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Analysis Of Risk Factors For Hungry Bone Syndrome After Total Parathyroidectomy In Patients On Single-center Maintenance Hemodialysis

Posted on:2023-09-02Degree:MasterType:Thesis
Country:ChinaCandidate:Y H QiFull Text:PDF
GTID:2544306824474424Subject:Internal Medicine
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Objective:To explore the incidence and related risk factors of postoperative Hungry Bone Syndrome in patients with total parathidectomy for secondary hyperparathyroidism,and the correlation between preoperative bone mineral density and postoperative HBS.Methods:Collect perioperative clinical data from successful MHD patients who underwent uremia r SHPT in Hainan Hospital affiliated to Hainan Medical University from October 2018 to October 2021.According to the definition of HBS,it is divided into HBS and non-HBS groups,the changes of preoperative clinical indicators,incidence of postoperative HBS and related risk factors;according to the definition of WHO osteoporosis,T value was divided into osteoporosis group and nonosteoporosis group,and the incidence of preoperative osteoporosis,independent influencing factors of osteoporosis,BMD and HBS were counted.Results:A total of 116 patients were included.Serum calcium,serum phosphorus and i PTH decreased significantly 1 week after surgery compared with preoperative(P<0.05).However,postoperative serum potassium and ALP increased compared with preoperative serum potassium(P <0.05).The incidence of HBS at 1 week after surgery was 75.86%.Logistic multivariate regression analysis suggested that postoperative age(β=-0.081,OR=0.922,95%CI:0.879-0.967 P<0.001),preoperative blood calcium(β=-1.567,OR=0.209,95%CI:0.044-0.997P=0.049),and ALP at 1 week(β=0.003,OR=1.003,95%CI:1.001-1.005P=0.009)were independent risk factors for postoperative HBS.Age(β=-1.126,t=-2.957,P=0.003),preoperative blood i PTH(β=0.029,t=3.065,P=0.003),4h postoperative blood calcium(β=-54.019,t=-2.767,P=0.007),and postoperative blood phosphorus(β=-42.916,t=-2.66,P=0.009)were independent factors influencing the perioperative intravenous calcium duration and total calcium supplementation in patients with HBS.The prevalence of osteoporosis was 56.03%,and age,BMI,preoperative ALP were independent factors affecting osteoporosis in patients with uremic r SHPT.Conclusions:Patients of MHD with r SHPT had up to 75.86% incidence of HBS at 1week after t PTX treatment.For patients with younger age,lower preoperative blood calcium,and higher postoperative ALP,the higher the incidence of HBS after t PTX.The younger the age,the lower the blood calcium after 4h,the higher the preoperative i PTH,the longer the calcium supplementation time and the more calcium supplementation.The incidence of OP in patients with MHD with r SHPT was as high as 56.03%,age,BMI,and ALP were the independent influencing factors.
Keywords/Search Tags:Hemodialysis, secondary hyperparathyroidism, parathyroidism, Hungry Bone Syndrome, osteoporosis
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