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Calcitriol Supplementation Before Parathyroidectomy and Calcium Level After Surgery in Parathyroid Adenoma Patients: A Randomized Controlled Trial Publisher Pubmed



Shahriarirad R1, 2 ; Meshkati Yazd SM3 ; Ardekani A2 ; Mokhtari Ardekani A4 ; Moradi N3 ; Nasiri S3
Authors
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Authors Affiliations
  1. 1. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran

Source: Journal of Endocrinological Investigation Published:2023


Abstract

Background: Hypocalcemia is the most common complication after parathyroidectomy, contributing to extended hospital stays and higher hospitalization costs. The present study aimed to evaluate whether preoperative Calcitriol could help reduce hypocalcemia rates. Method: In this randomized controlled trial, we included 80 patients with primary hyperparathyroidism candidates for parathyroidectomy. The intervention group received Calcitriol 0.25 µg/day 1 week before parathyroidectomy. Baseline laboratory data, parathyroid hormone level (before, during, after 5, and 10 min of operation), calcium level (6, 24, and 48 h after operation), and clinical signs and symptoms were recorded. Results: Of the 80 participants, 40 (mean age: 53.36 ± 12.97) were randomized to the intervention, and 40 (mean age: 52.84 ± 12.32) to the control group. There were no statistically significant differences in age, tumor size, gender, baseline laboratory data, intra-operative PTH, and calcium level 6 and 24 h after the operation. We observed a significantly higher calcium level in the intervention group 48 h post-operation (8.57 ± 0.30 vs. 8.33 ± 0.38). Also, days of hospital stay and symptomatic hypocalcemia rate were significantly lower in the intervention group. Conclusion: In patients with primary hyperparathyroidism, preoperative Calcitriol may be of value in preventing post-parathyroidectomy hypocalcemia and subsequent complications. © 2022, The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).