Should vitamin D deficiency be corrected before parathyroidectomy?

• Published in: The Journal of surgical research 2016-07, Vol.204 (1), p.94-100
• Main Authors: Randle, Reese W., MD, Balentine, Courtney J., MD, MPH, Wendt, Elizabeth, BS, Schneider, David F., MD, MS, Chen, Herbert, MD, Sippel, Rebecca S., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Case-Control Studies; Databases, Factual; Female; Follow-Up Studies; Humans; Hyperparathyroidism; Hyperparathyroidism, Primary - complications; Hyperparathyroidism, Primary - surgery; Hypocalcemia; Hypocalcemia - etiology; Hypocalcemia - prevention & control; Male; Middle Aged; Multivariate Analysis; Parathyroidectomy; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Preoperative Care - methods; Preoperative Period; Retrospective Studies; Risk Factors; Surgery; Treatment Outcome; Vitamin D - therapeutic use; Vitamin D deficiency; Vitamin D Deficiency - complications; Vitamin D Deficiency - drug therapy; Vitamins - therapeutic use
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2016.04.022

Abstract Background Vitamin D deficiency is common in patients with hyperparathyroidism, but, the importance of replacement before surgery is controversial. We aimed to evaluate the impact of vitamin D deficiency on the extent of resection and risk of postoperative hypocalcemia for patients undergoing parathyroidectomy for primary hyperparathyroidism. Methods We identified patients with primary hyperparathyroidism undergoing parathyroid surgery between 2000 and 2015 using a prospectively maintained database. Patients with normal (≥30 ng/mL) vitamin D were compared to those with levels less than 30 ng/mL. Results There were 1015 (54%) patients with normal vitamin D and 872 (46%) patients with vitamin D deficiency undergoing parathyroidectomy for primary hyperparathyroidism. Vitamin D deficiency was associated with higher preoperative parathyroid hormone (median 90 versus 77 pg/mL, P