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End-organ effects of primary hyperparathyroidism: A population-based study
Yasmine Assadipour1, Hui Zhou2, Eric J Kuo1
1Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA.
Surgery
|November 14, 2018
Summary
Primary hyperparathyroidism frequently causes skeletal and renal damage, often before diagnosis. Classic forms pose a higher risk for end-organ damage compared to nonclassic forms.
Area of Science:
- Endocrinology
- Nephrology
- Bone Metabolism
Background:
- Primary hyperparathyroidism (PHP) poses significant risks for skeletal and renal complications.
- End-organ damage, including osteoporosis and kidney stones, is a common concern for PHP patients.
Purpose of the Study:
- To investigate the frequency and progression of skeletal and renal end-organ damage in patients with primary hyperparathyroidism.
- To compare the risk of end-organ damage between classic and nonclassic PHP, and assess the role of hypercalcemia severity.
Main Methods:
- A retrospective study of 9,485 patients with biochemically confirmed primary hyperparathyroidism from 1995-2014.
- Quantified the incidence of osteoporosis, nephrolithiasis, hypercalciuria, and decreased renal function, analyzing progression over a median of 3.7 years.
Main Results:
- 35% of patients had pre-existing end-organ effects; 29% of the remaining cohort progressed to end-organ damage.
- Progression was not linked to hypercalcemia severity in classic PHP.
- Nonclassic PHP showed a lower risk of progression compared to classic PHP, irrespective of calcium levels.
Conclusions:
- Most patients develop end-organ manifestations of PHP within 5 years of diagnosis or before biochemical confirmation.
- Classic PHP is associated with a higher frequency of end-organ damage than nonclassic PHP, independent of hypercalcemia severity.
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