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04-10-2022 | Hyperparathyroidism | Original Article

A reappraisal of risk factors for early hypocalcemia after parathyroidectomy in dialysis patients

Authors: Long Cao, Xinzeng Sun, Ting Zhang, Yue Niu, Haijin Suo, Ziwen Zhao, Chen Wang, Jianping Bai

Published in: Updates in Surgery | Issue 6/2022

Abstract

We aimed to identify risk factors for early hypocalcemia after parathyroidectomy in patients with secondary hyperparathyroidism. We retrospectively enrolled 106 of 120 consecutive patients with secondary hyperparathyroidism who underwent parathyroidectomy between January 2019 and July 2021. Perioperative laboratory parameters, preoperative computerized tomography (CT) images, and postoperative histology were evaluated. Parathyroid calcification was defined as hyperdense regions with a density of > 130 Hounsfield Units on CT images of the parathyroid. Subtotal parathyroidectomy, total parathyroidectomy without auto-transplantation, or total parathyroidectomy with auto-transplantation were performed in the present study. Postoperative hypocalcemia was defined as a serum calcium concentration < 2.1 mmol/L within 4 days of surgery. The participants were categorized according to the presence (n = 33) or absence (n = 73) of postoperative hypocalcemia. The demographics, comorbidities, and surgical details were similar in the two groups. Multivariate analysis showed that the preoperative alkaline phosphatase activity, serum intact parathyroid hormone and calcium concentrations, and parathyroid calcification were independent risk factors for postoperative hypocalcemia (all P < 0.05). Receiver operating characteristic analysis generated areas under the curves for preoperative alkaline phosphatase, intact parathyroid hormone, and parathyroid calcification of 0.82, 0.80, and 0.70, respectively (all P < 0.05). Cut-off values for preoperative alkaline phosphatase (> 242.9 IU/L) and intact parathyroid hormone (> 2,104 pg/mL) were found to be predictive of postoperative hypocalcemia. High preoperative alkaline phosphatase activity and serum intact parathyroid hormone concentration and low serum calcium are associated with higher risks of postoperative hypocalcemia. Calcification of the parathyroid may represent a novel radiologic means of predicting postoperative hypocalcemia.

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Title: A reappraisal of risk factors for early hypocalcemia after parathyroidectomy in dialysis patients
Authors: Long Cao
Xinzeng Sun
Ting Zhang
Yue Niu
Haijin Suo
Ziwen Zhao
Chen Wang
Jianping Bai
Publication date: 04-10-2022
Publisher: Springer International Publishing
Keywords: Hyperparathyroidism
Parathyroidectomy
Parathyroidectomy
Hypocalcemia
Published in: Updates in Surgery / Issue 6/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-022-01395-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A reappraisal of risk factors for early hypocalcemia after parathyroidectomy in dialysis patients

Abstract

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Graphical abstract

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