SFEBES2022 Poster Presentations Bone and Calcium (40 abstracts)
Primary Hyperparathyroidism Audit: Does routine Ultrasound Kidneys add value?
Mario Eyzaguirre Valencia 1 , Sunaya Chandrashekar 1 , Eswari Chinnasamy 1 , Ye Kyaw 1 , Panayiotis Theofanoyiannis 1 , Koteshwara Muralidhara 1 , Darshi Sivakumaran 1 , Enyinnaya Ofo 1,2 & Ramesh Yella 1
1Kingston Hospital NHS Trust, London, United Kingdom; 2St George’s Hospital, London, United Kingdom
Introduction: Primary hyperparathyroidism (PHPT) is a commonly encountered endocrine pathology. Asymptomatic renal stones have been reported in 7-22% of patients. NICE guideline (NG132) published in May 2019 on PHPT recommends renal US in all patients. The value of renal ultrasound for all patients with PHPT has been debated. This audit aims to compare local practice to NICE guideline (NG132) and to see if a tailored approach for renal ultrasound would be safe, practical and economical; and to assess its positive impact on the NHS radiology service which is under immense pressure due to long waiting lists triggered by the Covid pandemic.
Method: The data was collected prospectively from electronic records of the patients with PHPT attending the endocrine service at Kingston Hospital between March 2021 and April 2022. The collected data were compiled and analysed on Excel.
Results: Demographics: Total number: 100 - males n=26 (26%), females n=74 (74%). Age of patients referred ranged from 33-88, mean = 60.6 years. Peak C. Ca: <2.85 n=49, >2.85 n=51 Mean PTH: 14 pmol/l (range 3-111) Urine CCCR: >0.01 n=94, <0.01 n=1, not done n=4 Vitamin D Levels: <50 n=46, >50 n=53, not done n=1 Renal US Results Stone n=15, no stone n=70 Did/would US help with decision making? Maybe n=1 (missed imaging appointment), No n=99
Conclusion: Routine renal US did not add value to clinical decision making in people with PHPT. We recommend that renal US should be limited to asymptomatic patients with no other clear indications for surgery. This will help reduce the demand for precious radiology resource while providing patient centric approach to management. There is annual saving of about £4000/100 patients in addition to reducing number of hospital visits for patients. We are planning to modify our practice considering these results
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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