Acute and long-term kidney function after parathyroidectomy for primary hyperparathyroidism

Autor: Munro Peacock, Climerio Pereira do Nascimento, Bruno Ferraz-de-Souza, Sérgio Samir Arap, Regina Matsunaga Martin, Marcelo Belli, Rosa M.A. Moysés, Fábio Luiz de Menezes Montenegro, Ledo Mazzei Massoni Neto, Marília D'Elboux Guimarães Brescia
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
urologic and male genital diseases
Biochemistry
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
Chronic Kidney Disease
Medicine and Health Sciences
030212 general & internal medicine
Vitamin D
Aged
80 and over
Univariate analysis
Multidisciplinary
Acute kidney injury
Acute Kidney Injury
Middle Aged
Hyperparathyroidism
Primary
Adenomas
Oncology
Parathyroid Hormone
Nephrology
Creatinine
Medicine
Female
Anatomy
Glomerular Filtration Rate
Research Article
Adult
Parathyroidectomy
medicine.medical_specialty
Endocrine System Procedures
Adolescent
Science
Urology
Renal function
Surgical and Invasive Medical Procedures
030209 endocrinology & metabolism
03 medical and health sciences
Renal Diseases
medicine
Humans
Aged
Hyperparathyroidism
business.industry
Thyroidectomy
Biology and Life Sciences
Cancers and Neoplasms
Kidneys
Renal System
medicine.disease
Otolaryngological Procedures
chemistry
business
Biomarkers
Primary hyperparathyroidism
Zdroj: PLoS ONE, Vol 15, Iss 12, p e0244162 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Background In kidney transplant patients, parathyroidectomy is associated with an acute decrease in renal function. Acute and chronic effects of parathyroidectomy on renal function have not been extensively studied in primary hyperparathyroidism (PHPT). Methods This retrospective cohort study included 494 patients undergoing parathyroidectomy for PHPT. Acute renal changes were evaluated daily until day 4 post-parathyroidectomy and were stratified according to acute kidney injury (AKI) criteria. Biochemical assessment included serum creatinine, total and ionized calcium, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25OHD). The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. We compared preoperative and postoperative renal function up to 5 years of follow-up. Results A total of 391 (79.1%) patients were female, and 422 (85.4%) were non-African American. The median age was 58 years old. The median (first and third quartiles) preoperative serum creatinine, PTH and total calcium levels were 0.81 mg/dL (0.68–1.01), 154.5 pg/mL (106–238.5), and 10.9 mg/dL (10.3–11.5), respectively. The median (first and third quartiles) preoperative eGFR was 86 mL/min/1.73 m2 (65–101.3). After surgery, the median acute decrease in the eGFR was 21 mL/min/1.73 m2 (p Conclusion There was significant acute impairment in renal function after parathyroidectomy for PHPT, and almost half of the patients met the criteria for AKI. Significant eGFR recovery was observed during the first month after surgery, but a small permanent reduction may occur. Patients treated for PHPT seemed to present with prominent renal dysfunction compared to patients who underwent thyroidectomy.
Databáze: OpenAIRE
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