Abstract: 【Abstract】Objective Parathyroidectomy (PTX) is the main method to treat secondary hyperparathyroidism (SHPT). However, the risk factors for postoperative hyperkalemia are uncertain. This study was to investigate the risk factors for postoperative hyperkalemia after PTX for SHPT. Methods A total of 53 patients with SHPT undergoing PTX in Changzhou First People’s Hospital from January 2013 to August 2019 were involved in this study. Laboratory examinations including serum K+, Ca2+, alkaline phosphatase, phosphorus and intact parathyroid hormone were conducted before and after PTX. Results In PTX patients, postoperative serum K+ was higher than preoperative level (t=-9.125, P<0.001), and postoperative serum Ca2 + (t=-9.853, P<0.001), phosphorus (t=2.044, P=0.046) and iPTH (Z=-6.334, P<0.001) were lower than the preoperative levels. Postoperative hyperkalemia developed in 28 (52.8%) patients. Preoperative serum K+ level was the independent risk factor for hyperkalemia after PTX in SHPT patients (β=-3.054, P=0.008). The ROC curve showed that the optimal cut- off value for preoperative serum K+ was 4.3mmol/L. Conclusion SHPT patients with higher serum K+ before surgery have a higher risk of hyperkalemia after PTX, Lowering serum K+ below 4.3mmol/L before surgery is useful to reduce the risk of postoperative hyperkalemia.

Key words: Parathyroidectomy, Hyperkalemia, Hyperparathyroidism, Hemodialysis