Long-term effects of primary hyperparathyroidism and parathyroidectomy on kidney function
An erratum to this article was published (Eur J Endocrinol, 17 Oct 2023 ↗)
Authors' conclusion
Compared with matched controls, accelerated eGFR decline was observed in the minority of PHPT patients with serum calcium >2.87 mmol/L (11.5 mg/dL). Parathyroidectomy was associated with mitigation of eGFR decline in patients with serum calcium >2.87 mmol/L.
Study context
- Population
- Subjects with biochemically confirmed primary hyperparathyroidism (PHPT) and matched controls, vertically integrated health care system in Southern California, 2000–2016
- Comparison
- PHPT by serum calcium category vs matched controls; parathyroidectomy vs no parathyroidectomy
- Matched controlsn = 16,388reference
- Outcome
- eGFR trajectories, by severity of hypercalcemia
- Follow-up
- 10 years
Methodological detailspropensity-score-matched, interrupted time series analysis
- Propensity-score-matched
- Interrupted time series analysis
Main finding
As reported in the abstract
Rate of eGFR decline (mL/min/1.73 m²/year)
| Outcome | Values |
|---|---|
| Rate of eGFR decline (mL/min/1.73 m²/year) · 10 years | Ca 2.62-2.74 mmol/L −1.0 mL/min/1.73 m²/year · share of cases 56% · Ca 2.75-2.87 mmol/L −1.1 mL/min/1.73 m²/year · share of cases 28% · Ca 2.88-2.99 mmol/L −1.5 mL/min/1.73 m²/year · share of cases 9% · Ca >2.99 mmol/L −2.1 mL/min/1.73 m²/year · share of cases 7% · Controls −1.0 mL/min/1.73 m²/year |
- Ca 2.88-2.99 mmol/L vs Controls: P < 0.001 — accelerated decline
- Ca >2.99 mmol/L vs Controls: P < 0.001 — accelerated decline
Further findings
Estimated glomerular filtration rate (eGFR) decline before to after parathyroidectomy, serum calcium >2.87 mmol/L
- Rate of eGFR decline before parathyroidectomy (mL/min/1.73 m²/year)
- −2.0 [95% CI: −2.6 to −1.5]
- Rate of eGFR decline after parathyroidectomy (mL/min/1.73 m²/year)
- −0.9 [95% CI: −1.5 to 0.4]
- Propensity score-matched population
- Interrupted time series analysis
Original publication
Long-term effects of primary hyperparathyroidism and parathyroidectomy on kidney function. Eur J Endocrinol. Published 14 July 2023. doi:10.
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