre B may reflect different pre- and postoperative care approaches. These findings highlight the need for careful management and identification of factors which may impact outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1308\/rcsann.2025.0112","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:16:06Z","timestamp":1768216566000},"page":"449-456","source":"Crossref","is-referenced-by-count":0,"title":["Renal hyperparathyroidism: comparative outcomes of parathyroidectomy in two regional centres over 14 years"],"prefix":"10.1308","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9310-0478","authenticated-orcid":false,"given":"S","family":"Michael","sequence":"first","affiliation":[{"name":"University of Manchester","place":["UK"]},{"name":"Manchester University NHS Foundation Trust","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Matias","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation 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