Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism

doi:10.21037/gs-22-27

科研成果详情

题名	Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism
作者	Zhu, Xi; Li, Zhouting; Xia, Xiaofang; Zeng, Xiaomin; Cheng, Feng; Zhou, Bin; Wu, Yong; Zhu, Lei
发表日期	2022-04
发表期刊	GLAND SURGERY 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Drug-refractory secondary hyperparathyroidism (SHPT) total parathyroidectomy (TPTX) autotransplantation hyperkalemia
其他关键词	INTRAOPERATIVE HYPERKALEMIA ; HEMODIALYSIS-PATIENTS ; RISK-FACTORS ; HORMONE ; DISEASE
摘要	Background: The purpose of this retrospective study was to explore the primary possible risk factors for the development of postoperative hyperkalemia after total parathyroidectomy with autotransplantation (TPTX + AT) in patients with drug-refractory secondary hyperparathyroidism (SHPT). Methods: The clinical data of 149 patients receiving maintenance dialysis for drug-refractory SHPT, who underwent TPTX + AT, were reviewed and analyzed. Demographic data, dialysis status, and laboratory test indices were collected from enrolled patients. According to the postoperative serum potassium level >5.3 mmol/L or not, they were divided into hyperkalemia group and non-hyperkalemia group. The differences in general clinical data and laboratory indicators between the two groups were compared; logistic regression analysis was performed to analyze the risk factors affecting the development of postoperative hyperkalemia in patients; receiver operating characteristic (ROC) subject workup curves were analyzed for the threshold values of postoperative hyperkalemia. Results: Of the 149 participants, 25 (16.78%) developed postoperative hyperkalemia after TPTX + AT. Univariate analysis suggested that dialysis duration, SHPT duration, dialysis modality, and preoperative alkaline phosphatase, blood potassium, and blood calcium levels were independently associated with the development of hyperkalemia after TPTX + AT. Univariate logistic analysis suggested that dialysis duration [odds ratio (OR) 1.18, 95% confidence interval (CI): 1.03, 1.35, P=0.014], preoperative blood potassium (OR 4.95, 95% CI: 2.05, 11.96, P<0.001), and preoperative blood calcium (OR 16.17, 95% CI: 1.36, 191.58, P=0.027) were 3 factors that predicted hyperkalemia after TPTX + AT. According to ROC curve analysis, the optimal cutoff point for dialysis duration was 8.5 years, the optimal cutoff level for preoperative blood potassium was 4.57 mmol/L, and the optimal cutoff level for preoperative blood calcium was 2.31 mmol/L. Of these 3 factors, preoperative blood potassium had a more balanced sensitivity, specificity, and optimal diagnostic efficacy. Conclusions: Patients with drug-refractory SHPT are prone to hyperkalemia after TPTX + AT. Duration of dialysis and preoperative blood potassium and blood calcium levels can help predict the development of postoperative hyperkalemia.
资助项目	Medical and Health Research Program of Zhejiang Province [2021435899, 2022ZH090]; Lishui Municipal Science and Technology Program [2019SJZC07]
出版者	AME PUBL CO
出版地	SHATIN
ISSN	2227-684X
EISSN	2227-8575
卷号	11 期号:4 页码:702-709
DOI	10.21037/gs-22-27
页数	8
WOS类目	Surgery
WOS研究方向	Surgery
WOS记录号	WOS:000783997300001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	35531117
SCOPUSEID	2-s2.0-85129638540
通讯作者地址	[Zhu, Lei]Department of General Surgery,The Fifth Affiliated Hospital of Wenzhou Medical University & Lishui Central Hospital,Lishui,China
Scopus学科分类	Surgery
引用统计	被引频次：1[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/148533
专题	附属第一医院其他_附属第五医院（丽水市中心医院）
通讯作者	Zhu, Lei
作者单位	Department of General Surgery,The Fifth Affiliated Hospital of Wenzhou Medical University & Lishui Central Hospital,Lishui,China
第一作者单位	附属第五医院（丽水市中心医院）
通讯作者单位	附属第五医院（丽水市中心医院）
第一作者的第一单位	附属第五医院（丽水市中心医院）
推荐引用方式 GB/T 7714	Zhu, Xi,Li, Zhouting,Xia, Xiaofang,et al. Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism[J]. GLAND SURGERY,2022,11(4):702-709.
APA	Zhu, Xi., Li, Zhouting., Xia, Xiaofang., Zeng, Xiaomin., Cheng, Feng., ... & Zhu, Lei. (2022). Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism. GLAND SURGERY, 11(4), 702-709.
MLA	Zhu, Xi,et al."Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism".GLAND SURGERY 11.4(2022):702-709.