Hungry bone syndrome: Clinical and biochemical predictors of its occurrence after parathyroid surgery

https://doi.org/10.1016/0002-9343(88)90100-3Get rights and content

Abstract

The hospital course of 218 consecutive patients with primary hyperparathyroidism admitted over a three-year period for parathyroidectomy at the Massachusetts General Hospital was reviewed to determine the incidence and identify the risk factors for the development of the hungry bone syndrome. Twenty-five patients with the hungry bone syndrome were identified (12.6 percent). Compared to patients with uncomplicated metabolic responses to parathyroid surgery, these patients were older by a mean of 10 years; they had higher preoperative serum levels of calcium, alkaline phosphatase, N-terminal parathyroid hormone, and blood urea nitrogen; and their resected parathyroid adenomata were larger. The mean duration of hospitalization averaged three days longer in the group with hungry bone disease. Stepwise multivariate analysis of preoperative variables enabled the development of a discriminant function for prediction of postoperative hypocalcemia and hypophosphatemia. Identified predictive variables were volume of resected parathyroid adenoma, blood urea nitrogen, alkaline phosphatase, and age. When validated on an independent patient population, these readily obtainable preoperative clinical and laboratory parameters will allow identification of a subgroup of patients who are at greater risk for the development of the hungry bone syndrome following parathyroid surgery.

References (20)

There are more references available in the full text version of this article.

Cited by (266)

  • Hypocalcemia after parathyroidectomy in patients taking proton pump inhibitors

    2023, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
  • A case report of rare giant parathyroid adenoma

    2022, Journal of Clinical and Translational Endocrinology: Case Reports
  • Data to inform counseling on parathyroidectomy for secondary hyperparathyroidism of renal origin

    2022, Surgery (United States)
    Citation Excerpt :

    This association was also seen in a prior single institution study13 and could possibly be related to higher resected gland weight; several studies have shown that body mass index correlates with adenoma weight in primary hyperparathyroidism.21–23 In patients with primary hyperparathyroidism, postoperative hypocalcemia has been shown to correlate with higher weight of resected adenomas.24,25 The association of resected gland weight with postoperative hypocalcemia and HBS in SHRO is less clear; studies have shown both no correlation between postoperative HBS and gland weight,13 and a positive correlation with both higher26 and lower15 gland weights.

View all citing articles on Scopus
View full text