|
KMID : 0359919960150020209
|
|
Korean Journal of Nephrology
1996 Volume.15 No. 2 p.209 ~ p.215
|
|
|
Treatment of Hungry Bone Syndrome after parathyroidectomy Using Continuous Ambulatory Intraperitoneal Calcium Therapy
|
|
|
|
|
Abstract
|
|
|
Patients with chronic renal failure may require parathyroidectomy to correct the complications of hyperparathyroidism. But severe recalcitrant hypocalcemia and hungry bone syndrome can complicate the postoerative course of parathyroidectomy,
despite of
aggressive therapy with oral calcium and vitamin D. Intravenous calcium infusion can be used to treat this condition, but generally prolongs hospitalization and has adverse side effects such as gastroinstinal distrurbances and cardiac conduction
abnormalities. In patients maintained on peritoneal dialysis intraperitoneal administration of calcium is a reasonable alternative. We report severe tertiary hyperparathyroidism in a patient who has been receiving CAPD after renal transplant
failure. He
required parathyroidectomy because he demonstrated lersistent elevation of the derum clacium level, elevated intact paratyroid hormone level, bone pain, and soft tissue calcification. He diveloped hungry bone syndrome requiring proloned clacium
therapy
including intraperitoneal administration of calcium gluconate after subtotal parathyroidectomy. He has been treated for 6 months by adding 20mL of 10% claium gluconate solution (caicium concentration 93.23mg; mL) to each beag of dialysate after
subtotal
parathyroidectomy. Complications such as visible dialysate precititation, increased rate of peritonitis. Or abdominal pain were not observed. Mean total lcacium uptake ws 167.36mg exchnange. We conclude that the intraperitoneal calcium therapy is
a
safe
and effective treatment in CAPD patients who require parenteral calcium for more than a few days after operation.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|