Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism

Background: Secondary Hyperparathyroidism (SHPT) in renal failure patients are common and had different clinical presentations. Total parathyroidectomy is the surgery of choice in this group of patient. Hypocalceamia or even hungry bone syndrome are well known and is one of the serious complicat...

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Main Author:	Guan, Tan Poh
Format:	Thesis
Language:	English
Published:	2017
Subjects:	RC Internal medicine
Online Access:	http://eprints.usm.my/45620/1/Dr.%20Tan%20Poh%20Guan-24%20pages.pdf
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spelling	my-usm-ep.456202020-10-22T03:03:13Z Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism 2017 Guan, Tan Poh RC Internal medicine Background: Secondary Hyperparathyroidism (SHPT) in renal failure patients are common and had different clinical presentations. Total parathyroidectomy is the surgery of choice in this group of patient. Hypocalceamia or even hungry bone syndrome are well known and is one of the serious complication in post-parathyroidectomy patient. The objectives of this study are to identify the predictors of early post-operative hypocalcaemia after total parathyroidectomy as well as the clinical presentations of secondary hyperparathyroidism in renal failure patient. Methods: Renal failure patient with secondary hyperparathyroidism who had underwent total parathyroidectomy in between 1st January 2007 till 31st December 2014 were retrospectively reviewed. The patients were divided into 2 groups according to their serum calcium level within 24 hours post surgery: the Hypocalcaemia group (25 patients) with post-operative serum calcium level of 2mmol/L or less, and the normocalcaemia group (43 patients), with the post-operative serum calcium level more then 2mmol/L. Patient details (age, gender and duration of renal failure) and preoperative blood investigations (preoperative serum calcium level , phosphorus level, alkaline phosphatase level ,serum albumin, serum intact parathyroid hormone and creatinine level) were analyzed in order to identify the predictor for early post-operative hypocalcaemia. The clinical presentations of secondary hyperparathyroidism in renal failure patient have also recorded.Results: By using multiple logistic regression analysis, alkaline phosphatase (ALP) has predictive value for early post operative hypocalcaemia with adjusted Odd ratio 1.004. Most of the patient who underwent surgery is symptomatic pre-operatively and the common presentations were bone pain (73%) and muscle weakness (21%). Hypocalcaemia is common in renal hyperparathyrosim patient post total parathyroidectomy. Up to 37% of our patient suffered from this post op complication. Conclusion: In conclusion, preoperative serum alkaline phosphatase correlate positively with the development of early post-operative hypocalcaemia so patient with high preoperative alkaline phosphatase should be monitored more closely in the early post operative period. 2017 Thesis http://eprints.usm.my/45620/ http://eprints.usm.my/45620/1/Dr.%20Tan%20Poh%20Guan-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine Guan, Tan Poh Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
description	Background: Secondary Hyperparathyroidism (SHPT) in renal failure patients are common and had different clinical presentations. Total parathyroidectomy is the surgery of choice in this group of patient. Hypocalceamia or even hungry bone syndrome are well known and is one of the serious complication in post-parathyroidectomy patient. The objectives of this study are to identify the predictors of early post-operative hypocalcaemia after total parathyroidectomy as well as the clinical presentations of secondary hyperparathyroidism in renal failure patient. Methods: Renal failure patient with secondary hyperparathyroidism who had underwent total parathyroidectomy in between 1st January 2007 till 31st December 2014 were retrospectively reviewed. The patients were divided into 2 groups according to their serum calcium level within 24 hours post surgery: the Hypocalcaemia group (25 patients) with post-operative serum calcium level of 2mmol/L or less, and the normocalcaemia group (43 patients), with the post-operative serum calcium level more then 2mmol/L. Patient details (age, gender and duration of renal failure) and preoperative blood investigations (preoperative serum calcium level , phosphorus level, alkaline phosphatase level ,serum albumin, serum intact parathyroid hormone and creatinine level) were analyzed in order to identify the predictor for early post-operative hypocalcaemia. The clinical presentations of secondary hyperparathyroidism in renal failure patient have also recorded.Results: By using multiple logistic regression analysis, alkaline phosphatase (ALP) has predictive value for early post operative hypocalcaemia with adjusted Odd ratio 1.004. Most of the patient who underwent surgery is symptomatic pre-operatively and the common presentations were bone pain (73%) and muscle weakness (21%). Hypocalcaemia is common in renal hyperparathyrosim patient post total parathyroidectomy. Up to 37% of our patient suffered from this post op complication. Conclusion: In conclusion, preoperative serum alkaline phosphatase correlate positively with the development of early post-operative hypocalcaemia so patient with high preoperative alkaline phosphatase should be monitored more closely in the early post operative period.
format	Thesis
qualification_level	Master's degree
author	Guan, Tan Poh
author_facet	Guan, Tan Poh
author_sort	Guan, Tan Poh
title	Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
title_short	Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
title_full	Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
title_fullStr	Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
title_full_unstemmed	Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
title_sort	predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2017
url	http://eprints.usm.my/45620/1/Dr.%20Tan%20Poh%20Guan-24%20pages.pdf
_version_	1747821536518078464

Predictors of early post-operative hypocalcemia after total parathyroidectomy in renal failure patients with secondary hyperparathyroidism

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