Faculty Collaboration Database

Preoperative vitamin D replacement therapy in primary hyperparathyroidism: safe and beneficial? Surgery 2008 Dec;144(6):852-8; discussion 858-9

Date

12/02/2008

Pubmed ID

19040987

DOI

10.1016/j.surg.2008.06.032

Scopus ID

2-s2.0-56449118815 (requires institutional sign-in at Scopus site)   66 Citations

Abstract

BACKGROUND: The significance of vitamin D deficiency with primary hyperparathyroidism (PHPT) remains unclear. The safety and value of preoperative vitamin D (Vit D) replacement is unknown.

METHODS: A prospective surgical database of PHPT patients was queried to identify those who were vitamin D sufficient, deficient, and deficient but repleted. Biochemical parameters were measured preoperatively, after vitamin D replacement, at 1-month follow-up, and at 6-months follow-up.

RESULTS: Of 301 patients, 118 (39%) had a vitamin D level of 30 ng/mL or more; 71 patients (24%) were deficient, and 112 patients (37%) were vitamin D deficient but underwent repletion. The median duration of replacement was 28 days, and the dose of ergocalciferol was 400,000 U. Among the 112 patients who underwent repletion, the mean serum calcium remained relatively unchanged or decreased in 91 patients (81%). The gland size was smallest in patients with a preoperative sufficiency and largest in those deficient and not repleted. Postoperative PTH values at 1 month and at 6 months in the baseline-normal group were significantly less than in the other 2 groups (P = .05 and = .009, respectively), with no differences observed between the deficient and the deficient-repleted groups.

CONCLUSION: Preoperative Vit D replacement therapy was safe in PHPT patients and did not increase serum calcium levels. Vit D status affects gland size and postoperative PTH elevation. Repletion in this population is not durable.

Author List

Grubbs EG, Rafeeq S, Jimenez C, Feng L, Lee JE, Evans DB, Perrier ND

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Biomarkers
Calcium
Female
Humans
Hyperparathyroidism
Male
Middle Aged
Preoperative Care
Retrospective Studies
Vitamin D
Vitamin D Deficiency
Vitamins