Hungry Bone Syndrome (HBS) as an Outcome of Parathyroidectomy for Treatment of Hyperparathyroidism in a Third-Level Hospital in a Medium-Income Country

Background: Hyperparathyroidism is a common disorder of mineral metabolism that is due to excessive secretion of PTH from one or more of the four parathyroid glands. It can be classified as primary, secondary and tertiary. In ESRD the definitive treatment in severe disease is parathyroidectomy. HBS is one complication after the surgery. Methods: Retrospective cohort study with information (Jan 2023 and Jan 2024) in a third level hospital “Centro Médico Nacional 20 de Noviembre”. The goal was to describe and analyze the incidence of HBS on patients with hyperpharatidoidism primary, secondary and tertiary treated with parathyroidectomy. We made a Principal Component Analysis (PCA) to observe the factors that have more impact. Results: 51 cases were included. There were 16 patients with primary, 29 patients with secondary and 5 with tertiary hyperparathyroidism. Patients with ERSRD with secondary and tertiary hyperparathyroidism were mainly in Hemodialysis (71%) as Kidney Replacement Therapy (n=25). The mean value of PTH before surgery was 728 pg/ml among all patients. 80% patients (n=41) have AP >100 mg/dl as a parameter of high bone replacement. 30% patients (n=15) develop hungry bone syndrome. 86% of patients (n=13) that developed HBS have 3 ½ surgery. We made a PCA we observed that the principal components that predict to developed HBS in our population were AP, PTH and the surgery 3 ½ and patients have more risk if they have the three of them together. Conclusion: The principal components observed that predict the developed HBS in our population were AP, PTH and the surgery 3 ½ and patients have more risk to develop HBS if they have them together.