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Updated: Jul 17, 2025

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Dynamic nomogram for predicting hungry bone syndrome before parathyroidectomy.

Runmin Cao1, Honghe Jiang2, Guangpeng Liang1

  • 1Jinzhou Medical University Postgraduate Training Base (Jinzhou Central Hospital), Jinzhou City, Liaoning Province, China.

Endocrine
|August 28, 2023
PubMed
Summary

A new nomogram predicts hungry bone syndrome (HBS) after parathyroidectomy in secondary hyperparathyroidism (SHPT) patients using age, parathyroid hormone, and calcium. This tool aids timely treatment adjustments to reduce HBS incidence.

Keywords:
Chronic kidney diseaseHungry bone syndromeNomogramSecondary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Nephrology
  • Surgical Oncology

Background:

  • Secondary hyperparathyroidism (SHPT) is a common complication, often requiring parathyroidectomy.
  • Hungry Bone Syndrome (HBS) is a potential post-parathyroidectomy complication characterized by severe hypocalcemia.
  • Accurate prediction of HBS risk is crucial for effective patient management.

Purpose of the Study:

  • To develop a simple and reliable prediction model for HBS in SHPT patients undergoing parathyroidectomy.
  • To utilize pre-operative clinical data for HBS risk assessment.
  • To facilitate prompt clinical decision-making and treatment adjustments.

Main Methods:

  • A nomogram was developed using logistic regression analysis on data from 136 eligible patients.
  • Independent predictors for HBS were identified.
  • Model performance was validated using ROC curves, calibration curves, and decision curve analysis (DCA).

Main Results:

  • Age, parathyroid hormone (PTH), and blood calcium levels were identified as independent risk factors for HBS.
  • The developed nomogram demonstrated strong predictive accuracy, as confirmed by ROC and calibration curves.
  • Clinical decision analysis indicated significant practical clinical value for the dynamic nomogram.

Conclusions:

  • The dynamic nomogram, incorporating age, PTH, and calcium, accurately predicts HBS risk post-parathyroidectomy in SHPT patients.
  • This tool enables clinicians to make faster decisions and adjust treatment plans proactively.
  • Timely interventions guided by the nomogram can help reduce the incidence of HBS.