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Calcitriol supplementation before parathyroidectomy and calcium level after surgery in parathyroid adenoma patients: a randomized controlled trial

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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.

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Availability of data and materials

SPSS data of the participants can be requested from the authors. Please write to the corresponding author if you are interested in such data.

Abbreviations

PTH:

Parathyroid hormone

PTX:

Parathyroidectomy

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Funding

The study was financially supported by the office of vice-chancellor for research at Tehran University of Medical Sciences.

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Authors and Affiliations

  1. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    R. Shahriarirad

  2. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    R. Shahriarirad & A. Ardekani

  3. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran

    S. M. Meshkati Yazd, N. Moradi & S. Nasiri

  4. Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran

    A. Mokhtari Ardekani

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  5. N. Moradi
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Contributions

SN, SMMY, and RS designed the study. NM collected the data while RS performed the statistical analysis. RS, AA, and AMA drafted the manuscript. RS, SN and SMMY revised the manuscript. All authors proofread the final version of the manuscript.

Corresponding author

Correspondence to S. Nasiri.

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Conflict of interest

The authors have not disclosed any competing interests.

Ethical approval and consent to participate

Tehran University of Medical Sciences Human Ethics Committee approved the study (IR.TUMS.MEDICINE.REC.1396.3403). This study was registered in the Iranian registry of clinical trials (Trial number: IRCT20220822055773N2). Written informed consent form was obtained from all the participants enrolled in this trial. All patients’ information was de-identified and documented confidentially, and patients were able to exit any time during the trial if they desired. All ethical principles of the Declaration of Helsinki were considered in this trial.

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All participants provided informed consent prior to their participation.

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Shahriarirad, R., Meshkati Yazd, S.M., Ardekani, A. et al. Calcitriol supplementation before parathyroidectomy and calcium level after surgery in parathyroid adenoma patients: a randomized controlled trial. J Endocrinol Invest 46, 985–990 (2023). https://doi.org/10.1007/s40618-022-01963-8

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  • DOI: https://doi.org/10.1007/s40618-022-01963-8

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