A New Calculation Model for Calcium Requirements After Parathyroidectomy in Patients With Secondary Hyperparathyroidism

Abstract

Objectives: We aimed to develop a new calculation model for calcium requirements in dialysis patients following parathyroidectomy.

Methods: A total of 98 patients with secondary hyperparathyroidism receiving parathyroidectomy from January 2014 to January 2022 were enrolled in this study. Among these patients, 78 were randomly selected for construction of the calcium requirement calculation model, and the remaining 20 patients were selected for model validation. The calcium requirement model estimated the total calcium supplementation for 1 week after surgery using variables with significant relationships in the derivation group by stepwise multiple linear regression analysis. Bias, precision, and accuracy were measured in the validation group to determine the performance of the model.

Results: The model was as follows: calcium requirement for 1 week after surgery=33.798-8.929×immediate postoperative calcium+0.190×C-reactive protein-0.125×age+0.002×preoperative intact parathyroid hormone+0.003×preoperative alkaline phosphatase (R2=0.8). The model was successfully validated.

Conclusion: We generated a novel model to guide calcium supplementation. This model can assist in stabilizing the serum calcium levels of patients during the early postoperative period. Furthermore, it contributes to the individualized and precise treatment of hypocalcemia in patients following parathyroidectomy.

Keywords: Hemodialysis; Hypocalcemia; Parathyroidectomy; Secondary Hyperparathyroidism.

Fig. 1.

Study profile.

Fig. 2.

Actual and predicted calcium requirements in 1-week postoperation. (A) The comparison between actual and predicted calcium requirements. (B) Scatter plot of actual and predicted calcium requirements.