Borretta Giorgio, Gianotti Laura, Cesario Flora, Borretta Valentina, Tassone Francesco
S.C. di Endocrinologia e Malattie del Ricambio, ASO ''S. Croce e Carle'', Cuneo, Italy.
G Ital Nefrol. 2010 Sep-Oct;27 Suppl 50:S91-5.
The kidney is one of the classical target organs of PTH action. Symptomatic primary hyperparathyroidism (PHPT) is nowadays less frequent but mostly occurs with renal symptoms, in particular kidney stones. Nephrocalcinosis and polyuria, the latter closely related to the severity of hypercalcemia, are uncommon. Parathyroidectomy leads to a marked and long-lasting improvement of nephrolithiasis, whereas it has a limited effect on nephrocalcinosis. Kidney failure is one of the long-term complications of PHPT and is associated with a more severe clinical expression of the disease and a higher risk of morbidity and mortality. Current guidelines on the management of asymptomatic PHPT, the most common presentation of PHPT today, recommend surgical treatment if renal function is decreased. However, in this particular clinical setting it is unclear whether PHPT is really associated with a more rapid decline of renal function or whether successful parathyroidectomy could protect renal function.
肾脏是甲状旁腺激素作用的经典靶器官之一。有症状的原发性甲状旁腺功能亢进症（PHPT）如今较为少见，但大多伴有肾脏症状，尤其是肾结石。肾钙质沉着症和多尿（后者与高钙血症的严重程度密切相关）并不常见。甲状旁腺切除术可显著且持久地改善肾结石，而对肾钙质沉着症的效果有限。肾衰竭是PHPT的长期并发症之一，与该疾病更严重的临床表现以及更高的发病和死亡风险相关。目前关于无症状PHPT（如今PHPT最常见的表现形式）管理的指南建议，如果肾功能下降则进行手术治疗。然而，在这种特殊的临床情况下，尚不清楚PHPT是否真的与肾功能更快下降相关，或者成功的甲状旁腺切除术是否能保护肾功能。
