Pill burden: A quality-of-life measure after parathyroidectomy for secondary hyperparathyroidism

Secondary hyperparathyroidism (SHPT), a condition that affects most dialysis patients, is associated with vascular calcifications and increased risk of cardiovascular mortality. While most cases are managed medically, many patients are referred to surgery because of high parathyroid hormone (PTH) levels refractory to medication or due to medication side effects or nonadherence. Both medical and surgical management are associated with high pill burdens that negatively impact quality of life in dialysis patients. To improve preoperative counseling and shared decision-making, the aim of this study was to compare the pre and postoperative daily pill burdens of patients on dialysis undergoing parathyroidectomy and to examine the relationship between preoperative PTH levels and postoperative pill burden.

This retrospective cohort study used electronic health record data of adult patients with kidney failure on dialysis admitted after index parathyroidectomy (July 2017–April 2025) at a single, high-volume academic hospital. Patients were identified using the Complete Inpatient Record Using Comprehensive Electronic database—a platform within our health system designed to capture and share clinically validated healthcare data.

Rachael C Acker, Jasmine Hwang, Shane Williams, Heather Wachtel, Douglas Fraker, Gary E Weissman, Yuvaram Reddy, Rachel R Kelz