已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

Parathyroidectomy and Cinacalcet Use in Medicare-Insured Kidney Transplant Recipients

西那卡塞特 甲状旁腺切除术 医学 拟钙质 肾移植 回顾性队列研究 甲状旁腺功能亢进 继发性甲状旁腺功能亢进 内科学 入射(几何) 泌尿科 移植 外科 甲状旁腺激素 物理 光学
作者
Aileen X. Wang,Sai Liu,Maria E. Montez‐Rath,Glenn M. Chertow,Colin R. Lenihan
出处
期刊:American Journal of Kidney Diseases [Elsevier]
卷期号:81 (3): 270-280.e1 被引量:5
标识
DOI:10.1053/j.ajkd.2022.07.015
摘要

Rationale & Objective Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic use in a cohort of Medicare-insured US kidney transplant recipients. Study Design Retrospective observational cohort study. Setting & Participants We used the US Renal Data System to extract demographic, clinical, and prescription data from Medicare Parts A, B, and D-insured patients who received their first kidney transplant in 2007-2013. We excluded patients with pretransplant parathyroidectomy. Predictors Calendar year of transplantation and pretransplant patient characteristics. Outcome (1) Incidence of and secular trends in parathyroidectomy and cinacalcet use in the 3 years after transplant; (2) 90-day outcomes after posttransplant parathyroidectomy and cinacalcet initiation. Analytical Approach Temporal trends and pretransplant correlates of parathyroidectomy and cinacalcet use were assessed using proportional hazards models and multivariable Poisson regression, respectively. Results The inclusion criteria were met by 30,127 patients, of whom 10,707 used cinacalcet before transplant, 551 underwent posttransplant parathyroidectomy, and 5,413 filled ≥1 prescription for cinacalcet. The rate of posttransplant parathyroidectomy was stable over time. By contrast, cinacalcet use increased during the period studied. Long dialysis vintage and pretransplant cinacalcet use were strongly associated with posttransplant parathyroidectomy and cinacalcet use. Roughly 1 in 4 patients were hospitalized within 90 days of posttransplant parathyroidectomy, with hypocalcemia-related diagnoses being the most common complication. Parathyroidectomy (vs cinacalcet initiation) was not associated with an increase in acute kidney injury. Limitations We lacked access to laboratory data to help assess the severity of secondary/tertiary hyperparathyroidism. The cohort was limited to Medicare beneficiaries. Conclusions Almost one-fifth of our study cohort was treated with parathyroidectomy and/or cinacalcet. Further studies are needed to establish the optimal treatment for posttransplant hyperparathyroidism. Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic use in a cohort of Medicare-insured US kidney transplant recipients. Retrospective observational cohort study. We used the US Renal Data System to extract demographic, clinical, and prescription data from Medicare Parts A, B, and D-insured patients who received their first kidney transplant in 2007-2013. We excluded patients with pretransplant parathyroidectomy. Calendar year of transplantation and pretransplant patient characteristics. (1) Incidence of and secular trends in parathyroidectomy and cinacalcet use in the 3 years after transplant; (2) 90-day outcomes after posttransplant parathyroidectomy and cinacalcet initiation. Temporal trends and pretransplant correlates of parathyroidectomy and cinacalcet use were assessed using proportional hazards models and multivariable Poisson regression, respectively. The inclusion criteria were met by 30,127 patients, of whom 10,707 used cinacalcet before transplant, 551 underwent posttransplant parathyroidectomy, and 5,413 filled ≥1 prescription for cinacalcet. The rate of posttransplant parathyroidectomy was stable over time. By contrast, cinacalcet use increased during the period studied. Long dialysis vintage and pretransplant cinacalcet use were strongly associated with posttransplant parathyroidectomy and cinacalcet use. Roughly 1 in 4 patients were hospitalized within 90 days of posttransplant parathyroidectomy, with hypocalcemia-related diagnoses being the most common complication. Parathyroidectomy (vs cinacalcet initiation) was not associated with an increase in acute kidney injury. We lacked access to laboratory data to help assess the severity of secondary/tertiary hyperparathyroidism. The cohort was limited to Medicare beneficiaries. Almost one-fifth of our study cohort was treated with parathyroidectomy and/or cinacalcet. Further studies are needed to establish the optimal treatment for posttransplant hyperparathyroidism.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
华桦子完成签到 ,获得积分10
1秒前
经钧完成签到 ,获得积分10
2秒前
2秒前
4秒前
iorpi完成签到,获得积分10
4秒前
师大刘亦菲完成签到 ,获得积分10
4秒前
香蕉觅云应助李钢采纳,获得10
6秒前
孝艺完成签到 ,获得积分10
6秒前
靖柔完成签到 ,获得积分10
7秒前
昏睡的笑南完成签到,获得积分20
7秒前
武大帝77完成签到 ,获得积分10
7秒前
汉堡包应助李昕123采纳,获得20
10秒前
小蘑菇应助医生采纳,获得10
11秒前
平平完成签到,获得积分10
11秒前
呵呵贺哈完成签到 ,获得积分10
15秒前
pietro完成签到,获得积分20
15秒前
dochx完成签到,获得积分10
16秒前
明时完成签到,获得积分10
16秒前
善学以致用应助pietro采纳,获得10
19秒前
虚心的惮完成签到 ,获得积分10
20秒前
深情安青应助wu采纳,获得10
22秒前
Worenxian完成签到,获得积分10
22秒前
李钢完成签到,获得积分10
22秒前
gc完成签到 ,获得积分10
24秒前
桐桐应助一一一一一采纳,获得10
26秒前
27秒前
27秒前
NS完成签到,获得积分10
27秒前
怡然发卡完成签到,获得积分20
29秒前
iiomee完成签到 ,获得积分10
29秒前
哈哈酱完成签到,获得积分20
29秒前
千寻完成签到,获得积分10
29秒前
wonder完成签到 ,获得积分10
30秒前
32秒前
趣多多发布了新的文献求助30
33秒前
太阳想玉米完成签到 ,获得积分10
34秒前
123完成签到 ,获得积分10
35秒前
36秒前
医生发布了新的文献求助10
36秒前
丘比特应助怡然发卡采纳,获得10
37秒前
高分求助中
Sustainability in Tides Chemistry 1500
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 799
Livre et militantisme : La Cité éditeur 1958-1967 500
Retention of title in secured transactions law from a creditor's perspective: A comparative analysis of selected (non-)functional approaches 500
"Sixth plenary session of the Eighth Central Committee of the Communist Party of China" 400
New China Forges Ahead: Important Documents of the Third Session of the First National Committee of the Chinese People's Political Consultative Conference 400
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3056378
求助须知:如何正确求助?哪些是违规求助? 2712952
关于积分的说明 7433961
捐赠科研通 2357944
什么是DOI,文献DOI怎么找? 1249173
科研通“疑难数据库(出版商)”最低求助积分说明 606972
版权声明 596195

今日热心研友

搜集达人
3 10
田様
2
mmyhn
1
所所
1
Jasper
10
结实大白
1
注:热心度 = 本日应助数 + 本日被采纳获取积分÷10