How has propensity-matched data showing lower mortality and fewer cardiovascular events with parathyroidectomy versus cinacalcet affected your PTH threshold for surgical referral in a patient with CKD-related secondary hyperparathyroidism?

I have always been a fan of parathyroidectomy for patients who often have uncontrolled serum phosphorus and PTH despite medical therapy for a number of months or years. If parathyroidectomy is done right, then serum phosphorus will drop significantly for at least a few months, and serum PTH will be ...