{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:59:07Z","timestamp":1787803147463,"version":"build-2784847793"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005047","name":"Natural Science Foundation of Liaoning Province","doi-asserted-by":"publisher","award":["2022-YGJC-11\u00a0\u00a02022 \u5e74 YGJC-11"],"award-info":[{"award-number":["2022-YGJC-11\u00a0\u00a02022 \u5e74 YGJC-11"]}],"id":[{"id":"10.13039\/501100005047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to construct a predictive scoring model for the factors influencing serum phosphorus reduction following total parathyroidectomy (tPTX) in secondary hyperparathyroidism (SHPT) and provide a reference for identifying patients who can successfully correct hyperphosphatemia before surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of 529 patients with SHPT who underwent tPTX were retrospectively analyzed according to the inclusion and exclusion criteria. Univariate and multivariate analyses were conducted to determine the independent factors and establish a predictive scoring model. The receiver operating characteristic curve (ROC) was applied to verify the model in the training and validation groups, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the whole group, 315 patients had a significant decrease in serum phosphorus after tPTX. Univariate and multivariate analysis showed that preoperative alkaline phosphatase (AKP), intact parathyroid hormone (iPTH) and free triiodothyronine (FT3) were independent influencing factors to promote the decrease of serum phosphorus after tPTX; Serum phosphorus and bone pain were inhibitory factors (all P&amp;lt;0.05). According to the cut-off value, AKP&amp;gt;193.33 U\/L, iPTH&amp;gt;1808 pg\/mL, FT3&amp;gt;2.825 pg\/mL, serum phosphorus&amp;gt;2.285 mmol\/L and bone pain were used to establish the predictive scoring model for serum phosphorus decline. The results showed that the success rate of serum phosphorus reduction was 67.55% at 10~14 points and 95.35% at 15~24 points. The area under ROC curves (AUC) for the training and validation group were 0.818 (95% CI=0.775~0.861) and 0.840 (95% CI=0.780~0.901, both P&amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The established prediction score model for serum phosphorus decrease has a good prediction efficiency which is helpful for the early identification. The model provides important clinical guidance for the postoperative management and treatment of SHPT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1584602","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T04:12:46Z","timestamp":1748491966000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism"],"prefix":"10.3389","volume":"16","author":[{"given":"Yingnan","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qila","family":"Sa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wantao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengyang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangming","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.06040710","article-title":"Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options","volume":"6","author":"Cunningham","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12772","article-title":"Secondary hyperparathyroidism: pathogenesis and latest treatment","volume":"23","author":"Mizobuchi","year":"2019","journal-title":"Ther Apher Dial"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab006","article-title":"Secondary hyperparathyroidism and adverse health outcomes in adults with chronic kidney disease","volume":"14","author":"Xu","year":"2021","journal-title":"Clin Kidney J"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2017.02.008","article-title":"Secondary hyperparathyroidism in heart failure","volume":"354","author":"Morsy","year":"2017","journal-title":"Am J Med Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/0272-6386(95)90570-7","article-title":"Effect of administering calcium carbonate to treat secondary hyperparathyroidism in nondialyzed patients with chronic renal failure","volume":"25","author":"Tsukamoto","year":"1995","journal-title":"Am J Kidney Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4646732","article-title":"Sevelamer carbonate crystal-induced colitis","volume":"2020","author":"Lai","year":"2020","journal-title":"Case Rep Gastrointest Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2017.05.008","article-title":"Correction of 25-OH-vitamin D deficiency improves control of secondary hyperparathyroidism and reduces the inflammation in stable haemodialysis patients","volume":"38","author":"Ojeda L\u00f3pez","year":"2018","journal-title":"Nefrologia (Engl Ed)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-019-02175-5","article-title":"Treatment of secondary hyperparathyroidism with paricalcitol in patients with end-stage renal disease undergoing hemodialysis in Turkey: an observational study","volume":"51","author":"Koc","year":"2019","journal-title":"Int Urol Nephrol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.3390\/nu10091164","article-title":"Association of anabolic effect of calcitriol with osteoclast-derived wnt 10b secretion","volume":"10","author":"Lu","year":"2018","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1159\/000510360","article-title":"Real world use and effects of calcimimetics in treating mineral and bone disorder in hemodialysis patients","volume":"51","author":"Danese","year":"2020","journal-title":"Am J Nephrol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1590\/2175-8239-jbn-2018-0219","article-title":"The impact of cinacalcet in the mineral metabolism markers of patients on dialysis with severe secondary hyperparathyroidism","volume":"41","author":"Bucharles","year":"2019","journal-title":"J Bras Nefrol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2017.1363779","article-title":"Total parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism: systematic review and meta-analysis","volume":"39","author":"Li","year":"2017","journal-title":"Ren Fail"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.06.032","article-title":"Quality of life after surgery in secondary hyperparathyroidism, comparing subtotal parathyroidectomy with total parathyroidectomy with immediate parathyroid autograft: Prospective randomized trial","volume":"164","author":"Filho","year":"2018","journal-title":"Surgery"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.7659\/j.issn.1005-6947.2020.05.009","article-title":"Safety and short-and long-termefficacy of parathyroidectomy for refractory renal secondaryhyperparathyroidism","volume":"29","author":"Yu","year":"2020","journal-title":"Chin J Gen Surgery"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.10390917","article-title":"Parathyroidectomy in the management of secondary hyperparathyroidism","volume":"13","author":"Lau","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1191914","article-title":"Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease","volume":"14","author":"Iorga","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1059828","article-title":"Advances in the treatment of secondary and tertiary hyperparathyroidism","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2024.2333919","article-title":"Outcome of surgical parathyroidectomy for tertiary hyperparathyroidism in kidney transplant recipients: tertiary hyperparathyroidism should not be ignored, for the sake of precious allografts","volume":"46","author":"Nakamura","year":"2024","journal-title":"Ren Fail"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.19538\/j.cjps.issn1005-2208.2021.08.01","article-title":"Chinese expert consensus on surgical practice of hyperthyroidism in patients with chronic kidney disease(2021 edition)","volume":"41","year":"2021","journal-title":"Chin J ofPractical Surgery"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-017-0442-6","article-title":"Admission hyperphosphatemia increases the risk of acute kidney injury in hospitalized patients","volume":"31","author":"Thongprayoon","year":"2018","journal-title":"J Nephrol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.06.026","article-title":"A physiologic-based approach to the evaluation of a patient with hyperphosphatemia","volume":"61","author":"Leaf","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.024","article-title":"Vascular calcification in chronic kidney disease: different bricks in the wall","volume":"91","author":"Vervloet","year":"2017","journal-title":"Kidney Int"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2005.06.008","article-title":"Vascular calcification in uremic conditions: new insights into pathogenesis","volume":"26","author":"Cozzolino","year":"2006","journal-title":"Semin Nephrol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5551\/jat.RV22012","article-title":"Phosphate and coronary artery disease in patients with chronic kidney disease","volume":"31","author":"Ogata","year":"2024","journal-title":"J Atheroscler Thromb"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.00810110","article-title":"Serum phosphate and mortality in patients with chronic kidney disease","volume":"5","author":"Eddington","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-018-1608-9","article-title":"Acute phosphate nephropathy leading to graft failure","volume":"23","author":"Zhou","year":"2019","journal-title":"Clin Exp Nephrol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.08.079","article-title":"Parathyroidectomy for tertiary hyperparathyroidism: A multi-institutional analysis of outcomes","volume":"258","author":"Patel","year":"2021","journal-title":"J Surg Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.7659\/j.issn.1005-6947.2022.11.002","article-title":"Establishment and validation of postoperative risk scoring model for severe hypocalcemia in patients with secondary hyperparathyroidism after surgery","volume":"31","author":"Guo","year":"2022","journal-title":"Chin J Gen Surg"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1006-298X.2019.01.012","article-title":"Summary of China chronic kidney disease mineral and bone disorder guideline","volume":"28","year":"2019","journal-title":"J Nephrol Dialy Transplant"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1042\/cs20190895","article-title":"Inflammation: a putative link between phosphate metabolism and cardiovascular disease","volume":"135","author":"Voelkl","year":"2021","journal-title":"Clin Sci (Lond)"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2018.07.003","article-title":"Physiology of parathyroid hormone","volume":"47","author":"Goltzman","year":"2018","journal-title":"Endocrinol Metab Clinics"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.0301264","article-title":"FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis","volume":"19","author":"Shimada","year":"2004","journal-title":"J Bone Miner Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-007-9254-2","article-title":"Effects of parathyroidectomy on bone remodeling markers and vitamin D status in patients with chronic kidney disease-mineral and bone disorder","volume":"39","author":"Peters","year":"2007","journal-title":"Int Urol Nephrol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.kisu.2017.04.001","article-title":"KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)","volume":"7","year":"2017","journal-title":"Kidney Int Suppl (2011)"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.06091108","article-title":"Association of serum alkaline phosphatase with coronary artery calcification in maintenance hemodialysis patients","volume":"4","author":"Shantouf","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.2174\/1381612820666140212193011","article-title":"Role of bone-type tissue-nonspecific alkaline phosphatase and PHOSPO1 in vascular calcification","volume":"20","author":"Bobryshev","year":"2014","journal-title":"Curr Pharm Des"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1671-4091.2018.09.003","article-title":"Changes of bone metabolic markers in uremic patients with secondary hyperparathyroidism before andafter parathyroidectomy","volume":"17","author":"Ge","year":"2018","journal-title":"Chin J Blood Purif"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1007\/s11302-022-09867-1","article-title":"Role of the extracellular ATP\/pyrophosphate metabolism cycle in vascular calcification","volume":"19","author":"Villa-Bellosta","year":"2023","journal-title":"Purinergic Signal"},{"key":"B39","doi-asserted-by":"publisher","first-page":"13536","DOI":"10.3390\/ijms222413536","article-title":"Vascular calcification: key roles of phosphate and pyrophosphate","volume":"22","author":"Villa-Bellosta","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.11.035","article-title":"Pyrophosphate deficiency in vascular calcification","volume":"93","author":"Villa-Bellosta","year":"2018","journal-title":"Kidney Int"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159858","article-title":"Alkalosis and dialytic clearance of phosphate increases phosphatase activity: A hidden consequence of hemodialysis","volume":"11","author":"Villa-Bellosta","year":"2016","journal-title":"PloS One"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-012-1560-x","article-title":"Postoperative hungry bone syndrome in patients with secondary hyperparathyroidism of renal origin","volume":"36","author":"Goldfarb","year":"2012","journal-title":"World J Surg"},{"key":"B43","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jss.2020.05.036","article-title":"A nomogram to predict hungry bone syndrome after parathyroidectomy in patients with secondary hyperparathyroidism","volume":"255","author":"Wang","year":"2020","journal-title":"J Surg Res"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(14)70059-2","article-title":"Bone: a new endocrine organ at the heart of chronic kidney disease and mineral and bone disorders","volume":"2","author":"Vervloet","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft244","article-title":"Phosphate control in end-stage renal disease: barriers and opportunities","volume":"28","author":"Waheed","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"B46","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1159\/000486172","article-title":"Influence of parathyroidectomy on bone metabolism and bone pain in patients with secondary hyperparathyroidism","volume":"59","author":"Schneider","year":"2018","journal-title":"Eur Surg Res"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.290","article-title":"Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production","volume":"89","author":"David","year":"2016","journal-title":"Kidney Int"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn682","article-title":"The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone","volume":"24","author":"Song","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-021-02800-2","article-title":"Thyroid hormone status in patients with impaired kidney function","volume":"53","author":"Peters","year":"2021","journal-title":"Int Urol Nephrol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s12882-023-03349-1","article-title":"Free triiodothyronine predicts the risk of developing diabetic kidney disease","volume":"24","author":"Li","year":"2023","journal-title":"BMC Nephrol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1671-4091.2015.05.001","article-title":"Effects of parathyroidectomy on phosphate and bone metabolism in maintenance hemodialysis patients with secondary hyperparathyroidism","volume":"14","author":"Li","year":"2015","journal-title":"Chin J Blood Purif"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1584602\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T04:12:51Z","timestamp":1748491971000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1584602\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":51,"alternative-id":["10.3389\/fendo.2025.1584602"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1584602","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"article-number":"1584602"}}