Calcitriol plus hydrochlorothiazide prevents transient post-thyroidectomy hypocalcemia.
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).


CONCLUSIONS
The administration of calcitriol plus hydrochlorothiazide is able to prevent transient post-thyroidectomy hypocalcemia and to reduce hospital stay.
Testa
A
A
Department of Emergency Medicine, A. Gemelli University Hospital, Rome, Italy. testaa@rm.unicatt.it
Fant
V
V
De Rosa
A
A
Fiore
G F
GF
Grieco
V
V
Castaldi
P
P
Persiani
R
R
Rausei
S
S
D'ugo
D
D
De Rosa
G
G
D000328:Adult; D000368:Aged; D002117:Calcitriol / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006996:Hypocalcemia / Q000209:etiology / Q000517:prevention & control*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010919:Placebos; D011184:Postoperative Period; D013965:Thyroidectomy / Q000009:adverse effects*
D010281:Parathyroid Hormone; D010919:Placebos; D006852:Hydrochlorothiazide; D002117:Calcitriol; D002118:Calcium