Occult Renal Calcifications in Patients with Normocalcemic Primary Hyperparathyroidism and Their Association with the Parathyroid Hormone-Vitamin D Axis.

Autor: Victor F; Division of Endocrinology & Diabetes, and Division of Radiology, University of Pernambuco Medical School, Recife, Brazil., Pereira Lemos AL; Division of Endocrinology & Diabetes, and Division of Radiology, University of Pernambuco Medical School, Recife, Brazil., de Holanda Ribas AM; Division of Endocrinology & Diabetes, and Division of Radiology, University of Pernambuco Medical School, Recife, Brazil., Bandeira L; FBandeira Endocrine Institute, Recife, Brazil.; Grupo Fleury, Recife, Brazil., Pimentel JH; Division of Endocrinology & Diabetes, and Division of Radiology, University of Pernambuco Medical School, Recife, Brazil., de Andrade Damázio LO; Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Brazil., Bandeira F; Division of Endocrinology & Diabetes, and Division of Radiology, University of Pernambuco Medical School, Recife, Brazil.; FBandeira Endocrine Institute, Recife, Brazil.
Jazyk: angličtina
Zdroj: International journal of endocrinology [Int J Endocrinol] 2022 Apr 08; Vol. 2022, pp. 4558236. Date of Electronic Publication: 2022 Apr 08 (Print Publication: 2022).
DOI: 10.1155/2022/4558236
Abstrakt: Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by elevated serum levels of parathyroid hormone (PTH) with persistently normal serum calcium concentrations after excluding secondary causes of hyperparathyroidism. Urolithiasis and/or nephrocalcinosis may occur in hypercalcemic PHPT, but little is known about these complications in NPHPT. Objectives . To identify occult urolithiasis and nephrocalcinosis in asymptomatic patients with NPHPT and evaluate biochemical markers as risk predictors for the development of renal calcification (RC). Methods . Cross-sectional analysis of 34 patients with no history of urolithiasis and/or nephrocalcinosis. The diagnosis of NPHPT was as follows: elevated serum PTH (reference range: 15-65 pg/mL), normal albumin-corrected serum calcium, normal urinary calcium excretion, serum 25(OH)D >30 ng/mL, eGFR (CKD-EPI) > 60 mL/min/1.73 m 2 , without intestinal disease, and not on medications such as thiazide diuretics, lithium, bisphosphonates, or denosumab. Patients were categorized according to the presence or absence of RC identified by renal imaging. Their clinical and biochemical characteristics were then compared. Results . The patients had a mean age of 67.97 ± 10.45 years, predominantly postmenopausal women (88.2%); serum PTH, 119.67 ± 64.44 pg/mL; 25(OH)D, 39.00 ± 8.88 ng/dL; 1.25(OH)) 2 D, 74.53 ± 26.37 pg/mL; corrected serum calcium, 9.34 ± 0.62 mg/dL; and 24-hour urinary calcium, 134.87 ± 79.68 mg/day. RC was identified in 26.5% of the patients. There was no difference in anthropometric and clinical parameters, renal function, 25(OH)D, and urinary pH in patients with or without RC. Patients with RC had higher PTH values (176.22 vs. 99.32 pg/mL, P  = 0.001), 1.25(OH) 2D (96.83 vs. 62.36 pg/mL, P  = 0.005), and 24-hour urinary calcium (181.9 vs. 117.94 mg/day, P  = 0.037). Conclusion . Occult renal calcifications are common in NPHPT and are associated with increased serum PTH, 1.25(OH)) 2 D, and 24 h urinary calcium.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 Fernanda Victor et al.)
Databáze: MEDLINE
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