Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis

Malina Grube,1 Frank Weber,2 Anna Lena Kahl,3 Andreas Kribben,1 Nils Mülling,1 Walter Reinhardt1 1Department of Nephrology, University Hospital Essen, Essen, Germany; 2Department of General-, Visceral- and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, Essen, Germa...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Grube M, Weber F, Kahl AL, Kribben A, Mülling N, Reinhardt W
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	secondary hyperparathyroidism hungry bone disease parathyroidectomy vitamin d dialysis ckd stage 5 Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/b0db78fcc01a44d2bb13725fa836e6d3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b0db78fcc01a44d2bb13725fa836e6d3
record_format	dspace
spelling	oai:doaj.org-article:b0db78fcc01a44d2bb13725fa836e6d32021-11-11T18:22:26ZEffect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis1178-7058https://doaj.org/article/b0db78fcc01a44d2bb13725fa836e6d32021-11-01T00:00:00Zhttps://www.dovepress.com/effect-of-high-dose-active-vitamin-d-therapy-on-the-development-of-hyp-peer-reviewed-fulltext-article-IJNRDhttps://doaj.org/toc/1178-7058Malina Grube,1 Frank Weber,2 Anna Lena Kahl,3 Andreas Kribben,1 Nils Mülling,1 Walter Reinhardt1 1Department of Nephrology, University Hospital Essen, Essen, Germany; 2Department of General-, Visceral- and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, Essen, Germany; 3Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Essen, GermanyCorrespondence: Nils MüllingDepartment of Nephrology, University Hospital Essen, Hufelandstr. 55, Essen, 45147, GermanyEmail nils.muelling@uk-essen.deBackground: The period after parathyroidectomy (PTx) in dialysis patients is characterized by periods of severe hypocalcemia. This study aims to investigate the effect of high doses of active vitamin D immediately after PTx on the development of hypocalcemia.Materials and Methods: We retrospectively reviewed 111 patients with secondary hyperparathyroidism receiving subtotal PTx between 2010 and 2019. A high dose group “HDG” (n = 67) receiving 12 μg alfacalcidol in combination with 8.550 mg calcium acetate per day, which was then adapted according to lab values, was compared with a low dose group “LDG” (n = 44) receiving up to 4 μg alfacalcidol per day. The laboratory values were recorded up to ten weeks postoperatively.Results: The assumed drops in parathyroid hormone (PTH) and calcium were observed in both groups after PTx. We observed significantly lower calcium values in the LDG between days 4 and 18 postoperatively than in the HDG (p < 0.001). The proportion of severe hypocalcemia after PTx (total calcium < 1.5 mmol/l) in the HDG was 8.5% on day 1 and 47% on day 4 in the LDG. Intravenous calcium requirements were significantly lower in the HDG (7.6%) than in the LDG (45.7%; p = 0.001).Conclusion: The period after PTx in dialysis patients is characterized by an expected drop in PTH and calcium within the first days. Ongoing high turnover is observed in the 2nd and 3rd week after PTx. Administering high doses of alfacalcidol combined with calcium acetate diminishes the episodes of severe hypocalcemia and the need for intravenous calcium.Keywords: secondary hyperparathyroidism, hungry bone disease, parathyroidectomy, vitamin D, dialysis, CKD stage 5Grube MWeber FKahl ALKribben AMülling NReinhardt WDove Medical Pressarticlesecondary hyperparathyroidismhungry bone diseaseparathyroidectomyvitamin ddialysisckd stage 5Diseases of the genitourinary system. UrologyRC870-923ENInternational Journal of Nephrology and Renovascular Disease, Vol Volume 14, Pp 399-410 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	secondary hyperparathyroidism hungry bone disease parathyroidectomy vitamin d dialysis ckd stage 5 Diseases of the genitourinary system. Urology RC870-923
spellingShingle	secondary hyperparathyroidism hungry bone disease parathyroidectomy vitamin d dialysis ckd stage 5 Diseases of the genitourinary system. Urology RC870-923 Grube M Weber F Kahl AL Kribben A Mülling N Reinhardt W Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
description	Malina Grube,1 Frank Weber,2 Anna Lena Kahl,3 Andreas Kribben,1 Nils Mülling,1 Walter Reinhardt1 1Department of Nephrology, University Hospital Essen, Essen, Germany; 2Department of General-, Visceral- and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, Essen, Germany; 3Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Essen, GermanyCorrespondence: Nils MüllingDepartment of Nephrology, University Hospital Essen, Hufelandstr. 55, Essen, 45147, GermanyEmail nils.muelling@uk-essen.deBackground: The period after parathyroidectomy (PTx) in dialysis patients is characterized by periods of severe hypocalcemia. This study aims to investigate the effect of high doses of active vitamin D immediately after PTx on the development of hypocalcemia.Materials and Methods: We retrospectively reviewed 111 patients with secondary hyperparathyroidism receiving subtotal PTx between 2010 and 2019. A high dose group “HDG” (n = 67) receiving 12 μg alfacalcidol in combination with 8.550 mg calcium acetate per day, which was then adapted according to lab values, was compared with a low dose group “LDG” (n = 44) receiving up to 4 μg alfacalcidol per day. The laboratory values were recorded up to ten weeks postoperatively.Results: The assumed drops in parathyroid hormone (PTH) and calcium were observed in both groups after PTx. We observed significantly lower calcium values in the LDG between days 4 and 18 postoperatively than in the HDG (p < 0.001). The proportion of severe hypocalcemia after PTx (total calcium < 1.5 mmol/l) in the HDG was 8.5% on day 1 and 47% on day 4 in the LDG. Intravenous calcium requirements were significantly lower in the HDG (7.6%) than in the LDG (45.7%; p = 0.001).Conclusion: The period after PTx in dialysis patients is characterized by an expected drop in PTH and calcium within the first days. Ongoing high turnover is observed in the 2nd and 3rd week after PTx. Administering high doses of alfacalcidol combined with calcium acetate diminishes the episodes of severe hypocalcemia and the need for intravenous calcium.Keywords: secondary hyperparathyroidism, hungry bone disease, parathyroidectomy, vitamin D, dialysis, CKD stage 5
format	article
author	Grube M Weber F Kahl AL Kribben A Mülling N Reinhardt W
author_facet	Grube M Weber F Kahl AL Kribben A Mülling N Reinhardt W
author_sort	Grube M
title	Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
title_short	Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
title_full	Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
title_fullStr	Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
title_full_unstemmed	Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis
title_sort	effect of high dose active vitamin d therapy on the development of hypocalcemia after subtotal parathyroidectomy in patients on chronic dialysis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/b0db78fcc01a44d2bb13725fa836e6d3
work_keys_str_mv	AT grubem effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis AT weberf effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis AT kahlal effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis AT kribbena effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis AT mullingn effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis AT reinhardtw effectofhighdoseactivevitamindtherapyonthedevelopmentofhypocalcemiaaftersubtotalparathyroidectomyinpatientsonchronicdialysis
_version_	1718431845119426560

Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis

Ejemplares similares