Determinants of hypercalciuria and renal calcifications in chronic hypoparathyroidism: A cross‐sectional study

Ridder, Lukas Ochsner; Harsløf, Torben; Sikjær, Tanja; Underbjerg, Line; Rejnmark, Lars

doi:10.1111/cen.14470

Cited by 9 publications

(11 citation statements)

References 25 publications

(63 reference statements)

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“…The assessment of urinary calcium excretion identifies patients at risk of developing kidney stones and/or nephrocalcinosis and decline of renal function. Even if recent studies did not find a clear correlation between kidney stones and hypercalciuria (148), or between urinary biochemical parameters and kidney outcomes (146), patients with HypoPT should be considered at a high risk of developing nephrolithiasis, nephrocalcinosis (149), as well as chronic kidney disease (146), Table 4.…”

Section: Q9 Which Biochemical Parameters Should Be Monitored To Adjus...mentioning

confidence: 99%

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Bollerslev

Rejnmark

Zahn

et al. 2022

European Journal of Endocrinology

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105

125

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This European expert consensus statement provides recommendations for the diagnosis and management of primary hyperparathyroidism (PHPT), chronic hypoparathyroidism in adults (HypoPT), and parathyroid disorders in relation to pregnancy and lactation. Specified areas of interest and unmet needs identified by experts at the second ESE Educational Program of Parathyroid Disorders (PARAT) in 2019, were discussed during two virtual workshops in 2021, and subsequently developed by working groups with interest in the specified areas. PHPT is a common endocrine disease. However, its differential diagnosing to familial hypocalciuric hypercalcemia (FHH), the definition and clinical course of normocalcemic PHPT, and the optimal management of its recurrence after surgery represent areas of uncertainty requiring clarifications. HypoPT is an orphan disease characterized by low calcium concentrations due to insufficient PTH secretion, most often secondary to neck surgery. Prevention and prediction of surgical injury to the parathyroid glands are essential to limit the disease-related burden. Long-term treatment modalities including the place for PTH replacement therapy and the optimal biochemical monitoring and imaging surveillance for complications to treatment in chronic HypoPT, need to be refined. The physiological changes in calcium metabolism occurring during pregnancy and lactation modify the clinical presentation and management of parathyroid disorders in these periods of life. Modern interdisciplinary approaches to PHPT and HypoPT in pregnant and lactating women and their newborns children are proposed. The recommendations on clinical management presented here will serve as background for further educational material aimed for a broader clinical audience, and were developed with focus on endocrinologists in training.

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Section: Q9 Which Biochemical Parameters Should Be Monitored To Adjus...mentioning

confidence: 99%

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Bollerslev

Rejnmark

Zahn

et al. 2022

European Journal of Endocrinology

Self Cite

105

125

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“…Previous studies in patients with chronic hypoPT have linked elevated serum calcium concentration and increased calcium-phosphate product level with increased risk of CKD ( 11 , 27 , 28 ). A recent study showed that hypercalciuria and renal calcification did not fully explain the increased risk of renal insufficiency in patient with chronic hypoPT ( 29 ). The role of serum phosphate in the risk for urolithiasis or CKD is not well understood.…”

Section: Discussionmentioning

confidence: 99%

Kidney Complications and Hospitalization in Patients With Chronic Hypoparathyroidism: A Cohort Study in Sweden

Swartling

Evans

Spelman

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Kidney complications may be considerably higher in patients with chronic hypoparathyroidism (hypoPT) treated with activated vitamin D and calcium supplementation. Objective To investigate the risk of chronic kidney disease (CKD), urolithiasis and hospitalization in patients with chronic hypoPT. Design The Swedish National Patient Register, the Swedish Prescribed Drug Register and the Total Population Register, 1997–2018. Setting Population-based cohort study in Sweden. Patients National registries were used to identify patients with chronic hypoPT and controls matched by sex, age, and county of residence. Main Outcome Measures Incidence rates of hospitalization; time to CKD and urolithiasis diagnosis. Results A total of 1,562 patients with chronic hypoPT without preexisting CKD and 15,620 controls were included. The risk of developing CKD was higher in patients with chronic hypoPT compared with controls (hazard ratio [HR] 4.45, 95% confidence interval [CI] 3.66–5.41). In people without prior urolithiasis (n=1,810 chronic hypoPT and n=18,100 controls), the risk of developing urolithiasis was higher in patients with chronic hypoPT (HR 3.55, 95% CI 2.84–4.44) compared with controls. Patients with chronic hypoPT had higher incidence rates for all-cause hospitalization (49.59, 95% CI 48.50–50.70, per 100 person-years vs. 28.43, 95% CI 28.15–28.71, respectively) and for CKD (3.46, 95% CI 3.18–3.76, per 100 person-years vs. 0.72, 95% CI 0.68–0.77, respectively), compared to controls. Men with hypoPT appear to have a higher risk of CKD than women. Conclusions Patients with chronic hypoPT had an increased risk of CKD, urolithiasis, and hospitalization compared to controls.

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“…Phosphate in the urine of patients with hypoparathyroidism is lower than that seen in the general population. According to recent studies, excessive calcium excretion might have a dominant role compared to phosphate metabolism, although uncertainty remains about this pathogenetic hypothesis [ 34 ].…”

Section: Phosphate In Hypoparathyroidismmentioning

confidence: 99%

Phosphate Metabolism and Pathophysiology in Parathyroid Disorders and Endocrine Tumors

Zavatta

Altieri

Vandi

et al. 2021

IJMS

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The advent of new insights into phosphate metabolism must urge the endocrinologist to rethink the pathophysiology of widespread disorders, such as primary hyperparathyroidism, and also of rarer endocrine metabolic bone diseases, such as hypoparathyroidism and tumor-induced hypophosphatemia. These rare diseases of mineral metabolism have been and will be a precious source of new information about phosphate and other minerals in the coming years. The parathyroid glands, the kidneys, and the intestine are the main organs affecting phosphate levels in the blood and urine. Parathyroid disorders, renal tubule defects, or phosphatonin-producing tumors might be unveiled from alterations of such a simple and inexpensive mineral as serum phosphate. This review will present all these disorders from a ‘phosphate perspective’.

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Determinants of hypercalciuria and renal calcifications in chronic hypoparathyroidism: A cross‐sectional study

Cited by 9 publications

References 25 publications

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Kidney Complications and Hospitalization in Patients With Chronic Hypoparathyroidism: A Cohort Study in Sweden

Phosphate Metabolism and Pathophysiology in Parathyroid Disorders and Endocrine Tumors

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