Document Detail


Preoperative vitamin D replacement therapy in primary hyperparathyroidism: safe and beneficial?
MedLine Citation:
PMID:  19040987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Elizabeth G Grubbs; Safia Rafeeq; Camilo Jimenez; Lei Feng; Jeffrey E Lee; Douglas B Evans; Nancy D Perrier
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  144     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2008-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  852-8; discussion 858-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Tex, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Calcium / blood
Female
Humans
Hyperparathyroidism / complications,  surgery*
Male
Middle Aged
Preoperative Care
Retrospective Studies
Vitamin D / administration & dosage*,  blood
Vitamin D Deficiency / complications,  drug therapy*
Vitamins / administration & dosage*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Vitamins; 1406-16-2/Vitamin D; 7440-70-2/Calcium
Comments/Corrections
Comment In:
Surgery. 2008 Dec;144(6):860-1   [PMID:  19040988 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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