Primary Hyperparathyroidism
Conditions
Keywords
Primary Hyperparathyroidism, Renal function
Brief summary
Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT.
Detailed description
Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT. Criteria are detailled in Outcomes measures
Interventions
PROCEDUREparathyroidectomy
surgical removal of parathyroid adenoma(s) with postoperative biological cure
Sponsors
Central Hospital, Nancy, France
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- patients undergoing parathyroidectomy for primary hyperparathyroidism with surgical cure defined as postoperative normocalciemia
Exclusion criteria
* patients on dialysis * GFR \< 15 ml/min * renal graft
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in renal function | preoperative, postoperative at 3, 6, and 12 months | glomerular filtration rate (CKD in mL/min) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in vitamin D | preoperative, postoperative at 3, 6, and 12 months | Blood vitamine D level (in ng/mL) |
| Change in urinary calcium | preoperative, postoperative at 3, 6, and 12 months | Urine calcium level (in mg/24h) |
| Change in insulin | preoperative, postoperative at 3, 6, and 12 months | Fasting blood insuline level (in mUI/L) |
| Change in glycemia | preoperative, postoperative at 3, 6, and 12 months | Fasting blood glucose level (in g/L) |
| Change in osteocalcin | preoperative, postoperative at 3, 6, and 12 months | Blood osteocalcin level (in ng/mL) |
| Change in triglycerides | preoperative, postoperative at 3, 6, and 12 months | Blood triglycerides (in gr/L) |
| CAC scoring on CT scan | preoperative | CAC score (actual value) |
| Change in parathormone | preoperative, postoperative at 3, 6, and 12 months | Blood parathormone level (in ng/dL) |
| Change in aldosterone | preoperative, postoperative at 3, 6, and 12 months | Blood aldosterone level (in pg/mL) |
| Change in renin | preoperative, postoperative at 3, 6, and 12 months | Blood active renin (in pg/mL) |
| Change in total cholesterol | preoperative, postoperative at 3, 6, and 12 months | Blood total cholesterol (in gr/L) |
| Change in HDL cholesterol | preoperative, postoperative at 3, 6, and 12 months | Blood HDL Cholesterol (in gr/L) |
| Change in LDL cholesterol | preoperative, postoperative at 3, 6, and 12 months | Blood LDL Cholesterol (in gr/L) |
| Change in calcium | preoperative, postoperative at 3, 6, and 12 months | Blood calcium level (in mg/L) |
| Change in bone alkaline phosphatases | preoperative, postoperative at 3, 6, and 12 months | Blood bone alkaline phosphatases level (in microgr/L) |
Countries
France
Contacts
Primary Contactlaurent Brunaud
Outcome results
None listed