PURPOSE: The characteristics of hypoparathyroidism in patients with Hashimoto thyroiditis (HT) after total thyroidectomy are not well established. The aim of this study was to investigate the relationship between hypoparathyroidism and loss of parathyroid glands in patients with or without HT who underwent total thyroidectomy. METHODS: Patients who underwent total thyroidectomy were divided into two groups; with HT (n=166) and without HT (n=526). Clinicopathologic characteristics were compared between the two groups. RESULTS: The mean numbers of parathyroid glands in specimens were significantly smaller in the with HT group than in the without HT group (0.34+/-0.51 vs. 0.42+/-0.58, P=0.003). The rate of transient hypoparathyroidism was significantly higher in the with HT group than in the without HT group (51.8% vs. 34.6%, P=0.000). Serum total calcium levels in patients who experienced transient hypoparathyroidism did not differ significantly between groups (P=0.335). The incidence of transient hypoparathyroidism of patients who preserved all four parathyroid glands or sacrificed one parathyroid gland was higher in the with HT group than in the without HT group, although that of patients who sacrificed two or more parathyroid glands was similar between groups. The incidence of permanent hypoparathyroidism in the two groups did not differ (P=0.546). CONCLUSION: Patients with HT had a higher rate of transient hypoparathyroidism after total thyroidectomy, particularly patients who preserved all four or three parathyroid glands. It is likely that the blood supply to the parathyroid gland might be vulnerable in patients with HT. Therefore, even though all parathyroid glands were preserved, careful monitoring of hypoparathyroidism is necessary after total thyroidectomy in patients with HT.
Calcium ; Hashimoto Disease* ; Humans ; Hypoparathyroidism* ; Incidence ; Parathyroid Glands ; Thyroidectomy*

Intradialytic blood pressure abnormalities are associated with adverse outcomes in patients with end-stage renal disease on dialysis. Vascular calcification is a common complicating feature, but whether this complication results in intradialytic blood pressure abnormalities remains uncertain. Therefore, this study investigated the relationship between coronary artery calcium score and intradialytic blood pressure abnormalities in patients with end-stage renal disease on maintenance hemodialysis. Thirty-six patients who received nongated chest computed tomography scans were included. Intradialytic hypotension was defined as a minimum intradialytic systolic blood pressure of <100 mmHg or a pre-dialysis blood pressure – minimum intradialytic systolic blood pressure >30 mmHg. Intradialytic hypertension was defined as >10 mmHg increase in systolic blood pressure (pre- to post-dialysis). Patients were classified as 22 (61.1%) with coronary artery calcium score <400 and 14 (38.9%) with coronary artery calcium score ≥400. Median systolic and diastolic blood pressures were equivalent, but median pulse pressure was higher in patients with coronary artery calcium score ≥400 than in those with scores <400. Coronary artery calcium score was comparable according to both intradialytic hypotension and hypertension, and had no correlation with systolic blood pressure fall and nadir systolic blood pressure. Coronary artery calcium score predicted the occurrence of cardiovascular events and all-cause mortality (hazard ratio 1.001 and 1.001; p=0.058 and 0.010). Coronary vascular calcification could be irrelevant to intradialytic blood pressure abnormalities in patients with end-stage renal disease on dialysis.