Calcitriol Plus Hydrochlorothiazide Prevents Transient Post-Thyroidectomy Hypocalcemia
Abstract
BACKGROUND: The aim of our double-blinded randomized prospective placebo-controlled study was to test if a week long pre-treatment with hypercalcemic drugs may prevent transient post-thyroidectomy hypocalcemia and reduce hospital stay. METHODS: Forty-two patients undergoing total thyroidectomy were randomized into two groups. Group 1: 22 patients treated with calcitriol 1.5 mcg/die plus hydrochlorothiazide; Group 2: 20 patients only treated with placebo (mineral integrates) as control group. Calcium and PTHi serum levels were assayed baseline and the days before and after thyroidectomy. RESULTS: Baseline calcium and PTHi did not differ between the two groups. Pre-surgery calcemia significantly increased in group 1 (p<0.05) while PTHi significantly decreased (p<0.05). Post-surgery calcemia and PTHi further significantly decreased in both groups, hypocalcemia (<2.10 mmol/l) occurring in 1 out of 22 patients in group 1 without symptoms and in 10 out of 20 in controls (20% developing symptoms) (p<0.01). The hospital stay resulted significantly shorter in group 1 (2.4+/-0.6 days) in respect to the control group (3.6+/-1.4 days, p<0.05). CONCLUSION: The administration of calcitriol plus hydrochlorothiazide is able to prevent transient post-thyroidectomy hypocalcemia and to reduce hospital stay.
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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 [192]
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Preoperative Vitamin D Deficiency Predicts Postoperative Hypocalcemia After Total Thyroidectomy
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- Authors
- Testa, A., Fant, V., De Rosa, A., Fiore, G., Grieco, V., Castaldi, P., Persiani, R., Rausei, S., D'ugo, D., & De Rosa, G.
- Affiliations
- Agostino Gemelli University Polyclinic (IT)
- Venue
- Hormone and Metabolic Research
- Publisher
- Georg Thieme Verlag KG
- Published
- 2006-12
- Volume
- 38
- Issue
- 12
- Pages
- 821-826
- ISSN
- 0018-5043 (ISSN-L)
- 1439-4286
- OpenAlex
- W1980003307
- Cited by
- 41
- References
- 0
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 5 · 2014: 3 · 2013: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hormone and Metabolic Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministerul Educaţiei Naţionale
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- post-thyroidectomy hypocalcemia, 1,25-dihydroxyvitamin D3, hydrochlorothiazide, total thyroidectomy, parathyroid hormone, serum calcium, length of hospital stay
- MeSH terms
- Adult, Aged, Calcitriol, Calcium, Double-Blind Method, Female, Humans, Hydrochlorothiazide, Hypocalcemia, Length of Stay, Male, Middle Aged, Parathyroid Hormone, Placebos, Postoperative Period, Thyroidectomy
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