A reappraisal of risk factors for early hypocalcemia after parathyroidectomy in dialysis patients

Cao, Liangzhi; Sun, Xinzeng; Zhang, Ting; Niu, Yue; Suo, Haijin; Zhao, Zhihui; Wang, Chen; Bai, Jianping

doi:10.1007/s13304-022-01395-2

Cited by 1 publication

(2 citation statements)

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“…Many studies on patients with hyperparathyroidism after PTX showed that preoperative iPTH [ 12 – 24 ], ALP [ 12 – 16 , 18 – 20 , 22 – 28 ], serum Ca [ 13 – 15 , 17 – 28 ], serum P [ 12 , 16 , 22 ], and age [ 14 , 18 – 23 , 26 ] are influencing factors for postoperative SH. In the present study, there was a statistically significant difference in ALP and iPTH levels between the two groups, and both had a strong negative correlation with postoperative serum Ca levels, but there was no statistical significance in the binary logistic regression multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, their study revealed that the presence of parathyroid calcification was associated with a higher risk of SH in the short-term after surgery. This finding suggests that the identification of parathyroid calcification through radiological imaging may be a useful means of predicting the likelihood of developing SH following parathyroid surgery [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Identification of novel risk factors for postoperative severe hypocalcemia in patients with primary hyperparathyroidism undergoing parathyroidectomy: a case control study

Xu,

Kong,

Bai

et al. 2024

BMC Endocr Disord

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Background Patients with primary hyperparathyroidism (PHPT) are at risk for severe hypocalcemia (SH) following parathyroidectomy (PTX), but limited data exist on the predictors of SH. We aimed to identify risk factors for early postoperative SH after PTX in patients with PHPT and to evaluate the predictive value of clinical parameters. Methods A retrospective review of patients with PHPT who underwent PTX between January 2010 and December 2022 was performed. A total of 46 patients were included in the study, with 15 (32.6%) experiencing postoperative SH, 19 (41.3%) having calculi in the ureter or kidney, and 37 (80.4%) having osteoporosis. Patients were divided into SH and non-SH groups based on postoperative serum calcium levels. Preoperative biochemical indicators, bone turnover markers, and renal function parameters were analyzed and correlated with postoperative SH. Results Statistically significant (P < 0.05) differences were found in preoperative serum calcium (serum Ca), intact parathyroid hormone, serum phosphorus (serum P), serum Ca/P, percentage decrease of serum Ca, total procollagen type 1 intact N-terminal propeptide, osteocalcin (OC), and alkaline phosphatase levels between the two groups. Multivariate analysis showed that serum P (odds ratio [OR] = 0.989; 95% confidence interval [95% CI] = 0.981–0.996; P = 0.003), serum Ca (OR = 0.007; 95% CI = 0.001–0.415; P = 0.017), serum Ca/P (OR = 0.135; 95% CI = 0.019–0.947; P = 0.044) and OC levels (OR = 1.012; 95% CI = 1.001–1.024; P = 0.036) were predictors of early postoperative SH. The receiver operating characteristic curve analysis revealed that serum P (area under the curve [AUC] = 0.859, P < 0.001), serum Ca/P (AUC = 0.735, P = 0.010) and OC (AUC = 0.729, P = 0.013) had high sensitivity and specificity. Conclusion Preoperative serum P, serum Ca/P and osteocalcin levels may identify patients with PHPT at risk for early postoperative SH after PTX.

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