Q: 54 years old male with End-Stage Renal Disease (ESRD) is postoperative parathyroidectomy. The patient is transferred from the floor to ICU on a postoperative day #3 due to clinical symptoms of "Hungry Bone Syndrome" (HBS). All of the following are the feature of HBS EXCEPT?
Hypocalcemia immediately after parathyroidectomy is almost always universal. Usually, it is transient but ESRD patients have a high tendency to go into hypocalcemia crisis and it may last longer.
In hyperparathyroidism, parathyroid hormone (PTH) increases bone formation and resorption with a net efflux of calcium from bone, resulting in hypercalcemia. The acute withdrawal of the parathyroid hormone (PTH) results in an imbalance resulting in a marked bone uptake of calcium, phosphate, and magnesium. The overall indirect effect on electrolytes is hyperkalemia, particularly in renal patients.
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