Predictors of long-term morbidity and mortality in patients with chronic post-surgical hypoparathyroidism

Line Underbjerg; Jensen Simon Kok; Thomas Rasmussen; Tanja Sikjaer; O Ayodele; F.  Castriota; Claudio Marelli; Richard Finkelman; Christiansen Christian Fynbo; Lars Rejnmark

doi:10.1530/endoabs.110.P256

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Endocrine Abstracts (2025) 110 P256 | DOI: 10.1530/endoabs.110.P256

ECEESPE2025 Poster Presentations Bone and Mineral Metabolism (112 abstracts)

Predictors of long-term morbidity and mortality in patients with chronic post-surgical hypoparathyroidism

Line Underbjerg ¹ , Simon Kok Jensen ² , Thomas Rasmussen ² , Tanja Sikjaer ¹ , O Ayodele ³ , F. Castriota ⁴ , Claudio Marelli ⁴ , Richard Finkelman ³ , Christian Fynbo Christiansen ² & Lars Rejnmark ¹

Author affiliations

¹Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; ²Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; ³Takeda Pharmaceuticals U. S. A., Inc., Cambridge, MA, USA, Aarhus, United States; ⁴Takeda Pharmaceuticals International AG, Zurich, Switzerland., Zurich, Switzerland

JOINT2747

We aimed to examine factors associated with long-term morbidity and mortality for patients with post-surgical hypoparathyroidism (HypoPT), as a means of assisting healthcare providers in identifying patients at high risk of long-term adverse outcomes. We included 160 patients with post-surgical HypoPT and at least five years of follow-up from the Central Denmark Region. The majority were females (87. 5%) and the main indications for surgery were atoxic goiter and thyroid cancer. Median age was 46 years (interquartile range [IQR], 37-57 years). During the first year after surgery, the median ionized calcium level was 1. 18 mmol/l (IQR, 1. 14-1. 22). Thirty-nine percent of patients experienced episodes of hypocalcemia, whereas 31. 2% had episodes of hypercalcemia. Over a five-year period starting a year after surgery, 16. 4% of patients developed incident chronic kidney disease (CKD), 43. 8% had more than two hospitalizations, and 16. 3% had either a cardiovascular event, incident CKD or died. Patients with prevalent disease were excluded. Multivariable models were used to access factors associated with morbidity and mortality in patients with HypoPT. Higher age and more episodes of hypercalcemia were factors associated with of an increased risk of incident CKD. Elevated levels of phosphate and the presence of comorbidity were associated with a higher risk of two or more hospitalizations. In conclusion, episodes of hypercalcemia and higher age may be associated with the development of CKD. Furthermore, elevated levels of phosphate and comorbidity were linked to two or more hospitalizations. While this study provides new insight into the prognosis of postsurgical HypoPT, study findings should be validated externally in a larger cohort.