Abstract
The study addresses the challenge of treating secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients, focusing on the cost-effectiveness of surgical versus pharmacological interventions. Conducting a retrospective analysis on 152 CKD patients with SHPT at the Third People's Hospital of Chengdu, the study matched 80 patients into two groups: 40 undergoing parathyroidectomy with autotransplantation (PTX + AT) and 40 treated with calcimimetics. PTX + AT was more effective in alleviating symptoms, particularly bodily pain, and demonstrated greater cost-effectiveness over a long-term period compared to calcimimetics. This was especially significant in patients with PTH levels > 1800 pg/mL and hyperphosphatemia. Despite similar initial costs, PTX + AT led to a substantial decrease in expenses during the 2–5 years post-treatment period, PTX + AT results in an ICER of -RMB 26.71/QALY for the first post-treatment year and -RMB-111.9k/QALY for the 2–5 year period, indicating cost-effectiveness with reduced long-term costs. The study also found an increased economic burden in managing patients with hyperphosphatemia. Surgical intervention (PTX + AT) is advocated as the primary treatment strategy for severe SHPT in CKD patients, owing to its long-term economic and clinical advantages. The results underscore the need for a severity-based approach in treating SHPT.
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The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
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WenJie Zhang: Formal analysis, Investigation, Methodology, Writing—original draft, Jian Wu: Conceptualization, Writing—review & editing, Hailiang Ren: Data curation, Software, Qianxiu Liao: Data curation, Investigation.
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No financial conflicts of interest were reported by the authors WenJie Zhang, Hailiang Ren,Qianxiu Liao,Jian Wu.
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This study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All procedures performed in this study involving human participants were in line with the ethical standards of the institutional research committee at the Third Hospital of Chengdu and the national research council. Informed consent was obtained from all individual participants involved in the study. Participant data were de-identified and confidentiality was ensured throughout the study and subsequent data analysis process.This study did not involve any animals.
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Zhang, W., Ren, H., Liao, Q. et al. Cost-Effectiveness and Clinical Outcomes of Secondary Hyperparathyroidism Treatments in Patients with Chronic Kidney Disease. Calcif Tissue Int 114, 368–376 (2024). https://doi.org/10.1007/s00223-024-01187-3
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DOI: https://doi.org/10.1007/s00223-024-01187-3