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Horm Metab Res. 2019 Jun;51(6):362-366. doi: 10.1055/a-0902-8476. Epub 2019 Jun 17.

Long-Term Treatment with Calcitriol in Postsurgical Hypoparathyroidism Leads to Renal Function Decline.

Author information

1
Department of Endocrinology, UZ Brussel, Vrije Universiteit Brussel (VUB), Jette, Belgium.
2
Department of Nephrology, Erasmus Ziekenhuis, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.
3
Department of Statistics, Vrije Universiteit Brussel (VUB), Jette, Belgium.

Abstract

Hypoparathyroidism is a rare endocrine disease with insufficient parathyroid hormone levels. Replacing the missing hormone is not yet a standard therapy. The objective of this retrospective cohort study was to evaluate if the usual therapy regimens of postsurgical hypoparathyroidism with calcitriol have a negative effect on renal function. We performed a chart analysis of patients who were seen in a tertiary care hospital in Brussels, Belgium. A total of 101 subjects were identified as patients with permanent post-surgical hypoparathyroidism, based on the hospital records of patients who underwent a total thyroidectomy between 1996 and 2016, while still being treated with calcitriol. Patients with pre-existing renal insufficiency and/or active malignancy were excluded. The cohort was predominantly female of Caucasian origin. Renal function was evaluated before and after surgery (with a maximum follow-up of 12 years), using the CKD-EPI equation. A multivariate linear regression model was used to correlate renal function decline with the duration of calcitriol therapy, while correcting for the mean calcium phosphate product and age. We found a statistically significant (p=0.027) relationship between the duration of calcitriol treatment and renal function decline at a rate of 1.06 ml/min/1.73 m2 per year of calcitriol therapy. Our study, although being retrospective, is the first one to demonstrate a relationship between the cumulative use of calcitriol therapy and renal function decline.

PMID:
31207657
DOI:
10.1055/a-0902-8476

Conflict of interest statement

The authors declare that they have no conflict of interest.

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