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Indian Journal of Surgery

27-06-2023 | Parathyroidectomy | Review Article

Hungry Bone Syndrome Following Parathyroidectomy: a Comprehensive Systematic Review of Risk Factors

Authors: Rupa Mehta, Karthik Nagaraja Rao, Nitin M. Nagarkar, Amritava Ghosh, Harshal Sakale

Published in: Indian Journal of Surgery

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Abstract

This study aim s, primarily, to identify the incidence of hungry bone syndrome in parathyroidectomy and, secondarily, to systematically determine the factors predisposing to hungry bone syndrome. PubMed, Embase and Cochrane databases were searched for the data extraction. Human studies reporting risk factors for developing HBS in patients undergoing parathyroidectomy for primary (PHP), secondary (SHP) or tertiary hyperparathyroidism (THP) were included. Newcastle–Ottawa score was used to assess the quality of studies. PROSPERO registration CRD42022293002. This systematic review comprised 2598 patients in the 18 included comparative studies. The overall incidence of HBS following parathyroidectomy in PHP, SHP and THP was 15.9% (8.6–39.1, CI 95%), 43.6% (20.6–87.8, CI 95%) and 12.4% (6.03–32.4, CI 95%), respectively. Younger age group (PHP and SHP), thyroidectomy along with parathyroidectomy (PHP), longer duration of surgery (PHP), larger and heavier resected parathyroids (PHP and SHP), previous dialysis (SHP), longer duration of dialysis (SHP), preoperative cinacalcet (THP) and bisphosphonates use (protective effect) (PHP and THP), calcium levels close to normal (SHP), higher values of parathormone (PHP and SHP), > 90% drop in PTH after surgery (PHP and SHP), raised ALP (PHP and SHP), higher osteocalcin (PHP and SHP), lower albumin (PHP and SHP), higher TRAP 5b (SHP), higher P1NP (PHP), BALP (PHP) and testosterone (PHP) were predictors of HBS. The risk factors for developing hypocalcaemia and HBS should be actively monitored. A complete and accurate recording of the parameters is encouraged among the clinicians to understand the HBS further.
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Metadata
Title
Hungry Bone Syndrome Following Parathyroidectomy: a Comprehensive Systematic Review of Risk Factors
Authors
Rupa Mehta
Karthik Nagaraja Rao
Nitin M. Nagarkar
Amritava Ghosh
Harshal Sakale
Publication date
27-06-2023
Publisher
Springer India
Published in
Indian Journal of Surgery
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-023-03853-6