Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark.
J Clin Endocrinol Metab. 2018 Sep 1;103(9):3574-3583. doi: 10.1210/jc.2018-00923.
Some patients with primary hyperparathyroidism (PHPT) develop renal calcifications. Investigation of urinary and nonurinary risk factors are essential.
We aimed to study the prevalence and potential biochemical predictors of renal calcifications.
Nested case-control study.
University hospital.
We identified 792 patients with PHPT from 2005 to 2015. We used biochemical data to validate the diagnosis of PHPT.
The prevalence of renal calcifications defined as nephrolithiasis or nephrocalcinosis assessed by a routine CT scan at the time of diagnosis.
A total of 792 patients with PHPT were identified among whom 617 patients (78%) had a CT scan preformed. We found a prevalence of renal calcifications of 23%, equally frequent between sexes. A total of 76 patients (12%) had nephrolithiasis and 75 patients (12%) had nephrocalcinosis where 7 patients (1%) had both nephrolithiasis and nephrocalcinosis. Compared with patients without renal calcifications, patients with renal calcifications had significantly higher levels of ionized calcium, parathyroid hormone, and 24-hour calcium excretion (Pall < 0.01). Patients with nephrocalcinosis had higher plasma levels of phosphate and a higher calcium-phosphate product compared with patients with nephrolithiasis (Pall < 0.05). Impaired renal function (estimated glomerular filtration rate <60 mL/min) was observed in 12% of patients. However, no differences in renal function were observed between those with and without renal calcifications.
Renal calcifications are frequent in patients with PHPT and are associated with the severity of the disease. Impaired renal function is also common in PHPT, but renal function was not associated with renal calcifications.
一些原发性甲状旁腺功能亢进症（PHPT）患者会出现肾钙化。调查尿和非尿风险因素是必不可少的。
我们旨在研究肾钙化的患病率和潜在的生化预测因素。
巢式病例对照研究。
大学医院。
我们从 2005 年至 2015 年期间确定了 792 例 PHPT 患者。我们使用生化数据来验证 PHPT 的诊断。
诊断时常规 CT 扫描评估的肾结石或肾钙质沉着症定义的肾钙化的患病率。
共确定了 792 例 PHPT 患者，其中 617 例（78％）进行了 CT 扫描。我们发现肾钙化的患病率为 23％，男女患病率相等。共有 76 例（12％）患者患有肾结石，75 例（12％）患者患有肾钙质沉着症，其中 7 例（1％）患者同时患有肾结石和肾钙质沉着症。与无肾钙化的患者相比，有肾钙化的患者的离子钙、甲状旁腺激素和 24 小时钙排泄水平显著更高（Pall <0.01）。与肾结石患者相比，肾钙质沉着症患者的血磷酸盐水平更高，钙磷乘积更高（Pall <0.05）。肾功能受损（估计肾小球滤过率<60 mL/min）在 12％的患者中观察到。然而，有和无肾钙化的患者之间的肾功能无差异。
PHPT 患者中肾钙化很常见，并且与疾病的严重程度相关。肾功能不全在 PHPT 中也很常见，但肾功能与肾钙化无关。
