Intraoperative and postoperative hyperkalaemia after total parathyroidectomy following exposure to cinacalcet in sixteen patients for renal hyperparathyroidism

Abstract

Our clinical observation suggested that patients with prior treatment with cinacalcet and undergoing parathyroidectomy for renal hyperparathyroidism had greater acute hyperkalaemia in the intraoperative and immediate postoperative period

81.25% of the cinacalcet patients recorded an intraoperative or 24 hour postoperative potassium value >6mmol/L compared to 1.67% in the controls (P<0.001)

Cinacalcet patients had greater median percentage rise of potassium from preoperative value (33.33%) compared to control group (11.54%) (P<0.001)

Cinacalcet patients demonstrated greater degree of hypocalcaemia and an increased requirement for intravenous calcium in the postoperative period

The mechanism for this observation/association is unknown, however awareness of the phenomenon is imperative for surgeons, anaesthetists and renal physicians.

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