CKD-MBD management: what is the role of parathyroidectomy? Results from a nationwide survey in Italy

J Nephrol. 2018 Aug;31(4):585-591. doi: 10.1007/s40620-018-0481-7. Epub 2018 Mar 7.

Abstract

We herein report on a nationwide survey conducted in Italy to investigate the use of parathyroidectomy (PTX). In spite of the availability of newer and more effective drugs to control chronic kidney disease mineral bone disorder (CKD-MBD) biochemical abnormalities, PTX still remains a resource for nephrologists to use. However, observational analyses suggest that in recent years there has been a constant decline in the number of patients undergoing PTX. The reasons are not clear, though the increasing age and number of comorbidities of dialysis patients may partly explain this trend. Poor adherence to guidelines and/or geographical as well as logistic factors may also contribute to the lower use of PTX. The working group on CKD-MBD of the Italian Society of Nephrology launched a nationwide survey to investigate clinical practice patterns for PTX in Italy and identify modifiable factors that may limit accessibility to surgery.

Keywords: CKD; CKD-MBD; Dialysis; Parathyroidectomy.

MeSH terms

  • Chronic Kidney Disease-Mineral and Bone Disorder / blood
  • Chronic Kidney Disease-Mineral and Bone Disorder / surgery*
  • Chronic Kidney Disease-Mineral and Bone Disorder / therapy
  • Health Care Surveys
  • Health Services Accessibility
  • Hospital Units / statistics & numerical data*
  • Humans
  • Italy
  • Nephrology / statistics & numerical data*
  • Parathyroid Hormone / blood
  • Parathyroidectomy / statistics & numerical data*
  • Patient Selection
  • Practice Patterns, Physicians' / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Renal Replacement Therapy / statistics & numerical data

Substances

  • Parathyroid Hormone