In Patients with Primary Hyperparathyroidism, Does Surgery Prevent Decline in Renal Function?

For patients with mild primary hyperparathyroidism (PHPT), one rationale for parathyroidectomy is to prevent decline in renal function. However, evidence to support this rationale is limited.

In this observational study of patients with PHPT in the U.S. Veterans Affairs health system, researchers compared renal outcomes in 3800 patients who underwent early parathyroidectomy and 40,000 patients who were managed nonoperatively. At baseline, mean age was 67, mean serum calcium level was 10.8 mg/dL, and mean estimated glomerular filtration rate (eGFR) was 72 mL/minute/1.73 m²; most patients were men. Patients with eGFR ≤30 mL/minute were excluded. Statistical techniques were used to adjust for substantial baseline differences between groups.

Inci…