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Routine low-dose calcium supplementation after thyroidectomy does not reduce the rate of symptomatic hypocalcemia: A prospective randomized trial

Title
Routine low-dose calcium supplementation after thyroidectomy does not reduce the rate of symptomatic hypocalcemia: A prospective randomized trial
Authors
Lee J.W.Kim J.-K.Kwon H.Lim W.Moon B.-I.Paik N.S.
Ewha Authors
문병인임우성백남선권형주이준우김종규
SCOPUS Author ID
문병인scopus; 임우성scopus; 백남선scopus; 권형주scopus; 이준우scopus
Issue Date
2019
Journal Title
Annals of Surgical Treatment and Research
ISSN
2288-6575JCR Link
Citation
Annals of Surgical Treatment and Research vol. 96, no. 4, pp. 177 - 184
Keywords
CalciumHypocalcemiaHypoparathyroidismThyroid neoplasmsThyroidectomy
Publisher
Korean Surgical Society
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Purpose: Routine supplementation of high-dose calcium significantly decreased the risk of postoperative symptomatic hypocalcemia after thyroidectomy. However, there is an ongoing debate about whether the same results can be achieved with low-dose calcium supplementation. Methods: Patients (n = 138) who underwent total thyroidectomy for thyroid cancer were 1:1 randomly assigned to receive oral supplements of 1,500 mg/day elemental calcium and 1,000 IU/day cholecalciferol for 2 weeks or no supplementation. Primary objective was to compare the incidence of symptomatic hypocalcemia for 3 days after total thyroidectomy. Secondary objective was to find the predictors for postoperative hypocalcemia in patients with thyroid cancer. Results: Sixty-five patients in the calcium group and 69 patients in the control group were finally analyzed. The incidence of symptomatic hypocalcemia showed no difference between the calcium and control group (32.3% vs. 21.7%, P = 0.168). The total dosage of intravenous calcium (593.4 ± 267.1 mg vs. 731.6 ± 622.7 mg, P = 0.430) administered to patients with symptomatic hypocalcemia was also comparable between groups. In a multivariate analysis, parathyroid hormone level of 13 pg/mL at postoperative day 1 was only predictive for symptomatic hypocalcemia, and its incidence was 20.9 times (95% confidence interval, 6.8–64.5) higher in patients with parathyroid hormone <13 pg/mL. Other factors did not predict the development of hypocalcemia, including clinicopathological features and routine supplementation of low-dose calcium. Conclusion: Routine low-dose calcium supplementation did not reduce the risk of postoperative hypocalcemia. Patients who may benefit from calcium supplementation should be carefully selected. Copyright © 2019, the Korean Surgical Society.
DOI
10.4174/astr.2019.96.4.177
Appears in Collections:
의과대학 > 의학과 > Journal papers
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