ECE2017 Eposter Presentations: Calcium and Bone Calcium & Vitamin D metabolism (65 abstracts)
Renal complications in patients with chronic postoperative hypoparathyroidism treated with oral calcium and active vitamin D metabolites
Filomena Cetani 1 , Antonella Meola 2 , Edda Vignali 1 , Giovanni Guglielmi 3 , Irene Donato 4 , Antonio Matrone 2 , Rossella Elisei 2 & Claudio Marcocci 2
1University Hospital of Pisa, Endocrine Unit, Pisa, Italy; 2Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 3University Hospital of Pisa Medicina Preventiva del Lavoro, Pisa, Italy; 4Department of Traslational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Patients with chronic hypoparathyroidism (HypoPT) treated with oral calcium and active vitamin D metabolites are at risk of renal complications, because of the lack of action of PTH at the renal tubule. In the present study we evaluated 90 patients (68 females and 22 males; age: 51.8±14.1 yrs) with chronic postoperative Hypo (PO-HypoPT) diagnosed since at least 3 years. All patients were treated with calcitriol and 35 (39%) with oral calcium two patients were also treated with thiazide diuretics. One-hundred forty-two healthy Hospital employers, matched for age and sex, undergoing routine medical evaluation, were used as control. Mean levels of Alb-Ca and ionized calcium were in the normal range and but 39 (43.3%) patients had values that did not meet the range recommended by the recent guidelines of the European Society of Endocrinology (ESE). Serial measurements of serum calcium prior to the present evaluation were available in 78 patients: only 9 (11.5%) patients had all values within the recommended ESE range, and a large proportion of patients (32, 41.0%) had values greater than the upper recommended value. The mean serum phosphorus and creatinine levels were in the normal range, but 7 (7.7%) patients had elevated values of phosphorus and 22 (24.4%) of creatinine. The serum calcium-phosphate product was normal in all patients. Forty-four (54%) patients showed increased 24-h urinary calcium excretion and 27 (30%) microlithiasis, mostly asymptomatic. Compared to the controls, patients had statistically significant lower mean serum Alb-Ca (P<0.0001) and higher serum creatinine (P=0.0008) and greater prevalence of kidney stones (27/90 vs 7/142, P<0.0001, OR: 8.2 (3.4–19.9)). In conclusion, conventional treatment of chronic PO-HypoPT is suboptimal and associated with an increased risk of renal complications. Careful monitoring of patients, as recommended by the ESE guidelines, should be therefore performed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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