Glomerular Filtration Rate and Parathyroid Hormone Secretion in Primary Hyperparathyroidism

Tassone, F.; Gianotti, Laura; Emmolo, I; Ghio, Michela; Borretta, Giorgio

doi:10.1210/jc.2009-0587

Cited by 53 publications

(31 citation statements)

References 7 publications

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“…In a cross-sectional study including 224 consecutive patients with PHPT diagnosed between 1994 and 2003, creatinine clearance was reported to be below the lower limit of the reference interval (Ͻ70 ml/min) in 40% of the patients (10). Similarly, in a cross-sectional survey of 294 consecutive PHPT patients, an estimated glomerular filtration rate below 60 ml/min was found in 17% of the patients, indicating that an impaired renal function may be rather common in PHPT (11). In addition to nephrolithiasis, PHPT is associated with an increased risk of hypertension, obesity, and glucose intolerance that may also predispose to an impaired kidney function (12).…”

Section: Occurrence Of Nephrolithiasis In Phptmentioning

confidence: 96%

Nephrolithiasis and Renal Calcifications in Primary Hyperparathyroidism

Rejnmark¹,

Vestergaard²,

Mosekilde³

2011

The Journal of Clinical Endocrinology & Metabolism

167

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Section: Occurrence Of Nephrolithiasis In Phptmentioning

confidence: 96%

Nephrolithiasis and Renal Calcifications in Primary Hyperparathyroidism

Rejnmark¹,

Vestergaard²,

Mosekilde³

2011

The Journal of Clinical Endocrinology & Metabolism

167

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“…Почечная недо-статочность является одним из наиболее тяжелых и малообратимых осложнений и связана с более вы-раженными клиническими проявлениями, повы-шением риска смерти, увеличением распространен-ности артериальной гипертензии [2,9,55]. Cниже-ние СКФ до ХБП 3-й стадии диагностируется у 17-20% с ПГПТ, при этом часть пациентов могут иметь мягкую форму заболевания [56].…”

Section: сцинтиграфию с 99munclassified

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Dedov

Иванович²,

Мельниченко

et al. 2017

Probl Endokrinol (Mosk)

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Primary hyperparathyroidism (PHT) is the third most common endocrine disorder in men and women after diabetes mellitus and thyroid disease and one of the most frequent causes of osteoporosis and fractures among the secondary osteopathy. PHT refers to socially significant problems in connection with involvement in the pathological process of the majority of organs and system In recent years, the conception of epidemiology, clinic and tactics of management of patients with PHT has changed due to significant increase of morbidity at the expense of identification of mild forms of disease. The modern management concept tactics depends on clinical manifestations. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of PHT based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on PHT.

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“…Kidney is a target of PTH action: a subset of PHPT patients ranging from 7 to 35% experienced kidney stones or, less frequently, nephrocalcinosis (1,2). Reduction of glomerular filtration rate (GFR, !60 ml/min) has been reported in both symptomatic, affected with kidney stones and osteoporosis, and asymptomatic PHPT patients (3,4,5), and is considered a criteria for surgery in patients with asymptomatic PHPT according the clinical guidelines from the Fourth International Workshop (6).…”

Section: Introductionmentioning

confidence: 99%

Estimated glomerular filtration rate by serum cystatin C correlates with cardiometabolic parameters in patients with primary hyperparathyroidism

Ermetici

Filopanti

Verga

et al. 2015

European Journal of Endocrinology

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Objective: Patients with primary hyperparathyroidism (PHPT) are at risk of chronic kidney disease (CKD). Cystatin C (Cys-C) is considered a more reliable tool to assess glomerular filtration rate (GFR) than creatinine. The study aimed to assess circulating Cys-C and its relationships with biochemical PHPT and cardiometabolic parameters. Design and methods: The present cross-sectional study was performed in academic endocrine units on PHPT patients (nZ190) and non-hypertensive, non-diabetic, age-and sex-matched healthy controls (nZ135) with no established CKD. The main outcomes were creatinine by alkaline picrate method, Cys-C by immunonephelometry and calculation of estimated GFR based on creatinine and Cys-C (eGFRcr-cys) using the CKD-EPI equation. Results: In PHPT patients, circulating Cys-C ranged 0.45-3.13 mg/l and correlated with creatinine, age and BMI. Mean Cys-C level was higher in PHPT patients than in controls (0.93G0.02 vs 0.78G0.14 mg/l; PZ0.03). Cys-C levels in PHPT patients were predicted by age, BMI, ionized calcium, hypertension and HDL-cholesterol, the most significant determinant being ionized calcium. Cys-C positively correlated with cardiovascular disease (CVD) occurrence. Overall, 18.4% of PHPT patients with eGFRcr O60 ml/min per 1.73 m 2 (nZ169) had Cys-C levels higher than the 95th percentile in controls (1.03 mg/l), consistent with a preclinical CKD, which was associated with hypertension and insulin resistance. Considering eGFRcr-cys, CKD (stages G3a, G3b, 4) was diagnosed in 13.7% of PHPT patients. Estimated GFRcr-cys, but not eGFR based on creatinine, was predicted by insulin resistance and hypertension and positively correlated with CVD. Conclusions: Elevated Cys-C levels were associated with ionized calcium, cardiometabolic risk factors and CVD, and identified preclinical CKD in PHPT patients.

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Glomerular Filtration Rate and Parathyroid Hormone Secretion in Primary Hyperparathyroidism

Abstract: In our series of PHPT patients, only a severe impairment of GFR was characterized by a further PTH increase. These findings challenge the concept of a PTH elevation below the threshold of 60 ml/min of GFR.

Cited by 53 publications

References 7 publications

Nephrolithiasis and Renal Calcifications in Primary Hyperparathyroidism

Nephrolithiasis and Renal Calcifications in Primary Hyperparathyroidism

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Estimated glomerular filtration rate by serum cystatin C correlates with cardiometabolic parameters in patients with primary hyperparathyroidism

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