Clinical factors associated with early and persistent hypocalcaemia after parathyroidectomy in patients on dialysis with severe hyperparathyroidism

• Published in: Nephrology (Carlton, Vic.) Vic.), 2021-05, Vol.26 (5), p.408-419
• Main Authors: Fonseca‐Correa, Jorge I., Nava‐Santana, Carlos, Tamez‐Pedroza, Luis, Paz‐Cortes, Armando, Santillan‐Ceron, Airy, Rojas‐Concha, Luis J., Pantoja‐Millán, Juan Pablo, Sierra‐Salazar, Mauricio, Velazquez‐Fernández, David, Herrera, Miguel F., Correa‐Rotter, Ricardo, Ramirez‐Sandoval, Juan C.
• Format: Article
• Language: English
• Subjects: Alkaline phosphatase; Bone diseases; Calcium; Dialysis; end‐stage renal disease; Hyperparathyroidism; hypocalcaemia; Hypocalcemia; hypophosphataemia; mineral bone disorder; Parathyroidectomy; Risk factors
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.13854

Aim Severe hypocalcaemia following parathyroidectomy for secondary or tertiary hyperparathyroidism (SHPT/THPT) is scarcely studied. We aimed to describe and identify risk factors for early and persistent hypocalcaemia after parathyroidectomy. Methods Retrospective pair‐matched cohort study. We assessed 87 dialysis patients with SHPT (n = 73) or THPT (n = 14) paired with 146 subjects with primary hyperparathyroidism (PHPT) who underwent parathyroidectomy and were followed for 12 months. Early severe hypocalcaemia was defined as a free Ca ≤0.8 mmol/L [3.2 mg/dl] or corrected Ca ≤1.87 mmol/L [7.5 mg/dl] within 48 h. After parathyroidectomy and persistent hypocalcaemia, as an elemental Ca intake >3.0 g/day to achieve corrected Ca >2 mmol/L [8.0 mg/dl]. Results Early severe hypocalcaemia occurred in 77% (67/87) versus 6.8% (10/146) of subjects with SHPT/THPT and PHPT, respectively (p