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Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
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Age-specific differences in parathyroidectomy after implementation of guidelines for primary hyperparathyroidism.
Gonzalo J Acosta1, Robert Medina2, Michel S Kabbash3
1Division of Endocrinology, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
Gland Surgery
|March 11, 2026
Summary
Older adults with primary hyperparathyroidism (PHPT) face longer delays for parathyroidectomy, even with guideline-based evaluations. They present with more bone disease and kidney issues, underscoring the need for timely intervention.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Surgical Oncology
Background:
- Primary hyperparathyroidism (PHPT) is common, but older adults undergo parathyroidectomy less frequently despite meeting surgical criteria.
- Age-related disparities in surgical treatment for PHPT persist, necessitating investigation into diagnostic and treatment timelines.
Purpose of the Study:
- To analyze age-specific differences in the diagnosis, surgical timing, and indications for parathyroidectomy in patients with PHPT.
- To compare preoperative evaluation completeness between younger and older adult patients undergoing parathyroidectomy.
Main Methods:
- Retrospective cohort study of 266 adults with sporadic PHPT undergoing parathyroidectomy (2017-2022).
- Surgical indications assessed against 2016 AAES and Fourth International Workshop guidelines.
- Preoperative evaluation completeness documented, including biochemical markers and imaging.
Main Results:
- Older adults (≥65 years) experienced significantly longer median time from diagnosis to surgery (14.5 vs. 7.53 months).
- Patients ≥65 years were more likely to have surgery for bone disease (31.4% vs. 20.0%) and impaired renal function (eGFR <60 mL/min/1.73 m²; 43.8% vs. 13.1%).
- Nephrolithiasis was less common in older adults (29.8% vs. 43.3%), and complete preoperative evaluations were similar across age groups.
Conclusions:
- Older adults with PHPT face significant delays in receiving parathyroidectomy, despite adequate preoperative evaluations.
- Increased prevalence of bone disease and renal impairment in older adults highlights the need for earlier diagnosis and intervention to prevent long-term complications.
- Strategies to expedite surgical referral and treatment are crucial for improving outcomes in elderly PHPT patients.
