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Intraoperative parathyroid hormones have been used to establish operative success in patients with primary hyperparathyroidism. This study's aim was to assess the impact of estimated glomerular filtration rate and serum creatinine levels on the fulfillment of50% drop and normalization of intraoperative parathyroid hormone levels.Patients successfully treated for primary hyperparathyroidism were analyzed. The samples for parathyroid hormone were collected at baseline, 5-, 10-, and 30-minutes postexcision. The patients were classified as follows: (1) estimated glomerular filtration rate60 mL/min, (2) estimated glomerular filtration rate60 mL/min and serum creatinine levels1.2 mg/dL, and (3) estimated glomerular filtration rate60 mL/min and serum creatinine levels1.2 mg/dL. Comparative analysis of patients achieving the50% parathyroid hormone drop criterion and normalization of intraoperative parathyroid hormone was performed.One hundred-fourteen patients were distributed as follows: 88 patients (77.2%), 14 (12.3%), and 12 (10.5%) for groups 1, 2 and 3, respectively. No difference between groups in the proportion of patients fulfilling the50% parathyroid hormone drop criterion was found. An abnormally elevated intraoperative parathyroid hormone level at 30-minute postexcision was observed in 0, 14.3, and 16.6% in groups 1, 2, and 3, respectively (P ≤ .0001).In the study,50% parathyroid hormone drop criterion was equally achieved despite normal or reduced estimated glomerular filtration rate. When serum creatinine levels increased1.2 mg/dL and estimated glomerular filtration rate declined60 mL/min, the likelihood of reaching normal intraoperative parathyroid hormone levels postexcision was significantly lower. |
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