Evaluation of management of patients with postoperative permanent hypoparathyroidism. How close are we to the targets?

• Published in: Minerva endocrinology Vol. 48; no. 1; p. 12
• Main Authors: Onder, Cagatay E, Kuskonmaz, Serife M, Koc, Gonul, Firat, Sevde N, Omma, Tulay, Culha, Cavit
• Format: Journal Article
• Language: English
• Published: Italy 01-03-2023
• Subjects: Calcium - therapeutic use; Humans; Hypoparathyroidism - diagnosis; Hypoparathyroidism - drug therapy; Hypoparathyroidism - etiology; Kidney; Kidney Calculi - complications; Nephrocalcinosis - complications
• ISSN: 2724-6116
• DOI: 10.23736/S2724-6507.20.03291-5

Postoperative hypoparathyroidism (PO-HypoPT) is a complication usually seen after thyroid surgery. PO-HypoPT, which lasts longer than 6 months is defined permanently. The aim of this study was to evaluate how close permanent PO-HypoPT patients can approach target values.
One hundred seven patients who were followed-up with permanent diagnosis of PO-HypoPT between 2016-2020 were included in the study. The study protocol includes serum albumin corrected total calcium (Alb-sCa), phosphate (P), Ca-P product, and 24 h urine calcium measurements. Laboratory measurements of the patients include the values recorded in 4-year visits and in the last visit. In addition, radiological reports of renal/abdominal ultrasound and cranial tomography examinations performed in our hospital for any reason during this period were also reviewed.
When looking at the total measurements in the 4-year period, the Alb-sCa level was below the target in most of the measurements (68.1%). P level was higher than normal in 296 (46.2%) measurements. Twenty-four h urine ca excretion was measured 185 times in total visits, and 81 (43.7%) of these measurements showed hypercalciuric values. The patient's latest visit measurements were evaluated on 4 targets (Alb-sCa, P, Ca-P product and 24 h urine Ca excretion). The number of patients meeting all four targets was only 21 (19.6%). Six (7.5%) patients had kidney stones or nephrocalcinosis. Three (0.09%) patients with imaging had calcification in the basal ganglia.
Our study shows that the management of the patients with PO-HypoPT is suboptimal with active vitamin D and cholecalciferol treatment.