Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Clin Endocrinol (Oxf). 2021 Aug;95(2):286-294. doi: 10.1111/cen.14470. Epub 2021 Apr 12.
Hypercalciuria, impaired kidney function and renal calcifications are common in chronic hypoparathyroidism (HypoPT). We aimed to study associations between indices of known importance to the kidney in HypoPT by hypothesizing adverse effects of hypercalciuria on renal outcomes.
We used cross-sectional design.
We identified all patients followed for chronic HypoPT at our department and who had been examined by a 24-h urine collection for measurement of renal calcium excretion (24 h U-Ca).
By chart review, we identified additional biochemistry measured in close connection with the collection of urine, as well as demographic, treatments and anthropometrics.
The 166 included patients (79.5% females) had a high prevalence of hypercalciuria (65.7%). In multiple adjusted analyses, hypercalciuria was in an independent manner inversely associated with (residual) levels of plasma PTH and positively associated with levels of 1,25-dihydroxyvitamin D and ionized calcium as well as 24 h U-phosphate, gender, and etiology (surgical vs. non-surgical). Overall, this model explained 54% (p < .001) of the variation in the presence of hypercalciuria. Chronic kidney disease stage three or above was present in 18.3% of the patients, and 42.6% of the 54 patients examined by renal imaging had renal calcifications. However, neither renal function nor renal calcifications were associated with 24 h U-Ca.
Hypercalciuria, impaired renal function and renal calcifications are common in hypoparathyroidism. Hypercalciuria is to a large extent explained by indices of known physiological importance to 24 h U-Ca. However, in the present study, a high renal calcium excretion did not explain renal impairment or kidney calcifications.
高钙尿症、肾功能受损和肾钙化在慢性甲状旁腺功能减退症（HypoPT）中很常见。我们旨在通过假设高钙尿对肾脏结局的不良影响，研究 HypoPT 中已知对肾脏重要的指标之间的相关性。
我们使用了横断面设计。
我们在我们的科室中确定了所有接受慢性 HypoPT 治疗并通过 24 小时尿液收集来测量尿钙排泄量（24 h U-Ca）的患者。
通过病历回顾，我们确定了在收集尿液时密切测量的其他生物化学指标，以及人口统计学、治疗和人体测量学指标。
纳入的 166 例患者（79.5%为女性）中，高钙尿症的患病率很高（65.7%）。在多变量调整分析中，高钙尿症与（残留）血浆 PTH 水平呈独立负相关，与 1,25-二羟维生素 D 和离子钙水平以及 24 h U-磷酸盐水平呈正相关，与性别和病因（手术与非手术）有关。总的来说，该模型解释了高钙尿症存在的 54%（p < 0.001）的变异性。有 18.3%的患者患有慢性肾脏病三期或以上，54 例接受肾脏影像学检查的患者中有 42.6%有肾钙化。然而，肾功能或肾钙化与 24 h U-Ca 均无关。
高钙尿症、肾功能受损和肾钙化在甲状旁腺功能减退症中很常见。高钙尿在很大程度上可以用已知对 24 h U-Ca 具有生理重要性的指标来解释。然而，在本研究中，高钙尿排泄量并未解释肾功能不全或肾脏钙化。
