Kuroya S, et al. - Among patients who received treatment for presumed hypoparathyroidism following total thyroidectomy, researchers determined the incidence of hypercalcemia, renal impairment, metabolic alkalosis, and calcium-alkali syndrome (CAS) in this retrospective study. They included 27 patients with neck cancers on whom total thyroidectomy was performed without parathyroid autotransplantation between January 2010 and October 2013. Calcium lactate and alfacalcidol were administered to all patients for postsurgical hypocalcemia. At a median of 326 days post-surgery, the peak in cCa (corrected serum calcium level) was noted. The presence of hypercalcemia, alkalosis, renal impairment, and CAS was detected in 15 patients (55.6%), in 19 (70.3%), 12 (44.4%), and 9 patients (33.3%), respectively. Older age was reported in patients with CAS vs those without CAS. Findings revealed that CAS incidence was high among patients with hypoparathyroidism following total thyroidectomy. For patients with postsurgical hypoparathyroidism who were treated with large doses of active vitamin D, close monitoring of serum calcium level, acid-base balance, and renal function was recommended.