Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Severe Secondary…

Cohort studyWorld journal of surgery· Jul 2026

Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Severe Secondary Hyperparathyroidism due to Kidney Failure.

Juan C Ramírez-Sandoval, Gabriel Cojuc-Konigsberg, Vianca A Canaviri-Flores … David Velazquez-Fernández

Endocrine SurgeryCohort studyQ1IF 2.0

10-minute intraoperative parathyroid hormone strongly predicts parathyroidectomy success in secondary hyperparathyroidism.

Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Severe Secondary Hyperparathyroidism due to Kidney Failure.

Juan C Ramírez-Sandoval … David Velazquez-Fernández

World journal of surgery · Jul 2026 · Q1 in Surgery

Background

The utility of intraoperative parathyroid hormone (intraoperative parathyroid hormone) monitoring during subtotal parathyroidectomy to predict long-term intact PTH levels in kidney failure remains uncertain.

Methods

Diagnostic accuracy study in a cohort of 46 patients with severe, uncontrolled secondary hyperparathyroidism.

n = 46 patients

Results

0.86

AUC of 0.86 (1.0 perfect) shows 10-min hormone level predicts surgical success well.

n = 46 patients

More results

Surgical success was achieved in 37 (80%) patients using the KDOQI criterion.

AUCs for percentage decline at 10 and 30 min were 0.78 (95% CI: 0.63-0.92, p = 0.03) and 0.75 (95% CI: 0.60-0.92, p = 0.02), respectively.

More results

A 10-min intraoperative parathyroid hormone < 270.7 pg/mL yielded 89% sensitivity and 68% specificity for predicting KDOQI success.

Using KDIGO criterion, 41 (89%) patients achieved surgical success, with similar trends observed.

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Conclusion

In severe secondary hyperparathyroidism due to kidney failure, 10-min intraoperative parathyroid hormone is a strong predictor of surgical success, with < 270 pg/mL suggesting better outcomes; percentage decline and 30-min values add little benefit.

Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Severe Secondary Hyperparathyroidism due to Kidney Failure.

Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Severe Secondary Hyperparathyroidism due to Kidney Failure.

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