Impact of enhanced recovery after surgery program for hungry bone syndrome in patients on maintenance hemodialysis undergoing parathyroidectomy for secondary hyperparathyroidism

Ling Wang; Xiaohong Zhang; Fengqi Hu; Hai Yuan; Zhao Gao; Li He; Shuang Zou

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자료유형: 학술저널

저자정보: Ling Wang (Affiliated Hospital of Hubei University of Arts and Science) Xiaohong Zhang (Affiliated Hospital of Hubei University of Arts and Science) Fengqi Hu (Affiliated Hospital of Hubei University of Arts and Science) Hai Yuan (Affiliated Hospital of Hubei University of Arts and Science) Zhao Gao (Affiliated Hospital of Hubei University of Arts and Science) Li He (Affiliated Hospital of Hubei University of Arts and Science) Shuang Zou (Affiliated Hospital of Hubei University of Arts and Science)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.103 No.5

발행연도: 2022.11

수록면: 264 - 270 (7page)

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Purpose: Hungry bone syndrome after parathyroidectomy is an important clinical problem in patients on maintenance hemodialysis. We examined the effect of an enhanced recovery after surgery (ERAS) program on the incidence of hungry bone syndrome after parathyroidectomy in this population.
Methods: This single-institution, retrospective study analyzed 108 patients on hemodialysis who underwent parathyroidectomy for secondary hyperparathyroidism. Patients were classified into the pre-ERAS (n = 52) and post-ERAS (n = 56) groups. The ERAS program identified high-risk patients and enforced aggressive measures to normalize calcium levels following parathyroidectomy.
Results: There was no significant difference in age, sex, body weight, presenting symptoms, preoperative calcium and alkaline phosphatase levels, postoperative intact parathyroid levels, postoperative calcium levels at 1 and 24 hours after parathyroidectomy, and 30-day readmission rates between the groups. The post-ERAS group had significantly higher levels of postoperative calcium at 48 and 72 hours after parathyroidectomy, but a lower incidence of hungry bone syndrome and shorter postoperative length of stay. Patients with hungry bone syndrome had higher preoperative levels of alkaline phosphatase and intact parathyroid, longer postoperative length of stay, and were less likely to have been part of the ERAS program. High preoperative alkaline phosphatase levels and absence of the ERAS program were independent risk factors for hungry bone syndrome after parathyroidectomy.
Conclusion: The ERAS program reduced the incidence of hungry bone syndrome and shortened the postoperative length of stay in patients on maintenance hemodialysis who underwent parathyroidectomy for secondary hyperparathyroidism.

#Enhanced recovery after surgery #Hemodialysis #Hungry bone syndrome #Parathyroidectomy #Secondary hyperparathyroidism

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