MedPath

Impact of Parathyroidectomy on Renal Function

Conditions
Primary Hyperparathyroidism
Registration Number
NCT04798092
Lead Sponsor
Central Hospital, Nancy, France
Brief Summary

Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT.

Detailed Description

Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands. The parathyroid gland(s) becomes overactive and secretes excess amounts of parathyroid hormone (PTH). As a result, the blood calcium rises to a level that is higher than normal. PHPT is associated with several other metabolic complications as osteoporosis, kidney stones, hypertension, insulin resistance, cardiac calcifications, cardiac arrhythmias, and kidney failure. Renal function deterioration over time has also been reported. However, the role of parathyroidectomy on renal function remains controversial in patients with PHPT. In some studies, surgical cure of PHPT has been shown to halt renal function deterioration in patients with coexisting renal disease. On the other hand, other studies showed no significant impact of parathyroidectomy on renal function. Consequently, the goal of this study was to evaluate renal function before and after parathyroidectomy in a large cohort of patients with pHPT.

Criteria are detailled in "Outcomes measures"

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
500
Inclusion Criteria
  • patients undergoing parathyroidectomy for primary hyperparathyroidism with surgical cure defined as postoperative normocalciemia
Exclusion Criteria
  • patients on dialysis
  • GFR < 15 ml/min
  • renal graft

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Change in renal functionpreoperative, postoperative at 3, 6, and 12 months

glomerular filtration rate (CKD in mL/min)

Secondary Outcome Measures
NameTimeMethod
Change in vitamin Dpreoperative, postoperative at 3, 6, and 12 months

Blood vitamine D level (in ng/mL)

Change in urinary calciumpreoperative, postoperative at 3, 6, and 12 months

Urine calcium level (in mg/24h)

Change in insulinpreoperative, postoperative at 3, 6, and 12 months

Fasting blood insuline level (in mUI/L)

Change in glycemiapreoperative, postoperative at 3, 6, and 12 months

Fasting blood glucose level (in g/L)

Change in osteocalcinpreoperative, postoperative at 3, 6, and 12 months

Blood osteocalcin level (in ng/mL)

Change in bone alkaline phosphatasespreoperative, postoperative at 3, 6, and 12 months

Blood bone alkaline phosphatases level (in microgr/L)

Change in aldosteronepreoperative, postoperative at 3, 6, and 12 months

Blood aldosterone level (in pg/mL)

Change in reninpreoperative, postoperative at 3, 6, and 12 months

Blood active renin (in pg/mL)

Change in total cholesterolpreoperative, postoperative at 3, 6, and 12 months

Blood total cholesterol (in gr/L)

Change in calciumpreoperative, postoperative at 3, 6, and 12 months

Blood calcium level (in mg/L)

Change in parathormonepreoperative, postoperative at 3, 6, and 12 months

Blood parathormone level (in ng/dL)

Change in HDL cholesterolpreoperative, postoperative at 3, 6, and 12 months

Blood HDL Cholesterol (in gr/L)

Change in LDL cholesterolpreoperative, postoperative at 3, 6, and 12 months

Blood LDL Cholesterol (in gr/L)

Change in triglyceridespreoperative, postoperative at 3, 6, and 12 months

Blood triglycerides (in gr/L)

CAC scoring on CT scanpreoperative

CAC score (actual value)

Trial Locations

Locations (1)

CHRU Nancy

🇫🇷

Vandœuvre-lès-Nancy, Lorraine, France

© Copyright 2025. All Rights Reserved by MedPath