Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the effectiveness and safety of parathyroidectomy and analyze the impact of different levels of intact parathyroid hormone (iPTH) on longterm prognosis.
Ｍｅｔｈｏｄｏｌｏｇｙ：Our study includes uremic patients with secondary hyperparathyroidism who undergo parathyroidectomy in general surgery of Huashan Hospital from January 2014 to December 2024. The exposure group is the patients with iPTH level≤20 pg／ml one week after parathyroidectomy and the control group is the patients with iPTH level> 20 pg／ml. All the patients are enrolled to form a prospective cohort design for baseline and followup investigation. The end time of followup is December 2029.
Ｒｅｓｕｌｔｓ：124 patients were enrolled between January 2014 and July 2021. The mean level of preoperative serum calcium and phosphorus were (258±026) mmol／L and (208±064) mmol／L. The level of preoperative iPTH were 19000(13920,24335) pg／mL. After the operation, the levels of serum calcium, phosphorus, calciumphosphorus product, and iPTH decreased significantly. There was no significant difference in serum calcium, phosphorus, calciumphosphorus between the exposure group and the control group. Postoperative iPTH was statistically significant between the two groups. The level of calcium and iPTH remained stable but phosphorus and calciumphosphorus product rose slowly one year after surgery. The rate of recurrence and death events of these patients was 26／100 personyears and 41／100 personyears, respectively, during a median followup of 24 years.
Ｃｏｎｃｌｕｓｉｏｎ：The cumulative survival rate between the exposure group and the control group was not statistical different. Parathyroidectomy is a safe and effective therapeutic method to improve the metabolism of calcium and phosphorus and reduce the level of iPTH.