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2015 ; 30
(6
): 856-64
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Predicting postoperative total calcium requirements after parathyroidectomy in
secondary hyperparathyroidism
#MMPMID26552461
Kang BH
; Hwang SY
; Kim JY
; Hong YA
; Jung MY
; Lee EA
; Lee JE
; Lee JB
; Ko GJ
; Pyo HJ
; Kwon YJ
Korean J Intern Med
2015[Nov]; 30
(6
): 856-64
PMID26552461
show ga
BACKGROUND/AIMS: To prevent hypocalcemia after parathyroidectomy (PTX),
parenteral calcium is required in addition to oral calcitriol and calcium. After
switching to oral calcium, patients can be discharged from the hospital. The aim
of this study was to analyze the clinical characteristics and outcomes of PTX
performed at a single Korean center and to investigate the associated laboratory
factors used to analyze the total amount of postoperative calcium required.
METHODS: We enrolled 91 hemodialysis patients undergoing PTX from November 2003
to December 2011. We collected clinical and laboratory data preoperatively, 12
and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively.
RESULTS: In total, 59 patients underwent PTX with autotransplantation (AT), 6
underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent
limited PTX. Total PTX without AT showed the lowest recurrence rate. At all
postoperative time points, the mean levels of serum calcium, phosphorus, and
intact parathyroid hormone (iPTH) decreased significantly, compared with
preoperative levels; however, alkaline phosphatase (ALP) increased significantly
from 48 hours postoperatively to discharge (p < 0.001). On multiple linear
regression analysis, the total amount of injected calcium during hospitalization
showed a significant correlation with preoperative ALP (p < 0.001), preoperative
iPTH (p = 0.037), and ?phosphorus at 48 hours (p < 0.001). We developed an
equation for estimating the total calcium requirement after PTX. CONCLUSIONS:
Preoperative ALP, preoperative iPTH, and ?phosphorus at 48 hours may be
significant factors in estimating the postoperative calcium requirement. The
formula for postoperative calcium requirement after PTX may help to predict the
duration of postoperative hospitalization.
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