Early Postoperative Intact Parathyroid Hormone Dynamics After Curative Parathyroidectomy for Sporadic Primary Hyperparathyroidism: Trajectories, Predictors of Eucalcemic PTH Elevation, and 18-Month Outcomes
Authors' conclusion
After curative parathyroidectomy, higher baseline iPTH, β-CTX, and lower eGFR identified patients at increased risk of PePTH at 6 months. PePTH was associated with biochemical recurrence through 18 months and may identify higher-risk postoperative phenotype requiring closer follow-up.
Study context
- Population
- Adults with sporadic PHPT undergoing curative minimally invasive parathyroidectomy with intraoperative PTH confirmation of cure
- Participants
- 58 adults
- Exposure
- PePTH vs normalized intact PTH (iPTH) at 6 months
- PePTHn = 13
- Normalized iPTHn = 45reference
- Outcome
- PePTH at 6 months
- Follow-up
- 6 months
Main finding
As reported in the abstract
PePTH
13/58 patients
22%
Higher baseline iPTH, lower estimated glomerular filtration rate (eGFR) and higher β-CTX independently predicted PePTH (AUROC)
0.81
Observational data: associations, not effects.
Further findings
| Outcome | PePTH | Normalized iPTH |
|---|---|---|
| Biochemical recurrence · 18 months | 46% | 0 events |
Early iPTH trajectory · 6 h to 3 months
- iPTH nadir at 6 h (median)
- 12.1 pg/mL
- iPTH re-entered reference range by POD2, stabilized by POD5, similar at 3 months
- Calcium normalized within 48 h; phosphate rose from POD2 and stabilized by 3 months
Original publication
Early Postoperative Intact Parathyroid Hormone Dynamics After Curative Parathyroidectomy for Sporadic Primary Hyperparathyroidism: Trajectories, Predictors of Eucalcemic PTH Elevation, and 18-Month Outcomes. Endocr Pract. Published 19 May 2026. doi:10.
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