Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment
ContextAlthough renal long-term complications are acknowledged in chronic hypoparathyroidism (HPT), standardized investigations are scarce.ObjectiveTo systematically investigate renal complications and their predictors in hypoparathyroid patients compared to matched individuals.DesignProspective obs...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-11-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1244647/full |
| _version_ | 1827773607295582208 |
|---|---|
| author | Karen Gronemeyer Carmina Teresa Fuss Franca Hermes Armin Plass Ann-Cathrin Koschker Anke Hannemann Anke Hannemann Henry Völzke Henry Völzke Stefanie Hahner |
| author_facet | Karen Gronemeyer Carmina Teresa Fuss Franca Hermes Armin Plass Ann-Cathrin Koschker Anke Hannemann Anke Hannemann Henry Völzke Henry Völzke Stefanie Hahner |
| author_sort | Karen Gronemeyer |
| collection | DOAJ |
| description | ContextAlthough renal long-term complications are acknowledged in chronic hypoparathyroidism (HPT), standardized investigations are scarce.ObjectiveTo systematically investigate renal complications and their predictors in hypoparathyroid patients compared to matched individuals.DesignProspective observational study in 161 patients with chronic HPT.MethodsPatients received renal ultrasound, clinical and laboratory assessments. An individual 1:3 matching with participants from the German population-based Study of Health in Pomerania was performed.ResultsOf 161 patients (92% postoperative HPT), prevalence of eGFR <60ml/min/1.73m2 was 21%, hypercalciuria 41%. Compared to healthy individuals, HPT patients had a significantly lower eGFR (74.2 vs. 95.7 ml/min/1.73m², p<0.01). Renal ultrasound revealed calcifications in 10% (nephrocalcinosis in 7% and calculi in 3%). Patients with renal calcifications had higher levels of 24-hour urine calcium excretion (8.34 vs. 5.08 mmol/d, p=0.02), spot urine calcium excretion (4.57 vs. 2.01 mmol/L, p=0.01) and urine calcium-to-creatinine ratio (0.25 vs. 0.16, p<0.01) than patients without calcifications. Albumin-corrected calcium, phosphate, calcium-phosphate product, 25-hydroxyvitamin D in serum, eGFR, daily calcium intake or disease duration were not significantly different between these two groups. Including patients receiving rhPTH therapy, a lower serum phosphate concentration (odds ratio 1.364 [95% confidence interval (CI) 1.049-1.776], p<0.05) and a longer disease duration of HPT (odds ratio 1.063 [95% CI 1.021-1.106], p<0.01) were significant predictors for renal calcifications. Excluding patients receiving rhPTH therapy, a higher 24-hour urine calcium excretion (odds ratio 1.215 [95% CI 1.058-1.396], p<0.01) was a significant predictor for renal calcifications but not serum magnesium or disease duration.ConclusionsPrevalence of impaired renal function among patients with chronic HPT is increased and independent from visible renal calcifications. Depending on exclusion of patients with rhPTH therapy, regression analysis revealed disease duration and serum phosphate or disease duration and 24-hour urinary calcium excretion as predictors for renal calcifications.Clin Trials IdentifierNCT05585593 |
| first_indexed | 2024-03-11T13:26:14Z |
| format | Article |
| id | doaj.art-305c12734f734e3e8b23fc69fa323608 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T13:26:14Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-305c12734f734e3e8b23fc69fa3236082023-11-03T06:30:51ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-11-011410.3389/fendo.2023.12446471244647Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessmentKaren Gronemeyer0Carmina Teresa Fuss1Franca Hermes2Armin Plass3Ann-Cathrin Koschker4Anke Hannemann5Anke Hannemann6Henry Völzke7Henry Völzke8Stefanie Hahner9Department of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyDepartment of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyDepartment of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyDepartment of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyDepartment of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, GermanyGerman Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, GermanyGerman Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, GermanyInstitute for Community Medicine, University Medicine Greifswald, Greifswald, GermanyDepartment of Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, GermanyContextAlthough renal long-term complications are acknowledged in chronic hypoparathyroidism (HPT), standardized investigations are scarce.ObjectiveTo systematically investigate renal complications and their predictors in hypoparathyroid patients compared to matched individuals.DesignProspective observational study in 161 patients with chronic HPT.MethodsPatients received renal ultrasound, clinical and laboratory assessments. An individual 1:3 matching with participants from the German population-based Study of Health in Pomerania was performed.ResultsOf 161 patients (92% postoperative HPT), prevalence of eGFR <60ml/min/1.73m2 was 21%, hypercalciuria 41%. Compared to healthy individuals, HPT patients had a significantly lower eGFR (74.2 vs. 95.7 ml/min/1.73m², p<0.01). Renal ultrasound revealed calcifications in 10% (nephrocalcinosis in 7% and calculi in 3%). Patients with renal calcifications had higher levels of 24-hour urine calcium excretion (8.34 vs. 5.08 mmol/d, p=0.02), spot urine calcium excretion (4.57 vs. 2.01 mmol/L, p=0.01) and urine calcium-to-creatinine ratio (0.25 vs. 0.16, p<0.01) than patients without calcifications. Albumin-corrected calcium, phosphate, calcium-phosphate product, 25-hydroxyvitamin D in serum, eGFR, daily calcium intake or disease duration were not significantly different between these two groups. Including patients receiving rhPTH therapy, a lower serum phosphate concentration (odds ratio 1.364 [95% confidence interval (CI) 1.049-1.776], p<0.05) and a longer disease duration of HPT (odds ratio 1.063 [95% CI 1.021-1.106], p<0.01) were significant predictors for renal calcifications. Excluding patients receiving rhPTH therapy, a higher 24-hour urine calcium excretion (odds ratio 1.215 [95% CI 1.058-1.396], p<0.01) was a significant predictor for renal calcifications but not serum magnesium or disease duration.ConclusionsPrevalence of impaired renal function among patients with chronic HPT is increased and independent from visible renal calcifications. Depending on exclusion of patients with rhPTH therapy, regression analysis revealed disease duration and serum phosphate or disease duration and 24-hour urinary calcium excretion as predictors for renal calcifications.Clin Trials IdentifierNCT05585593https://www.frontiersin.org/articles/10.3389/fendo.2023.1244647/fullHypoparathyroidismrenal calcificationRenal InsufficiencyultrasoundParathyreoidectomy |
| spellingShingle | Karen Gronemeyer Carmina Teresa Fuss Franca Hermes Armin Plass Ann-Cathrin Koschker Anke Hannemann Anke Hannemann Henry Völzke Henry Völzke Stefanie Hahner Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment Frontiers in Endocrinology Hypoparathyroidism renal calcification Renal Insufficiency ultrasound Parathyreoidectomy |
| title | Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment |
| title_full | Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment |
| title_fullStr | Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment |
| title_full_unstemmed | Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment |
| title_short | Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment |
| title_sort | renal complications in chronic hypoparathyroidism a systematic cross sectional assessment |
| topic | Hypoparathyroidism renal calcification Renal Insufficiency ultrasound Parathyreoidectomy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1244647/full |
| work_keys_str_mv | AT karengronemeyer renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT carminateresafuss renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT francahermes renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT arminplass renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT anncathrinkoschker renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT ankehannemann renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT ankehannemann renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT henryvolzke renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT henryvolzke renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment AT stefaniehahner renalcomplicationsinchronichypoparathyroidismasystematiccrosssectionalassessment |