BACKGROUND/AIMS: Calcium supplements are often required following successful parathyroidectomy (PTX) in order to prevent overt hypocalcemia. The current study aims to quantify these calcium needs and to identify predictors of a high calcium need present at the time of surgery. METHODS: Charts of 42 patients with chronic kidney disease stage 5D, who underwent a successful subtotal PTX, were reviewed in detail. Biochemical indices of mineral metabolism available within a time frame of 4 weeks before and 6 weeks after the surgery were registered. Details concerning active vitamin D (1-alpha-calcidiol and calcitriol) and calcium supplementation were recorded as well. RESULTS: Serum calcium, phosphorus and PTH levels declined whereas total alkaline phosphatase levels increased significantly in the early post-PTX period. Transient hypocalcemia was observed in 83% of the patients. The median daily postoperative elemental calcium requirements amounted to 3.2 g during week 1, and declined to 2.4 g during week 6. A high preoperative PTH level and a low serum calcium level were identified as independent predictors of a high postoperative calcium need. CONCLUSION: Substantial amounts of elemental calcium are required following successful subtotal PTX in order to avoid frank hypocalcemia, especially in patients with a high PTH level and a low calcium level before surgery. Copyright 2008 S. Karger AG, Basel.
BACKGROUND/AIMS: Calcium supplements are often required following successful parathyroidectomy (PTX) in order to prevent overt hypocalcemia. The current study aims to quantify these calcium needs and to identify predictors of a high calcium need present at the time of surgery. METHODS: Charts of 42 patients with chronic kidney disease stage 5D, who underwent a successful subtotal PTX, were reviewed in detail. Biochemical indices of mineral metabolism available within a time frame of 4 weeks before and 6 weeks after the surgery were registered. Details concerning active vitamin D (1-alpha-calcidiol and calcitriol) and calcium supplementation were recorded as well. RESULTS: Serum calcium, phosphorus and PTH levels declined whereas total alkaline phosphatase levels increased significantly in the early post-PTX period. Transient hypocalcemia was observed in 83% of the patients. The median daily postoperative elemental calcium requirements amounted to 3.2 g during week 1, and declined to 2.4 g during week 6. A high preoperative PTH level and a low serum calcium level were identified as independent predictors of a high postoperative calcium need. CONCLUSION: Substantial amounts of elemental calcium are required following successful subtotal PTX in order to avoid frank hypocalcemia, especially in patients with a high PTH level and a low calcium level before surgery. Copyright 2008 S. Karger AG, Basel.
Authors: Melanie Goldfarb; Stephan S Gondek; Susan M Lim; Josephina C Farra; Vania Nose; John I Lew Journal: World J Surg Date: 2012-06 Impact factor: 3.352
Authors: Joerg Latus; Meike Roesel; Peter Fritz; Niko Braun; Christoph Ulmer; Wolfgang Steurer; Dagmar Biegger; M Dominik Alscher; Martin Kimmel Journal: Int J Nephrol Renovasc Dis Date: 2013-07-08
Authors: Karly S Louie; Clement Erhard; David C Wheeler; Peter Stenvinkel; Bruno Fouqueray; Jürgen Floege Journal: J Nephrol Date: 2019-12-17 Impact factor: 3.902