The aim of this study is to assess the clinical, laboratory and vascular calcification outcome within 6 months duration in patients undergoing surgical parathyroidectomy (total, subtotal, and total with autotransplantation)

All patients above the age of 18, with end stage renal disease maintained on regular hemodialysis and are indicated for surgical parathyroidectomy.

The indications for parathyroidectomy included persistently elevated intact parathormone hormone levels of greater than 500 pg/mL, uncontrolled hypercalcaemia with hyperphosphataemia or clinical symptoms of secondary hyperparathyroidism refractory to medical treatment. These symptoms included bone pain, pruritus, fracture, fatigue and calciphylaxis

These patients will be exposed to pre-operative evaluation of clinical, laboratory and vascular calcification in abdominal aorta and coronary calcium scoring using ECG- gated non contrast CT in hemodialysis patients undergoing parathyroidectomy

Post-operative evaluation of clinical, laboratory and vascular calcification in abdominal aorta and coronary calcium scoring using non contrast CT will be done 6 months post-operative

Assessment of the relation between preoperative and postoperative measures

Patients with the following criteria will be excluded:

1. chronic kidney disease patients not yet on regular Hemodialysis
2. patients who had primary hyperparathyroidism
3. patients who had received kidney transplantation
4. patients who underwent repeated parathyroidectomy
5. patients who were lost to follow-up or with missing data.

Inclusion Criteria:

• All patients above the age of 18
• patients with End stage renal disease maintained on regular hemodialysis
• indicated for surgical parathyroidectomy

Exclusion Criteria:

• Chronic kidney disease patients not yet on regular Hemodialysis
• patients who had primary hyperparathyroidism
• patients who had received kidney transplantation
• patients who underwent repeated parathyroidectomy
• patients who were lost to follow-up or with missing data.

All patients above the age of 18, with ESRD maintained on regular hemodialysis and are indicated for surgical parathyroidectomy

data collection is not yet complete, study is still ongoing for upgrading and expansion