TY - JOUR
T1 - Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism.
AU - Vulpio, Carlo
AU - Bossola, Maurizio
AU - Di Stasio, Enrico
AU - Pepe, Gilda
AU - Nure, Erida
AU - Magalini, Sabina
AU - Agnes, Salvatore
PY - 2016
Y1 - 2016
N2 - The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG).\r\nMETHODS:\r\nThe ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT.\r\nRESULTS:\r\nThe concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT.\r\nCONCLUSIONS:\r\nThe monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT
AB - The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG).\r\nMETHODS:\r\nThe ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT.\r\nRESULTS:\r\nThe concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT.\r\nCONCLUSIONS:\r\nThe monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT
KW - parathyroid hormone
KW - parathyroid hormone
UR - https://publicatt.unicatt.it/handle/10807/96955
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84965079435&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84965079435&origin=inward
U2 - 10.1016/j.clinbiochem.2016.01.012
DO - 10.1016/j.clinbiochem.2016.01.012
M3 - Article
SN - 0009-9120
VL - 49
SP - 538
EP - 543
JO - Clinical Biochemistry
JF - Clinical Biochemistry
IS - 7-8
ER -