Vol.:(0123456789) 1 3 Journal of Nephrology https://doi.org/10.1007/s40620-018-0527-x ORIGINAL ARTICLE Multicenter study on parathyroidectomy (PTX) in Italy: preliminary results Sandro Mazzaferro 1,2,13  · Lida Tartaglione 1  · Carmelo Cascone 3  · Nicola Di Daniele 4  · Antonello Pani 5  · Massimo Morosetti 6  · Marco Francisco 7  · Maurizio Nordio 8  · Maria Leonardi 9  · Mauro Martello 10  · Cristina Grimaldi 11  · Mario Cozzolino 12  · Silverio Rotondi 13  · Marzia Pasquali 2  on behalf of The Italian Study Group on Mineral Metabolism Received: 22 June 2018 / Accepted: 16 August 2018 © Italian Society of Nephrology 2018 Abstract Background When medical therapy is unable to achieve biochemical control of secondary hyperparathyroidism, parathy- roidectomy (PTX) is indicated, fortunately in a minority of patients. Thus, data on PTX prevalence and biochemical control are limited and, in particular in Italy, date back to 1999. Methods We designed a prospective, observational and multicenter study to collect data from dialysis units distributed throughout the Italian regions. Clinical data were collected with a dedicated data sheet. Results From January to December 2010, 149 Centers serving a total of 12,515 patients provided data on 528 living PTX cases (PTX prevalence = 4.2%). Prevalence was higher in hemo- than in peritoneal dialysis (4.5 vs. 1.9%, X 2 = 21.52; p < 0.001), with non-signifcant regional diferences (range 0.8–7.4%). PTX patients were younger (57.6 ± 12.5 vs. 67.1 ± 14.5 years; p < 0.001), more frequently female (56 vs. 38%, X 2 = 68.05, p < 0.001) and had been on dialysis for a longer time (14.63 ± 8.37 vs. 4.8 ± 6.0 years, p < 0.001) compared to the 11,987 who did not undergo neck surgery. Median time since surgery was 6.0 years (3.0–9.0; 50%, IQR). The most frequent type of surgery was subtotal PTX (sPTX = 55.0%), signifcantly higher than total PTX (tPTX = 38.7%) or total PTX plus auto-transplantation (aPTX = 6.3%) (X 2 = 5.18; Bonfer- roni post-hoc test, sPTX vs. tPTX + aPTX = p < 0.05). As for parathyroid hormone (PTH), calcium and phosphate control, cases targeting the KDOQI ranges were 18, 50.1 and 54.4%, respectively. The most prevalent biochemical condition was low PTH (62.7%). Conclusion PTX prevalence in Italy is stable compared to previous observations, is higher in hemodialysis than in peritoneal dialysis and results in a suboptimal biochemical control. Keywords Parathyroidectomy · Hemodialysis · Peritoneal dialysis · Secondary hyperparathyroidism * Sandro Mazzaferro sandro.mazzaferro@uniroma1.it 1 Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy 2 Nephrology Unit, Azienda Policlinico Umberto I, Rome, Italy 3 Nephrology Unit, Ospedale Ca’Foncello, Treviso, Italy 4 Nephrology and Dialysis Unit, Policlinico Tor Vergata, Rome, Italy 5 Division of Nephrology and Dialysis, Azienda Ospedaliera G. Brotzu, Cagliari, Italy 6 Nephrology Unit, G.B. Grassi Hospital, Rome, Italy 7 Nephrology and Dialysis Unit, Ospedale Civile di Ivrea, Turin, Italy 8 Nephrology and Dialysis Unit, Provincial Hospital, Camposampiero, Padua, Italy 9 Nephrology and Dialysis Unit, Ospedale Santa Maria Goretti, Latina, Italy 10 Nephrology and Dialysis Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio S. Salvatore, Pesaro, Italy 11 Nephrology Unit, Firenze 1 ed Empoli, Florence, Italy 12 Nephrology and Dialysis Unit, ASST Santi Paolo e Carlo, Presidio San Paolo, Milan, Italy 13 Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, Rome, Italy