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Article

Post-Operative Permanent Hypoparathyroidism and Preoperative Vitamin D Prophylaxis

1
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
2
Department of Endocrinology, John Hunter Hospital, Newcastle, NSW 2305, Australia
3
Department of Surgery, John Hunter Hospital, Newcastle, NSW 2305, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(3), 442; https://doi.org/10.3390/jcm10030442
Received: 2 December 2020 / Revised: 10 January 2021 / Accepted: 18 January 2021 / Published: 24 January 2021
(This article belongs to the Section Endocrinology & Metabolism)
Permanent hypoparathyroidism, a feared thyroidectomy complication, leads to significant patient morbidity, medical treatment, and monitoring. This study explores whether preoperative high-dose vitamin D loading decreases the incidence of permanent hypoparathyroidism. In a subgroup analysis, the study examines the predictive utility of day 1 parathyroid hormone (PTH) in permanent hypoparathyroidism. Patients (n = 150) were previously recruited in the VItamin D In Thyroidectomy (VIDIT) trial, a multicentre, randomised, double blind, placebo-controlled trial evaluating the role of 300,000 IU cholecalciferol administered orally a week before total thyroidectomy. Patients were contacted postoperatively beyond six months through a telephonic questionnaire. The primary outcome was permanent hypoparathyroidism, strictly defined as the need for activated vitamin D six months postoperatively. Out of 150 patients, 130 (86.7%) were contactable. Permanent hypoparathyroidism occurred in 11/130 (8.5%) patients, with a lower incidence of 5.3% (3/57) in the cholecalciferol group compared to 11% (8/73) in the placebo group; however, this was non-significant (p = 0.34). In a subgroup analysis, no relationship between day 1 PTH level and the incidence of permanent hypoparathyroidism was found (p ≥ 0.99). There was a lower rate of permanent hypoparathyroidism in the cholecalciferol group, which was not significant. The predictive utility of day 1 postoperative PTH levels may be limited to transient hypoparathyroidism. View Full-Text
Keywords: permanent hypoparathyroidism; postoperative hypocalcaemia; thyroidectomy; preoperative vitamin D permanent hypoparathyroidism; postoperative hypocalcaemia; thyroidectomy; preoperative vitamin D
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MDPI and ACS Style

Kannan, T.; Foster, Y.; Ho, D.J.; Gelzinnis, S.J.; Merakis, M.; Wynne, K.; Balogh, Z.J.; Bendinelli, C. Post-Operative Permanent Hypoparathyroidism and Preoperative Vitamin D Prophylaxis. J. Clin. Med. 2021, 10, 442. https://doi.org/10.3390/jcm10030442

AMA Style

Kannan T, Foster Y, Ho DJ, Gelzinnis SJ, Merakis M, Wynne K, Balogh ZJ, Bendinelli C. Post-Operative Permanent Hypoparathyroidism and Preoperative Vitamin D Prophylaxis. Journal of Clinical Medicine. 2021; 10(3):442. https://doi.org/10.3390/jcm10030442

Chicago/Turabian Style

Kannan, Tara, Yasmin Foster, David J. Ho, Scott J. Gelzinnis, Michael Merakis, Katie Wynne, Zsolt J. Balogh, and Cino Bendinelli. 2021. "Post-Operative Permanent Hypoparathyroidism and Preoperative Vitamin D Prophylaxis" Journal of Clinical Medicine 10, no. 3: 442. https://doi.org/10.3390/jcm10030442

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