Preoperative Vitamin D Levels as a Predictor of Transient Hypocalcemia and Hypoparathyroidism After Parathyroidectomy

Abstract

Hypocalcemia is a common problem after parathyroidectomy and/or thyroidectomy. The complication may be transient or permanent. Most cases occur as a result of removal of the parathyroid glands or damage to the glands during neck surgery. The purpose of this study was to evaluate the effect of preoperative vitamin D deficiency in predicting transient hypocalcemia and hypoparathyroidism after parathyroidectomy.Retrospective evaluation was made of 180 patients with primary hyperparathyroidism in respect of serum 25(OH)D, calcium and parathyroid hormone before and after parathyroidectomy. Transient hypocalcemia was defined as corrected calcium ≤ 8.4 mg/dL, and these cases were then evaluated for preoperative 25(OH)D values. Transient hypoparathyroidism has been described as low PTH level immediately after surgery before beginning any supplementation. Permanent hypoparathyroidism is accepted as the need for medical treatment is necessary over 12 months.Both transient hypocalcemia and hypoparathyroidism developed at statistically significantly higher rates in patients with preoperative vitamin D deficiency and vitamin D insufficiency.Vitamin D deficiency is an independent contributor to transient hypocalcemia and hypoparathyroidism following parathyroidectomy.

Vitamin D3 Levels in Predicting Transient Hypocalcemia After Parathyroidectomy

“…Soares et al did, however, show that hypocalcemia is dependent on postoperative levels of PTH [ 13 ]. Unsal et al, on the other hand, in their study, showed that there was a significant drop in postoperative calcium levels following parathyroidectomy in patients with vitamin D deficiency and vitamin D insufficiency [ 14 ].…”

Vitamin D Insufficiency Predicts Susceptibility of Parathyroid Hormone Reduction after Total Thyroidectomy in Thyroid Cancer Patients

“…e relationship of vitamin D and postoperative hypoparathyroidism or hypocalcemia has been evaluated in a number of studies, but the results are controversial. Several studies reported that low preoperative 25OHD was associated with postoperative hypoparathyroidism or hypocalcemia [11,[21][22][23]. Bove et al [11] analyzed clinical and lab data of 177 patients who underwent total thyroidectomy and found preoperative vitamin D deficiency (<25 ng/mL) was an independent risk factor in the development of hypocalcemia [24].…”

Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management

“…Other studies were able to demonstrate the association between low vitamin D status and increased bone turnover [ 65 ] as well as decreased BMD (FN, distal radius, whole body) [ 66 ]. Vitamin D insufficiency was also identified as an independent risk factor for post-operative hypocalcemia [ 67 , 68 , 69 ] and hungry bone syndrome [ 70 ]. Concerns regarding the effects of vitamin D repletion on further elevating serum calcium in PHPT have not been validated.…”