4D CT-guided focused parathyroidectomy: a paradigm shift from experience-based surgery in end-stage renal disease patients with medically refractory secondary hyperparathyroidism

4D CT-guided focused parathyroidectomy versus experience-based surgery in end-stage renal disease patients with medically refractory secondary hyperparathyroidism: impact on surgical outcomes and biochemical control

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ISRCTN

Registry ID

ISRCTN18282884

Enrollment

135

Registered

2025-07-14

Start date

2023-02-01

Completion date

Unknown

Last updated

2026-08-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

End-stage renal disease (ESRD) patients with medically refractory secondary hyperparathyroidism Nutritional, Metabolic, Endocrine

Interventions

This is a retrospective comparative cohort study analyzing end-stage renal disease (ESRD) patients with medically refractory secondary hyperparathyroidism who underwent parathyroidectomy. Patients wil

therefore, no randomization was performed. Patient allocation to study arms was based on the surgical approach used during their treatment period (before and after implementation of 4D CT-guided proto

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Diagnosed with secondary or tertiary hyperparathyroidism 2. Dialysis-dependent due to end-stage renal disease (ESRD) 3. Underwent parathyroidectomy between January 2023 and December 2024 4. Underwent a primary parathyroidectomy (i.e., no previous parathyroid surgery) 5. Underwent removal of multiple parathyroid glands during the procedure

Exclusion criteria

Exclusion criteria: 1. Reoperation for recurrent hyperparathyroidism 2. Underwent concurrent surgical procedures 3. Had only one parathyroid gland removed during surgery

Design outcomes

Primary

Measure	Time frame
1. Operative time measured using surgical records documenting time from skin incision to completion of surgery as recorded in operative reports at the time of surgery 2. Intraoperative frozen section requirements measured using the number of frozen section pathology reports obtained during surgery at the time of surgery	—

Secondary

Measure	Time frame
Diagnostic accuracy and positive predictive value of preoperative CT imaging for parathyroid gland identification, measured using comparison of preoperative CT-identified parathyroid gland count with total parathyroid gland count in final pathological report, with true positive defined as: preoperative prediction of =4 glands AND final pathology report showing =4 glands AND postoperative day 1 iPTH concentration <300 pg/dl, at preoperative CT imaging and postoperative day 1 iPTH measurement	—

Measure

Time frame

Diagnostic accuracy and positive predictive value of preoperative CT imaging for parathyroid gland identification, measured using comparison of preoperative CT-identified parathyroid gland count with total parathyroid gland count in final pathological report, with true positive defined as: preoperative prediction of =4 glands AND final pathology report showing =4 glands AND postoperative day 1 iPTH concentration <300 pg/dl, at preoperative CT imaging and postoperative day 1 iPTH measurement

—

Countries

Taiwan

Contacts

Public ContactYungyuan Chan

isc@cgmh.org.tw+886 (0)33281200

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Aug 25, 2026