Effect of sodium zirconium cyclosilicate on hyperkalemia after parathyroidectomy in secondary hyperparathyroidism patients with maintenance hemodialysis: A randomized trial

Abstract

Background: Postoperative hyperkalemia is 1 common complication after parathyroidectomy (PTX), which requires close monitoring and prompt treatment. This study aimed to determine whether using sodium zirconium cyclosilicate (SZC) would lower the risk of hyperkalemia in patients with maintenance hemodialysis after PTX. Methods: Sixty-two patients with secondary hyperparathyroidism (SHPT) were randomly divided into the experimental and control groups. Patients in the experimental group were required to take 10 g of SZC before PTX. Laboratory chemistries were obtained before and after surgery. Results: Parathyroid hormone (PTH) decreased dramatically in the experimental and control groups after PTX. There were no significant differences in serum potassium ion (K+) between the 2 groups at 6 am on the day of surgery and immediately after surgery. However, serum potassium in the experimental group at 9 pm on the day of surgery was significantly lower than in the control group. Three patients with severe hyperkalemia in the control group received emergency hemodialysis or insulin and glucose treatment, while none in the experimental group required hemodialysis. Serum calcium levels declined immediately after the operation, but no significant differences were found between these 2 groups at all time points. Conclusion: SZC has the potential to reduce the occurrence of hyperkalemia and avoid urgent hemodialysis after PTX. We recommended that SZC could be used routinely in SHPT patients on the day of PTX surgery.