Patients (pts) with hypoparathyroidism (HypoPT) are at risk to develop renal failure possibly caused by hypercalciuria and nephrocalcinosis. We retrospectively evaluated the data of 711 Patients with HypoPT in 3 endocrine centres in Germany.
Methods: Records of 711 pts with HypoPT were reviewed. Patients were predominantly female (n=592, male: n=119; age 50.9±14.1 years, range 12 99 years). The following parameters were documented during treatment and follow-up (MW 52±40.9 months, time range 2334 months): medication, calcium in serum and urine, phosphate, calcium-phosphate-product (CPP), glomerular filtration rate (GFR) calculated by CKD-EPI formula.
Results: Of these 711 pts. 29 had idiopathic HypoPT, 10 HypoPT after parathyroidectomy, 669 after thyroid operation. At first visit 4.0% of pts <40 years, 11.1% in the age group 4059, 28.4% in the age group 6069, and 49.0% in pts >69 years had a GFR < 60 ml/min. At the last visit no worsening of renal function was observed (GFR < 60 ml/min in 5.9% <40 years, 9.8% in the age group 4059, 17.1% in the age group 6069, 36.0% >69 years). An elevated CPP > 55 mg2/dl2 was found in 25 pts (3.5%). In these pts the proportion of GFR < 60 ml/min was 33.5% compared to 21.1% of those with normal CPP. In comparison of the therapeutic strategies pts treated exclusively with dihydrotachysterol renal function was the lowest (n=46; mean GFR 70.2±26.2 ml/min). In pts treated with calcitriol and calcium (n=226) mean GFR was better than in all other treatment groups (84.9±20.9).
Conclusion: We saw no worsening of renal function in a large cohort of patients with HypoPT during 4 years of therapy. High CPP was associated with lower GFR. Different treatment strategies of HypoPT seem to affect kidney function.
18 - 21 May 2019
European Society of Endocrinology