Internal and Emergency Medicine | 2019
Perioperative hyperkalemia in hemodialysis patients undergoing parathyroidectomy for renal hyperparathyroidism
Abstract
The present study investigates the incidence of perioperative hyperkalemia and the influence factors of serum potassium levels during and after parathyroidectomy (PTX) in hemodialysis patients with renal hyperparathyroidism (rHPT). A total of 204 hemodialysis patients with refractory rHPT undergoing successful total parathyroidectomy with autotransplantation (tPTX\u2009+\u2009AT) were analyzed retrospectively. Hyperkalemia was defined as serum potassium levels\u2009≥\u20095.5\xa0mmol/L. The preoperative baseline level of serum potassium (Kbase+) was defined as a mean of the three preoperative prehemodialysis serum potassium levels. The higher levels of serum potassium during and immediately after surgery were recorded as Kd0+ and the peak prehemodialysis serum potassium levels 3\xa0days after surgery as Kd3+. 136/204 (66.7%) patients suffered from hyperkalemia during or immediately after surgery and 65/204 (31.9%) patients were affected with prehemodialysis hyperkalemia 3\xa0days after surgery. Kbase+ was the only influencing factor for Kd0+. Serum Kbase+, preoperative serum alkaline phosphatase, and total calcium supplement dosage during intravenous calcium supplement were the influencing factors for Kd3+. In the case of PTX, the serum potassium levels of patients with higher serum Kbase+ and severe postoperative hypocalcemia need to be monitored with extended attention perioperatively.