PMID- 34991581
OWN - NLM
STAT- MEDLINE
DCOM- 20220328
LR  - 20220328
IS  - 1472-6823 (Electronic)
IS  - 1472-6823 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Jan 6
TI  - The effect of parathyroidectomy compared to non-surgical surveillance on kidney 
      function in primary hyperparathyroidism: a nationwide historic cohort study.
PG  - 14
LID - 10.1186/s12902-021-00918-z [doi]
LID - 14
AB  - 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.
CI  - (c) 2022. The Author(s).
FAU - Matzen, Josephine
AU  - Matzen J
AD  - Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Bislev, Lise Sofie
AU  - Bislev LS
AD  - Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Sikjaer, Tanja
AU  - Sikjaer T
AD  - Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Rolighed, Lars
AU  - Rolighed L
AD  - Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark.
FAU - Hitz, Mette Friberg
AU  - Hitz MF
AD  - Department of Medical Endocrinology, Zealand University Hospital Koge, Koge, 
      Denmark.
AD  - Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
FAU - Eiken, Pia
AU  - Eiken P
AD  - Department of Endocrinology, Bispebjerg, Copenhagen University Hospital, 
      Copenhagen, Denmark.
FAU - Hermann, Anne Pernille
AU  - Hermann AP
AD  - Department of Endocrinology, Odense University Hospital, Odense, Denmark.
FAU - Jensen, Jens-Erik Beck
AU  - Jensen JB
AD  - Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
AD  - Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, 
      Denmark.
FAU - Abrahamsen, Bo
AU  - Abrahamsen B
AD  - Department of Clinical Research, University of Southern Denmark and Odense 
      University Hospital, Odense C, Denmark.
AD  - Holbaek Hospital, Department of Medicine, Holbaek, Denmark.
FAU - Rejnmark, Lars
AU  - Rejnmark L
AD  - Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 
      Aarhus, Denmark.
AD  - Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20220106
PL  - England
TA  - BMC Endocr Disord
JT  - BMC endocrine disorders
JID - 101088676
RN  - 0 (Biomarkers)
SB  - IM
MH  - Aged
MH  - Biomarkers/analysis
MH  - Denmark
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Hyperparathyroidism, Primary/*physiopathology/*surgery
MH  - Kidney Function Tests
MH  - Male
MH  - Middle Aged
MH  - *Parathyroidectomy
MH  - Registries
MH  - Retrospective Studies
MH  - *Watchful Waiting
PMC - PMC8734053
OTO - NOTNLM
OT  - Kidney function
OT  - Parathyroid glands
OT  - Parathyroid hormone
OT  - Parathyroidectomy
OT  - Primary hyperparathyroidism
OT  - Renal function
COIS- None.
EDAT- 2022/01/08 06:00
MHDA- 2022/03/29 06:00
PMCR- 2022/01/06
CRDT- 2022/01/07 05:43
PHST- 2021/04/08 00:00 [received]
PHST- 2021/12/14 00:00 [accepted]
PHST- 2022/01/07 05:43 [entrez]
PHST- 2022/01/08 06:00 [pubmed]
PHST- 2022/03/29 06:00 [medline]
PHST- 2022/01/06 00:00 [pmc-release]
AID - 10.1186/s12902-021-00918-z [pii]
AID - 918 [pii]
AID - 10.1186/s12902-021-00918-z [doi]
PST - epublish
SO  - BMC Endocr Disord. 2022 Jan 6;22(1):14. doi: 10.1186/s12902-021-00918-z.