Hungry Bone Syndrome in Patients with End-Stage Renal Disease Receiving Hemodialysis

Abstract

Objective: Hyperparathyroidism develops in the majority of patients with end-stage renal disease receiving hemodialysis. Parathyroidectomy can be performed in cases who cannot be managed with medical therapy and a portion of the patients develop hungry bone syndrome (HBS) in the postoperative period. In this study, we investigated the factors that influence the development of HBS and the hospitalization times in hemodialysis patients who underwent parathyroidectomy. Method: This study included 49 patients. Demographic, clinical and laboratory parameters of these patients were retrospectively evaluated. Results: Patients’ median age was 46 years (22-62). The parathyroid gland that showed hyperplasia the most frequently was the left inferior 79.6% (n=39), followed by the right inferior 77.6% (n=38) gland. Rate of four-gland hyperplasia was 32.7% (n=16). Of the 49 operated patients, 34 (69.4%) developed HBS. In patients with postoperative PTH <500 pg/ml, calcium < 7mg/dl during the first 24 hours after surgery and calcium infusion > 4 ampules during the first 24 hours, hospitalization times were prolonged and the need for parenteral calcium infusion was elevated. Conclusion: The need for parenteral calcium replacement during the first 24 hours, postoperative PTH and calcium levels during the first 24 hours were determined to be factors indicating the severity of HBS in the postoperative period.

Keywords

• Hungry bone syndrome
• Hemodialysis
• Chronic renal failure
• Hyperparathyroidism
• Calcium

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