Surgery for Primary Hyperparathyroidism (pHPT) in Patients Older Than 65 Years Compared With Follow-up
Surgery for Primary Hyperparathyroidism (pHPT) in Patients Older Than 65 Years Compared With Follow-up
General consensus and contemporary guidelines, recommend surgery for primary
 hyperparathyroidism (pHPT)for all patients below the age of 50, for patients with pronounced
 hypercalcemia and for patients with organ complications to the disease (osteoporosis and
 decreased renal function).

 The purpose of this study is to determine if surgery for pHPT, is appropriate for patients
 with moderate to mild hypercalcemia older than 65 years of age.

 The hypothesis of the study is that surgery for pHPT in patients older than 65 years of age,
 and with mild hypercalcemia, will increase bone density and hence decrease future risk for
 fragility fractures compared to patients with follow-up only.
The majority of patients diagnosed and operated due to primary HPT in Scandinavia are older
 than 65 years of age. The vast majority of the patients have mild aberrations of serum
 calcium (< 1.50 mmol/l ionized calcium), and some patients may even be asymptomatic. The
 present trial is designed to clarify the indications for surgical treatment in this large
 subgroup of patients.
Inclusion Criteria:

 -  Primary Hyperparathyroidism

 -  No previous parathyroid surgery

 -  Sporadic disease

 Exclusion Criteria:

 -  Z-score of Bone density < -2.5 SD (regardless of site)

 -  Serum level of ionized calcium > 1.50 mmol/L

 -  Inability to understand given information or to comply with scheduled follow-up

 -  Symptoms of hypercalcaemia for which specific medical treatment has been prescribed