{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T22:58:09Z","timestamp":1788044289221,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In severe renal hyperparathyroidism (RHPT), whether administrating Cinacalcet before total parathyroidectomy can reduce post\u2010operative hypocalcemia remains unclear. We compared post\u2010operative calcium kinetics between those who took Cinacalcet before surgery (Group I) and those who did not (Group II).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with severe RHPT (defined by PTH\u2009\u2265\u2009100 pmol\/L) who underwent total parathyroidectomy between 2012 and 2022 were analyzed. Standardized peri\u2010operative protocol of calcium and vitamin D supplementation was followed. Blood tests were performed twice daily in the immediate post\u2010operative period. Severe hypocalcemia was defined as serum albumin\u2010adjusted calcium\u2009&lt;\u20092.00\u00a0mmol\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 159 patients who underwent parathyroidectomy, 82 patients were eligible for analysis (Group I, <jats:italic>n<\/jats:italic>\u2009=\u200927; Group II, <jats:italic>n<\/jats:italic>\u2009=\u200955). Demographics and PTH levels before Cinacalcet administration were comparable (Group I: 169\u2009\u00b1\u200949 pmol\/L vs Group II: 154\u2009\u00b1\u200945, <jats:italic>p<\/jats:italic>\u2009=\u20090.209). Group I had significantly lower pre\u2010operative PTH (77\u2009\u00b1\u200960 pmol\/L vs 154\u2009\u00b1\u200945, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), higher post\u2010operative calcium (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and lower rate of severe hypocalcemia (33.3% vs 60.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.023). Longer duration of Cinacalcet use correlated with higher post\u2010operative calcium levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Cinacalcet use for\u2009&gt;\u20091 year resulted in fewer severe post\u2010operative hypocalcemia than non\u2010users (<jats:italic>p<\/jats:italic>\u2009=\u20090.022, OR 0.242, 95% CI 0.068\u20130.859). Higher pre\u2010operative ALP independently correlated with severe post\u2010operative hypocalcemia (OR 3.01, 95% CI 1.17\u20137.77, <jats:italic>p<\/jats:italic>\u2009=\u20090.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In severe RHPT, Cinacalcet led to significant drop in pre\u2010operative PTH, higher post\u2010operative calcium levels, and less frequent severe hypocalcemia. Longer duration of Cinacalcet use correlated with higher post\u2010operative calcium levels, and the use of Cinacalcet for\u2009&gt;\u20091 year reduced severe post\u2010operative hypocalcemia.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07030-4","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T14:03:19Z","timestamp":1683208999000},"page":"1986-1994","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pre\u2010operative Cinacalcet Administration Reduces Immediate Post\u2010operative Hypocalcemia Following Total Parathyroidectomy in Severe Renal Hyperparathyroidism"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2812-0616","authenticated-orcid":false,"given":"Matrix Man\u2010Him","family":"Fung","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery The University of Hong Kong, Queen Mary 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