ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Bone Research
Efficacy and safety of prophylactic intravenous calcium supplementation in patients with secondary hyperparathyroidism after parathyroidectomy: a retrospective study
Provisionally accepted
- Wuxi People's Hospital, Wuxi, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Severe hypocalcemia is a common complication in patients with secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX). The necessity of postoperative prophylactic intravenous calcium supplementation and the corresponding strategies are controversial. This study aimed to analyze the efficacy and safety of prophylactic intravenous calcium supplementation after PTX. We retrospectively reviewed the clinical data of 126 125 patients with SHPT who underwent PTX between January 2020 and December 2023. Patients were divided into prophylactic intravenous calcium supplementation group (group A, 94 cases) and non-prophylactic intravenous calcium supplementation (group B, 32 31 cases). The incidence of severe hypocalcemia in group A (30 cases, 31.9%) was lower than that in group B (20 19 cases, 62.51.3%) (P=0.0042). Binary logistic regression analysis revealed that non-prophylactic intravenous calcium supplementation, high level of preoperative parathyroid hormone (PTH) and alkaline phosphatase (ALP), and low level of preoperative serum calcium were risk factors for severe hypocalcemia. Preoperative high level of ALP was a negative predictor for hypercalcemia after calcium supplementation. In conclusion, postoperative prophylactic intravenous calcium supplementation, followed by dynamic dosage adjustments based on serum calcium levels, in addition to routine oral calcium and calcitriol supplementation, could significantly reduce the incidence of severe hypocalcemia without substantially increasing the risk of hypercalcemia.
Keywords: Severe hypocalcemia, Secondary hyperparathyroidism, Parathyroidectomy, Alkaline Phosphatase, Dialysis
Received: 17 Jul 2025; Accepted: 11 Nov 2025.
Copyright: © 2025 Pan, Zhu, Wu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dengfeng Wu, wudengfengjzxwk@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.