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Prolonged hypophosphatemia following parathyroidectomy in chronic hemodialysis patients.

Abstract
Secondary hyperparathyroidism (SHPT) is a common problem in patients with end-stage renal disease. In cases with severe and resistant SHPT, surgical parathyroidectomy (PTX) is recommended. Hungry bone syndrome (HBS) following surgical PTX is most often associated with hypocalcemia and hypophosphatemia. The mechanisms for the HBS are not clear, and a method for its prevention has not been established. We present three hemodialysis patients with persistant hypophosphatemia after PTX. In our parathyroidectomized patients, hypocalcemia could be corrected with calcium and vitamin D treatment, but hypophosphatemia continued for eight months in one patient and in two other patients until the last visit (10 and 2 months, respectively). Predisposing factors such as old age, diabetes mellitus and parathyroid adenoma were not found in our patients. All three patients were younger (<35 years old) and anuric. Hemodialysis durations were seven, three and two years. In summary, HBS presented with hypocalcemia, and especially hypophosphatemia cannot be developed uncommonly and may persist for a long time following PTX in HD patients.
AuthorsEda Altun, Saime Paydas, Bulent Kaya, Mustafa Balal
JournalSaudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (Saudi J Kidney Dis Transpl) Vol. 26 Issue 5 Pg. 976-9 (Sep 2015) ISSN: 1319-2442 [Print] Saudi Arabia
PMID26354572 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Biomarkers
Topics
  • Adult
  • Biomarkers (blood)
  • Female
  • Humans
  • Hyperparathyroidism, Secondary (blood, diagnosis, etiology, surgery)
  • Hypocalcemia (etiology)
  • Hypophosphatemia (blood, diagnosis, etiology)
  • Kidney Failure, Chronic (blood, complications, diagnosis, therapy)
  • Male
  • Parathyroidectomy (adverse effects)
  • Renal Dialysis (adverse effects)
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult

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