Serum parathyroid hormone and alkaline phosphatase as predictors of calcium requirements after total parathyroidectomy for hypocalcemia in secondary hyperparathyroidism

Head & Neck ◽  
2017 ◽  
Vol 40 (2) ◽  
pp. 324-329 ◽  
Author(s):  
Pingjiang Ge ◽  
Shuangxin Liu ◽  
Xiaoli Sheng ◽  
Sijia Li ◽  
Mimi Xu ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Total Parathyroidectomy ◽  
Serum Parathyroid Hormone

Risk Factors for Elevated Preoperative Alkaline Phosphatase in Patients with Refractory Secondary Hyperparathyroidism

2017 ◽  
Vol 83 (12) ◽  
pp. 1368-1372 ◽  
Author(s):  
Meng Yang ◽  
Ling Zhang ◽  
Linping Huang ◽  
Xiaoliang Sun ◽  
Haoyang Ji ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
Univariate Analysis ◽  
Total Parathyroidectomy ◽  
Postoperative Hypocalcemia ◽  
Preoperative Serum ◽  
Significant Independent Risk Factor ◽  
Risk Patients ◽  
Optimal Cutoff Point

Elevated preoperative levels of alkaline phosphatase (ALP) in patients with refractory secondary hyperparathyroidism are correlated with postoperative hypocalcemia and mortality. The aim of this study was to identify the predictors of preoperative ALP in patients with secondary hyperparathyroidism. From April 2012 to December 2015, 220 patients with refractory secondary hyperparathyroidism undergoing total parathyroidectomy without autotransplantation were reviewed. A total of 164 patients presented with elevated preoperative ALP. Univariate analysis showed that patients with elevated ALP were significantly younger. The elevated ALP group had significantly higher levels of preoperative parathyroid hormone (PTH), lower preoperative serum calcium, higher preoperative phosphorus, lower postoperative hypocalcemia, and a longer hospital stay. Logistic regression analysis showed that elevated preoperative PTH was a significant independent risk factor for elevated preoperative ALP (P = 0.000), and its value of 1624 pg/mL was the optimal cutoff point. Factors predictive of elevated preoperative ALP in patients with secondary hyperparathyroidism include preoperative PTH. Earlier surgery, aggressive calcium supplementation, and more careful or aggressive postoperative care for high-risk patients are needed.

Seasonal levels of serum parathyroid hormone, calcitonin and alkaline phosphatase in relation to antler cycles in white-tailed deer

1984 ◽  
Vol 106 (2) ◽  
pp. 234-240 ◽  
Author(s):  
Chun Chin Chao ◽  
Robert D. Brown ◽  
Leonard J. Deftos
Keyword(s):  
Alkaline Phosphatase ◽  
Body Weight ◽  
Parathyroid Hormone ◽  
Feed Intake ◽  
Feed Consumption ◽  
Late Winter ◽  
Serum Parathyroid Hormone ◽  
Serum Samples ◽  
Antler Growth ◽  
Serum Pth

Abstract. Seasonal levels of serum parathyroid hormone (PTH), calcitonin (CT), and alkaline phosphatase (AP) were studied in relation to antler growth cycles in 8 male (2.5–6 years old) white-tailed deer. Feed consumption was recorded weekly, whereas body weight was recorded biweekly. Antler length was measured from the pedicle to the tip after velvet growth was initiated. Serum samples were obtained biweekly while animals were tranquilized with xylazine hydrochloride. Serum Ca was significantly (P < 0.05) elevated during the summer. Serum P was significantly (P < 0.05) elevated only during early fall. There was an increase in serum PTH during velvet initiation in April–May, but not thereafter. CT increased during the rapid antler growth period. Serum PTH levels were significantly (P < 0.05) elevated (0.628 vs 0.884 ng/ml) during post-velvet shedding and decreased (0.602 vs 0.346 ng/ml, P < 0.05) during postantler casting. Serum AP activity was highest during rapid velvet antler growth. Feed intake was lowest in early winter, but a compensatory increase was found in late winter. Feed intake peaked in May, then gradually decreased. Body weight was maximum in November and minimum in March. It is concluded that increased PTH during velvet initiation is responsible for Ca absorption and/or mobilization. Increasing PTH levels are related to final mineralization of antlers post-velvet shedding. Higher levels of serum Ca in June–July inhibit continued increase in PTH. Increased CT during rapid antler growth may have prevented excessive bone resorption.

scholarly journals Effect of Etelcalcetide vs Cinacalcet on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism

JAMA ◽  
2017 ◽  
Vol 317 (2) ◽  
pp. 156 ◽  
Author(s):  
Geoffrey A. Block ◽  
David A. Bushinsky ◽  
Sunfa Cheng ◽  
John Cunningham ◽  
Bastian Dehmel ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Serum Parathyroid Hormone

Demonstration of a Diurnal Variation in Serum Parathyroid Hormone in Primary and Secondary Hyperparathyroidism

1975 ◽  
Vol 41 (6) ◽  
pp. 1009-1013 ◽  
Author(s):  
TUSHAR K. SINHA ◽  
SARAH MILLER ◽  
JOHN FLEMING ◽  
RASHID KHAIRI ◽  
JAMES EDMONDSON ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Diurnal Variation ◽  
Serum Parathyroid Hormone

scholarly journals Control of hyperparathyroidism with the intravenous calcimimetic etelcalcetide in dialysis patients adherent and non-adherent to oral calcimimetics

2020 ◽  
Author(s):  
Maria Dolores Arenas ◽  
Cristian Rodelo-Haad ◽  
M Victoria Pendón-Ruiz de Mier ◽  
Mariano Rodriguez
Keyword(s):  
Parathyroid Hormone ◽  
Standard Deviation ◽  
Secondary Hyperparathyroidism ◽  
Serum Phosphate ◽  
Dialysis Patients ◽  
Serum Parathyroid Hormone ◽  
Apparent Lack ◽  
Serum Pth ◽  
And Control ◽  
Possible Cause

Abstract Background In dialysis patients, non-adherence to oral cinacalcet adds complexity to the control of secondary hyperparathyroidism. The present study aims to evaluate the use of intravenous calcimimetic, etelcalcetide, in the control of secondary hyperparathyroidism in patients adherent and non-adherent to oral calcimimetics. Method The Simplified Medication Adherence Questionnaire was used to identify non-adherence. Almost half of the patients were non-adherent to the treatment with cinacalcet. Twenty-five patients (15 non-adherent) were switched from cinacalcet to etelcalcetide and were followed-up monthly for 8 months. Results Cinacalcet was discontinued for 1 week before the initiation of etelcalcetide. After this period, the serum PTH levels increased by2-fold in adherent patients, whereas it did not change in non-adherent patients suggesting that they were not taking the medication. Etelcalcetide progressively reduced serum parathyroid hormone (PTH) (mean ± standard deviation) from 818 ± 395 to 367 ± 289 pg/mL (P &lt; 0.001) in non-adherents, and from 496 ± 172 to 228 ± 111 pg/mL (P &lt; 0.01) in adherent patients with a mean dose of 7.0 ± 2.3 and 5.1 ± 1.2 mg in non-adherent and in adherent patients, respectively. Etelcalcetide increased the percentage of patients with PTH on target from 28% to 58%. Patients with serum calcium &lt;8.4 mg/dL increased from 8% to 40%, although they remained asymptomatic. The percent of patients with serum phosphate on target increased from 40% to 65%. Conclusion The lack of adherence to cinacalcet is a possible cause of the apparent lack of response to oral calcimimetic. The use of etelcalcetide ensures compliance and control of secondary hyperparathyroidism in both non-adherent and adherent patients.

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