Hungry Bone Syndrome

Case: 62 year old male with End Stage Renal Disease (ESRD) is admitted to ICU after parathyroidectomy. All of the following electrolyte imbalances are expected except?

A) Hypocalcemia 
B) Hypophosphatemia 
C) Hypomagnesemia 
D) Hyperkalemia 
E) Hypernatremia


Answer:  E

The objective of the above question is to highlight the electrolyte imbalances in "Hungry Bone Syndrome" (HBS), a possible scenario after parathyroidectomy, particularly in ESRD patients. The hallmark of HBS is hypocalcemia (choice A) but other electrolyte imbalances may occur (choices B, C, D). ESRD patients are more prone to have hyponatremia due to volume-overload instead of hypernatremia (choice E).

#surgicalcriticalcare
#electrolyteimbalance
#nephrology


References:

1. Cruz DN, Perazella MA. Biochemical aberrations in a dialysis patient following parathyroidectomy. Am J Kidney Dis 1997; 29:759. 

2. Shpitz B, Korzets Z, Dinbar A, et al. Immediate postoperative management of parathyroidectomized hemodialysis patients. Dial Transplant 1986; 15:507.