Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism

Clinical Biochemistry
Carlo VulpioSalvatore Agnes

Abstract

The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG). The ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT. The concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) a...Continue Reading

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Citations

Feb 28, 2019·Drugs·Rowena Delos SantosThin Thin Maw
Jan 22, 2021·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Andre Albuquerque SilveiraFabio Luiz de Menezes Montenegro
Feb 23, 2021·KI Reports·Gabrielle K Steinl, Jennifer H Kuo
Jul 16, 2021·Frontiers in Surgery·Karla Verónica ChávezMariana Chavez-Tostado

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