PTH and chronic kidney disease: Studies have shown that kidney function, measured by preoperative creatinine, may have an influence on intraoperative PTH decline because of cross-reactions with PTH metabolites46,47; however, several studies have shown that patients with chronic kidney disease that undergo parathyroidectomy demonstrate IOPTH degradation kinetics similar to patients with normal kidney function, thus, the same IOPTH decline should be utilized in patients with normal kidney function and chronic kidney disease48,49.