Objective: Chronic hypoparathyroidism (HP) is associated with acute and chronic complications, especially those related to hypocalcemia. We aimed to analyze details on hospital admissions and the reported deaths in affected patients. Design and methods: In a retrospective analysis, we reviewed the medical history of 198 patients diagnosed with chronic HP over a continuous period of up to 17 years at the Medical University Graz. Results: The mean age in our mostly female cohort (70.2%) was 62.6 18.7 years. The etiology was predominantly postsurgical (84.8%). 87.4% of patients received standard medication (oral calcium/vitamin D), 15 patients (7.6%) used rhPTH1-84/Natpar and 10 patients (4.5%) had no/unknown medication. 219 ER visits and 627 hospitalizations were documented among 149 patients, 49 patients (24.7%) did not record any hospital admissions. According to symptoms and decreased calcium levels, 12% of ER (n = 26) visits and 7% of hospitalizations (n = 44) were likely attributable to HP. A subgroup of 13 patients (6.5%) received kidney transplants prior to the HP diagnosis. In 8 of these patients, parathyroidectomy for tertiary renal hyperparathyroidism was the cause of permanent HP. The mortality was 7.8% (n = 12) and the causes of death appeared to be unrelated to HP. Although, the awareness for HP was low, calcium levels were documented in 71% (n = 447) of hospitalizations. Conclusions: Acute symptoms directly related to HP did not represent the primary cause of ER visits. However, comorbidities (e.g. renal/cardiovascular diseases) associated with HP played a key role in hospitalizations and deaths.
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