Prolonged hypophosphatemia following parathyroidectomy in chronic hemodialysis patients.
OBJECTIVE
Hypoparathyroidism in patients with functioning kidneys leads to hyperphosphatemia. This paper reviews data suggesting that hypoparathyroidism in patients on maintenance dialysis leads to hypophosphatemia.


METHODS
Clinical data in two patients on dialysis with hypoparathyroidism following parathyroid surgery; literature review of dialysis patients with hypoparathyroidism following parathyroid surgery.


RESULTS
In the patients presented both here and in the literature, hypoparathyroidism in dialysis patients is associated with persistent hypophosphatemia or decrease in serum phosphorus from its pre-surgery level.


CONCLUSIONS
In patients on maintenance dialysis, persistent hypoparathyroidism post-parathyroidectomy may lead to chronic hypophosphatemia, in contrast to the hyperphosphatemia usually associated with hypoparathyroidism. Proposed mechanisms for this paradoxical phenomenon include ongoing phosphorus deposition into bone (Hungry Bone Syndrome), phosphorus deposition into soft tissue and/or diminished intestinal phosphorus absorption or increased intestinal phosphorus loss.
Adult Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel. Ishavit@szmc.org.il
Linda
L
Shavit
Meyer
M
Lifschitz
Itzchak
I
Slotki
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology*; D008297:Male; D016105:Parathyroidectomy / Q000009:adverse effects*; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000628:therapy
D010710:Phosphates; D002118:Calcium