#3838 Hungry bone syndrome (HBS) as an outcome of parathyroidectomy as a treatment of hyperparathyroidism in a third level hospital in a medium-income country

Abstract Background and Aims Hyperparathyroidism is a common disorder of mineral metabolism that is due to excessive secretion of parathyroid hormone (PTH) from one or more of the four parathyroid glands. It can be classified as primary, secondary and tertiary. In end stage renal disease (ESRD) the definitive treatment in severe disease is parathyroidectomy. Hungry bone syndrome (HBS) is one complication after the surgery, some risk factors to develop this condition are the levels of PTH, alkaline phosphate (AP), hypocalcemia and remove of all glands. Method Retrospective cohort study with information (January 2023 and January 2024) in a third level hospital “Centro Médico Nacional 20 de Noviembre”. The objective was to describe and analyze the incidence of HBS on patients with hyperparathyroidism primary, secondary and tertiary treated with parathyroidectomy. We made a Principal Component Analysis (PCA), to observe the factors that made more impact on HBS. Results 51 cases were included. There were 16 patients with primary, 29 patients with secondary and 5 with tertiary hyperparathyroidism. Patients with ESRD 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 and the mean value was 242 U/L. 30% patients (n = 15) develop hungry bone syndrome. 86% of patients (n = 13) that developed HBS have 3½ surgery. We made a PCA we observed that the principal components that predict to developed HBS in our population were the levels of AP and PTH and the surgery 3½ and patients have more risk if they have the three of them together. Conclusion In our population 30% of patients develop HBS. The principal components observed that predict the developed HBS in our population were AP, PTH and the surgery 3½ and patients have more risk to develop HBS if they have the three of them together. The PCA could be a tool that will allow us in the future to generate a risk scale for HBS.