A Novel Risk Score to Predict Hungry Bone Syndrome After Parathyroidectomy for Renal Hyperparathyroidism
Authors' conclusion
Preoperative serum PTH and ALP are significantly associated with HBS in patients with renal hyperparathyroidism undergoing parathyroidectomy for renal hyperparathyroidism. A scoring system with these 2 variables may be of clinical utility in predicting patients at high risk of HBS.
Study context
- Population
- Patients with renal hyperparathyroidism who underwent parathyroidectomy at a single institution, 2011–2021
- Participants
- 33 patients
- Exposure
- Patients who developed hungry bone syndrome (HBS) vs those who did not; development of a risk score
- HBSn = 16
- Outcome
- Predictive factors for HBS and a scoring system to predict HBS
Methodological detailssingle-centre, Boruta and binary logistic regression analyses used to develop the scoring system
- Single-centre
- Boruta and binary logistic regression analyses used to develop the scoring system
Main finding
As reported in the abstract
Two-point scoring system (ALP >150 U/L and PTH >1000 pg/mL) predicting HBS
- HBS incidence
- 16 (48%)
- Positive predictors of HBS on stepwise regression
- elevated alkaline phosphatase (ALP) (>150 U/L) and markedly elevated parathyroid hormone (PTH) (>1000 pg/mL)
- Overall diagnostic accuracy
- 96.8%
- Sensitivity
- 100%
- Specificity
- 94.1%
- PPV with 1 point
- 93.8%
- PPV with 2 points
- 100%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Preoperative serum levels, HBS vs no HBSHBS vs No HBS · PTH; higher with HBS | MD 2167.2 pg/mL | P < 0.001 |
| Preoperative serum levels, HBS vs no HBSHBS vs No HBS · phosphorus; higher with HBS | MD 3.5 mg/dl | P < 0.001 |
| Preoperative serum levels, HBS vs no HBSHBS vs No HBS · ALP; higher with HBS | MD 344.2 U/L | P = 0.002 |
| Preoperative serum levels, HBS vs no HBSHBS vs No HBS · calcium; lower with HBS | MD −0.96 mg/dL | P = 0.004 |
Original publication
A Novel Risk Score to Predict Hungry Bone Syndrome After Parathyroidectomy for Renal Hyperparathyroidism. Endocr Pract. Published 6 September 2023. doi:10.
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