Photo Credit: BeritK

The following is a summary of “Predictive Risk Score for Postparathyroidectomy Hungry Bone Syndrome in Patients With Secondary Hyperparathyroidism,” published in the March 2024 issue of Endocrinology by Amjad, et al.

Patients with end-stage renal disease often experience secondary hyperparathyroidism (SHPT). Hungry bone syndrome (HBS) is a common complication following parathyroidectomy for SHPT and can lead to prolonged hospitalization or intensive care. For a study, researchers sought to create a scoring system to categorize patients based on their risk of developing HBS.

A retrospective cohort study utilized data from the US Renal Data System (2010-2021). Univariate and multivariate logistic regression models were employed to identify factors associated with HBS development. Weighted β-coefficients from the multivariable model were used to construct a risk score for HBS. Positive and negative predictive values were evaluated.

Among 17,074 patients who underwent parathyroidectomy for SHPT, 19.4% developed HBS. Patients who developed HBS had a higher incidence of intensive care unit admission than those who did not (33.5% vs. 24.6%, P < .001). Multivariable logistic regression analysis revealed that younger age, renal osteodystrophy, longer dialysis duration, longer kidney transplant duration, and higher Elixhauser score were significantly associated with HBS. Based on these factors, a risk score was developed, with 6 possible points. HBS rates ranged from 8% in patients with 0 points to 44% in those with 6 points. The risk score demonstrated a poor positive predictive value (20.3%) but an excellent negative predictive value (89.3%) for HBS.

A weighted risk score was developed to stratify patients’ risk of developing HBS after parathyroidectomy for SHPT. The tool can assist in patient counseling and identifying individuals who may not require postoperative hospitalization.

Reference: academic.oup.com/jcem/article-abstract/109/3/603/7331933