Table 3.

Guidelines for Medical Monitoring in Patients With Asymptomatic Primary Hyperparathyroidism Managed Conservatively

Parameter	Frequency of Evaluation
Serum calcium	Annually
Skeletal	Three-site DXA every 1-2 years
	Imaging of spine to access vertebral fracture if clinically suspected (e.g., height loss, back pain)
Renal	Serum creatinine and eGFR annually
	If renal stones are clinically suspected: 24-hour biochemical stone profile, abdominal imaging by X-ray, ultrasonography, or CT

[Adapted with permission from Bilezikian JP, Brandi ML, Eastell R, et al. Consensus Statement: Guidelines for the management of asymptomatic primary hyperparathyroidism: Summary Statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99:3561–3569.]

Abbreviation: eGFR, estimated glomerular filtration rate.