血液透析患者合併骨質疏鬆因故延期副甲狀腺切除手術

腎臟與透析 31 卷 4 期，200-202 頁 (2019 年 12 月 ) 

Kidney and Dialysis Vol.31, No.4, pp. 200-202 (December, 2019) 

© Taiwan Society of Nephrology & Ainosco Press 

病例報告 

DOI:10.6340/KD.201912_31(4).0009 

血液透析患者合併骨質疏鬆因故延期副甲狀腺切除手術 

張智鴻 1 、陳靖博 2,* 

│摘要│ 

透析患者若合併副甲狀腺功能亢進，長期下來就會有骨質疏鬆的問題，除了傳統的藥物治療外，denosumab （Prolia）也逐漸被使用在透析患者。注射此藥物後的低血鈣、低血磷是常見副作用，大多在數週後恢復。本文 報告一個血液透析病患因為注射 denosumab 後發生嚴重低血鈣和低血磷，讓本來嚴重需急切開刀的副甲狀腺功 能亢進，因為麻醉風險過高而被延後。本文探討 denosumab 對透析患者的影響，以及相關論述。 

關鍵詞：血液透析、副甲狀腺、保骼麗

Unexpected Postpone for Parathyroidectomy in a Hemodialysis Patient With Osteoporosis 

Chih-Hung Chang1 , Jin-Bor Chen2,* 

Abstract 

The dialyzed patient with hyperparathyroidism is prone to osteoporosis. Recently, denosumab (Prolia) is being administered more frequently in dialyzed patients for osteoporosis treatment. Hypocalcemia and hypophosphatemia are common adverse effects after denosumab injection. The effects generally are recovered in a few weeks later. We presented a hemodialysis patient with severe hypocalcemia and hypophosphatemia after denosumab injection and led to an unexpected postpone for parathyroidectomy considering high risk for anesthesia and surgery. We also discuss the impact and relevant information of denosumab injection in dialyzed patients. 

Keywords: hemodialysis, parathyroid, denosumab