We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The effect of parathyroidectomy compared to non-surgical surveillance on kidney function in primary hyperparathyroidism: a nationwide historic cohort study.
- Authors
Matzen, Josephine; Bislev, Lise Sofie; Sikjær, Tanja; Rolighed, Lars; Hitz, Mette Friberg; Eiken, Pia; Hermann, Anne Pernille; Jensen, Jens-Erik Beck; Abrahamsen, Bo; Rejnmark, Lars
- Abstract
Background: Patients with primary hyperparathyroidism (pHPT) and impaired kidney function (estimated glomerular filtration rate (eGFR) < 60 mL/min) are offered parathyroidectomy (PTX) to protect them from further complications. Surprisingly, two recent uncontrolled cohort studies have suggested a further decrease in kidney function following PTX. We aimed to examine the effects of PTX compared to non-surgical surveillance on kidney function in pHPT patients. Methods: Historic cohort study. From the Danish National Patient Registry (NPR) and major medical biochemistry laboratories in Denmark, we identified 3585 patients with biochemically confirmed pHPT among whom n = 1977 (55%) were treated with PTX (PTX-group) whereas n = 1608 (45%) were followed without surgery (non-PTX group). Baseline was defined as time of diagnosis and kidney function was re-assessed 9–15 months after PTX (PTX group) or 9–15 months after diagnosis (non-PTX group). Results: At follow-up, eGFR had decreased significantly in the PTX- compared to the non-PTX-group (median − 4% vs. − 1%, p < 0.01). Stratification by baseline eGFR showed that the decrease was significant for those with a baseline eGFR value of 80–89 and > 90 mL/min, but not for those with lower eGFR values. Findings did not differ between patients with mild compared to moderate/severe hypercalcemia. However, after mutual adjustments, we identified baseline levels of calcium, PTH, and eGFR as well as age and treatment (PTX vs. no-PTX) as independent predictors for changes in kidney function. Conclusion: Compared to non-surgical surveillance, PTX is associated with a small but significant decrease in kidney function in pHPT patients with an initial normal kidney function.
- Subjects
PARATHYROID gland surgery; GLOMERULAR filtration rate; BIOCHEMISTRY; STATISTICS; KIDNEYS; SCIENTIFIC observation; RETROSPECTIVE studies; MANN Whitney U Test; HYPERPARATHYROIDISM; TREATMENT effectiveness; PARATHYROID hormone; DESCRIPTIVE statistics; CHI-squared test; DATA analysis software; DATA analysis; LONGITUDINAL method
- Publication
BMC Endocrine Disorders, 2022, Vol 22, Issue 1, p1
- ISSN
1472-6823
- Publication type
Article
- DOI
10.1186/s12902-021-00918-z