title: Does elective parathyroidectomy for primary hyperparathyroidism affect renal function? A prospective cohort study.
abstract: BACKGROUND
  Major surgery is associated with acute kidney injury (AKI). This study examines associations between elective parathyroid surgery and post-operative renal impairment.
  
  
  METHODS
  Consecutive patients undergoing elective parathyroidectomy were evaluated, and demographic data and relevant blood parameters collected. A renal risk score was calculated for each patient based on locally agreed criteria.
  
  
  RESULTS
  62 patients were evaluated. Mean ± standard deviation creatinine increased between pre-operative and day 1 post-operative (72 ± 19 vs. 76 ± 20 μmol/L; p < 0.010). Mean eGFR reduced between baseline and day 1 (78 ± 15 vs. 75 ± 16; p < 0.010) and baseline and follow-up (78 ± 15 vs. 73 ± 17; p < 0.050). 19 patients (30.7%) had a creatinine increase of ≥10% on day 1 post-operatively and 7 (11.3%) a rise of >20%. At follow-up, 14 (30.4% of 46 patients with follow up creatinine measurements) and 5 (10.9%) patients had a creatinine of >10% and >20% higher than pre-operative or day 1 values respectively. Those with an increase in serum creatinine of ≥10% (at any time point) had a greater renal risk score [median 2 (inter-quartile range, IQR 0-3) vs. 1 (0-2); p = 0.040].
  
  
  CONCLUSIONS
  A significant minority of patients undergoing elective parathyroid surgery demonstrate worsening renal function post-operatively. A pre-operative risk stratification tool may identify those at risk in the clinical setting.
authors.affiliation: Department of General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Egan
authors.affiliation: Department of General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom. Electronic address: ffion_d83@hotmail.com.
authors.forename: Ffion
authors.initials: F
authors.lastname: Dewi
authors.affiliation: Department of General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: Rose
authors.initials: R
authors.lastname: Arkell
authors.affiliation: Department of General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Ansell
authors.affiliation: Department of Clinical Biochemistry, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: Soha
authors.initials: S
authors.lastname: Zouwail
authors.affiliation: Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Scott-Coombes
authors.affiliation: Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XY, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Stechman
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000009:adverse effects*; D011446:Prospective Studies; D012306:Risk
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; Parathyroidectomy; Post-operative acute kidney injury