BACKGROUND. Optimal mineral and bone disorder (CKD-MBD) targets after parathyroidectomy (PTX) in dialysis patients remain undefined, and current guidelines do not address this population specifically. PATIENTS AND METHODS. This retrospective single-centre cohort study included adult patients on dialysis who underwent subtotal or total PTX with autotransplantation between 2011 and 2019. A total of 485 patients with available preoperative and postoperative laboratory data were analyzed. Serum parathyroid hormone (PTH), phosphate, total and ionized calcium, and alkaline phosphatase were measured before PTX and within predefined postoperative time windows (3–6, 9–12, 24–36 and 48–60 months) to account for intraindividual variability and missing values. The primary endpoint was all-cause mortality; successful kidney transplantation and the end of follow-up were treated as censoring events. Associations between CKD-MBD parameters and survival were examined using Cox proportional hazards models adjusted for demographics, dialysis vintage, primary kidney disease, prior transplantation and type of PTX. RESULTS. Preoperative PTH, phosphate and calcium showed no significant linear or non-linear association with survival, either as continuous variables or across quartiles. In contrast, postoperative CKD-MBD status at 3–6 months provided stronger prognostic discrimination. In comparison with the “intermediate” pattern (PTH 150–300 pg/mL, phosphate 0.81–1.45 mmol/L, calcium 2.15–2.50 mmol/L) combinations of low PTH with high or very high phosphate levels were linked to increased risk. Calcium levels were not consistently associated with survival across time windows or categorizations. CONCLUSIONS. Long-term survival after PTX in dialysis patients is driven mainly by postoperative phosphate control and maintenance of PTH within an intermediate range, while preoperative CKD-MBD parameters have limited independent prognostic impact.