Faculty Collaboration Database

High prevalence of chronic kidney disease in patients with multiple endocrine neoplasia type 1 and improved kidney function after parathyroidectomy. Surgery 2019 Jan;165(1):124-128

Date

11/12/2018

Pubmed ID

30414705

Pubmed Central ID

PMC8191379

DOI

10.1016/j.surg.2018.04.064

Scopus ID

2-s2.0-85055971101 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND: Because chronic kidney disease is an important comorbidity associated with primary hyperparathyroidism, we sought to evaluate the prevalence of chronic kidney disease and effects of parathyroidectomy on kidney function in patients with multiple endocrine neoplasia type 1-associated primary hyperparathyroidism.

METHODS: We performed a retrospective analysis of 112 patients with multiple endocrine neoplasia type 1-associated primary hyperparathyroidism who had at least 1 operation for primary hyperparathyroidism at 2 tertiary referral centers. The preoperative and postoperative estimated glomerular filtration rates were compared. The prevalence of chronic kidney disease stage 3 or worse (estimated glomerular filtration rates less than 60 mL/min/1.73m²) in this cohort was compared to the rates in the US population reported by the Centers for Disease Control and Prevention.

RESULTS: The median age at the time of parathyroidectomy was 36.5 years (range: 12-76 years). A total of 99 patients had biochemical remission. The rate of chronic kidney disease stage 3 or worse in patients with multiple endocrine neoplasia type 1-associated primary hyperparathyroidism was greater than that observed in the US population for ages 20-39 and 40-59 (5% [n = 2/44] vs 0.39% [n = 18/4565], P = .015 and 10% [n = 4/40] vs 2.31% (n = 89/3848), P = .015, respectively). We observed improved estimated glomerular filtration rates in those with chronic kidney disease stage 3 or worse postoperatively (48 vs 57 mL/min/1.73m², P = .047). A successful parathyroidectomy normalized all 24-hour urine calcium excretion.

CONCLUSION: An indication for early parathyroidectomy should include estimated glomerular filtration rates less than 60mL/min/1.73m² in patients with multiple endocrine neoplasia type 1-associated primary hyperparathyroidism.

Author List

Green P, Zagzag J, Patel D, Weinstein LS, Simonds WF, Blau J, Marx S, Kebebew E, Perrier N, Nilubol N

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Calcium
Child
Female
Glomerular Filtration Rate
Humans
Hyperparathyroidism, Primary
Male
Middle Aged
Multiple Endocrine Neoplasia Type 1
Parathyroidectomy
Prevalence
Renal Insufficiency, Chronic
Retrospective Studies
Severity of Illness Index
United States
Young Adult