Predictors of early postoperative hypocalcemia after total parathyroidectomy in renal hyperparathyroidism

Poh Guan Tan; Imi Sairi Ab. Hadi; Zalina Zahari; Maya Mazuwin Yahya; Wan Zainira Wan Zain; Michael Pak-Kai Wong; Rosnelifaizur Ramely; Mohd Nizam Md Hashim; Syed Hassan Syed Abd. Aziz; Zaidi Zakaria; Andee Dzulkarnaen Zakaria

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저자정보: Poh Guan Tan (Universiti Sains Malaysia) Imi Sairi Ab. Hadi (Hospital Raja Perempuan Zainab 2) Zalina Zahari (Universiti Sultan Zainal Abidin) Maya Mazuwin Yahya (Universiti Sains Malaysia) Wan Zainira Wan Zain (Universiti Sains Malaysia) Michael Pak-Kai Wong (Universiti Sains Malaysia) Rosnelifaizur Ramely (Universiti Sains Malaysia) Mohd Nizam Md Hashim (Universiti Sains Malaysia) Syed Hassan Syed Abd. Aziz (Universiti Sains Malaysia) Zaidi Zakaria (Universiti Sains Malaysia) Andee Dzulkarnaen Zakaria (Universiti Sains Malaysia)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.1

발행연도: 2020.1

수록면: 1 - 6 (6page)

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Purpose: Patients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy.
Methods: Data of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated.
Results: Among 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002).
Conclusion: Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.

#Hypocalcemia #Parathyroidectomy #Parathyroid hormone #Renal insufficiency #Secondary hyperparathyroidism

참고문헌 (25)

참고문헌 신청

Lennard T / 2010 / Endocrine surgery : a companion to specialist surgical practice / Ann R Coll Surg Engl 92:717

Rashed A / 2004 / Effectiveness of surgical parathyroidectomy for secondary hyperparthyroidism in renal dialysis patients in Qatar / Transplant Proc 36:1815~1817

Gourgiotis S / 2006 / Total parathyroidectomy with autotransplantation in patients with renal hyperparathyroidism:indications and surgical approach / Hormones (Athens) 5:270~275

Saliba W / 2009 / Secondary hyperparathyroidism : pathophysiology and treatment / J Am Board Fam Med 22:574~581

Tominaga Y / 2006 / Surgical treatment of secondary hyperparathyroidism due to chronic kidney disease / Ups J Med Sci 111:277~292

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