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Purpose <p>To determine the prevalence of hyperparathyroidism (HPT), including primary, secondary and normocalcemic in a cohort of patients with PA of the SPAIN-ALDO registry.</p> Methods <p>A retrospective multicenter study of primary aldosteronism (PA) patients followed in 37 Spanish tertiary hospitals and with available information on serum calcium, phosphorus, iPTH, and vitamin D at the time of PA diagnosis. The diagnosis of normocalcemic HPT (n-HPT) associated with PA was based on a iPTH &gt; 65pg/mL with normal corrected serum calcium after excluding the most common causes of secondary HPT, and HPT was classified as secondary (S-HPT) in the presence of chronic kidney disease or vitamin D deficiency, and as primary (PHPT) when iPTH levels &gt;65 pg/mL were associated with high serum calcium levels. </p> Results <p>A total of 246 patients with PA were included, of whom 56% (<i>n</i> = 139) had PTH &gt; 65 pg/mL. In the group of participants with HPT (<i>n</i> = 139) the proportion of PHPT was 7.2%, of n-HPT 11.5% and of S-HPT 81.3%. Patients with n-HPT had a higher prevalence of atrial fibrillation (7.9% vs. 1.9%, <i>P</i> = 0.04) and hypokalemia (71.6% vs. 46.2%, <i>P</i> &lt; 0.001) and greater aldosterone (33.2 vs. 26.8 ng/dL, <i>p</i> = 0.003) and 24&#xa0;h urinary calcium excretion ( 243.5 vs. 160.5&#xa0;mg/24&#xa0;h, <i>p</i> = 0.01) than patients without hyperparathyroidism. No differences in surgical outcomes (biochemical and clinical response) were detected between patients with and without hyperparathyroidism.</p> Conclusions <p>HPT is a frequent condition in patients with PA and S-HPT is the most common etiology. Patients with HPT have a higher prevalence of atrial fibrillation and hypokalemia and a more severe PA than those without HPT. However, no differences in surgical outcomes were reported between patients with and without HPT.</p>

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Impact of primary aldosteronism on calcium phosphate homeostasis. Results from the SPAIN-ALDO

  • 期刊论文

  • 发表日期：

    2025年4月19日

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  • María Bernarda Iriarte-Durán,
  • Miguel Paja Fano,
  • Alicia Rizo Gellida,
  • Marga González-Boillos,
  • Paola Parra Ramírez,
  • Patricia Martín Rojas-Marcos,
  • Laura Caja,
  • Ana M García Cano,
  • Jorge Gabriel Ruiz-Sanchez,
  • Almudena Vicente,
  • Emilia Gómez-Hoyos,
  • Mònica Recasens,
  • Rebeca Barahona San Millan,
  • María José Picón César,
  • Patricia Díaz Guardiola,
  • Carolina M. Perdomo,
  • Laura Manjón-Miguélez,
  • Ángel Rebollo Román,
  • Cristina Robles Lázaro,
  • José María Recio,
  • María Calatayud,
  • Noemi Jiménez López,
  • Miguel Sampedro Nuñez,
  • Elena Mena Ribas,
  • Alicia Sanmartín Sánchez,
  • Cesar Gonzalvo Diaz,
  • Cristina Lamas,
  • Joaquín Serrano,
  • Theodora Michalopoulou,
  • Susana Tenes Rodrigo,
  • Fernando Jaén Aguila,
  • Eva María Moya Mateo,
  • Sonsoles Gutiérrez-Medina,
  • Felicia Alexandra Hanzu,
  • Marta Araujo-Castro

摘要

Purpose

To determine the prevalence of hyperparathyroidism (HPT), including primary, secondary and normocalcemic in a cohort of patients with PA of the SPAIN-ALDO registry.

Methods

A retrospective multicenter study of primary aldosteronism (PA) patients followed in 37 Spanish tertiary hospitals and with available information on serum calcium, phosphorus, iPTH, and vitamin D at the time of PA diagnosis. The diagnosis of normocalcemic HPT (n-HPT) associated with PA was based on a iPTH > 65pg/mL with normal corrected serum calcium after excluding the most common causes of secondary HPT, and HPT was classified as secondary (S-HPT) in the presence of chronic kidney disease or vitamin D deficiency, and as primary (PHPT) when iPTH levels >65 pg/mL were associated with high serum calcium levels.

Results

A total of 246 patients with PA were included, of whom 56% (n = 139) had PTH > 65 pg/mL. In the group of participants with HPT (n = 139) the proportion of PHPT was 7.2%, of n-HPT 11.5% and of S-HPT 81.3%. Patients with n-HPT had a higher prevalence of atrial fibrillation (7.9% vs. 1.9%, P = 0.04) and hypokalemia (71.6% vs. 46.2%, P < 0.001) and greater aldosterone (33.2 vs. 26.8 ng/dL, p = 0.003) and 24 h urinary calcium excretion ( 243.5 vs. 160.5 mg/24 h, p = 0.01) than patients without hyperparathyroidism. No differences in surgical outcomes (biochemical and clinical response) were detected between patients with and without hyperparathyroidism.

Conclusions

HPT is a frequent condition in patients with PA and S-HPT is the most common etiology. Patients with HPT have a higher prevalence of atrial fibrillation and hypokalemia and a more severe PA than those without HPT. However, no differences in surgical outcomes were reported between patients with and without HPT.