Management of Post-Parathyroidectomy Hypocalcemia in ESRD Patients

Immediate Management

• The American Journal of Kidney Diseases recommends increasing dialysate calcium to 1.75 mmol/L to provide continuous calcium supplementation in post-parathyroidectomy patients with ESRD 1, 2

Monitoring Requirements

• The National Kidney Foundation suggests monitoring PTH levels, as rising PTH suggests inadequate calcium replacement 2, 3
• Alkaline phosphatase levels should be monitored, as increasing levels indicate ongoing bone hunger and need for more aggressive calcium replacement 2, 3