{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:29:21Z","timestamp":1790026161034,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hungry bone syndrome (HBS) is one of the most serious complications following parathyroidectomy for severe hyperparathyroidism. There is a lack of literature informing the treatment and risk factors for this condition and the ideal pre\u2010operative strategy for prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The primary aims were to examine the incidence of HBS with pre\u2010operative calcitriol loading for 10 days and to determine the risk factors for HBS. The secondary aims were to determine the rate of intravenous calcium replacement in those with HBS and to assess whether cinacalcet removal has increased rates of parathyroidectomy in the end\u2010stage kidney disease population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study from 2011 to 2018 on 45 patients with end\u2010stage kidney disease undergoing total parathyroidectomy with autotransplantation for severe hyperparathyroidism. This was based at the John Hunter and Newcastle Private Hospitals in New South Wales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>28.3% of patients with calcitriol loading undergoing parathyroidectomy fulfilled criteria for HBS. Pre\u2010operative variables that were associated with HBS were elevated parathyroid hormone (<jats:italic>P<\/jats:italic> = 0.028) and longer duration of renal replacement therapy (<jats:italic>P<\/jats:italic> = 0.033). Rates of total parathyroidectomy were higher after the removal of calcimimetics from the Pharmaceutical Benefits Scheme (<jats:italic>P<\/jats:italic> = 0.0024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HBS remains a common complication of parathyroidectomy, even with prolonged high\u2010dose calcitriol loading. This emphasises the need for further trials investigating other targeted therapies, such as bisphosphonates, to prevent HBS. Those most at risk of HBS are patients with high bone turnover and prolonged renal replacement therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14209","type":"journal-article","created":{"date-parts":[[2018,12,15]],"date-time":"2018-12-15T10:39:43Z","timestamp":1544870383000},"page":"886-893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Calcitriol loading before total parathyroidectomy with autotransplant in patients with end\u2010stage kidney disease: does it prevent postoperative hypocalcaemia?"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3142-4503","authenticated-orcid":false,"given":"David","family":"Ferreira","sequence":"first","affiliation":[{"name":"Department of Nephrology, Medical and Interventional Services, John Hunter Hospital, School of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eswari","family":"Vilayur","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical and Interventional Services John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy","family":"Sankoorikal","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Medical and Interventional Services John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cino","family":"Bendinelli","sequence":"additional","affiliation":[{"name":"Endocrine and General Surgery, Department of Surgery John Hunter Hospital and Newcastle Private Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004020138"},{"key":"e_1_2_7_3_1","first-page":"51","article-title":"Marked reduction in use but minimal impact following PBS delisting of cinacalcet in a tertiary institution. 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