Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients
Marius C Florescu,1 KM Monirul Islam,2 Troy J Plumb,1 Sara Smith-Shull,3 Jennifer Nieman,3 Prasanti Mandalapu11Nephrology Department, 2Institute of Public Health, 3Department of Pharmacy, The Nebraska Medical Center, Omaha, NE, USABackground: Data on the risk factors and clinical course of hungry bo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2014-05-01
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| Series: | International Journal of Nephrology and Renovascular Disease |
| Online Access: | http://www.dovepress.com/calcium-supplementation-after-parathyroidectomy-in-dialysis-and-renal--a16832 |
| _version_ | 1811283710425694208 |
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| author | Florescu MC Islam KM Plumb TJ Smith-Shull S Nieman J Mandalapu P |
| author_facet | Florescu MC Islam KM Plumb TJ Smith-Shull S Nieman J Mandalapu P |
| author_sort | Florescu MC |
| collection | DOAJ |
| description | Marius C Florescu,1 KM Monirul Islam,2 Troy J Plumb,1 Sara Smith-Shull,3 Jennifer Nieman,3 Prasanti Mandalapu11Nephrology Department, 2Institute of Public Health, 3Department of Pharmacy, The Nebraska Medical Center, Omaha, NE, USABackground: Data on the risk factors and clinical course of hungry bone syndrome are lacking in dialysis and renal transplant patients who undergo parathyroidectomy. In this study, we aimed to assess the risks and clinical course of hungry bone syndrome and calcium repletion after parathyroidectomy in dialysis and renal transplant patients.Methods: We performed a retrospective review of parathyroidectomies performed at The Nebraska Medical Center.Results: We identified 41 patients, ie, 30 (73%) dialysis and eleven (27%) renal transplant patients. Dialysis patients had a significantly higher pre-surgery intact parathyroid hormone (iPTH, P<0.001) and a larger iPTH drop after surgery (P<0.001) than transplant recipients. Post-surgery hypocalcemia in dialysis patients was severe and required aggressive and prolonged calcium replacement (11 g) versus a very mild hypocalcemia requiring only brief and minimal replacement (0.5 g) in transplant recipients (P<0.001). Hypophosphatemia was not detected in the dialysis group. Phosphorus did not increase immediately after surgery in transplant recipients. The hospital stay was significantly longer in dialysis patients (8.2 days) compared with transplant recipients (3.2 days, P<0.001).Conclusion: The clinical course of hungry bone syndrome is more severe in dialysis patients than in renal transplant recipients. Young age, elevated alkaline phosphatase, elevated pre-surgery iPTH, and a large decrease in post-surgical iPTH are risk factors for severe hungry bone syndrome in dialysis patients.Keywords: parathyroidectomy, hungry bone syndrome, hypocalcemia |
| first_indexed | 2024-04-13T02:16:27Z |
| format | Article |
| id | doaj.art-e9c3170bc3bd4285881bcfddfdefe413 |
| institution | Directory Open Access Journal |
| issn | 1178-7058 |
| language | English |
| last_indexed | 2024-04-13T02:16:27Z |
| publishDate | 2014-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Nephrology and Renovascular Disease |
| spelling | doaj.art-e9c3170bc3bd4285881bcfddfdefe4132022-12-22T03:07:08ZengDove Medical PressInternational Journal of Nephrology and Renovascular Disease1178-70582014-05-012014default18319016832Calcium supplementation after parathyroidectomy in dialysis and renal transplant patientsFlorescu MCIslam KMPlumb TJSmith-Shull SNieman JMandalapu PMarius C Florescu,1 KM Monirul Islam,2 Troy J Plumb,1 Sara Smith-Shull,3 Jennifer Nieman,3 Prasanti Mandalapu11Nephrology Department, 2Institute of Public Health, 3Department of Pharmacy, The Nebraska Medical Center, Omaha, NE, USABackground: Data on the risk factors and clinical course of hungry bone syndrome are lacking in dialysis and renal transplant patients who undergo parathyroidectomy. In this study, we aimed to assess the risks and clinical course of hungry bone syndrome and calcium repletion after parathyroidectomy in dialysis and renal transplant patients.Methods: We performed a retrospective review of parathyroidectomies performed at The Nebraska Medical Center.Results: We identified 41 patients, ie, 30 (73%) dialysis and eleven (27%) renal transplant patients. Dialysis patients had a significantly higher pre-surgery intact parathyroid hormone (iPTH, P<0.001) and a larger iPTH drop after surgery (P<0.001) than transplant recipients. Post-surgery hypocalcemia in dialysis patients was severe and required aggressive and prolonged calcium replacement (11 g) versus a very mild hypocalcemia requiring only brief and minimal replacement (0.5 g) in transplant recipients (P<0.001). Hypophosphatemia was not detected in the dialysis group. Phosphorus did not increase immediately after surgery in transplant recipients. The hospital stay was significantly longer in dialysis patients (8.2 days) compared with transplant recipients (3.2 days, P<0.001).Conclusion: The clinical course of hungry bone syndrome is more severe in dialysis patients than in renal transplant recipients. Young age, elevated alkaline phosphatase, elevated pre-surgery iPTH, and a large decrease in post-surgical iPTH are risk factors for severe hungry bone syndrome in dialysis patients.Keywords: parathyroidectomy, hungry bone syndrome, hypocalcemiahttp://www.dovepress.com/calcium-supplementation-after-parathyroidectomy-in-dialysis-and-renal--a16832 |
| spellingShingle | Florescu MC Islam KM Plumb TJ Smith-Shull S Nieman J Mandalapu P Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients International Journal of Nephrology and Renovascular Disease |
| title | Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| title_full | Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| title_fullStr | Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| title_full_unstemmed | Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| title_short | Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| title_sort | calcium supplementation after parathyroidectomy in dialysis and renal transplant patients |
| url | http://www.dovepress.com/calcium-supplementation-after-parathyroidectomy-in-dialysis-and-renal--a16832 |
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