{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:53Z","timestamp":1787840513978,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Near-total parathyroidectomy (NPTX) could provide persistent improvements in dysregulated mineral metabolism, leading to a reduction in all-cause and cardiovascular (CV) mortality by reducing coronary artery calcium score (CACS) in refractory secondary hyperparathyroidism (SHPT). In this study, we have attempted to compare the effect of NPTX and cinacalcet therapy in patients with refractory SHPT on dialysis, with regard to their effects on CACS and FGF-23.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 14 patients with refractory SHPT were followed prospectively. Five patients were enrolled in the NPTX arm and nine in the cinacalcet arm. Demographics, CACS, biochemical, and hormonal analysis were performed at baseline with a planned follow-up of 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The NPTX group showed a more favourable change in total calcification score over 1 year compared to the cinacalcet group, with a mean difference of 625.6 units. After NPTX, CACS was stable or reduced (&lt;15% per year increase in CACS) in four of five (80%) patients. In the cinacalcet group, for those with a very severe baseline CACS (&gt;400), there was a progression in the CACS. In the NPTX group, iPTH and FGF 23 reduced significantly after 1 year with an iPTH of 58.00 (8.5\u201376) pg\/mL (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and FGF 23 of 5.4 (5.4\u20137.9) pg\/mL (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.04), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>NTPTX resulted in amelioration of dysregulated mineral metabolism, leading to reduction or stabilization of CACS. There was also a marked reduction in FGF-23 levels following NPTX, which may be the principal factor in preventing the progression of CACS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_502_24","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:00:11Z","timestamp":1756278011000},"page":"446-452","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Cardiovascular Risks by CT-Derived Calcium Scoring and FGF-23 in Patients with Renal Hyperparathyroidism Undergoing Near-Total Parathyroidectomy and Cinacalcet Therapy: A Prospective Pilot Study"],"prefix":"10.4103","volume":"29","author":[{"given":"Anirudh J.","family":"Shetty","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manphool","family":"Singhal","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathirvel","family":"Soundappan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay K.","family":"Bhadada","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Sudhayakumar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"R1-20250827","article-title":"USRDS 2008 Annual Data Report:Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States","year":"2008","journal-title":"National Institutes of Health"},{"key":"R2-20250827","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1681\/ASN.2004030203","article-title":"Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999","volume":"16","author":"Foley","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"R3-20250827","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1093\/ndt\/gfac194","article-title":"Association of coronary artery calcium with adverse cardiovascular outcomes and death in patients with chronic kidney disease:results from the KNOW-CKD","volume":"38","author":"Jung","year":"2023","journal-title":"Nephrol Dial Transplant"},{"key":"R4-20250827","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1245\/s10434-018-6998-0","article-title":"Biochemical and skeletal outcomes of parathyroidectomy for normocalcemic (Incipient) primary hyperparathyroidism","volume":"26","author":"Sho","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"R5-20250827","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jamcollsurg.2011.12.046","article-title":"Improved long-term survival of dialysis patients after near-total parathyroidectomy","volume":"214","author":"Sharma","year":"2012","journal-title":"J Am Coll Surg"},{"key":"R6-20250827","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1001\/archsurg.1995.01430050088015","article-title":"Subtotal parathyroidectomy in dialysis-dependent and post-renal transplant patients. 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