Alternate-day calcium dosing may be an effective treatment option for chronic hypoparathyroidism

Akkan, Tolga; Dağdeviren, Murat; Koca, Arzu Or; Ertuğrul, Derun Taner; Altay, Mustafa

doi:10.1007/s40618-019-01173-9

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…obstipation, fl atulence and others), risk for vascular calcifi cations and renal stones [17][18][19]. Diff erent strategies have been implemented by other authors to overcome these worries -alternate calcium intake or even "no calcium" regimens [20,21]. The most common worries about calcitriol are kidney damage and polyuria as already reported in a diff erent study with 64 patients [20].…”

Section: Discussionmentioning

confidence: 99%

“…Diff erent strategies have been implemented by other authors to overcome these worries -alternate calcium intake or even "no calcium" regimens [20,21]. The most common worries about calcitriol are kidney damage and polyuria as already reported in a diff erent study with 64 patients [20]. Calcitriol has actually been linked to declining renal function and risk for polyuria and nephrolithiasis [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Biochemical Control of 78 Patients with Chronic Hypoparathyroidism Referred between 2006 and 2020 – Where do We Actually Stand?

Boyanov

Zamfirova

Bakalov

et al. 2023

Acta Medica Bulgarica

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Hypoparathyroidism (hypoPT) is a relatively rare endocrine disease, mainly due to thyroid surgery. The classical supplementation with calcium and active vitamin D may represent a challenge to the clinician. Objective To describe the level of biochemical control in patients with chronic hypoPT and to look for differences between postsurgical and non-surgical cases referred between 2006 and 2020. Materials and Methods This was a retrospective cross-sectional study with data review from the database of a tertiary endocrine clinic from the last 15 years. Cases with hypocalcemia not related to PTH were excluded. The patients’ medical history was reviewed as well as concomitant diseases and medications. Serum calcium (total, albumin-corrected and ionized; sCa, corrCa, iCa+) and phosphates (P), magnesium, creatinine, alkaline phosphatase together with 24hr urinary calcium and phosphate were measured. The intact parathyroid hormone (iPTH) was determined by electro-hemi-luminescence (Elecsys, Roche Diagnostics). Thyroid and abdominal ultrasound (US) were both performed. Results Seventy-eight patients met the study criteria – 69 were females. Most of them were between 30 and 60 years (mean age 50.6 ± 14.5 years). Albumin-corrected calcium was in target in 20.5% of the patients, ionized calcium – in 36.5%, serum phosphate – in 46.3%, serum magnesium – in 87.9%. When all four parameters were taken together, less than 20% were in target. Hypercalciuria was registered in 11.8%, while 57.1% of the patients had nephrolithiasis and 27.3% had CKD grade 3-4. Thus, a high proportion of patients with kidney involvement was identified. Calcium carbonate and calcitriol were the preferred replacement choices. Comparing patients with post-surgical and non-surgical hypoPT significant differences were found only for age, total serum calcium, serum magnesium and TSH. Conclusion Our study is the first of its kind in our country during the last two decades describing the contemporary clinical and biochemical picture of chronic hypoPT in patients referred for specialized care. Low supplementation doses leading to hypocalcemia and hyperphosphatemia were a common finding. Low patient’s adherence may be just one possible explanation. Non-surgical cases tend to have even lower calcium and magnesium levels. The patients, their families and treating physicians should be better informed about up-to-date management of chronic hypoPT and the possible impact of suboptimal treatment on morbidity and mortality of the affected subjects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biochemical Control of 78 Patients with Chronic Hypoparathyroidism Referred between 2006 and 2020 – Where do We Actually Stand?

Boyanov

Zamfirova

Bakalov

et al. 2023

Acta Medica Bulgarica

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“…Parathyroid hormone replacement therapy has been used as an auxiliary treatment to adult patients with chronic low parathyroid hormone, but it cannot adequately control these patients. To date, the data from randomized clinical trials (RCTS) only demonstrated that parathyroid hormone therapy reduced the serum phosphorus levels and the dose of calcium supplements and active vitamin D required to maintain normal serum calcium [14,15]. In randomized controlled trials, improved quality of life or documented reduction of urinary calcium was not obtained.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of human umbilical cord mesenchymal stem cells into parathyroid cells by editing the PTH gene with the CRISPR/Cas9 system

Zhang

Qiu

et al. 2021

Biotechnology & Biotechnological Equipment

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With CRISPR/Cas9 gene editing technology, human umbilical cord mesenchymal stem cells (HUMSCs) were directionally induced to differentiate into parathyroid cells. The study provides the theoretical and experimental basis for the application of HUMSCs in the clinical treatment of parathyroid hypofunction. In this study the CRISPR/Cas9 gene editing technology was used to introduce the PTH gene into HUMSCs to induce the differentiation of HUMSCs. After 28 days of induction culture, HUMSCs edited by CRISPR/Cas9 showed morphological changes. PTH expression was detected by quantitative real-time PCR (qRT-PCR), western blotting and immunohistochemistry, the expression level of PTH in parathyroid adenoid cells obtained after CRISPR/Cas9 gene editing was significantly increased. The expression levels of CASR, GCM2 and PTH were 98.9%, 93.6% and 97%, respectively. This experiment verified that editing the PTH gene with the CRISPR/Cas9 system could directionally induce human umbilical cord mesenchymal stem cells to differentiate into parathyroid cells.

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Parathyroid Gland and Bone Therapies

2023

Endocrinology

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Alternate-day calcium dosing may be an effective treatment option for chronic hypoparathyroidism

Cited by 6 publications

References 12 publications

Biochemical Control of 78 Patients with Chronic Hypoparathyroidism Referred between 2006 and 2020 – Where do We Actually Stand?

Biochemical Control of 78 Patients with Chronic Hypoparathyroidism Referred between 2006 and 2020 – Where do We Actually Stand?

Differentiation of human umbilical cord mesenchymal stem cells into parathyroid cells by editing the PTH gene with the CRISPR/Cas9 system

Parathyroid Gland and Bone Therapies

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