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Perioperative hyperkalemia in hemodialysis patients undergoing parathyroidectomy for renal hyperparathyroidism

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Abstract

The present study investigates the incidence of perioperative hyperkalemia and the influence factors of serum potassium levels during and after parathyroidectomy (PTX) in hemodialysis patients with renal hyperparathyroidism (rHPT). A total of 204 hemodialysis patients with refractory rHPT undergoing successful total parathyroidectomy with autotransplantation (tPTX + AT) were analyzed retrospectively. Hyperkalemia was defined as serum potassium levels ≥ 5.5 mmol/L. The preoperative baseline level of serum potassium (K +base ) was defined as a mean of the three preoperative prehemodialysis serum potassium levels. The higher levels of serum potassium during and immediately after surgery were recorded as K +d0 and the peak prehemodialysis serum potassium levels 3 days after surgery as K +d3 . 136/204 (66.7%) patients suffered from hyperkalemia during or immediately after surgery and 65/204 (31.9%) patients were affected with prehemodialysis hyperkalemia 3 days after surgery. K +base was the only influencing factor for K +d0 . Serum K +base , preoperative serum alkaline phosphatase, and total calcium supplement dosage during intravenous calcium supplement were the influencing factors for K +d3 . In the case of PTX, the serum potassium levels of patients with higher serum K +base and severe postoperative hypocalcemia need to be monitored with extended attention perioperatively.

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Author notes

  1. Ningning Wang and Changying Xing contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300# Guangzhou Road, Nanjing, 210029, Jiangsu, China

    Guang Yang, Jing Wang, Ningning Wang & Changying Xing

  2. Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China

    Jie Sun

  3. Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China

    Xiaoming Zha

Authors
  1. Guang Yang
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  2. Jing Wang
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  4. Xiaoming Zha
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  5. Ningning Wang
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Correspondence to Changying Xing.

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The authors declare that they have no conflict of interest.

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The current study has been approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (Nanjing, China) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Yang, G., Wang, J., Sun, J. et al. Perioperative hyperkalemia in hemodialysis patients undergoing parathyroidectomy for renal hyperparathyroidism. Intern Emerg Med 14, 1065–1071 (2019). https://doi.org/10.1007/s11739-019-02031-5

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  • DOI: https://doi.org/10.1007/s11739-019-02031-5

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