{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T12:27:59Z","timestamp":1766320079825,"version":"build-2065373602"},"reference-count":20,"publisher":"FapUNIFESP (SciELO)","issue":"9","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Primary hyperparathyroidism is considered the third most common endocrine disorder. Moreover, persistently elevated levels of parathyroid hormone occur in up to 30% of patients undergoing parathyroidectomy. The aim of this study was to determine the prevalence of persistently elevated parathyroid hormone levels after parathyroidectomy and analyze its associated factors.  METHODS: An anonymized medical record query was conducted, filtering patients who underwent parathyroidectomy at a tertiary hospital center in Southern Brazil from 2010 to 2019. Clinical, laboratory, and sociodemographic data were collected. The analyzed period ranged from 3 months prior to surgery and up to 18 months after surgery.  RESULTS: A total of 261 patients with an average age of 56 (45\u201365) years and a body mass index of 25.53 (22.19\u201328.86) kg\/m2 were included. Patients with normal parathyroid hormone levels after 18 months of surgery were compared to those with high parathyroid hormone levels in the same period. The latter had lower levels of median parathyroid hormone, minimum achieved parathyroid hormone, and higher values of vitamin D. The two groups showed no difference in terms of age, body mass index, parathyroid hormone before parathyroidectomy, calcium before and after parathyroidectomy, and glomerular filtration rate. The multivariate linear regression model showed a negative association between body mass index, glomerular filtration rate, and total calcium after parathyroidectomy with parathyroid hormone variation. Patients with reduced glomerular filtration rate had higher levels of parathyroid hormone before parathyroidectomy, with no significant difference after the procedure between glomerular filtration rate groups.  CONCLUSION: Persistently elevated levels of parathyroid hormone occurred in more than half of the patients subjected to parathyroidectomy. The observed variation in parathyroid hormone was significantly higher in patients with reduced glomerular filtration rate.<\/jats:p>","DOI":"10.1590\/1806-9282.20250013","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:05:28Z","timestamp":1760713528000},"source":"Crossref","is-referenced-by-count":1,"title":["Predictors of persistently elevated parathyroid hormone levels after parathyroidectomy: experience from a reference center"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2310-0218","authenticated-orcid":false,"given":"L\u00e9o Canterle Dal","family":"Osto","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil; Hospital de Cl\u00ednicas de Porto Alegre,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1251-6672","authenticated-orcid":false,"given":"Sofia Vacaro","family":"Macedo","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7751-0197","authenticated-orcid":false,"given":"Tayane Muniz","family":"Fighera","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil; Hospital de Cl\u00ednicas de Porto Alegre,  Brazil; Universidade Federal do Rio Grande do Sul,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1210\/jc.2012-4022","article-title":"Incidence and prevalence of primary hyperparathyroidism in a racially mixed population","volume":"98","author":"Yeh MW","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"10116","key":"ref2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian JP","year":"2018","journal-title":"Lancet"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1002\/jbmr.4677","article-title":"Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the fifth international workshop","volume":"37","author":"Bilezikian JP","year":"2022","journal-title":"J Bone Miner Res"},{"issue":"10","key":"ref4","doi-asserted-by":"crossref","first-page":"4473","DOI":"10.1210\/jc.2019-00705","article-title":"Persistently elevated PTH after parathyroidectomy at one year: experience in a tertiary referral center","volume":"104","author":"Caldwell M","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00405-017-4836-9","article-title":"Elevated parathyroid hormone levels after successful parathyroidectomy for primary hyperparathyroidism: a clinical review","volume":"275","author":"Plaza Llamas R","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1093\/ckj\/sfab006","article-title":"Secondary hyperparathyroidism and adverse health outcomes in adults with chronic kidney disease","volume":"14","author":"Xu Y","year":"2021","journal-title":"Clin Kidney J"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.kisu.2017.04.001","article-title":"KDIGO 2017 Cliniccal Practice Guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)","volume":"7","year":"2017","journal-title":"Kidney Int Suppl (2011)"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"366","DOI":"10.4103\/ijem.IJEM_212_20","article-title":"Persistent elevation of parathormone levels after surgery for primary hyperparathyroidism","volume":"24","author":"Kota SK","year":"2020","journal-title":"Indian J Endocrinol Metab"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.surg.2016.10.021","article-title":"Pattern of calcium and parathyroid hormone normalization at 12-months follow-up after parathyroid operation","volume":"161","author":"Lavryk OA","year":"2017","journal-title":"Surgery"},{"issue":"4","key":"ref10","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.surg.2012.07.005","article-title":"Persistent elevation in serum parathyroid hormone levels in normocalcemic patients after parathyroidectomy: does it matter?","volume":"152","author":"Carsello CB","year":"2012","journal-title":"Surgery"},{"issue":"6","key":"ref11","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.surg.2011.09.017","article-title":"Normocalcemic parathormone elevation after successful parathyroidectomy: long-term analysis of parathormone variations over 10 years","volume":"150","author":"Goldfarb M","year":"2011","journal-title":"Surgery"},{"issue":"1","key":"ref12","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4158\/EP09122.RA","article-title":"Significance of elevated parathyroid hormone after parathyroidectomy","volume":"16","author":"Biskobing DM","year":"2010","journal-title":"Endocr Pract"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1002\/hed.21119","article-title":"Elevated parathyroid hormone levels after parathyroidectomy for primary hyperparathyroidism","volume":"31","author":"Mizrachi A","year":"2009","journal-title":"Head Neck"},{"issue":"7","key":"ref14","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/archsurg.143.7.659","article-title":"Long-term outcome of patients with elevated parathyroid hormone levels after successful parathyroidectomy for sporadic primary hyperparathyroidism","volume":"143","author":"Solorzano CC","year":"2008","journal-title":"Arch Surg"},{"issue":"4","key":"ref15","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.surg.2004.12.009","article-title":"Reelevation of parathyroid hormone level after parathyroidectomy in patients with primary hyperparathyroidism: importance of decreased renal parathyroid hormone sensitivity","volume":"137","author":"Yamashita H","year":"2005","journal-title":"Surgery"},{"key":"ref16","series-title":"Hungry bone syndrome","author":"Cartwright C","year":"2023"},{"issue":"23","key":"ref17","doi-asserted-by":"crossref","first-page":"7130","DOI":"10.3390\/jcm11237130","article-title":"Is adynamic bone always a disease? Lessons from patients with chronic kidney disease","volume":"11","author":"Nagy E","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"7583","DOI":"10.1038\/s41598-024-58154-z","article-title":"Unraveling the complex interplay between obesity and vitamin D metabolism","volume":"14","author":"Alzohily B","year":"2024","journal-title":"Sci Rep"},{"issue":"3","key":"ref19","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1159\/000212381","article-title":"Rate of kidney function decline in older adults: a comparison using creatinine and cystatin C","volume":"30","author":"Shlipak MG","year":"2009","journal-title":"Am J Nephrol"},{"issue":"1","key":"ref20","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s12020-022-03208-3","article-title":"Vitamin D in the older population: a consensus statement","volume":"79","author":"Giustina A","year":"2023","journal-title":"Endocrine"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302025000900603&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:05:31Z","timestamp":1760713531000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302025000900603&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0104-42302025000900603"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20250013","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20250013"}}