Table 2.
Comparison of new and old management guidelines for patients with asymptomatic primary hyperparathyroidism who do not undergo parathyroid surgery
| Measurement | 1990 | 2002 | 2008 |
|---|---|---|---|
| Serum calcium | Biannually | Biannually | Annually |
| 24-h urinary calcium | Annually | Not recommended | Not recommended |
| Creatinine clearance (24-h urine collections) | Annually | Not recommended | Not recommended |
| Serum creatinine | Annually | Annually | Annually |
| Bone density | Annually (forearm) | Annually (3 sites) | Every 1–2 yr (3 sites) |
| Abdominal x-ray (±ultrasound) | Annually | Not recommended | Not recommended |
a
This recommendation acknowledges country-specific advisories as well as the need for more frequent monitoring if the clinical situation is appropriate.