Kidney Complications and Hospitalization in Patients With Chronic Hypoparathyroidism: A Cohort Study in Sweden

Abstract

Context Kidney complications may be considerably higher in patients with chronic hypoparathyroidism (hypoPT) treated with activated vitamin D and calcium supplementation. Objective To investigate the risk of chronic kidney disease (CKD), urolithiasis and hospitalization in patients with chronic hypoPT. Design The Swedish National Patient Register, the Swedish Prescribed Drug Register and the Total Population Register, 1997–2018. Setting Population-based cohort study in Sweden. Patients National registries were used to identify patients with chronic hypoPT and controls matched by sex, age, and county of residence. Main Outcome Measures Incidence rates of hospitalization; time to CKD and urolithiasis diagnosis. Results A total of 1,562 patients with chronic hypoPT without preexisting CKD and 15,620 controls were included. The risk of developing CKD was higher in patients with chronic hypoPT compared with controls (hazard ratio [HR] 4.45, 95% confidence interval [CI] 3.66–5.41). In people without prior urolithiasis (n=1,810 chronic hypoPT and n=18,100 controls), the risk of developing urolithiasis was higher in patients with chronic hypoPT (HR 3.55, 95% CI 2.84–4.44) compared with controls. Patients with chronic hypoPT had higher incidence rates for all-cause hospitalization (49.59, 95% CI 48.50–50.70, per 100 person-years vs. 28.43, 95% CI 28.15–28.71, respectively) and for CKD (3.46, 95% CI 3.18–3.76, per 100 person-years vs. 0.72, 95% CI 0.68–0.77, respectively), compared to controls. Men with hypoPT appear to have a higher risk of CKD than women. Conclusions Patients with chronic hypoPT had an increased risk of CKD, urolithiasis, and hospitalization compared to controls.

Total thyroidectomy: reduction in postoperative hypoparathyroidism

“…Increased morbidity and mortality have been linked to postoperative hypoPT (5,6,15,16,17,18), this fact could also have contributed to increased surgical awareness to preserve the PG. The morbidity is primarily associated with reduced quality of life and reduced kidney function (4,7,16,19). Other forms of long-term morbidity from hypoPT include ectopic calcifications (17).…”

“…HypoPT may reduce quality of life (4) and increases both mortality (5) and morbidity (6). Morbidity for patients with hypoPT includes an increased risk of developing chronic kidney disease (CKD) and kidney calcifications (7). Finally, hypoPT results in a longer hospital stay (8) after TT.…”