Evaluation of the prophylactic effects of oral calcium supplement alone and with calcitriol in the development of symptomatic hypocalcemia after total or near-total thyroidectomy

Abstract

Hypocalcemia is a common complication after total or near-total thyroidectomy. The aim of this study was to evaluate the prophylactic effects of oral calcium supplementation alone and with calcitriol in the development of symptomatic hypocalcemia after total or near-total thyroidectomy. Materials and Methods: In this randomized clinical trial, 105 patients who were candidates for total or near-total thyroidectomy were included in the study. After the operation, they were randomly assigned to one of the following three groups: Group 1, 35 patients without supplementation; Group 2, 35 patients receiving oral calcium carbonate ( 500 mg every 8 h ); Group 3, 35 patients received oral calcium carbonate ( 500 mg every 8 h ) and calcitriol ( 0.25 mcg daily ). Serum calcium levels, symptoms of hypocalcemia and duration of hospitalization were compared in three groups. Results: The incidence of symptomatic hypocalcemia in groups 2 and 3 was significantly lower than group 1 ( P = 0.02, P = 0.00 respectively ), but there was no significant difference between groups 2 and 3 ( P = 0.136 ). Serum calcium levels increased better in groups 3 than in groups 1 and 2 ( P < 0.001, P = 0.04 respectively ). The duration of hospitalization in groups 2 and 3 was significantly shorter than group 1 ( P = 0.034, P = 0.001 respectively ), but there was no significant difference between groups 2 and 3 ( P = 0.762 ).