The relationship of transient hypocalcemia and hypoparathyroidism to preoperative vitamin d levels after parathyroidectomy

ABSTRACT The Relationship of Transient Hypocalcemia and Hypoparathyroidism to Preoperative Vitamin D Levels After Parathyroidectomy Introduction and Objectives: This retrospective cohort study aimed to evaluate the relationship between preoperative vitamin D levels and postoperative transient hypocalcemia and hypoparathyroidism in patients undergoing parathyroidectomy with the diagnosis of primary hyperparathyroidism (PHPT). Method:A total of 41 patients who were operated on in our hospital between 2018 and 2024 were included in the study, 33 of whom were in the patient group (patients operated on for primary hyperparathyroidism with low Vitamin 25 OH-D3 levels) and 8 of whom were in the control group (patients with Vitamin 25 OH-D3 levels >30 ng/ml). Findings: Our study showed that male gender, high 24-hour urine calcium levels, and high preoperative TSH levels were significantly associated with these complications. Furthermore, the rate of preoperative vitamin D treatment and the amount of treatment were lower in patients who developed complications. A strong inverse correlation was found between preoperative vitamin D levels and early postoperative PTH in the control group. Our findings emphasize the importance of correcting preoperative vitamin D deficiency and monitoring postoperative thyroid function. Conclusion: Our study suggests that male gender, high 24-hour urine calcium levels, and inadequate preoperative vitamin D therapy may be associated with a risk of transient hypocalcemia and hypoparathyroidism after parathyroidectomy. The strong negative correlation observed between preoperative vitamin D and postoperative PTH in the control group highlights the importance of vitamin D sufficiency in calcium homeostasis. These findings further underscore the importance of meticulous preoperative assessment of vitamin D deficiency and careful postoperative monitoring of thyroid function in PHPT patients. Keywords: Primary hyperparathyroidism, Parathyroidectomy, Hypocalcemia, Vitamin D