Русский
Risk factors for development of severe hypocalciemia after paratyreoidectomy for secondary hyperparathyroidisis in dialysis patients
DOI: https://dx.doi.org/10.18565/nephrology.2021.3.23-30
P.N. Kislyy, E.V. Parshina, A.B. Zulkarnaev, A.D. Tolkach, S.S. Mikhailova, R.A. Chernikov, Ya.V. Zarya
1) Saint Petersburg State University Hospital, St. Petersburg, Russia; 2) M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia; 3) «Center of dialysis St. Petersburg», Saint Petersburg, Russia
Material and methods. The retrospective study included 640 patients who underwent successful PTE for SHPT. Severe hypocalcemia was defined as a blood ionized calcium level of less than 0.9 mmol/L on days 2–3 after surgery.
Results. Severe hypocalcemia during the second or third day of the postoperative period was detected in 76.7% of patients. The following factors were associated with the risk of its development: young age (P<0.0001), high preoperative parathyroid hormone (PTH) level (P<0.0001) and alkaline phosphatase (AP) level (P<0.0001), low total blood calcium (P=0.0257) and ionized blood calcium level (P<0.0001) before surgery.
Conclusion. The incidence of severe hypocalcemia after PTE in dialysis-dependent patients is high; the severity of SHPT (high preoperative blood PTH and AP levels) makes the greatest contribution to its development.
About the Autors
Pavel N. Kislyy – Leading Specialist in Nephrology of the Clinic, Head of Outpatient Department № 4, Saint Petersburg State University Hospital, St. Petersburg, Russia; e-mail: pashapanda@mail.ru
Ekaterina V. Parshina – Head of the Department of Nephrology and Dialysis, Saint Petersburg State University Hospital, St. Petersburg, Russia; e-mail: pannn@yandex.ru
Aleksey B. Zulkarnaev – Dr.Sci. (Med.), Associate Professor, Leading Researcher at the Surgical Department of Kidney Transplantation, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia; e-mail: 7059899@gmail.com
Aleksey D. Tolkach – Nephrologist at the Department of Nephrology and Dialysis, Saint Petersburg State University Hospital, St. Petersburg, Russia; e-mail: ab2769@mail.ru
Svetlana S. Mikhailova – Nephrologist at the Department of Nephrology and Dialysis, Saint Petersburg State University Hospital, St. Petersburg, Russia; e-mail: iamspb@yandex.ru
Roman A. Chernikov – Dr. Sci. (Med.), Head of the Department of Endocrine Surgery, Saint Petersburg State University Hospital, St. Petersburg, Russia; e-mail: yaddd@yandex.ru
Yana V. Zarya – Head of the Dialysis Department «Center of dialysis St. Petersburg», Saint Petersburg, Russia; e-mail: yana.zarya@fmc-ag.ru
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