Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2020) 70 AEP152 | DOI: 10.1530/endoabs.70.AEP152

ECE2020 Audio ePoster Presentations Bone and Calcium (121 abstracts)

Renal complications in chronic hypoparathyroidism – a german single-center analysis in 169 patients

Karen Gronemeyer , Carmina Teresa Fuss , Franca Hermes , Armin Plass , Ann-Cathrin Koschker & Stefanie Hahner


University Hospital Würzburg, Department of Medicine I, Division of Endocrinology and Diabetes, Germany


Introduction: Although long-term complications such as nephrocalcinosis and renal insufficiency are well-known in chronic hypoparathyroidism (HPT), standardized investigations of their prevalence and causes are still lacking.

Objective: To systematically investigate the prevalence of renal calcifications and dysfunction and their predictors in a well-characterized cohort of patients with HPT.

Methods: Cross-sectional assessment of comorbidities in 169 patients with chronic HPT (disease duration >6 months). Further examinations included renal ultrasound and laboratory analysis of serum- and urine samples. Logistic regression analysis with backward selection was performed to identify risk factors for the development of nephrocalcinosis.

Results: Out of 169 patients (55 ± 13 yr, 76% female, disease duration 17±15 y), 88% had postoperative HPT. Prevalence of eGFR <60 ml/min/1.73m2 was 21%, hypercalciuria 29%. Significant correlation between 24-h urine calcium excretion and spot urine calcium (r = 0.61, P < 0.0001) was observed. Renal ultrasound performed in 151 patients revealed renal calcifications in 9%, nephrocalcinosis in 7% and calculi in 3%. Significant differences between patients with renal calcifications (defined as nephrocalcinosis and nephrolithiasis) and without were found for 24-h urine calcium excretion (8.4 ± 5.9 mmol/d vs 6.1 ± 3.9 mmol/d, P < 0.05), albumin-corrected serum calcium (2.1 ± 0.2 mmol/l vs 1.99 ± 0.2 mmol/l, P < 0.02), serum phosphate (1.2 ± 0.3 mmol/l vs 1.3 ± 0.2 mmol/l, P < 0.05) and serum magnesium (0.73 ± 0.08 mmol/l vs 0.78 ± 0.07 mmol/l, P < 0.02). In contrast, no significant difference was found for prevalence of renal dysfunction and eGFR < 60 ml/min/1.73 m2, serum calcium-phosporus product, serum 25-hydroxyvitamin D, 24 h urine calcium-to-creatinine ratio, daily calcium intake or duration of disease (24 ± 20 y vs 16 ± 14 y). In logistic regression analysis only serum calcium could be identified as potential risk factor, in contrast to 24-h urine calcium, serum phosphate, disease duration, as well as dosage of calcium and active vitamin D.

Conclusion: Here we report a high prevalence of eGFR <60 ml/min/1,73 m2 and hypercalciuria but a low prevalence of renal calcifications. This reduction of eGFR is independent of type of HPT, daily calcium intake and disease duration. In our study, only fasting serum calcium represented a risk factor for the development of nephrocalcinosis. Further studies are warranted to elucidate the pathomechanism behind nephrocalcinosis in patients with HPT.

Volume 70

22nd European Congress of Endocrinology

Online
05 Sep 2020 - 09 Sep 2020

European Society of Endocrinology 

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