Parathyroidectomies: Pre and Post Op Usage of Calcium Supplementation and Effect on Calcium Levels
Journal Title: Archives of Renal Diseases and Management - Year 2016, Vol 2, Issue 1
Abstract
Introduction: PTH is released from the parathyroid glands behind the thyroid and is the primary regulator of calcium homeostasis. Indications for surgery in hyperparathyroidism remain controversial but can include symptomatic disease, renal stones, impaired renal function, bone involvement or marked reduction in bone density. Due to hypocalcaemia post op, pre-op calcium loading should occur. However not much research has been conducted into this area. Methods: We retrospectively reviewed notes of patients with hyperparathyroidism secondary to renal failure admitted to a single centre, single surgeon, for parathyroidectomies. The following were determined: calcium preloading (type and dose) in secondary hyperparathyroidism, average calcium level on admission and post op, for preloaded and non-loaded secondary hyperparathyroid cases. This was also determined for primary hyperparathyroidism and renal transplant cases. Notes were also reviewed for oral calcium supplementation or IV calcium supplemenyation (type and average dose), for preloaded/ non preloaded cases, primary cases and new transplants. Length of stay was also reviewed. Statistical differences will be calculated. Results: There were significant differences in the results for pre and none loaded secondary hyperparathyroidism cases. They were more prone to receiving IV calcium supplementation and had a longer length of stay. Conclusion: All secondary hyperparathyroid cases admitted for parathyroidectomy should be preloaded with 4 mcg alfacalcidol to prevent post op hypocalcaemia and IV calcium gluconate usage.
Authors and Affiliations
Goonewardene SS, Ready A
Keywords
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- EP ID EP343383
- DOI 10.17352/2455-5495.000007
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