From the Research
Potassium levels can significantly increase after parathyroidectomy, particularly in patients with preoperative serum potassium levels above 4.40 mmol/L, and close monitoring is essential to prevent hyperkalemia. To manage potential electrolyte imbalances, it is crucial to monitor serum potassium levels closely after parathyroidectomy. According to the study by 1, the preoperative serum potassium level is a significant predictor of postoperative hyperkalemia. The study found that 14.8% of patients had potassium levels rise more than 6.0 mmol/L after parathyroidectomy with autotransplantation. Key factors to consider in managing potassium imbalance include:
- Monitoring serum potassium levels before and after surgery
- Identifying patients at high risk of postoperative hyperkalemia based on preoperative serum potassium levels
- Implementing urgent treatment for severe or symptomatic hyperkalemia, including intravenous calcium, insulin, and beta agonists, as recommended by 2
- Considering the use of potassium binders, such as patiromer and sodium zirconium cyclosilicate, for chronic or acute hyperkalemia management, as suggested by 2
- Educating patients about symptoms of hyperkalemia, including muscle weakness, cardiac arrhythmias, and the importance of reporting these symptoms immediately. It is also essential to address the underlying cause of the potassium imbalance and to adjust causative medications, as recommended by 2 and 3. By prioritizing the management of potassium electrolyte imbalance after parathyroidectomy, clinicians can reduce the risk of morbidity, mortality, and improve the quality of life for patients undergoing this surgery.