The available therapies for secondary hyperparathyroidism include

• Cinacalcet
• Calcitriol
• Parathyroidectomy

• Parathyroidectomy has been known to reduce the risk for death and major adverse cardiovascular events in patients with secondary hyperparathyroidism on maintenance hemodialysis.
• Parathyroidectomy is a valid treatment option, particularly if the medical treatment fails
• In a retrospective observational cohort study, parathyroidectomy was shown to be linked with an improvement in biochemical measures, reduced all-cause mortality, reduced MACCE rates, and cumulative hospitalization rates in nondiabetic hemodialysis patients with severe hyperparathyroidism.
• In non-diabetic patients with severe hyperparathyroidism, parathyroidectomy was related to improved biochemical measures and patient-level outcomes.
• Parathyroidectomy may be a therapy of priority in centers with high-quality surgical experience and follow-up teams. 

Reference: Huang Q-X, Pang J, Shi C-ke, et al. Impact of parathyroidectomy among nondiabetic hemodialysis paitents with severe hyperparathyroidism. Renal failure. 2022; 44:1160-1168.