Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery
Secondary hyperparathyroidism (SHPT) is a common complication of end-stage kidney disease (ESKD). Hungry bone syndrome (HBS) occurs frequently in patients on maintenance dialysis receiving parathyroidectomy for refractory SHPT. However, there is scanty study investigating the clinical risk factors t...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-09-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/12/10/EC-23-0107.xml |
| _version_ | 1797674843287584768 |
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| author | Heng Yeh Hsuan Yeh Chun-Cheng Chiang Ju-Ching Yen I-Kuan Wang Shou-Hsuan Liu Cheng-Chia Lee Cheng-Hao Weng Wen-Hung Huang Ching-Wei Hsu Tzung-Hai Yen |
| author_facet | Heng Yeh Hsuan Yeh Chun-Cheng Chiang Ju-Ching Yen I-Kuan Wang Shou-Hsuan Liu Cheng-Chia Lee Cheng-Hao Weng Wen-Hung Huang Ching-Wei Hsu Tzung-Hai Yen |
| author_sort | Heng Yeh |
| collection | DOAJ |
| description | Secondary hyperparathyroidism (SHPT) is a common complication of end-stage kidney disease (ESKD). Hungry bone syndrome (HBS) occurs frequently in patients on maintenance dialysis receiving parathyroidectomy for refractory SHPT. However, there is scanty study investigating the clinical risk factors that predict postoperative HBS, and its outcome in peritoneal dialysis (PD) patients. We conducted a single-center retrospective study to analyze 66 PD patients who had undergone parathyroidectomy for secondary hyperparathyroidism at Chang Gung Memorial Hospital between 2009 and 2019. The patients were stratified into two groups based on the presence ( n=47) or absence (n=19) of HBS after parathyroidectomy. Subtotal parathyroidectomy was the most common surgery performed (74.2%), followed by total parathyroidectomy with autoimplantation (25.8%). Pathological examination of all surgical specimens revealed parathyroid hyperplasia (100%). Patients with HBS had lower levels of postoperative nadir corrected calcium, higher alkaline phosphate (ALP), and higher potassium levels compared with patients without HBS (all P<0.05). A multivariate logistic regression model confirmed that lower preoperative serum calcium level (OR 0.354, 95% CI 0.133–0.940, P=0.037), higher ALP (OR 1.026, 95% CI 1.008–1.044, P=0.004), and higher potassium level (OR 6.894, 95% CI 1.806–26.317, P=0.005) were associated with HBS after parathyroidectomy. Patients were followed for 58.2±30.8 months after the surgery. There was no significant difference between HBS and non-HBS groups in persistence (P=0.496) or recurrence (P=1.000) of hyperparathyroidism. The overall mortality rate was 10.6% with no significant difference found between both groups (P=0.099). We concluded that HBS is a common complication (71.2%) of parathyroidectomy for SHPT and should be managed appropriately. |
| first_indexed | 2024-03-11T22:04:55Z |
| format | Article |
| id | doaj.art-7f99c56c82de495390a910c41bb1c4cc |
| institution | Directory Open Access Journal |
| issn | 2049-3614 |
| language | English |
| last_indexed | 2024-03-11T22:04:55Z |
| publishDate | 2023-09-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-7f99c56c82de495390a910c41bb1c4cc2023-09-25T07:10:21ZengBioscientificaEndocrine Connections2049-36142023-09-011210111https://doi.org/10.1530/EC-23-0107Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgeryHeng Yeh0Hsuan Yeh1Chun-Cheng Chiang2Ju-Ching Yen3I-Kuan Wang4Shou-Hsuan Liu5Cheng-Chia Lee6Cheng-Hao Weng7Wen-Hung Huang8Ching-Wei Hsu9Tzung-Hai Yen10Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, China Medical University, Taichung, TaiwanCollege of Medicine, China Medical University, Taichung, Taiwan; Department of Nephrology, China Medical University Hospital, Taichung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanSecondary hyperparathyroidism (SHPT) is a common complication of end-stage kidney disease (ESKD). Hungry bone syndrome (HBS) occurs frequently in patients on maintenance dialysis receiving parathyroidectomy for refractory SHPT. However, there is scanty study investigating the clinical risk factors that predict postoperative HBS, and its outcome in peritoneal dialysis (PD) patients. We conducted a single-center retrospective study to analyze 66 PD patients who had undergone parathyroidectomy for secondary hyperparathyroidism at Chang Gung Memorial Hospital between 2009 and 2019. The patients were stratified into two groups based on the presence ( n=47) or absence (n=19) of HBS after parathyroidectomy. Subtotal parathyroidectomy was the most common surgery performed (74.2%), followed by total parathyroidectomy with autoimplantation (25.8%). Pathological examination of all surgical specimens revealed parathyroid hyperplasia (100%). Patients with HBS had lower levels of postoperative nadir corrected calcium, higher alkaline phosphate (ALP), and higher potassium levels compared with patients without HBS (all P<0.05). A multivariate logistic regression model confirmed that lower preoperative serum calcium level (OR 0.354, 95% CI 0.133–0.940, P=0.037), higher ALP (OR 1.026, 95% CI 1.008–1.044, P=0.004), and higher potassium level (OR 6.894, 95% CI 1.806–26.317, P=0.005) were associated with HBS after parathyroidectomy. Patients were followed for 58.2±30.8 months after the surgery. There was no significant difference between HBS and non-HBS groups in persistence (P=0.496) or recurrence (P=1.000) of hyperparathyroidism. The overall mortality rate was 10.6% with no significant difference found between both groups (P=0.099). We concluded that HBS is a common complication (71.2%) of parathyroidectomy for SHPT and should be managed appropriately.https://ec.bioscientifica.com/view/journals/ec/12/10/EC-23-0107.xmlhungry bone syndromeparathyroidectomyperitoneal dialysissecondary hyperparathyroidismhypocalcemia |
| spellingShingle | Heng Yeh Hsuan Yeh Chun-Cheng Chiang Ju-Ching Yen I-Kuan Wang Shou-Hsuan Liu Cheng-Chia Lee Cheng-Hao Weng Wen-Hung Huang Ching-Wei Hsu Tzung-Hai Yen Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery Endocrine Connections hungry bone syndrome parathyroidectomy peritoneal dialysis secondary hyperparathyroidism hypocalcemia |
| title | Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| title_full | Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| title_fullStr | Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| title_full_unstemmed | Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| title_short | Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| title_sort | hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery |
| topic | hungry bone syndrome parathyroidectomy peritoneal dialysis secondary hyperparathyroidism hypocalcemia |
| url | https://ec.bioscientifica.com/view/journals/ec/12/10/EC-23-0107.xml |
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