NCT04484116

Brief Summary

Secondary hyperparathyroidism (SHPT) is a multisystemic syndrome that affects calcium and bone homeostasis in patients with chronic kidney disease (CKD). Despite medical treatment, 1-2% of patients require parathyroidectomy anually. The use of an intraoperative paratohormone protocol (IOPTH) to predict cure still in debate, due to the lack of standardized protocols, the use of different assays and uneven PTH clearance. The aim of this study was to determine the diagnostic accuracy of an IOPTH in patients with SHPT for predicting successful surgery after parathyroidectomy.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
30

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Jul 2017

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2017

Completed
2.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 30, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 30, 2019

Completed
8 months until next milestone

First Submitted

Initial submission to the registry

July 20, 2020

Completed
3 days until next milestone

First Posted

Study publicly available on registry

July 23, 2020

Completed
Last Updated

July 23, 2020

Status Verified

July 1, 2020

Enrollment Period

2.4 years

First QC Date

July 20, 2020

Last Update Submit

July 20, 2020

Conditions

Secondary Hyperparathyroidism

Keywords

Secondary hyperparathyroidismParathyroidectomyIntraoperative paratohormone

Outcome Measures

Primary Outcomes (1)

  • Successful surgery

    Biochemical response to subtotal prathyroidectomy

    24 hours

Secondary Outcomes (1)

  • PTH drop

    15 minutes and 30 minutes after resection

Study Arms (2)

Succesful surgery

PTH 24 hours after surgery \<150pg/mL

Diagnostic Test: Intraoperative Paratohormone

Unsuccessful surgery

PTH 24 hours after surgery \>150pg/mL

Diagnostic Test: Intraoperative Paratohormone

Interventions

Intraoperative ParatohormoneDIAGNOSTIC_TEST

Three IOPTH determinations were withdrawn: at anesthetic induction (PTH0), 15 minutes (PTH15), and 30 minutes (PTH30) after completion gland resection. Another sample was taken 24 hours after the procedure (PTH24), values \<150pg/mL defined a successful surgery and patients were assigned to the successful or unsuccessful group. IOPTH drop was analyzed to predict successful surgery with drops of 70% and 90% at 15 and 30 minutes.

Succesful surgeryUnsuccessful surgery

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients with chronic kidney disease and secondary hyperparathyroidism

You may qualify if:

  • PTH \>800pg/mL and SHPT symptoms, or
  • Asymptomatic patients with PTH \>1000pg/mL who were resistant to treatment
  • compliance with the signature of the informed consent

You may not qualify if:

  • patients who respond adequately to medical treatment
  • incomplete IOPTH protocol

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital General Ajusco Medio

Mexico City, 14250, Mexico

Location

Related Publications (11)

  • Pitt SC, Sippel RS, Chen H. Secondary and tertiary hyperparathyroidism, state of the art surgical management. Surg Clin North Am. 2009 Oct;89(5):1227-39. doi: 10.1016/j.suc.2009.06.011.

    PMID: 19836494RESULT

  • IV. NKF-K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease: update 2000. Am J Kidney Dis. 2001 Jan;37(1 Suppl 1):S182-238. doi: 10.1016/s0272-6386(01)70008-x. No abstract available.

    PMID: 11229970RESULT

  • Young EW, Albert JM, Satayathum S, Goodkin DA, Pisoni RL, Akiba T, Akizawa T, Kurokawa K, Bommer J, Piera L, Port FK. Predictors and consequences of altered mineral metabolism: the Dialysis Outcomes and Practice Patterns Study. Kidney Int. 2005 Mar;67(3):1179-87. doi: 10.1111/j.1523-1755.2005.00185.x.

    PMID: 15698460RESULT

  • Lorenz K, Bartsch DK, Sancho JJ, Guigard S, Triponez F. Surgical management of secondary hyperparathyroidism in chronic kidney disease--a consensus report of the European Society of Endocrine Surgeons. Langenbecks Arch Surg. 2015 Dec;400(8):907-27. doi: 10.1007/s00423-015-1344-5. Epub 2015 Oct 2.

    PMID: 26429790RESULT

  • Carneiro DM, Solorzano CC, Nader MC, Ramirez M, Irvin GL 3rd. Comparison of intraoperative iPTH assay (QPTH) criteria in guiding parathyroidectomy: which criterion is the most accurate? Surgery. 2003 Dec;134(6):973-9; discussion 979-81. doi: 10.1016/j.surg.2003.06.001.

    PMID: 14668730RESULT

  • Hruska KA, Korkor A, Martin K, Slatopolsky E. Peripheral metabolism of intact parathyroid hormone. Role of liver and kidney and the effect of chronic renal failure. J Clin Invest. 1981 Mar;67(3):885-92. doi: 10.1172/jci110106.

    PMID: 7204561RESULT

  • Hiramitsu T, Tominaga Y, Okada M, Yamamoto T, Kobayashi T. A Retrospective Study of the Impact of Intraoperative Intact Parathyroid Hormone Monitoring During Total Parathyroidectomy for Secondary Hyperparathyroidism: STARD Study. Medicine (Baltimore). 2015 Jul;94(29):e1213. doi: 10.1097/MD.0000000000001213.

    PMID: 26200645RESULT

  • Seehofer D, Rayes N, Klupp J, Steinmuller T, Ulrich F, Muller C, Schindler R, Frei U, Neuhaus P. Predictive value of intact parathyroid hormone measurement during surgery for renal hyperparathyroidism. Langenbecks Arch Surg. 2005 Jun;390(3):222-9. doi: 10.1007/s00423-005-0541-z. Epub 2005 Feb 22.

    PMID: 15726399RESULT

  • Vulpio C, Bossola M, Di Stasio E, Pepe G, Nure E, Magalini S, Agnes S. Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism. Clin Biochem. 2016 May;49(7-8):538-43. doi: 10.1016/j.clinbiochem.2016.01.012. Epub 2016 Jan 20.

    PMID: 26800781RESULT

  • Lokey J, Pattou F, Mondragon-Sanchez A, Minuto M, Mullineris B, Wambergue F, Foissac-Geroux P, Noel C, de Sagazan HL, VanHille P, Proye CA. Intraoperative decay profile of intact (1-84) parathyroid hormone in surgery for renal hyperparathyroidism--a consecutive series of 80 patients. Surgery. 2000 Dec;128(6):1029-34. doi: 10.1067/msy.2000.110431.

    PMID: 11114639RESULT

  • Barczynski M, Cichon S, Konturek A, Cichon W. A randomised study on a new cost-effective algorithm of quick intraoperative intact parathyroid hormone assay in secondary hyperparathyroidism. Langenbecks Arch Surg. 2005 Apr;390(2):121-7. doi: 10.1007/s00423-004-0535-2. Epub 2005 Feb 15.

    PMID: 15711996RESULT

MeSH Terms

Conditions

Hyperparathyroidism, Secondary

Condition Hierarchy (Ancestors)

HyperparathyroidismParathyroid DiseasesEndocrine System Diseases

Study Officials

  • Karla V Chavez-Tostado, MD

    SEDESA

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD

Study Record Dates

First Submitted

July 20, 2020

First Posted

July 23, 2020

Study Start

July 1, 2017

Primary Completion

November 30, 2019

Study Completion

November 30, 2019

Last Updated

July 23, 2020

Record last verified: 2020-07

Locations

ME(1)