Abstract: TH-PO136
Comparison between the Different Doses of Preoperative Calcitriol to Prevent Hungry Bone Syndrome after Parathyroidectomy in ESKD: A Randomized Controlled Clinical Trial
Session Information
- CKD-MBD: Clinical
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Thookhamme, Ompan, Phramongkutklao College of Medicine, Bangkok, Thailand
- Inkong, Pitchamon, Phramongkutklao College of Medicine, Bangkok, Thailand
Background
The most common complication of parathyroidectomy in end-stage kidney disease (ESKD) is hungry bone syndrome (HBS), resulting in prolonged hospitalization. Administering calcitriol before surgery is one strategy for preventing these complications; however, limited studies on the recommended calcitriol dose. The study aims to compare the efficacy and safety of different doses of calcitriol in preventing hypocalcemia in end-stage kidney disease (ESKD).
Methods
ESKD patients on regular hemodialysis with renal hyperparathyroidism undergoing parathyroidectomy were randomly assigned to receive 4 mcg/day of calcitriol or 2 mcg/day for 3 days before surgery. The primary outcome was hungry bone syndrome, defined as severe hypocalcemia or hypocalcemia on day 7, and secondary outcomes included electrolyte disturbances and hospitalization length.
Results
28 ESKD patients who underwent parathyroidectomy were enrolled, 14 received 4 mcg and the other 14 received 2 mcg of calcitriol. The mean age was 47.11±11.47 years, the mean serum calcium was 10.56±0.78 mg/dL, and the mean serum parathyroid hormone was 1866±677.62 pg/mL. The incidence of HBS was 62.5%, occurring in 5 (38.5%) and 10 (90.1%) participants in the high and low calcitriol groups, respectively (p = 0.008). The incidence of severe hypocalcemia within 72 hours were 5 (35.7%) in high-dose and 7 (50%) in low-dose groups, respectively (p = 0.704). Other factors including hypophosphatemia and length of hospitalization were similar in both groups. No serious adverse events were reported.
Conclusion
4 mcg of calcitriol showed significant benefits in preventing hungry bone syndrome after parathyroidectomy compared to 2 mcg of calcitriol, without serious adverse effects.