Hungry bone syndrome after parathyroidectomy in secondary and tertiary hyperparathyroidism: a retrospective cohort study

Hyperparathyroidism (HPT) is a condition characterized by excessive secretion of parathyroid hormone (PTH), leading to disturbances in calcium (Ca) and phosphorus (P) metabolism [1].Secondary HPT (SHPT) and tertiary HPT (THPT) commonly develop in patients with chronic kidney disease, particularly those undergoing long-term dialysis [2,3].In these patients, chronic elevations in PTH drive high bone turnover, leading to compromised bone quality and an increased risk of fractures.If left untreated, HPT can contribute to severe bone disease, vascular calcifications, and cardiovascular complications [1,4].Parathyroidectomy (PTX) is the definitive treatment for refractory SHPT and THPT, particularly when medical management fails [5,6].Surgical approaches include subtotal PTX (SubPTX) and total PTX with or without