title: Quick PTH assay cannot predict incomplete parathyroidectomy in patients with renal hyperparathyroidism.
abstract: BACKGROUND
  Contradictory reports on the value of intraoperative quick parathyroid hormone (PTH) monitoring in renal hyperparathyroidism have been published.
  
  
  METHODS
  Thirty-five consecutive patients underwent total parathyroidectomy, central neck dissection, bilateral thymectomy, and immediate autotransplantation. PTH levels were measured by PTH assay at induction of anesthesia (baseline level) and in 5-minute intervals after excision of the last parathyroid gland. Parathyroidectomy was considered "total" in patients with PTH levels <10 pg/mL (subgroup 1), "subtotal" between 10 and 65 pg/mL (subgroup 2) and "insufficient" at >65 pg/mL (subgroup 3) within the first postoperative week.
  
  
  RESULTS
  Fifteen minutes after excision of the last gland, PTH levels dropped to 19.4 +/- 15.7% (subgroup 1), 14.9 +/- 5.9% (subgroup 2), and 18 +/- 6.7% (subgroup 3) from baseline among 22 patients on hemodialysis, to 22.1 +/- 18.7% and 17.5% in 9 patients (subgroups 1 and 2) after successful kidney transplantation, and to 10.7% and 17.5% (subgroup 1) and 12.8% and 31.4% (subgroup 2) in 4 patients with reduced renal function after kidney transplantation.
  
  
  CONCLUSIONS
  Currently available QPTH assays are not useful to predict insufficient resection of hyperfunctioning parathyroid tissue.
authors.affiliation: Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Klaus.kaczirek@meduniwien.ac.at
authors.forename: Klaus
authors.initials: K
authors.lastname: Kaczirek
authors.forename: Philipp
authors.initials: P
authors.lastname: Riss
authors.forename: Gerald
authors.initials: G
authors.lastname: Wunderer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Reza
authors.initials: R
authors.lastname: Asari
authors.forename: Christian
authors.initials: C
authors.lastname: Scheuba
authors.forename: Christian
authors.initials: C
authors.lastname: Bieglmayer
authors.forename: Bruno
authors.initials: B
authors.lastname: Niederle
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy / Q000379:methods; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D013997:Time Factors
chemical_list: D010281:Parathyroid Hormone