Risk of Nephrolithiasis and Nephrocalcinosis in Patients with Chronic Hypoparathyroidism: A Retrospective Cohort Study

Ketteler, Markus; Chen, Kristina; Gosmanova, Elvira O.; Signorovitch, James; Mu, Fan; Young, Joshua; Sherry, Nicole; Rejnmark, Lars

doi:10.1007/s12325-021-01649-2

Cited by 21 publications

(17 citation statements)

References 25 publications

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“…Results from this study strengthen an accumulating body of evidence indicating that patients with chronic hypoparathyroidism treated with conventional therapy are at increased risk for the development and progression of CKD 2,3,6,8,9 . Retrospective claims database studies reported that patients with hypoparathyroidism were at increased risk of developing CKD, nephrolithiasis, nephrocalcinosis and decline in eGFR compared with individuals without hypoparathyroidism 6,8,9 .…”

Section: Discussionsupporting

confidence: 71%

The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1‐84): A retrospective cohort study

Rejnmark

Ayodele

Lax

et al. 2022

Clinical Endocrinology

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Objective This study assessed the risk of developing chronic kidney disease (CKD) and decline in estimated glomerular filtration rate (eGFR) over a period of up to 5 years in adult patients with chronic hypoparathyroidism treated with recombinant human parathyroid hormone (1‐84) (rhPTH[1‐84]) compared with a historical control cohort of patients not treated with rhPTH(1‐84). Design Retrospective cohort study of patients with chronic hypoparathyroidism treated with rhPTH(1‐84) derived from the REPLACE (NCT00732615), RELAY (NCT01268098), RACE (NCT01297309) and HEXT (NCT01199614, and its continuation study NCT02910466) clinical trials and a historical control cohort who did not receive PTH selected from an electronic medical record database. Patients One hundred and eighteen patients treated with rhPTH(1‐84) and 497 patient controls. Measurements Incident CKD was defined as ≥2 eGFR measurements <60 ml/min/1.73 m2 ≥3 months apart during the study and a sustained eGFR decline of ≥30% from baseline. Results Over the 5‐year period, Kaplan–Meier analyses showed that rhPTH(1‐84)‐treated patients had a significantly lower risk of developing CKD (log‐rank p = .002) and a lower risk for a sustained eGFR decline ≥30% from baseline (log‐rank p < .001) compared with patients in the control cohort. In adjusted analyses, patients in the rhPTH(1‐84)‐treated cohort had a 53% lower risk of developing CKD (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.25–0.87) and a 65% lower risk for sustained eGFR decline ≥30% from baseline (HR, 0.35; 95% CI, 0.13–0.89) compared with controls. Conclusions Patients with chronic hypoparathyroidism treated with rhPTH(1‐84) in long‐term clinical trials had a significantly lower risk of developing CKD compared with patients in a historical control cohort not treated with rhPTH(1‐84).

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Section: Discussionsupporting

confidence: 71%

The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1‐84): A retrospective cohort study

Rejnmark

Ayodele

Lax

et al. 2022

Clinical Endocrinology

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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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108

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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“…The theory hypothesized that the pathophysiology is potentially through hypercalciuria. Alternatively, another hypothesis suggests the course of the disease and scarcity of normal physiological effect of parathyroid hormone on renal tubules being a risk factor for nephrocalcinosis and nephrolithiasis in hypoparathyroidism [ 12 ]. Inclusively, the calcium correction in hypoparathyroidism is linked with nephrolithiasis and many other renal complications [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A Staghorn Calcium Phosphate Stone in a Child With Sanjad-Sakati Syndrome: An Iatrogenic Manifestation?

Alomar¹,

Alghafees²,

Seyam³

et al. 2022

Cureus

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Sanjad-Sakati syndrome (SSS) is an autosomal recessive genetic condition, with the first report discussing this condition presented in Saudi Arabia. This case report describes an iatrogenic stone as a result of hypocalcemia overtreatment, along with its subsequent management procedure. The current literature concerning the iatrogenic stone occurrence and the operative outcome of percutaneous nephrolithotomy in individuals with SS is scarce, warranting further investigation.

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Risk of Nephrolithiasis and Nephrocalcinosis in Patients with Chronic Hypoparathyroidism: A Retrospective Cohort Study

Cited by 21 publications

References 25 publications

The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1‐84): A retrospective cohort study

The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1‐84): A retrospective cohort study

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)

A Staghorn Calcium Phosphate Stone in a Child With Sanjad-Sakati Syndrome: An Iatrogenic Manifestation?

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