{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:58:43Z","timestamp":1791536323550,"version":"4.3.4"},"reference-count":117,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy of Timi\u0219oara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Secondary hyperparathyroidism (SHPT) affects 30\u201350% of end-stage renal disease patients. Parathyroidectomy (PTX), while effective for medication-refractory SHPT, carries 20\u201370% risk of hungry bone syndrome (HBS)\u2014severe sustained hypocalcemia requiring intensive care and prolonged hospitalization. Accurate preoperative risk stratification using biochemical markers and validated prediction tools is critical for optimal preventive management. Methods: We conducted a comprehensive narrative review synthesizing evidence on HBS predictors after PTX in SHPT, evaluating traditional and novel bone turnover markers, clinical risk factors, and multivariate prediction models, through a structured literature search and analysis. Results: Preoperative bone turnover status represents the strongest contributor to HBS risk. Traditional biomarkers\u2014particularly parathyroid hormone (PTH &gt; 1000\u20132400 pg\/mL) and alkaline phosphatase (ALP &gt; 150\u2013300 U\/L)\u2014demonstrate moderate-to-strong individual predictive power. Novel bone turnover markers (bone-specific ALP, P1NP, TRAP-5b) offer incremental value, especially in CKD populations where renal clearance affects traditional markers. Combined risk prediction models substantially outperform single biomarkers, achieving area under curve values of 0.87\u20130.95. The simple NYU 2-point score (ALP &gt; 150 U\/L + PTH &gt; 1000 pg\/mL) showed 96.8% accuracy, with 100% negative predictive value. More complex tools like nomograms (C-index 0.92\u20130.94) and machine-learning algorithms (AUC 0.88) provide enhanced discrimination by integrating multiple continuous parameters. Additional clinical factors\u2014younger age (&lt;48 years), prolonged dialysis (\u22655 years), low preoperative calcium, high gland weight, and absence of autotransplantation\u2014further refine risk assessment. Postoperative calcium typically reaches nadir at 48\u201372 h, defining the critical monitoring window. Conclusions: High-turnover bone biomarkers and combined risk models effectively identify high-risk SHPT patients. Risk-stratified protocols (i.e., prophylactic supplementation, intensive monitoring, and selective ICU admission) can substantially reduce HBS-related morbidity. Ongoing efforts should focus on validating these predictive tools across diverse populations and integrating them into clinical practice, thereby facilitating real-time HBS risk assessment and protocol-driven care.<\/jats:p>","DOI":"10.3390\/jcm14217849","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:06:06Z","timestamp":1762362366000},"page":"7849","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of Hungry Bone Syndrome After Parathyroidectomy in Secondary Hyperparathyroidism: A Narrative Review of Bone Turnover Biomarkers and Risk Prediction Tools"],"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"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4630-3727","authenticated-orcid":false,"given":"Alexandru","family":"Isaic","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\/0000-0002-4320-229X","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\/0000-0002-1634-2836","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"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3596-4050","authenticated-orcid":false,"given":"Andrei","family":"Ardelean","sequence":"additional","affiliation":[{"name":"Department of Medicine, Discipline of Surgery I, Vasile Goldi\u015f Western University, Liviu Rebreanu Boulevard, No. 86, 310414 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca-Monica","family":"Macovei-Oprescu","sequence":"additional","affiliation":[{"name":"Department V, Discipline of Internal Medicine II and Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, Eroii Sanitari Bvd., No. 8, Sector 5, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazakas","family":"Roland","sequence":"additional","affiliation":[{"name":"Doctoral School, Faculty of Medicine, Vasile Goldi\u015f Western University, Liviu Rebreanu Boulevard, No. 86, 310414 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gheorghe-Nanu","family":"Pupca","sequence":"additional","affiliation":[{"name":"Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silviu","family":"Latcu","sequence":"additional","affiliation":[{"name":"Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian Silviu","family":"Suciu","sequence":"additional","affiliation":[{"name":"Department II of Microscopic Morphology, 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\/0000-0002-3045-6282","authenticated-orcid":false,"given":"Marius","family":"Murariu","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":[[2025,11,5]]},"reference":[{"key":"ref_1","first-page":"397","article-title":"Outcomes of Secondary Hyperparathyroidism in Chronic Kidney Disease and the Direct Costs of Treatment","volume":"13","author":"Joy","year":"2007","journal-title":"J. Manag. Care Pharm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.ajkd.2008.03.020","article-title":"Mortality Risk for Dialysis Patients with Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"52","author":"Tentori","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.bone.2016.03.017","article-title":"Bone Loss in Chronic Kidney Disease: Quantity or Quality?","volume":"87","author":"Zheng","year":"2016","journal-title":"Bone"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"(2017). KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease\u2013Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl., 7, 1\u201359.","DOI":"10.1016\/j.kisu.2017.04.001"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1007\/s00268-011-1392-0","article-title":"Initial Parathyroid Surgery in 606 Patients with Renal Hyperparathyroidism","volume":"36","author":"Schneider","year":"2012","journal-title":"World J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"952","DOI":"10.2215\/CJN.10390917","article-title":"Parathyroidectomy in the Management of Secondary Hyperparathyroidism","volume":"13","author":"Lau","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1530\/EJE-12-0528","article-title":"Hungry Bone Syndrome: Still a Challenge in the Post-Operative Management of Primary Hyperparathyroidism: A Systematic Review of the Literature","volume":"168","author":"Witteveen","year":"2013","journal-title":"Eur. J. Endocrinol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1007\/s00405-011-1833-2","article-title":"The Surgical Management of Renal Hyperparathyroidism","volume":"269","author":"Madorin","year":"2012","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.2215\/CJN.10370915","article-title":"Rates and Outcomes of Parathyroidectomy for Secondary Hyperparathyroidism in the United States","volume":"11","author":"Kim","year":"2016","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Carsote, M., and Nistor, C. (2023). Forestalling Hungry Bone Syndrome after Parathyroidectomy in Patients with Primary and Renal Hyperparathyroidism. Diagnostics, 13.","DOI":"10.3390\/diagnostics13111953"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/hdi.13067","article-title":"Hungry Bone Syndrome after Parathyroid Surgery","volume":"27","author":"Tai","year":"2023","journal-title":"Hemodial. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12262-023-03853-6","article-title":"Hungry Bone Syndrome Following Parathyroidectomy: A Comprehensive Systematic Review of Risk Factors","volume":"86","author":"Mehta","year":"2024","journal-title":"Indian. J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1159\/000209246","article-title":"Pathophysiology of Calcium and Phosphate Metabolism Impairment in Chronic Kidney Disease","volume":"27","author":"Cozzolino","year":"2009","journal-title":"Blood Purif."},{"key":"ref_14","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_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1038\/sj.ki.5002287","article-title":"Development and Progression of Secondary Hyperparathyroidism in Chronic Kidney Disease: Lessons from Molecular Genetics","volume":"74","author":"Goodman","year":"2008","journal-title":"Kidney Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1681\/ASN.2008010014","article-title":"Serum Alkaline Phosphatase Predicts Mortality among Maintenance Hemodialysis Patients","volume":"19","author":"Regidor","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.bone.2017.02.011","article-title":"Hypophosphatasia: An Overview For 2017","volume":"102","author":"Whyte","year":"2017","journal-title":"Bone"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1681\/ASN.V73506","article-title":"Plasma Total versus Bone Alkaline Phosphatase as Markers of Bone Turnover in Hemodialysis Patients","volume":"7","author":"Hruby","year":"1996","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1053\/j.ajkd.2015.02.323","article-title":"Bone Alkaline Phosphatase Isoforms in Hemodialysis Patients with Low Versus Non-Low Bone Turnover: A Diagnostic Test Study","volume":"66","author":"Haarhaus","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"296","DOI":"10.5414\/CNP70296","article-title":"Bone Histomorphometry and Biochemical Markers of Bone Turnover in Patients with Chronic Kidney Disease Stages 3\u20135","volume":"70","author":"Lehmann","year":"2008","journal-title":"Clin. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s11255-019-02217-y","article-title":"Bone Metabolism Markers and Hungry Bone Syndrome after Parathyroidectomy in Dialysis Patients with Secondary Hyperparathyroidism","volume":"51","author":"Ge","year":"2019","journal-title":"Int. Urol. Nephrol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1055\/a-1325-0351","article-title":"Role of Bisphosphonates in the Prevention of Postoperative Hungry Bone Syndrome in Primary Hyperparathyroidism: A Meta-Analysis and Need for Randomized Controlled Trials","volume":"71","author":"Pal","year":"2021","journal-title":"Drug Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jss.2020.05.036","article-title":"A Nomogram to Predict Hungry Bone Syndrome After Parathyroidectomy in Patients with Secondary Hyperparathyroidism","volume":"255","author":"Wang","year":"2020","journal-title":"J. Surg. Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ho, L.-Y., Wong, P.-N., Sin, H.-K., Wong, Y.-Y., Lo, K.-C., Chan, S.-F., Lo, M.-W., Lo, K.-Y., Mak, S.-K., and Wong, A.K.-M. (2017). Risk Factors and Clinical Course of Hungry Bone Syndrome after Total Parathyroidectomy in Dialysis Patients with Secondary Hyperparathyroidism. BMC Nephrol., 18.","DOI":"10.1186\/s12882-016-0421-5"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1146\/annurev.med.051308.111339","article-title":"Regulation of Phosphate Homeostasis by PTH, Vitamin D, and FGF23","volume":"61","author":"Bergwitz","year":"2010","journal-title":"Annu. Rev. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3893","DOI":"10.1016\/S0021-9258(17)33332-X","article-title":"Pre-Proparathyroid Hormone. Evidence for an Early Biosynthetic Precursor of Proparathyroid Hormone","volume":"251","author":"Habener","year":"1976","journal-title":"J. Biol. Chem."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1038\/s41467-019-12399-9","article-title":"Phosphate Acts Directly on the Calcium-Sensing Receptor to Stimulate Parathyroid Hormone Secretion","volume":"10","author":"Centeno","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1359\/JBMR.0301264","article-title":"FGF-23 Is a Potent Regulator of Vitamin D Metabolism and Phosphate Homeostasis","volume":"19","author":"Shimada","year":"2004","journal-title":"J. Bone Min. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1038\/ki.2009.464","article-title":"Parathyroid Cell Resistance to Fibroblast Growth Factor 23 in Secondary Hyperparathyroidism of Chronic Kidney Disease","volume":"77","author":"Galitzer","year":"2010","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1038\/nrendo.2009.196","article-title":"The FGF23\u2013Klotho Axis: Endocrine Regulation of Phosphate Homeostasis","volume":"5","author":"Razzaque","year":"2009","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1001\/jamasurg.2013.104","article-title":"Factors That Influence Parathyroid Hormone Half-Life: Are New Intraoperative Criteria Needed?","volume":"148","author":"Leiker","year":"2013","journal-title":"JAMA Surg."},{"key":"ref_32","first-page":"S29","article-title":"Circulating PTH Molecular Forms: What We Know and What We Don\u2019t","volume":"102","year":"2006","journal-title":"Kidney Int. Suppl."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1016\/j.kint.2016.06.041","article-title":"Parathyroid Hormone Metabolism and Signaling in Health and Chronic Kidney Disease","volume":"90","author":"Evenepoel","year":"2016","journal-title":"Kidney Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1210\/en.2004-1262","article-title":"Receptors Specific for the Carboxyl-Terminal Region of Parathyroid Hormone on Bone-Derived Cells: Determinants of Ligand Binding and Bioactivity","volume":"146","author":"Divieti","year":"2005","journal-title":"Endocrinology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5034","DOI":"10.1073\/pnas.0801027105","article-title":"Molecular Recognition of Parathyroid Hormone by Its G Protein-Coupled Receptor","volume":"105","author":"Pioszak","year":"2008","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0378-1119(01)00798-3","article-title":"Parathyroid Hormone-Dependent Signaling Pathways Regulating Genes in Bone Cells","volume":"282","author":"Swarthout","year":"2002","journal-title":"Gene"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.coph.2015.03.005","article-title":"Parathyroid Hormone: Anabolic and Catabolic Actions on the Skeleton","volume":"22","author":"Silva","year":"2015","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4577","DOI":"10.1210\/en.2005-0239","article-title":"Chronic Elevation of Parathyroid Hormone in Mice Reduces Expression of Sclerostin by Osteocytes: A Novel Mechanism for Hormonal Control of Osteoblastogenesis","volume":"146","author":"Bellido","year":"2005","journal-title":"Endocrinology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"877","DOI":"10.2215\/CJN.06550810","article-title":"Sclerostin and Dickkopf-1 in Renal Osteodystrophy","volume":"6","author":"Cejka","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/s41413-024-00342-8","article-title":"Wnt\/\u03b2-Catenin Signaling Components and Mechanisms in Bone Formation, Homeostasis, and Disease","volume":"12","author":"Hu","year":"2024","journal-title":"Bone Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1359\/jbmr.070804","article-title":"Control of the SOST Bone Enhancer by PTH Using MEF2 Transcription Factors","volume":"22","author":"Leupin","year":"2007","journal-title":"J. Bone Miner. Res."},{"key":"ref_42","unstructured":"Vall, H., Patel, P., and Parmar, M. (2025, October 10). Teriparatide, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559248\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/nature01658","article-title":"Osteoclast Differentiation and Activation","volume":"423","author":"Boyle","year":"2003","journal-title":"Nature"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Kitaura, H., Marahleh, A., Ohori, F., Noguchi, T., Shen, W.-R., Qi, J., Nara, Y., Pramusita, A., Kinjo, R., and Mizoguchi, I. (2020). Osteocyte-Related Cytokines Regulate Osteoclast Formation and Bone Resorption. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21145169"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1359\/jbmr.2000.15.1.2","article-title":"The Roles of Osteoprotegerin and Osteoprotegerin Ligand in the Paracrine Regulation of Bone Resorption","volume":"15","author":"Hofbauer","year":"2000","journal-title":"J. Bone Miner. Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Siddiqui, J.A., Johnson, J., Le Henaff, C., Bitel, C.L., Tamasi, J.A., and Partridge, N.C. (2017). Catabolic Effects of Human PTH (1-34) on Bone: Requirement of Monocyte Chemoattractant Protein-1 in Murine Model of Hyperparathyroidism. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-15563-7"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.bone.2012.09.016","article-title":"Effects of PTH on Osteocyte Function","volume":"54","author":"Bellido","year":"2013","journal-title":"Bone"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1152\/physrev.00003.2004","article-title":"Calcium Absorption across Epithelia","volume":"85","author":"Hoenderop","year":"2005","journal-title":"Physiol. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1038\/sj.ki.5001813","article-title":"Proximal Tubular Handling of Phosphate: A Molecular Perspective","volume":"70","author":"Forster","year":"2006","journal-title":"Kidney Int."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1177\/15353702221091982","article-title":"Regulation of 1 and 24 Hydroxylation of Vitamin D Metabolites in the Proximal Tubule","volume":"247","author":"Young","year":"2022","journal-title":"Exp. Biol. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3344","DOI":"10.3748\/wjg.v26.i24.3344","article-title":"Intestinal Ca2+ Absorption Revisited: A Molecular and Clinical Approach","volume":"26","author":"Areco","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Mihoc, T., Latcu, S., Secasan, C., Dema, V., Cumpanas, A., \u015eelaru, M., Pirvu, C., Valceanu, A., Zara, F., and Dumitru, C.-S. (2024). Pancreatic Morphology, Immunology, and the Pathogenesis of Acute Pancreatitis. Biomedicines, 12.","DOI":"10.20944\/preprints202410.1226.v1"},{"key":"ref_53","first-page":"E975","article-title":"Direct Effect of Parathyroid Hormone on Insulin Secretion from Pancreatic Islets","volume":"258","author":"Fadda","year":"1990","journal-title":"Am. J. Physiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1038\/nature02040","article-title":"Osteoblastic Cells Regulate the Haematopoietic Stem Cell Niche","volume":"425","author":"Calvi","year":"2003","journal-title":"Nature"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Dumitru, C.-S., and Raica, M. (2024). A Splice Form of VEGF, a Potential Anti-Angiogenetic Form of Head and Neck Squamous Cell Cancer Inhibition. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25168855"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Vornic, I., Buciu, V., Furau, C., Gaje, P., Ceau\u015fu, R., Dumitru, C.-S., Barb, A., Novacescu, D., Cumpanas, A., and Latcu, S. (2024). Oxidative Stress and Placental Pathogenesis: A Contemporary Overview of Potential Biomarkers and Emerging Therapeutics. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202410.0912.v1"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Latcu, S.C., Novacescu, D., Buciu, V.-B., Dumitru, C.-S., Ceausu, R.A., Raica, M., Cut, T.G., Ilina, R., Malita, D.C., and Tarta, C. (2023). The Cavernous Nerve Injury Rat Model: A Pictorial Essay on Post-Radical Prostatectomy Erectile Dysfunction Research. Life, 13.","DOI":"10.3390\/life13122337"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1161\/01.ATV.17.6.1135","article-title":"Parathyroid Hormone\u2013Related Peptide as a Local Regulator of Vascular Calcification","volume":"17","author":"Jono","year":"1997","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1046\/j.1523-1755.1998.00221.x","article-title":"Effect of Serum Phosphate on Parathyroid Hormone Secretion during Hemodialysis","volume":"54","author":"Cobo","year":"1998","journal-title":"Kidney Int."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Hocher, B., Armbruster, F.P., Stoeva, S., Reichetzeder, C., Gr\u00f6n, H.J., Lieker, I., Khadzhynov, D., Slowinski, T., and Roth, H.J. (2012). Measuring Parathyroid Hormone (PTH) in Patients with Oxidative Stress\u2014Do We Need a Fourth Generation Parathyroid Hormone Assay?. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0040242"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Novacescu, D., Latcu, S.C., Bardan, R., Daminescu, L., and Cumpanas, A.A. (2023). Contemporary Biomarkers for Renal Transplantation: A Narrative Overview. J. Pers. Med., 13.","DOI":"10.3390\/jpm13081216"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Novacescu, D., Feciche, B.O., Cumpanas, A.A., Bardan, R., Rusmir, A.V., Bitar, Y.A., Barbos, V.I., Cut, T.G., Raica, M., and Latcu, S.C. (2022). Contemporary Clinical Definitions, Differential Diagnosis, and Novel Predictive Tools for Renal Cell Carcinoma. Biomedicines, 10.","DOI":"10.3390\/biomedicines10112926"},{"key":"ref_63","unstructured":"(2025, October 07). Created in Biorender. Available online: https:\/\/BioRender.com\/fjnjwqa."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"410","DOI":"10.4103\/ijem.IJEM_678_17","article-title":"Intraoperative Parathyroid Hormone Monitoring in Guiding Adequate Parathyroidectomy","volume":"22","author":"Naik","year":"2018","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"327","DOI":"10.3803\/EnM.2019.34.4.327","article-title":"Intraoperative Parathyroid Hormone Monitoring in the Surgical Management of Sporadic Primary Hyperparathyroidism","volume":"34","author":"Khan","year":"2019","journal-title":"Endocrinol. Metab."},{"key":"ref_66","first-page":"5556977","article-title":"Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism","volume":"2021","author":"Zubieta","year":"2021","journal-title":"Case Rep. Endocrinol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1177\/000313480407000204","article-title":"Post-Parathyroidectomy Hypocalcemia: Incidence, Risk Factors, and Management","volume":"70","author":"Mittendorf","year":"2004","journal-title":"Am. Surg."},{"key":"ref_68","unstructured":"Pokhrel, B., Leslie, S.W., and Levine, S.N. (2025). Primary Hyperparathyroidism. StatPearls, StatPearls Publishing."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/j.1523-1755.2005.09500.x","article-title":"Consequences and Management of Hyperphosphatemia in Patients with Renal Insufficiency","volume":"67","author":"Friedman","year":"2005","journal-title":"Kidney Int."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1136\/bmj.284.6319.856","article-title":"Hypophosphataemia after Parathyroidectomy in Chronic Renal Failure","volume":"284","author":"Farrington","year":"1982","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1530\/eje.0.1420451","article-title":"Immediate Changes in Biochemical Markers of Bone Turnover and Circulating Interleukin-6 after Parathyroidectomy for Primary Hyperparathyroidism","volume":"142","author":"Guo","year":"2000","journal-title":"Eur. J. Endocrinol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1007\/s00774-008-0033-7","article-title":"Potential Utility of High Preoperative Levels of Serum Type I Collagen Markers in Postmenopausal Women with Primary Hyperparathyroidism with Respect to Their Short-Term Variations after Parathyroidectomy","volume":"27","author":"Boudou","year":"2009","journal-title":"J. Bone Min. Metab."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1308\/rcsann.2017.0092","article-title":"Changes in Bone Turnover Markers in Primary Hyperparathyroidism and Response to Surgery","volume":"99","author":"Rajeev","year":"2017","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1016\/j.bone.2008.07.050","article-title":"Tartrate Resistant Acid Phosphatase (TRACP 5b) as a Resorption Marker in Patients with Secondary Hyperparathyroidism Treated with Cinacalcet","volume":"43","author":"Nowak","year":"2008","journal-title":"Bone"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/S0272-6386(03)00909-0","article-title":"Changes of Bone Remodeling Immediately after Parathyroidectomy for Secondary Hyperparathyroidism","volume":"42","author":"Yajima","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e1922","DOI":"10.1210\/clinem\/dgae326","article-title":"Skeletal Effect of Parathyroidectomy on Patients with Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis","volume":"109","author":"Kongsaree","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"3845","DOI":"10.1210\/jcem.83.11.5249","article-title":"Bone Mineral Recovery after Parathyroidectomy in Patients with Primary and Renal Hyperparathyroidism","volume":"83","author":"Abdelhadi","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Peng, X., Xia, X., Li, Z., Cheng, F., and Zhu, X. (2022). Factors Influencing the Development of Bone Starvation Syndrome after Total Parathyroidectomy in Patients with Renal Hyperparathyroidism. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.963231"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"4473","DOI":"10.1210\/jc.2019-00705","article-title":"Persistently Elevated PTH After Parathyroidectomy at One Year: Experience in a Tertiary Referral Center","volume":"104","author":"Caldwell","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1002\/hed.21119","article-title":"Elevated Parathyroid Hormone Levels after Parathyroidectomy for Primary Hyperparathyroidism","volume":"31","author":"Mizrachi","year":"2009","journal-title":"Head. Neck"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1053\/j.ajkd.2015.06.023","article-title":"Diagnostic Accuracy of Bone Turnover Markers and Bone Histology in Patients with CKD Treated by Dialysis","volume":"67","author":"Sprague","year":"2016","journal-title":"Am. J. Kidney Dis."},{"key":"ref_82","first-page":"293","article-title":"Reference Intervals for Bone Turnover Markers in Spanish Premenopausal Women","volume":"54","author":"Filella","year":"2016","journal-title":"Clin. Chem. Lab. Med. (CCLM)"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2","DOI":"10.21037\/jlpm.2018.07.03","article-title":"Bone Markers and Chronic Kidney Diseases","volume":"3","author":"Cavalier","year":"2018","journal-title":"J. Lab. Precis. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1681\/ASN.2017050584","article-title":"Diagnostic Accuracy of Biomarkers and Imaging for Bone Turnover in Renal Osteodystrophy","volume":"29","author":"Salam","year":"2018","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s11914-017-0362-3","article-title":"Biomarkers Predicting Bone Turnover in the Setting of CKD","volume":"15","author":"Evenepoel","year":"2017","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.eprac.2023.08.007","article-title":"A Novel Risk Score to Predict Hungry Bone Syndrome After Parathyroidectomy for Renal Hyperparathyroidism","volume":"29","author":"Ramesh","year":"2023","journal-title":"Endocr. Pr."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s40001-024-01801-y","article-title":"A Nomogram Prediction Model for Hungry Bone Syndrome in Dialysis Patients with Secondary Hyperparathyroidism after Total Parathyroidectomy","volume":"29","author":"Gao","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"611","DOI":"10.7150\/ijms.4861","article-title":"Pre-Operative Serum Alkaline Phosphatase as a Predictor for Hypocalcemia Post-Parathyroid Adenectomy","volume":"9","author":"Loke","year":"2012","journal-title":"Int. J. Med. Sci."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/s00268-019-05251-0","article-title":"Osteocalcin Is an Independent Predictor for Hungry Bone Syndrome After Parathyroidectomy","volume":"44","author":"Ko","year":"2020","journal-title":"World J. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00423-023-02813-8","article-title":"Evaluation of Preoperative Procollagen Type 1 N-Terminal Peptide and Collagen Type 1 C-Telopeptide Levels in the Prediction of Postoperative Hypocalcemia in Patients Undergoing Parathyroidectomy Due to Primary Hyperparathyroidism","volume":"408","author":"Saylam","year":"2023","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.kint.2016.05.019","article-title":"Fibroblast Growth Factor 23 Directly Targets Hepatocytes to Promote Inflammation in Chronic Kidney Disease","volume":"90","author":"Singh","year":"2016","journal-title":"Kidney Int."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1681\/ASN.2005010052","article-title":"Fibroblast Growth Factor-23 Mitigates Hyperphosphatemia but Accentuates Calcitriol Deficiency in Chronic Kidney Disease","volume":"16","author":"Gutierrez","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Puliani, G., Hasenmajer, V., Spaziani, M., Frusone, F., Tarantino, C., Angelini, F., Vincenzi, L., Lubrano, R., Marcellino, A., and Biffoni, M. (2025). Case Report: Prolonged and Severe Hungry Bone Syndrome after Parathyroidectomy in X-Linked Hypophosphatemia. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1496386"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"E1848","DOI":"10.1210\/jc.2011-1534","article-title":"Acute Decline in Serum Sclerostin in Response to PTH Infusion in Healthy Men","volume":"96","author":"Yu","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.15190\/d.2016.2","article-title":"Validation of Commercially Available ELISAs for the Detection of Circulating Sclerostin in Hemodialysis Patients","volume":"4","author":"Mause","year":"2016","journal-title":"Discoveries"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Novacescu, D., Cut, T.G., Cumpanas, A.A., Bratosin, F., Ceausu, R.A., and Raica, M. (2022). Novel Expression of Thymine Dimers in Renal Cell Carcinoma, Demonstrated through Immunohistochemistry. Biomedicines, 10.","DOI":"10.3390\/biomedicines10112673"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Novacescu, D., Cut, T.G., Cumpanas, A.A., Latcu, S.C., Bardan, R., Ferician, O., Secasan, C.-C., Rusmir, A., and Raica, M. (2022). Evaluating Established Roles, Future Perspectives and Methodological Heterogeneity for Wilms\u2019 Tumor 1 (WT1) Antigen Detection in Adult Renal Cell Carcinoma, Using a Novel N-Terminus Targeted Antibody (Clone WT49). Biomedicines, 10.","DOI":"10.3390\/biomedicines10040912"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1210\/clinem\/dgad636","article-title":"Predictive Risk Score for Postparathyroidectomy Hungry Bone Syndrome in Patients with Secondary Hyperparathyroidism","volume":"109","author":"Amjad","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Chai, Y., Yuan, N., Yin, J., Shen, B., Sun, L., Zhang, L., Yin, L., Wang, X., Luo, F., and Luo, C. (2025). Machine Learning-Based Predictive Model for Hungry Bone Syndrome Following Parathyroidectomy in Secondary Hyperparathyroidism. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1635451"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1080\/0886022X.2020.1841655","article-title":"Incidence of and Risk Factors for Post-Parathyroidectomy Hungry Bone Syndrome in Patients with Secondary Hyperparathyroidism","volume":"42","author":"Kritmetapak","year":"2020","journal-title":"Ren. Fail."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.afos.2022.03.004","article-title":"Hungry Bone Syndrome Following Parathyroidectomy for Primary Hyperparathyroidism in a Developed Country in the Asia Pacific. A Cohort Study","volume":"8","author":"Chandran","year":"2022","journal-title":"Osteoporos. Sarcopenia"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1901697","DOI":"10.1155\/2023\/1901697","article-title":"Risk Factor Analysis and Prediction of Severe Hypocalcemia after Total Parathyroidectomy without Auto-Transplantation in Patients with Secondary Hyperparathyroidism","volume":"2023","author":"He","year":"2023","journal-title":"Int. J. Endocrinol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s12020-023-03493-6","article-title":"Dynamic Nomogram for Predicting Hungry Bone Syndrome before Parathyroidectomy","volume":"83","author":"Cao","year":"2024","journal-title":"Endocrine"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Wang, Y., Wei, B., Zhao, T., Shen, H., Liu, X., Wang, J., Wang, Q., Shen, R., and Feng, D. (2023). Machine Learning-Based Prediction Models for Parathyroid Carcinoma Using Pre-Surgery Cognitive Function and Clinical Features. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-46294-7"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jamasurg.2016.2310","article-title":"The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism","volume":"151","author":"Wilhelm","year":"2016","journal-title":"JAMA Surg."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive Summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: What\u2019s Changed and Why It Matters","volume":"92","author":"Ketteler","year":"2017","journal-title":"Kidney Int"},{"key":"ref_107","unstructured":"(2025, October 10). Adult Haemodialysis Patients Undergoing Parathyroidectomy (Guidelines)|Right Decisions. Available online: https:\/\/rightdecisions.scot.nhs.uk\/tam-treatments-and-medicines-nhs-highland\/adult-therapeutic-guidelines\/renal-disorders\/adult-haemodialysis-patients-undergoing-parathyroidectomy-guidelines\/."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.eprac.2023.01.009","article-title":"A Parathyroid Hormone\u2013Guided Calcium and Calcitriol Supplementation Protocol Reduces Hypocalcemia-Related Readmissions Following Total Thyroidectomy","volume":"29","author":"Chindris","year":"2023","journal-title":"Endocr. Pract."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s11255-020-02387-0","article-title":"Hungry Bone Syndrome after Parathyroidectomy in End-Stage Renal Disease Patients: Review of an Alkaline Phosphatase-Based Treatment Protocol","volume":"52","author":"Wong","year":"2020","journal-title":"Int. Urol. Nephrol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"264","DOI":"10.4174\/astr.2022.103.5.264","article-title":"Impact of Enhanced Recovery after Surgery Program for Hungry Bone Syndrome in Patients on Maintenance Hemodialysis Undergoing Parathyroidectomy for Secondary Hyperparathyroidism","volume":"103","author":"Wang","year":"2022","journal-title":"Ann. Surg. Treat. Res."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"30","DOI":"10.2478\/enr-2021-0005","article-title":"Intensive Calcium Monitoring Improves Outcomes on Hungry Bone Syndrome in Hyperparathyroidism","volume":"55","author":"Ferreira","year":"2021","journal-title":"Endocr. Regul."},{"key":"ref_112","unstructured":"Cartwright, C., and Anastasopoulou, C. (2025). Hungry Bone Syndrome. StatPearls, StatPearls Publishing."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s40265-019-01074-4","article-title":"Management of Post-Transplant Hyperparathyroidism and Bone Disease","volume":"79","author":"Rossi","year":"2019","journal-title":"Drugs"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2300","DOI":"10.1210\/jc.2015-3909","article-title":"Presentation of Hypoparathyroidism: Etiologies and Clinical Features","volume":"101","author":"Shoback","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"101703","DOI":"10.1016\/j.ando.2025.101703","article-title":"Chapter 14: Post Surgical Follow-up of Primary Hyperparathyroidism","volume":"86","author":"Barraud","year":"2025","journal-title":"Ann Endocrinol"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"674","DOI":"10.4158\/EP14462.DSC","article-title":"American Association of Clinical Endocrinologists And American College of Endocrinology Disease State Clinical Review: Postoperative Hypoparathyroidism\u2014Definitions and Management","volume":"21","author":"Stack","year":"2015","journal-title":"Endocr. Pr."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7849\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:26:57Z","timestamp":1762363617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":117,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14217849"],"URL":"https:\/\/doi.org\/10.3390\/jcm14217849","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}