Calcium supplementation after parathyroidectomy in dialysis and renal transplant patients

Figures & data

Table 1 Description of the study population

Patients (n)	41
Dialysis	30 (16 men, 14 women)
Renal transplant	11 (5 men, 6 women)
Mean (SD) patient age (years)
Dialysis	47.5±16.14
Transplant	52.0±7.33
Mean duration of ESRD (years) in dialysis patients	6.26±4.75
Mean (SD) serum creatinine level at surgery for transplant patients	1.74±0.67 mg/dL
Mean time to parathyroidectomy after renal transplantation (years)	5.3

Abbreviations: SD, standard deviation; ESRD, end-stage renal disease.

Table 2 Comparison of different variables between dialysis patients and transplant recipients

Variables	Dialysis group	Transplant group	P-value
Pre-surgery mean iPTH (ng/L)	2,042.1	261.7	<0.001
Post-surgery mean iPTH (ng/L)	289.9	114.7	0.21
Post-surgery decrease in iPTH (ng/L)	1,752	147	<0.001
Pre-surgery corrected tCa (mg/dL)	9.70	10.51	0.035
Post-surgery corrected tCa at day 1 (mg/dL)	7.96	9.01	0.003
Post-surgery decrease of serum tCa (mg/dL)	1.86	1.50	0.44
Mean lowest corrected tCa (mg/dL)	6.98	8.60	<0.001
Pre-surgery serum phosphorus (mg/dL)	6.27	3.61	<0.001
Post-surgery phosphorus (mg/dL)	5.63	3.58	<0.001
Post-surgery decrease in phosphorus (mg/dL)	0.46	0.13	0.473
Mean IV elemental Ca during admission per patient (g)	2.48	0.16	0.0017
Mean oral elemental Ca during admission per patient (g)	8.67	0.38	<0.001
Mean IV and oral elemental Ca during admission per patient (g)	11.15	0.55	<0.001
Gland weight (g)	1.51	0.99	0.194
Length of admission (days)	8.2	3.18	<0.001

Abbreviations: iPTH, intact parathyroid hormone; tCa, total calcium; Ca, calcium; IV, intravenous.

Figure 1 Mean iPTH (ng/L) levels before and after surgery in dialysis and transplant groups.

Abbreviation: iPTH, intact parathyroid hormone.

Figure 2 Comparison between dialysis and transplant patients of mean oral and intravenous elemental calcium (g) administered after parathyroidectomy per patient during hospital admission (P<0.001).

Abbreviations: IV, intravenous; Ca, calcium.

Figure 3 Comparison of length of admission (days) between dialysis and transplant patients (P<0.001).

Table 3 Spearman correlation of predictors of severe hungry bone syndrome

	Lowest Ca level		Ca replacement		Length of hospitalization
	Correlation coefficient	P-value	Correlation coefficient	P-value	Correlation coefficient	P-value
Duration of ESRD	−0.243	0.24	0.022	0.92	−0.09	0.67
Pre-surgery iPTH	−0.640	0.002	0.583	0.006	0.192	0.40
Post-surgery iPTH	−0.521	0.032	0.579	0.015	0.414	0.10
Change in iPTH	−0.596	0.019	0.396	0.14	0.013	0.96
Age	0.608	<0.001	−0.583	<0.001	−0.171	0.37
Gland weight	0.186	0.36	0.061	0.77	0.408	0.038
Alkaline phosphatase	−0.586	0.003	0.540	0.006	0.436	0.033

Abbreviations: Ca, calcium; ESRD, end-stage renal disease; iPTH, intact parathyroid hormone.