Hypocalcemia after parathyroidectomy in patients taking proton pump inhibitors

Abstract

PurposeLong-term use of proton pump inhibitors is associated with metabolic derangements, including hypocalcemia. Hypocalcemia is also a known complication of parathyroidectomy. We sought to determine the rate of hypocalcemia following parathyroidectomy in patients on proton pump inhibitors. Materials and methodsThe TriNetX Research Network was queried to identify patients with a history of primary hyperparathyroidism treated with parathyroidectomy between 2012 and 2022. The incidence of short-term (0–6 months following parathyroidectomy) and permanent (6–12 months following parathyroidectomy) postoperative hypocalcemia was compared between patients using proton pump inhibitors and those who were not. ResultsOf 34,595 total patients, 19.5 % (n = 6753) were taking proton pump inhibitors prior to surgery. Patients taking proton pump inhibitors were significantly more likely to experience both short-term (RR, 95 % CI, P) (1.5, 1.4–1.6, P < 0.001) and permanent (1.8, 1.6–2.1, P < 0.001) hypocalcemia, and were also more likely to be evaluated in the emergency department after surgery (1.5, 1.4–1.7, P < 0.001). ConclusionsOur study is the first to indicate an increased risk of hypocalcemia after parathyroidectomy in patients on proton pump inhibitors.