Urinary Hydroxyproline Concentration in Primary Hyperparathyroidism with and without Renal Stones

1977 ◽  
Vol 3 (4) ◽  
pp. 231-236
Author(s):  
E. Sommer
Keyword(s):  
Primary Hyperparathyroidism ◽  
Renal Stones ◽  
Urinary Hydroxyproline ◽  
Hydroxyproline Concentration

scholarly journals The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice

2014 ◽  
Vol 171 (6) ◽  
pp. 727-735 ◽  
Author(s):  
P Schwarz ◽  
J J Body ◽  
J Cáp ◽  
L C Hofbauer ◽  
M Farouk ◽  
...  
Keyword(s):  
Observational Study ◽  
Primary Hyperparathyroidism ◽  
Bone Pain ◽  
Prospective Observational Study ◽  
Renal Stones ◽  
Specialist Care ◽  
Treatment Start ◽  
Clinical Profiles ◽  
First Time ◽  
Time Information

ObjectiveMedical management of primary hyperparathyroidism (PHPT) is important in patients for whom surgery is inappropriate. We aimed to describe clinical profiles of adults with PHPT receiving cinacalcet.DesignA descriptive, prospective, observational study in hospital and specialist care centres.MethodsFor patients with PHPT, aged 23–92 years, starting cinacalcet treatment for the first time, information was collected on dosing pattern, biochemistry and adverse drug reactions (ADRs). Initial cinacalcet dosage and subsequent dose changes were at the investigator's discretion.ResultsOf 303 evaluable patients with PHPT, 134 (44%) had symptoms at diagnosis (mostly bone pain (58) or renal stones (50)). Mean albumin-corrected serum calcium (ACSC) at baseline was 11.4 mg/dl (2.9 mmol/l). The reasons for prescribing cinacalcet included: surgery deemed inappropriate (35%), patient declined surgery (28%) and surgery failed or contraindicated (22%). Mean cinacalcet dose was 43.9 mg/day (s.d., 15.8) at treatment start and 51.3 mg/day (31.8) at month 12; 219 (72%) patients completed 12 months treatment. The main reason for cinacalcet discontinuation was parathyroidectomy (40; 13%). At 3, 6 and 12 months from the start of treatment, 63, 69 and 71% of patients, respectively, had an ACSC of ≤10.3 mg/dl vs 9.9% at baseline. Reductions from baseline in ACSC of ≥1 mg/dl were seen in 56, 63 and 60% of patients respectively. ADRs were reported in 81 patients (27%), most commonly nausea. A total of 7.6% of patients discontinued cinacalcet due to ADRs.ConclusionsReductions in calcium levels of ≥1 mg/dl was observed in 60% of patients 12 months after initiation of cinacalcet, without notable safety concerns.

scholarly journals Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables

2012 ◽  
Vol 166 (6) ◽  
pp. 1093-1100 ◽  
Author(s):  
Jakob Starup-Linde ◽  
Elin Waldhauer ◽  
Lars Rolighed ◽  
Leif Mosekilde ◽  
Peter Vestergaard
Keyword(s):  
Primary Hyperparathyroidism ◽  
Renal Stones ◽  
Spiral Ct ◽  
University Hospital ◽  
Plasma Creatinine ◽  
Ct Scans ◽  
Cross Sectional ◽  
Biochemical Variables ◽  
Plasma Creatinine Level ◽  
High Prevalence

ObjectiveTo study the prevalence of renal stones and nephrocalcinosis in patients with primary hyperparathyroidism (PHPT) and to appraise biochemical variables as risk factors for developing renal calcifications.DesignCross-sectional.Materials and methodsAll patients (n=177) undergoing diagnostic evaluation and surgery for PHPT at Aarhus University Hospital between 2007 and 2009. All patients underwent routine spiral CT scans of the abdomen to determine the presence or absence of renal calcifications.ResultsA total of 45 patients (25.4%, 95% confidence intervals: 19.0–31.4%) had renal stones (15.3%) and/or renal calcifications (10.2%) on the CT scans. Compared with those without calcification (n=132), the group with calcification had a significantly lower plasma creatinine level (67.0±25.1 vs 74.6±17.5 μmol/l, 2P=0.03). Moreover, CaE was higher in PHPT patients with renal calcification than in PHPT patients without (0.91±0.28 vs 0.74±0.40 mmol/mmol, 2P=0.02). The other measured or derived biochemical variables were similar in the two groups. No biochemical variable was predictive for renal calcifications in a multiple regression analysis.ConclusionWe found a high prevalence of renal calcifications among PHPT patients but no deterioration of renal function. The occurrence of calcifications was related to low plasma creatinine and a high urine calcium/creatinine ratio. However, biochemical markers in general were poor predictors for the risk of renal stones or nephrocalcinosis indicating that routine image diagnostics may be needed for the identification of these complications in order to establish indication for surgery and ensure proper treatment.

Serum Phosphate: A Neglected Test in the Clinical Management of Primary Hyperparathyroidism

2021 ◽  
Author(s):  
Elena Castellano ◽  
Roberto Attanasio ◽  
Alberto Boriano ◽  
Micaela Pellegrino ◽  
Giorgio Borretta
Keyword(s):  
Bone Density ◽  
Primary Hyperparathyroidism ◽  
Clinical Picture ◽  
Inverse Correlation ◽  
Renal Stones ◽  
Serum Phosphate ◽  
Surgical Indication ◽  
Femoral Site ◽  
Serum Pth ◽  
The Relationship

Abstract Background Although the inverse correlation between serum PTH and phosphate (P) levels in patients with primary hyperparathyroidism (PHPT) is well known, the relationship between P levels and the clinical picture of the disease has not been well investigated. This was thus the aim of this paper. Patients A total of 472 consecutive patients with PHPT attending our center were retrospectively evaluated at diagnosis. Results P levels lower than 2.5 mg/dL (HypoP) were found in 198/472 patients (41.9%). HypoP was mild (2-2.5 mg/dL), moderate (1-1.9 mg/dL), and severe (<1 mg/dL) in 168 (84.9%), 30 (15.1%), and 0 cases, respectively. P levels were lower in males than females. Patients with more severe bone density impairment at the radial (but not the vertebral or femoral) site had P levels significantly lower than other patients. PHPT severity was worse in HypoP patients, both clinically (higher prevalence of renal stones, but not of osteoporosis) and biochemically (higher serum calcium and PTH levels). All patients in the moderate HypoP group were either symptomatic or asymptomatic reaching surgical indication according to the latest guidelines. Conclusions We observed a relationship between P levels and biochemical and clinical features of PHPT severity. In asymptomatic PHPT patients, even moderate HypoP is predictive of surgical indication, regardless of age and hypercalcemia severity.

Bone mass as referent for urinary hydroxyproline excretion: Age and sex-related changes in 125 normals and in primary hyperparathyroidism

1984 ◽  
Vol 36 (1) ◽  
pp. 639-644 ◽  
Author(s):  
Lars Hyldstrup ◽  
Peter McNair ◽  
Grethe Finn Jensen ◽  
Henrik Rist Nielsen ◽  
Ib Transbøl
Keyword(s):  
Primary Hyperparathyroidism ◽  
Bone Mass ◽  
Urinary Hydroxyproline ◽  
Hydroxyproline Excretion ◽  
Age And Sex

Surgery for hyperparathyroidism

2018 ◽  
pp. 519-526
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Adult Population ◽  
Renal Stones ◽  
Organ Damage ◽  
Urinary Calcium ◽  
Calcium Excretion ◽  
Biochemical Tests ◽  
Asymptomatic Patients

Hyperparathyroidism (HPT) is abnormal excessive production of parathyroid hormone (PTH) from the parathyroid gland(s), often with resultant hypercalcaemia. HPT affects 1% of adult population. Incidence increases after the age of 55. Over 80% of primary hyperparathyroidism (PHP) cases in Western countries are found incidentally by routine biochemical tests or on investigation of aetiology of resultant end-organ damage (osteoporosis and renal stones). Diagnosis can be established by demonstrating persistent hypercalcaemia (or serum calcium at the high normal levels) in the presence of elevated (or inappropriately normal) PTH concentrations and elevated urinary calcium excretion. Surgical resection is the treatment of choice for all symptomatic and asymptomatic patients with overactive parathyroid gland who are fit for surgery.

Primary hyperparathyroidism and calcium stone disease: Diagnosis and treatment

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 264-266
Author(s):  
A. Trinchieri ◽  
F. Rovera ◽  
R. Nespoli ◽  
G. Zanetti ◽  
A. Guarneri ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Renal Stones ◽  
Disease Diagnosis ◽  
Stone Disease ◽  
Preoperative Localization ◽  
Diagnosis And Treatment ◽  
Fasting Serum ◽  
Calcium Stone ◽  
Sensitivity Rate

During a 15-year period (1977–1992) 2,000 consecutive patients with renal stones were studied. Fasting serum and 24-hour urinary samples were analyzed for calcium and phosphate. In 32 cases (1.6%) primary hyperparathyroidism was diagnosed on the finding of hypercalcemia associated with hypophosphatemia, hypercalciuria and hyperphosphaturia. At surgery 14 adenomas and 2 multiglandular hyperplasias were found. For the preoperative localization of diseased glands double-tracer scintigraphy and ultrasonography were used. Double-tracer scintigraphy and ultrasound showed a sensitivity rate of 62% and 75%. When performed in association ultrasound and scintigraphy allowed a sensitivity rate of 87%.

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