Abstract
Objective: Hyperparathyroidism develops in the majority of patients with end-stage renal disease receiving hemodialysis. Parathyroidectomy can be performed in cases who cannot be managed with medical therapy and a portion of the patients develop hungry bone syndrome (HBS) in the postoperative period. In this study, we investigated the factors that influence the development of HBS and the hospitalization times in hemodialysis patients who underwent parathyroidectomy.
Method: This study included 49 patients. Demographic, clinical and laboratory parameters of these patients were retrospectively evaluated.
Results: Patients’ median age was 46 years (22-62). The parathyroid gland that showed hyperplasia the most frequently was the left inferior 79.6% (n=39), followed by the right inferior 77.6% (n=38) gland. Rate of four-gland hyperplasia was 32.7% (n=16). Of the 49 operated patients, 34 (69.4%) developed HBS. In patients with postoperative PTH <500 pg/ml, calcium < 7mg/dl during the first 24 hours after surgery and calcium infusion > 4 ampules during the first 24 hours, hospitalization times were prolonged and the need for parenteral calcium infusion was elevated.
Conclusion: The need for parenteral calcium replacement during the first 24 hours, postoperative PTH and calcium levels during the first 24 hours were determined to be factors indicating the severity of HBS in the postoperative period.
Supporting Institution
yok
Project Number
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Thanks
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References
- Filopanti F, Corbetta S, Barbieri AM, and Spada A, “Pharmacology of the calcium sensing receptor,” Clinical Cases in Mineral and Bone Metabolism, 2013; 10(3): 162–165.
- Dunlay R. and Hruska K. PTH receptor coupling to phospholipase C is an alternate pathway of signal transduction in bone and kidney, The American Journal of Physiology—Renal Fluid and Electrolyte Physiology, 1990; 258(2): F223–F231.
- Jofre R, Lopez Gomez JM, Menarguez J, et al. Parathyroidectomy: whom and when? Kidney Int Suppl. 2003;63:S97–S100.
- Jamal SA, Miller PD. Secondary and tertiary hyperparathyroidism. J Clin Densitom. 2013;16(1):64–68.
- Assadi F. Hypophosphatemia: An evidencebased problem-solving approach to clinical cases. Iran J Kidney Dis 2010;4:195-201.
- Albright F, Reifenstein EC. The parathyroid glands and metabolic bone disease, Ulster Medical Journal, 1950; 19 (1):130–131.
- Farese S. The hungry bone syndrome: An update. Ther Umsch 2007;64:277-80.
- Kritmetapak K, Kongpetch S, Chotmongkol W, Raruenrom Y, Sangkhamanon S and Pongchaiyakul C. Incidence of and risk factors for post-parathyroidectomy hungry bone syndrome in patients with secondary hyperparathyroidism. RENAL FAILURE 2020;42(1): 1118–1126.
- Jain N, Reilly RF. Hungry bone syndrome. Curr Opin Nephrol Hypertens. 2017;26(4):250–255.
- Brasier AR, Nussbaum SR. “Hungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery,” The American Journal of Medicine, 1988; 84(4): 654–660.
- Jofré R, López Gómez JM, Menárguez J. et al. Parathyroidectomy: whom and when? Kidney Int Suppl 2003; S97.
- Witteveen JE, van Thiel S, Romijn JA, Hamdy NA. Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. European Journal of Endocrinology/European Federation of Endocrine Societies. 2013;168(3):R45–R53.
- Heath DA, Van't Hoff W, Barnes AD and Gray JG. Value of 1-α-hydroxy vitamin D3 in treatment of primary hyperparathyroidism before parathyroidectomy. BMJ 1979;1: 450–452.
- Kebebew E, Duh QY, Clark OH. Tertiary hyperparathyroidism: histologic patterns of disease and results of parathyroidectomy. Arch Surg 2004; 139:974.
- Vercauteren M, Boeckx E and Adriaensen H. Parathyroidectomy and postoperative hypocalcemia: a retrospective study. Acta Anaesthesiologica Belgica 1988;39: 59–63.
- Benz RL, Schleifer CR, Teehan BP, et al. Successful treatment of postparathyroidectomy hypocalcemia using continuous ambulatory intraperitoneal calcium (CAIC) therapy. Perit Dial Int 1989; 9:285.
Abstract
Project Number
-
References
- Filopanti F, Corbetta S, Barbieri AM, and Spada A, “Pharmacology of the calcium sensing receptor,” Clinical Cases in Mineral and Bone Metabolism, 2013; 10(3): 162–165.
- Dunlay R. and Hruska K. PTH receptor coupling to phospholipase C is an alternate pathway of signal transduction in bone and kidney, The American Journal of Physiology—Renal Fluid and Electrolyte Physiology, 1990; 258(2): F223–F231.
- Jofre R, Lopez Gomez JM, Menarguez J, et al. Parathyroidectomy: whom and when? Kidney Int Suppl. 2003;63:S97–S100.
- Jamal SA, Miller PD. Secondary and tertiary hyperparathyroidism. J Clin Densitom. 2013;16(1):64–68.
- Assadi F. Hypophosphatemia: An evidencebased problem-solving approach to clinical cases. Iran J Kidney Dis 2010;4:195-201.
- Albright F, Reifenstein EC. The parathyroid glands and metabolic bone disease, Ulster Medical Journal, 1950; 19 (1):130–131.
- Farese S. The hungry bone syndrome: An update. Ther Umsch 2007;64:277-80.
- Kritmetapak K, Kongpetch S, Chotmongkol W, Raruenrom Y, Sangkhamanon S and Pongchaiyakul C. Incidence of and risk factors for post-parathyroidectomy hungry bone syndrome in patients with secondary hyperparathyroidism. RENAL FAILURE 2020;42(1): 1118–1126.
- Jain N, Reilly RF. Hungry bone syndrome. Curr Opin Nephrol Hypertens. 2017;26(4):250–255.
- Brasier AR, Nussbaum SR. “Hungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery,” The American Journal of Medicine, 1988; 84(4): 654–660.
- Jofré R, López Gómez JM, Menárguez J. et al. Parathyroidectomy: whom and when? Kidney Int Suppl 2003; S97.
- Witteveen JE, van Thiel S, Romijn JA, Hamdy NA. Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. European Journal of Endocrinology/European Federation of Endocrine Societies. 2013;168(3):R45–R53.
- Heath DA, Van't Hoff W, Barnes AD and Gray JG. Value of 1-α-hydroxy vitamin D3 in treatment of primary hyperparathyroidism before parathyroidectomy. BMJ 1979;1: 450–452.
- Kebebew E, Duh QY, Clark OH. Tertiary hyperparathyroidism: histologic patterns of disease and results of parathyroidectomy. Arch Surg 2004; 139:974.
- Vercauteren M, Boeckx E and Adriaensen H. Parathyroidectomy and postoperative hypocalcemia: a retrospective study. Acta Anaesthesiologica Belgica 1988;39: 59–63.
- Benz RL, Schleifer CR, Teehan BP, et al. Successful treatment of postparathyroidectomy hypocalcemia using continuous ambulatory intraperitoneal calcium (CAIC) therapy. Perit Dial Int 1989; 9:285.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Original Research Paper |
| Authors | |
| Project Number | - |
| Publication Date | December 21, 2021 |
| Published in Issue | Year 2021 Volume: 13 Issue: 2 |
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