Influence of renal function on clinico-pathological features of primary hyperparathyroidism

Noguchi, Shiro; Uchino, Shigehiko; Watanabe, Shin; Murakami, Tsukasa; Ogawa, Takahiro; Masatsugu, Toshihiro; Takamatsu, Yuji; Miyatake, Eiji; Yamashita, Hiroto

doi:10.1530/eje.0.1480597

Cited by 31 publications

(32 citation statements)

References 25 publications

(25 reference statements)

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“…Therefore, with dietary phosphorus excess, PTH increases and 1,25(OH) 2 D decreases, whereas the opposite occurs with dietary phosphate depletion (23). We recently reported that clinico-pathologic features of pHPT were notably influenced by even moderate renal insufficiency (24). We observed a higher phosphate excretion rate but lower 24-h urinary phosphate excretion in patients with pHPT and renal insufficiency (Ccr of , 70 ml/min) than in patients with normal renal function (25).…”

Section: Resultsmentioning

confidence: 99%

Fibroblast growth factor (FGF)-23 in patients with primary hyperparathyroidism

Yamashita

Miyamoto

et al. 2004

European Journal of Endocrinology

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Objective: We aimed to determine the serum level of fibroblast growth factor-23 (FGF-23) in patients with primary hyperparathyroidism (pHPT) to understand its physiological role in the disorder. Patients and methods: Ninety-eight patients with pHPT who underwent parathyroidectomy formed the study group. We also measured serum FGF-23 in 11 of these patients on postoperative day 6. Results: Serum FGF-23 levels was significantly higher in pHPT patients than in healthy controls (35.6^17.8 ng/l vs 28.9^11.2 ng/l (mean^S.D.); P , 0.001 (Pearson's correlation coefficient)), but there was no significant difference in the serum FGF-23 level between pHPT patients with normal renal function (creatinine clearance (Ccr) of $70 ml/min) and healthy controls. Serum FGF-23 correlated positively with serum calcium (P , 0.0001) and intact parathyroid hormone (PTH) (P , 0.01), and negatively with Ccr (P , 0.001), serum phosphate (P , 0.05), and serum 1,25-dihydroxyvitamin D (1,25(OH) 2 D) (P , 0.05). Multiple linear regression analysis of factors potentially determining serum FGF-23 levels in pHPT patients showed serum calcium (P , 0.01) and Ccr (P , 0.001) to be significant predictors. The serum levels of FGF-23 did not change after parathyroidectomy despite the normalization of serum calcium values. Multiple linear regression analysis revealed that serum FGF-23 was not a significant predictor of serum phosphate or 1,25(OH) 2 D in pHPT patients. Conclusions: FGF-23 may not play a significant role in regulating phosphate or 1,25(OH) 2 D in pHPT patients, especially in those with normal renal function. Further studies are warranted to determine the role of FGF-23 in renal insufficiency or failure.European Journal of Endocrinology 151 55-60

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Section: Resultsmentioning

confidence: 99%

Fibroblast growth factor (FGF)-23 in patients with primary hyperparathyroidism

Yamashita

Miyamoto

et al. 2004

European Journal of Endocrinology

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“…В 13-15% случаев выявляются одиночные камни, в 25-30% -множественные и в 30-32% случаев -конкременты в обеих почках. Конкре-менты в почках при ПГПТ состоят преимуществен-но из оксалатов или фосфатов кальция [54,55].…”

Section: сцинтиграфию с 99munclassified

“…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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“…The impact of renal function on the biochemical expression of PHPT has been well documented (45,46,47,48,49). Several studies clearly identify a correlation between PTH levels and degree of renal impairment in PHPT (50), but the eGFR threshold in PHPT, below which a significant stimulus elevates PTH levels, has not been established.…”

Section: Kidney Function In Phpt Patientsmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects

Verdelli

Corbetta

2017

European Journal of Endocrinology

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Primary hyperparathyroidism (PHPT) is the third most common endocrine disease. Kidney is a target of both chronic elevated PTH and calcium in PHPT. The classic PHPT complications of symptomatic kidney stones and nephrocalcinosis have become rare and the PHPT current presentation is asymptomatic with uncertain and long-lasting progression. Nonetheless, the routine use of imaging and of biochemical determinations have revealed the frequent occurrence of asymptomatic kidney stones, hypercalciuria and reduced kidney function in asymptomatic PHPT patients. Though the pathogenesis is far from being elucidated, PHPT is associated with reduced renal function, in terms of estimated glomerular filtration rate, and related increased morbidity and mortality. In the last decade, the effort of the Kidney Disease: Improving Global Outcomes (KDIGO) panel of experts highlighted that even mild reduction of kidney function is associated with increased risk of cardiovascular disease. These considerations provided the basis for the Fourth Workshop recommendations of a more extensive diagnostic workout about kidney features and of wider criteria for parathyroid surgery including asymptomatic kidney disease. Moreover, kidney involvement in PHPT is likely to be affected by variants of genes coding the key molecules regulating the calcium and ions renal handling; these features might have clinical relevance and should be considered both during diagnostic workout and follow-up. Finally, the effects of parathyroid surgery and of medical treatment on kidney involvement of PHPT are reviewed.

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Influence of renal function on clinico-pathological features of primary hyperparathyroidism

Cited by 31 publications

References 25 publications

Fibroblast growth factor (FGF)-23 in patients with primary hyperparathyroidism

Fibroblast growth factor (FGF)-23 in patients with primary hyperparathyroidism

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

MECHANISMS IN ENDOCRINOLOGY: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects

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