{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:13:13Z","timestamp":1785453193412,"version":"3.56.0"},"reference-count":41,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Secondary hyperparathyroidism (SHPT) is a prevalent complication in end-stage renal disease, often necessitating surgical intervention when refractory to medical therapy. The optimal surgical strategy\u2014subtotal parathyroidectomy (SPTX) versus total parathyroidectomy with\/without autotransplantation (TPTX \u00b1 AT)\u2014remains debated, especially considering postoperative complications like persistent HPT and hungry bone syndrome (HBS). This study aimed to compare early surgical outcomes and identify predictors for postoperative complications in patients undergoing SPTX and TPTX + AT. Methods: We conducted a retrospective, single-center observational study involving 93 dialysis patients who underwent PTX for drug-refractory SHPT. Patients were analyzed according to surgical procedure (SPTX vs. TPTX + AT), focusing on postoperative complications such as cervical bleeding, reintervention rates, and the incidence of HBS. Multivariate logistic regression was utilized to identify predictors of these outcomes. Results: TPTX + AT demonstrated superior control of HPT, with significantly lower rates of reintervention compared to SPTX (7.1% vs. 23.5%, p = 0.037). However, TPTX + AT was associated with a higher incidence of HBS (57.1% vs. 35.3%, p = 0.039). Independent predictors of reintervention included absence of concomitant thymectomy, preoperative hypercalcemia, fewer visualized glands preoperatively, and preoperative PTH &gt; 2000 pg\/mL. Elevated alkaline phosphatase levels (&gt;300 U\/L), severe bone pain, and the TPTX procedure itself were significant predictors of HBS. Conclusions: Surgical strategy for SHPT should be individualized, balancing the lower recurrence risk associated with TPTX + AT against its higher likelihood of postoperative hypocalcemia. Preoperative biochemical markers and clinical features could potentially influence operative decision-making and optimize patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm14144944","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T10:55:41Z","timestamp":1752490541000},"page":"4944","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictors of Hungry Bone Syndrome and Reintervention After Subtotal Versus Total Parathyroidectomy for Secondary Hyperparathyroidism in Dialysis Patients: A Single-Center Cohort"],"prefix":"10.3390","volume":"14","author":[{"given":"Adina","family":"Coman","sequence":"first","affiliation":[{"name":"Researching Future Surgery II Research Center, Department X, Discipline of General Surgery II, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Department X, Discipline of General Surgery I, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1772-3910","authenticated-orcid":false,"given":"Cristi","family":"Tarta","sequence":"additional","affiliation":[{"name":"Researching Future Surgery II Research Center, Department X, Discipline of General Surgery II, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gigi Adrian","family":"Aiordachioae","sequence":"additional","affiliation":[{"name":"Department of Medicine, Discipline of Surgery II, Vasile Goldi\u015f Western University, Liviu Rebreanu Boulevard, No. 86, 310414 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Goldis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Discipline of Surgery II, Vasile Goldi\u015f Western University, Liviu Rebreanu Boulevard, No. 86, 310414 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7708-7314","authenticated-orcid":false,"given":"Diana","family":"Utu","sequence":"additional","affiliation":[{"name":"Department II, Discipline of Pharmacology-Pharmacotherapy, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-229X","authenticated-orcid":false,"given":"Marco","family":"Marian","sequence":"additional","affiliation":[{"name":"Researching Future Surgery II Research Center, Department X, Discipline of General Surgery II, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-572X","authenticated-orcid":false,"given":"Amadeus","family":"Dobrescu","sequence":"additional","affiliation":[{"name":"Researching Future Surgery II Research Center, Department X, Discipline of General Surgery II, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-9561","authenticated-orcid":false,"given":"Florina","family":"Buleu","sequence":"additional","affiliation":[{"name":"Department VI, Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1634-2836","authenticated-orcid":false,"given":"Sorin","family":"Olariu","sequence":"additional","affiliation":[{"name":"Department X, Discipline of General Surgery I, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"913","DOI":"10.2215\/CJN.06040710","article-title":"Secondary Hyperparathyroidism: Pathogenesis, Disease Progression, and Therapeutic Options","volume":"6","author":"Cunningham","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"i15","DOI":"10.1093\/ckj\/sfae423","article-title":"Pathophysiology and Therapies of CKD-Associated Secondary Hyperparathyroidism","volume":"18","author":"Mazzaferro","year":"2025","journal-title":"Clin. 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