Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT.
Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT. Criteria are detailled in "Outcomes measures"
Study Type
OBSERVATIONAL
Enrollment
500
surgical removal of parathyroid adenoma(s) with postoperative biological cure
CHRU Nancy
Vandœuvre-lès-Nancy, Lorraine, France
RECRUITINGChange in renal function
glomerular filtration rate (CKD in mL/min)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in calcium
Blood calcium level (in mg/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in parathormone
Blood parathormone level (in ng/dL)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in vitamin D
Blood vitamine D level (in ng/mL)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in urinary calcium
Urine calcium level (in mg/24h)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in insulin
Fasting blood insuline level (in mUI/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in glycemia
Fasting blood glucose level (in g/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in osteocalcin
Blood osteocalcin level (in ng/mL)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in bone alkaline phosphatases
Blood bone alkaline phosphatases level (in microgr/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in aldosterone
Blood aldosterone level (in pg/mL)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in renin
Blood active renin (in pg/mL)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in total cholesterol
Blood total cholesterol (in gr/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in HDL cholesterol
Blood HDL Cholesterol (in gr/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in LDL cholesterol
Blood LDL Cholesterol (in gr/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
Change in triglycerides
Blood triglycerides (in gr/L)
Time frame: preoperative, postoperative at 3, 6, and 12 months
CAC scoring on CT scan
CAC score (actual value)
Time frame: preoperative
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