Randomized controlled trial of alfacalcidol supplementation for the reduction of hypocalcemia after total thyroidectomy
Abstract
Background The aim of this study was to evaluate the effect of perioperative alfacalcidol on postoperative hypocalcemia after total thyroidectomy.Methods A total of 219 patients scheduled for total thyroidectomy were randomized into groups not receiving (group A) or receiving (group B) perioperative alfacalcidol. Postoperative hypocalcemia was compared between groups on postoperative day (POD) 1 and POD2. Patients with hypocalcemia (<2.00 mmol/L) received oral calcium supplementation. Calcium and vitamin D levels were measured at 5-week and 6-month follow-ups.Results The incidence of symptomatic hypocalcemia was significantly lower in group A (P = .02), whereas similarly low levels of calcemia were observed in both groups on POD1 (37% and 30%, respectively; P = not significant) and persisted on POD2 (14% and 6%, respectively; P = not significant). Patients with severe hypocalcemia (<1.90 mmol/L) showed faster recovery in group A compared with group B (6% vs 1%, P = .04). At 5 weeks, calcium and vitamin D levels were similar between the groups. Six months after surgery, 4% (group A) versus 0% (group B) of subjects exhibited permanent hypoparathyroidism (P = .04).Conclusions Although the treatment did not correct vitamin D deficiency, perioperative alfacalcidol uptake resulted in decreased transient hypocalcemia and related symptoms in patients undergoing total thyroidectomy.
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In two studies included in another meta-analysis, supplementing calcitriol for a brief period preoperatively helped reduce transient postthyroidectomy hypocalcemia.
“In two studies included in another meta-analysis, supplementing calcitriol for a brief period preoperatively helped reduce transient postthyroidectomy hypocalcemia (191)(192)(193).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [191]
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- Authors
- Genser, L., Trésallet, C., Godiris-Petit, G., Li Sun Fui, S., Salepcioglu, H., Royer, C., & Menegaux, F.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Venue
- The American Journal of Surgery
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 207
- Issue
- 1
- Pages
- 39-45
- ISSN
- 0002-9610 (ISSN-L)
- OpenAlex
- W2098870649
- Cited by
- 47
- References
- 30
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 6 · 2016: 6 · 2015: 1 · 2014: 2
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- alfacalcidol, total thyroidectomy, postoperative hypocalcemia, hypoparathyroidism, calcium supplementation, vitamin D deficiency, parathyroid hormone
- MeSH terms
- Adult, Aged, Calcium, Female, Follow-Up Studies, Humans, Hydroxycholecalciferols, Hypocalcemia, Hypoparathyroidism, Male, Middle Aged, Thyroidectomy, Time Factors, Vitamin D, Vitamin D Deficiency, Treatment Outcome, Bone Density Conservation Agents
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