CALCIUM REQUIREMENT AFTER PARATHYROIDECTOMY (PTX) IN SECONDARY HYPERPARATHYROIDISM (2° HPT)

Abstract

After PTX in 2°HPT, appropriate calcium and calcitriol was supplied to prevent hungry bone syndrome. Duration of admission was variable according to multiple causes. We hypothesized the admission duration was mainly affected by calcium requirement. The aims of this study were to evaluate PTX in 2°HPT in single center and to make equation for calcium requirement. We evaluated 91 patients with 94 PTX from Nov. 2003 to Dec.2011 in Korea Univ. Guro Hospital. We retrieved demographic details including sex, age, body weight, DM, hypertension, mode of renal replacement therapy, duration of dialysis, duration of admission, mode of PTX, method of anesthetics, number of glands removed, the largest gland length, the heaviest gland, and histologic profile of removed gland. We also gathered preoperative and postoperative (12 hrs and 48 hrs after PTX, discharge, 3 mo, 6 mo, 1 yr after PTX) laboratory data such as calcium, phosphorus, iPTH, ALP, albumin, and Hb. We summated oral and intravenous calcium supplement during hospitalization after PTX. We prescribed oral calcitriol 2.0 μg/day after PTX. Statistical analysis was performed with SPSS ver. 12.0.1. We could find log(calcium total supplement during admission) is correlated with preoperative ALP (p=0.000), preoperative iPTH (p+0.037), and Δ phosphorus 48 hrs after PTX (p=0.000) by multiple linear regression. Log (calcium total supplement during admission) = 2.576 + 0.001 X preoperative ALP + 3.575 X 10-5 X preoperative iPTH + 0.06 X Δphosphorus 48 hrs after PTX. We believe this equation would be helpful to estimate calcium requirements after 48 hrs PTX and to give a clue about length of hospitalization. We also would evaluate whether this equation is predictable in our patients in the future.