Bone metabolism markers and hungry bone syndrome after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Ge, Yifei; Yang, Guang; Wang, Ningning; Zha, Xiaoming; Yu, Xiangbao; Mao, Huijuan; Sun, Bin; Zhang, Ming; Zhang, Bo; Xing, Changying

doi:10.1007/s11255-019-02217-y

Cited by 42 publications

(52 citation statements)

References 28 publications

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“…Integration of multiple risk factors may improve the detection of postoperative HBS. [29][30][31] In addition, literature focusing on SHPT of renal origin treated with PTXþAT is limited. The present study was performed to investigate the incidence of and risk factors for HBS after PTXþAT for SHPT of renal origin.…”

Section: Introductionmentioning

confidence: 99%

Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy

et al. 2021

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Objective To summarize the clinical features of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure and to explore the predictive factors of postoperative hypocalcemia after total parathyroidectomy in these patients. Methods The clinical data of 87 patients admitted to Guangdong Electric Power Hospital from May 2013 to February 2020 were reviewed. All patients underwent total parathyroid resection and sternocleidomastoid microtransplantation. Age, sex, and the serum calcium, phosphorus, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) concentrations were analyzed as predictive factors of postoperative hypocalcemia. Results Bone pain was the most common clinical manifestation in this study population, and all 87 patients experienced relief from their clinical symptoms after the surgical procedure. Age and the preoperative serum calcium, ALP, and iPTH concentrations were determined to be early predictive factors of postoperative hypocalcemia. Conclusions Age and the preoperative calcium, ALP, and iPTH concentrations are independent risk factors for postoperative hypocalcemia in patients with SHPT and renal disease who undergo total parathyroidectomy with sternocleidomastoid microtransplantation. These factors can help identify high-risk patients who can be managed by a multidisciplinary team to improve graft survival and quality of life.

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Section: Introductionmentioning

confidence: 99%

Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy

et al. 2021

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“…The use of PTx in patients with CKD is associated with improvements in biochemical parameters of mineral and bone metabolism 60 – 62 , cardiovascular health 63 , and mortality 64 , 65 . However, this technique is not free of complications, such as persistent hyperparathyroidism, often due to the existence of supernumerary or abnormally located parathyroid glands 66 , or the development of hungry bone syndrome due to PTH oversuppression 67 .…”

Section: Parathyroidectomymentioning

confidence: 99%

Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease

Rodríguez‐Ortiz

Rodríguez

2020

F1000Res

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Secondary hyperparathyroidism is a complex pathology that develops as chronic kidney disease progresses. The retention of phosphorus and the reductions in calcium and vitamin D levels stimulate the synthesis and secretion of parathyroid hormone as well as the proliferation rate of parathyroid cells. Parathyroid growth is initially diffuse but it becomes nodular as the disease progresses, making the gland less susceptible to be inhibited. Although the mechanisms underlying the pathophysiology of secondary hyperparathyroidism are well known, new evidence has shed light on unknown aspects of the deregulation of parathyroid function. Secondary hyperparathyroidism is an important feature of chronic kidney disease–mineral and bone disorder and plays an important role in the development of bone disease and vascular calcification. Thus, part of the management of chronic kidney disease relies on maintaining acceptable levels of mineral metabolism parameters in an attempt to slow down or prevent the development of secondary hyperparathyroidism. Here, we will also review the latest evidence regarding several aspects of the clinical and surgical management of secondary hyperparathyroidism.

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“…Postoperative SH is a well-known and severe complication following parathyroidectomy [3]. e reported incidence of postoperative SH is 10-46% among patients with primary hyperparathyroidism who underwent parathyroidectomy and 28-88% among patients with SHPT [4][5][6][7][8][9]. SH following parathyroidectomy can be severe and prolonged in some situations and a poorly defined entity termed "hungry bone syndrome" (HBS) has been adapted to describe this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Severe Hypocalcemia in Patients with Secondary Hyperparathyroidism after Total Parathyroidectomy

Wen

Zhao

et al. 2021

International Journal of Endocrinology

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Background. Hypocalcemia is the most common complication of total parathyroidectomy in secondary hyperparathyroidism (SHPT) and is associated with adverse consequences such as spasms, epilepsy, and arrhythmia and even death if the serum calcium level decreases rapidly. Previous studies have identified several risk factors for postoperative severe hypocalcemia (SH) in patients with SHPT, but the sample sizes were small and thus the results may not be reliable. Objectives. This study was performed to investigate the risk factors for SH after total parathyroidectomy without autotransplantation (tPTX) in a large sample of patients with uremic hyperparathyroidism. Methods. We retrospectively investigated the records of 1,095 patients with SHPT treated with tPTX between January 2008 and December 2018. Based on the postoperative serum calcium concentration, the patients were grouped into SH and non-SH groups. The clinical characteristics and biochemical results were analyzed, and binary logistic regression analysis was used to identify the risk factors for SH. Results. After surgery, 25.9% of the patients developed SH. Age, diastolic blood pressure (DBP), heart rate, frequency of bone pain, weight of resected glands, preoperative serum calcium, intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and hemoglobin levels differed between the two groups. Binary logistic regression analyses identified preoperative serum calcium, iPTH, and ALP levels as independent predictors of SH after surgery. Conclusions. The preoperative serum calcium, iPTH, and ALP levels can be used to assess the risk of postoperative SH in patients with SHPT. Such patients should thus be monitored closely in order to initiate prompt interventions to avoid SH.

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Bone metabolism markers and hungry bone syndrome after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Cited by 42 publications

References 28 publications

Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy

Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy

Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease

Risk Factors for Severe Hypocalcemia in Patients with Secondary Hyperparathyroidism after Total Parathyroidectomy

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