Calcitonin concentrations in patients with chronic kidney disease on hemodialysis in reference to parathyroidectomy

OBJECTIVE: Calcitonin is considered to be a biomarker of medullary thyroid carcinoma and C-cell hyperplasia, but calcitonin can also be elevated in about 30% of the patients with end-stage kidney disease. We reported preoperative calcitonin serum levels in 31 patients on hemodialysis before parathyroid surgery, evaluate influencing factors on calcitonin levels and determine postoperative calcitonin levels after parathyroid surgery. RESULTS: Median preoperative serum calcitonin was 8 pg/ml (range 2 to 165 pg/ml), serum calcitonin concentration declined postoperatively to 3 pg/ml (range 1 to 192 pg/ml). There was a strong positive correlation between pre- and postoperative serum calcitonin levels (r = 0.92; p > 0.01). Elevated preoperative serum calcitonin concentrations (more than 10 pg/ml) were found in 14 out of 32 dialysis-dependent patients (44%). Preoperative calcitonin levels of male patients were significantly higher than female patients. Hypercalcitoninemia showed a positive correlation to body mass index (p < 0.01). We found no correlation between preoperative calcitonin levels and patients’ age, duration of hemodialysis dependency, cinacalcet medication or preoperative concentrations of parathyroid hormone, creatinine and calcium. Basal calcitonin levels higher than 10 pg/ml are common in patients on dialysis. Male gender and morbid obesity are risk factors for hypercalcitoninemia. Calcitonin concentration decreases after parathyroid operation.