Table 4.3.3 Open in new tab A comparison...

Table 4.3.3

A comparison of new and old guidelines for surgery in asymptomatic primary hyperparathyroidism

Measurement	Guidelines 1990	Guidelines 2002	Guidelines 2008
Serum calcium (above normal)	1–1.6 mg/dl	1.0 mg/dl	1.0 mg/dl
24-h urinary calcium	>400 mg	>400 mg
Creatinine clearance	Reduced by 30%	Reduced by 30%	< 60 cc/min
Bone mineral density	Z-score < −2.0 (forearm)	T-score < −2.5 (any site)	T-score < −2.5/ fragility fracture
Age	50	50	50

Measurement	Guidelines 1990	Guidelines 2002	Guidelines 2008
Serum calcium (above normal)	1–1.6 mg/dl	1.0 mg/dl	1.0 mg/dl
24-h urinary calcium	>400 mg	>400 mg
Creatinine clearance	Reduced by 30%	Reduced by 30%	< 60 cc/min
Bone mineral density	Z-score < −2.0 (forearm)	T-score < −2.5 (any site)	T-score < −2.5/ fragility fracture
Age	50	50	50