ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation

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Predictive value of intraoperative parathyroid hormone measurement in patients with secondary hyperparathyroidism

  

  • Online:2020-12-28 Published:2020-12-28

Abstract: Objective:To observe the predictive value of intraoperative parathyroid hormone(IOPTH) determination on the success of parathyroidectomy(PTx) for secondary hyperparathyroidism(SHPT) in dialysis patients.Methodology:A total of 151 dialysis patients with SHPT who underwent parathyroidectomy from July 1,2017 to March 31,2019 were collected,and the PTH values of 20 min(PTH20) and 30 min(PTH30) after the last parathyroid gland was removed during  operation were measured,PTH20,PTH30 and preoperative PTH decline rate (PTH20%,PTH30%) were calculated.PTH<100 pg/ml a week after surgery was judged as successful operation.The predictive value of PTH20,PTH30,PTH20% and PTH30% to judge successful of operation were analyzed.Results:PTH20<2075 pg/ml,PTH30<1065 pg/ml,PTH20%>9138%,PTH30%>9578% are the best criteria for judging the success of operation.When PTH20<2075 pg/ml,sensitivity to predict successful operation is 859%,and specificity is 739%;And the sensitivity of PTH30<1065 pg/ml to predict successful operation was 891%,and the specificity was 652%; PTH20%>9138% predicted the success of surgery with a sensitivity of 758% and a specificity of 783%,PTH30%>9578% predicted the success of surgery with a sensitivity of 75% and a specificity of 696%.Conclusion:IOPTH is a useful method to predict the complete surgical removal of parathyroid glands.Intraoperative determination of parathyroid hormone PTH20,PTH30 can be basically predicted the successful operation.