Background Use of intraoperative parathyroid hormone (ioPTH) monitoring during total parathyroidectomy for secondary hyperparathyroidism is common, although its ability to predict long-term normoparathyroid state is not known. Methods Prospective evaluation of 57 consecutive patients undergoing total parathyroidectomy for renal hyperparathyroidism with ioPTH monitoring and follow-up PTH assays were used to categorize the patients into 3 groups: success, adequate biochemical control, and failure. Results There was no statistically significant difference in percentage reduction of ioPTH between the 3 groups (p =.07), although there was a moderate negative correlation between percentage reduction of ioPTH and percentage reduction of PTH at follow-up (R = 0.57). Conclusions When used under current guidelines, ioPTH monitoring is of no use in predicting long-term cure for these patients because it does not predict success. Patients that undergo total parathyroidectomy are required to have long-term calcium and PTH assay follow-up because normoparathyroidism cannot be assumed. Using the regression equation calculated, success may be predicted for future patients.
- follow-up studies
- intraoperative monitoring
- parathyroid hormone
- secondary hyperparathyroidism
ASJC Scopus subject areas