Graves CE, Hwang R, McManus CM, et al. - Among patients with asymptomatic primary hyperparathyroidism, a significant proportion undergoing parathyroidectomy have chronic kidney disease. Researchers here investigated the kinetics of intraoperative parathyroid hormone decline during parathyroidectomy in patients with vs without chronic kidney disease. In this retrospective single-center study, they included 646 patients with primary hyperparathyroidism undergoing parathyroidectomy. Grouping of patients was done on the basis of estimated glomerular filtration rate greater than (normal renal function) or less than (chronic kidney disease) 60 mL/min/1.73m ². Although the groups had similar pre-excision values, significantly higher intraoperative parathyroid hormone values at 5 minutes (76 vs 58 pg/mL) and 10 minutes (54 vs 37 pg/mL) post excision were observed in patients with chronic kidney disease. However, renal function was not identified affecting the change in intraoperative parathyroid hormone over time, as well as did not ultimately affect the possibility of meeting the Miami criterion. In this population, utility remains concerning intraoperative parathyroid hormone monitoring, although additional time points may be required to observe normalization of values.