Preoperative biochemical values are correlated with adenoma volume, but not predictive factors for hungry bone syndrome in patients with primary hyperparathyroidism

Abstract

We aimed to investigate correlation between perioperative biochemical values and adenoma volume, the effects of perioperative biochemical values and clinicopathological variables on postoperative hypocalcemia after parathyroidectomy. A retrospective study planned in tertiary university hospital on patients undergone surgery for primer hyperparathyroidism. Preoperative calcium (first, close to surgery, maximum), PTH (first, close to surgery, maximum), alkaline phosphatase (ALP) and phosphorus (P) values, postoperative calcium (early, late), postoperative PTH (early, late), 24-hour urinary calcium calculation, time from the first diagnosis of elevated calcium until surgery, preoperative hypercalcemia treatments, excised parathyroid gland, histopathologic diagnosis, maximum diameter and volume of the excised parathyroid on histopathologic examination, postoperative intravenous calcium supplement were analyzed. 73 patients were included in the study. The median age of the patients was 54 years (range, 18-82), and 83.6% were female. In univariate analysis, patients who were administrated intravenous (IV) calcium supplement had higher preoperative PTH (p=0.024). adenoma volume correlated moderate with preoperative PTH first (r=0.396, p=0.001), preoperative maximum parathormone (r=0.380, p=0.001), preoperative PTH CS (r=0.432, p<0.001) and preoperative first elevated calcium (r=0.240, p=0.041) levels. We conclude that biochemical parameters and adenoma size are not predictive factors in determining the requirement of IV calcium supplement. Preoperative PTH and calcium levels were moderately associated with adenoma volume.