AI Article Synopsis
- The study examined how long it takes for parathyroid hormone (PTH) levels to return to normal after parathyroid surgery for primary hyperparathyroidism, evaluating data from 186 patients over five years.
- Out of the final group of 176 patients, 26.1% had elevated PTH levels post-surgery despite normal calcium levels, with a median time to normalization of 6 months.
- Findings suggest that high preoperative PTH levels can predict postoperative normocalcaemic hyperparathyroidism, while vitamin D and creatinine levels don’t appear to impact the normalization timeline.
Article Abstract
Introduction: This study aimed to determine the time to normalisation of postoperative parathyroid hormone levels after successful parathyroid surgery and to analyse the pathophysiology of postoperative normocalcaemic hyperparathyroidism.
Method: An observational retrospective study was conducted on a cohort of 186 patients who had undergone parathyroidectomy for primary hyperparathyroidism over a 5-year period. Demographic characteristics, surgical and histopathological data, bone densitometry (pre-and postoperative pharmacological treatment), creatinine plasma levels, and pre-and postoperative parathyroid hormone, calcium and vitamin D levels were recorded as predictive variables. The time to normalisation of the postoperative parathyroid hormone levels was recorded as the output variable. A univariate analysis was performed to investigate the factors related to the time to normalisation of parathyroid hormone levels.
Results: The final study sample was comprised of 176 patients, 46 of which (26.1%) had elevated postoperative parathyroid hormone levels and normocalcaemia. The median time to normalisation of the postoperative parathyroid hormone levels was 6 months. The cumulative probability of having normal parathyroid hormone levels 30 months after surgery was 89%. The time to normalisation was associated only with preoperative parathyroid hormone levels (P = .007; HR: 0.998). Vitamin D and creatinine levels were not associated with time to normalisation of parathyroid hormone levels (P = .744).
Conclusions: Persistently elevated postoperative parathyroid hormone levels with normocalcaemia may occur in one-quarter of patients after parathyroidectomy. Parathyroid hormone levels normalise in up to 90% of cases by 30 months. A high preoperative parathyroid hormone level is predictive of postoperative normocalcaemic hyperparathyroidism, and vitamin D deficiency does not seem to influence the pathogenic mechanism.
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| http://dx.doi.org/10.1016/j.cireng.2024.10.006 | DOI Listing |
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