Surgical Parathyroidectomy versus Cinacalcet Therapy

Objectives The aim of this study was to compare the clinical effectiveness of surgery with calcimimetics as treatment strategies for managing the biochemical abnormalities that characterize secondary hyperparathyroidism (2HPTH), resistant to optimal conventional therapy in patients with end‐stage renal failure (ESRF). Study Design A historical cohort study. Setting Maxillofacial Department, Morriston Hospital, Swansea, United Kingdom. Subjects and Methods Fifty‐four patients with 2HPTH resistant to optimal conventional medical management were studied. One cohort of 20 patients was treated with surgical parathyroidectomy, the other cohort of 34 patients with cinacalcet. Serum parathyroid hormone (PTH) and bone profile were measured before and at monthly intervals after intervention. Results Both cohorts were comparable in their demographic profile, pretreatment comorbidities, baseline PTH, and bone profile. In all 20 surgical patients, the 1‐week postoperative PTH had decreased by 97% (P