Comparison of calcitriol versus cholecalciferol therapy in addition to oral calcium after total thyroidectomy with central neck lymph node dissection: a prospective randomized study.
Study Goal
The researchers aimed to compare the effectiveness of oral calcium plus vitamin D supplementation (cholecalciferol vs. calcitriol) in preventing postoperative hypocalcemia after total thyroidectomy with central neck dissection.
Results Summary
Routine supplementation reduced hypocalcemia incidence but did not prevent severe cases. Calcitriol was more effective and faster-acting than cholecalciferol when used on-demand.
Population
306 patients who underwent total thyroidectomy with central neck dissection.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral calcium plus vitamin D supplementation | decrease | hypocalcemia | patients after total thyroidectomy with central neck dissection | - | developed less frequently | #1 |
routine oral calcium and vitamin D supplements | neutral | postoperative outcome | patients after total thyroidectomy with central neck lymph node dissection | - | are beneficial | #2 |
routine supplementation | no change | severe hypocalcemia | patients after total thyroidectomy with central neck dissection | - | did not prevent | #3 |
calcitriol | neutral | hypocalcemia treatment | patients receiving on-demand supplements after total thyroidectomy with central neck dissection | - | was more effective and faster acting than was cholecalciferol | #4 |
calcitriol along with calcium carbonate | neutral | hypocalcemia treatment | patients after the onset of hypocalcemia following total thyroidectomy | - | seems to be more effective than is cholecalciferol with calcium carbonate | #5 |
cholecalciferol versus calcitriol | no change | effectiveness | patients receiving routine supplementation after total thyroidectomy with central neck dissection | - | no difference | #6 |
BACKGROUND: The purpose of this study was to determine the effectiveness of oral calcium plus vitamin D supplementation and to compare the effects of cholecalciferol versus calcitriol treatments on postoperative hypocalcemia. METHODS: After total thyroidectomy with central neck dissection, 306 patients were divided into 4 groups according to "routine use versus on-demand use" and "cholecalciferol versus calcitriol." RESULTS: Hypocalcemic symptoms developed in 101 patients (33.0%). Hypocalcemia developed less frequently in patients receiving routine supplementation regardless of vitamin D type. However, routine supplementation did not prevent severe hypocalcemia. In patients receiving on-demand supplements, calcitriol was more effective and faster acting than was cholecalciferol. CONCLUSION: Routine oral calcium and vitamin D supplements are beneficial after total thyroidectomy with central neck lymph node dissection with no difference between cholecalciferol and calcitriol. If taken after the onset of hypocalcemia, however, calcitriol along with calcium carbonate seems to be more effective than is cholecalciferol with calcium carbonate.