{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:33:56Z","timestamp":1778808836383,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Severe hypocalcaemia following parathyroidectomy for secondary or tertiary hyperparathyroidism (SHPT\/THPT) is scarcely studied. We aimed to describe and identify risk factors for early and persistent hypocalcaemia after parathyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective pair\u2010matched cohort study. We assessed 87 dialysis patients with SHPT (<jats:italic>n<\/jats:italic> =\u200973) or THPT (<jats:italic>n<\/jats:italic> =\u200914) paired with 146 subjects with primary hyperparathyroidism (PHPT) who underwent parathyroidectomy and were followed for 12\u2009months. Early severe hypocalcaemia was defined as a free Ca \u22640.8\u2009mmol\/L [3.2 mg\/dl] or corrected Ca \u22641.87\u2009mmol\/L [7.5 mg\/dl] within 48\u2009h. After parathyroidectomy and persistent hypocalcaemia, as an elemental Ca intake &gt;3.0 g\/day to achieve corrected Ca &gt;2\u2009mmol\/L [8.0 mg\/dl].<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Early severe hypocalcaemia occurred in 77% (67\/87) versus 6.8% (10\/146) of subjects with SHPT\/THPT and PHPT, respectively (<jats:italic>p<\/jats:italic> &lt;\u2009.001). In SHPT\/THPT cases, persistent hypocalcaemia occurred in 77% (49\/64) and 64% (35\/54) after 6 and 12\u2009months of parathyroidectomy, respectively. In PHPT cases, persistent hypocalcaemia occurred in 6.8% (10\/146) after 4\u201312\u2009months of parathyroidectomy. Preoperative serum alkaline phosphatase (ALP) was the only risk factor associated to early severe hypocalcaemia (OR 7.3, 95% C.I. 1.7\u201310.9, <jats:italic>p<\/jats:italic> =\u2009.006) and persistent hypocalcaemia (OR 7.1, 95% C.I: 2.1\u201314.2, <jats:italic>p<\/jats:italic> =\u2009.011). Subjects with persistently low intact parathormone (iPTH) (&lt;5.3 pmol\/L [50\u2009ng\/ml]), suggestive of adynamic bone disease) showed higher Ca increases and less oral calcium requirements compared to those who progressively increased iPTH after parathyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early and persistent hypocalcaemia after parathyroidectomy in severe HPT were a common event associated directly to preoperative ALP levels. Subjects with persistently low postoperative iPTH normalized serum Ca more frequently after 1 year of follow up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13854","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T14:10:15Z","timestamp":1611756615000},"page":"408-419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical factors associated with early and persistent hypocalcaemia after parathyroidectomy in patients on dialysis with severe hyperparathyroidism"],"prefix":"10.1111","volume":"26","author":[{"given":"Jorge I.","family":"Fonseca\u2010Correa","sequence":"first","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Nava\u2010Santana","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Tamez\u2010Pedroza","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Paz\u2010Cortes","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Airy","family":"Santillan\u2010Ceron","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis J.","family":"Rojas\u2010Concha","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Pantoja\u2010Mill\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio","family":"Sierra\u2010Salazar","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Velazquez\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel F.","family":"Herrera","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City 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