Hypophosphataemia after parathyroidectomy in chronic renal failure

Out of 24 patients receiving hemodialysis who were subjected to parathryoidectomy, 13 developed hypophosphatemia; this persisted for 3-52 weeks (mean 10.6 weeks). Before operation these 13 patients had had significantly higher plasma alkaline phosphatase activities (p < 0.01) and significantly higher values in iliac crest bone biopsy samples for active resorption surface and active formation surface (p < 0.05 in each case) than the group who remained normophosphatemic. Significantly more of the patients who remained normophosphatemic had shown periarticular calcification in preoperative skeletal radiographs (p < 0.001). Hypophosphatemia may result from reduced mobilisation of phosphate from bone or its increased accretion into bone, and resorption of phosphate from periarticular mineral deposits may protect against development.