What is your approach to managing hypocalcemia following a parathyroidectomy in patients with end stage kidney disease?  

The hungry bone syndrome can be tricky and insidious. I have seen patients go home after a pth-ectomy without evidence of it and then a few days later show up in the ED with symptoms of hypocalcemia. Hemodialysis may mask it (as well as treat it) by supplying a large IV calcium load. If you dialyze ...