Development of strategy for treatment of secondary hyperparathyroidism based on clinical and cost-effectiveness

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The objective of this study is to determine a reasonable strategy for treatment of secondary hyperparathyroidism based on clinical and cost-effectiveness.In the cost-effectiveness analysis of cinacalcet hydrochloride for severe secondary hyperparathyroidism, we showed that the use of cinacalcet is likely to be cost-effective for only those who cannot undergo parathyroidectomy (Komaba H et al. Am J Kidney Dis 60: 262-271, 2012).In the cost-effectiveness analysis of 99m_Tc-MIBI scintigraphy, we showed that this method is likely to be cost-effective for preoperative identification of ectopic parathyroid glands in hemodialysis patients with persistent or recurrent secondary hyperparathyroidism (Komaba H et al. 49th ERA-EDTA Congress, Paris).Finally, using retrospective cohort data of 2,292 maintenance hemodialysis patients, we demonstrated that treatment with lanthanum carbonate, a novel phosphate bidder, is independently associated with survival benefit among those with uncontrolled hyperphosphatemia (Komaba H et al.50th ERA-EDTA Congress, Istanbul).