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. 2021 Jun;22(2):297-316.
doi: 10.1007/s11154-020-09613-1. Epub 2021 Feb 18.

Renal complications in patients with chronic hypoparathyroidism on conventional therapy: a systematic literature review : Renal disease in chronic hypoparathyroidism

Elvira O Gosmanova  1 , Pascal Houillier  2 , Lars Rejnmark  3 , Claudio Marelli  4 , John P Bilezikian  5
Affiliations

Renal complications in patients with chronic hypoparathyroidism on conventional therapy: a systematic literature review : Renal disease in chronic hypoparathyroidism

Elvira O Gosmanova et al. Rev Endocr Metab Disord. 2021 Jun.

Abstract

A systematic literature review was performed to summarize the frequency and nature of renal complications in patients with chronic hypoparathyroidism managed with conventional therapy. Methodology was consistent with the recommendations outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Peer-reviewed journal articles with specified medical subject heading terms were identified using the PubMed, EMBASE, and Cochrane databases. Data were extracted from eligible articles based on prespecified parameters for clinical outcomes of renal calcifications and disease. Because of the heterogeneity of the data, a meta-analysis could not be conducted. From 1200 potentially relevant articles, data were extracted from 13 manuscripts that reported data for ≥1 of the 19 predefined renal outcomes for ≥10 adult patients (n = 11 manuscripts) or pediatric patients (n = 2 manuscripts). The collective data provide evidence that adult and pediatric patients with chronic hypoparathyroidism and treated with conventional therapy (oral calcium and active vitamin D) had an increased risk of renal complications. The reported rate of nephrolithiasis was up to 36%, with the lowest rates in studies reporting shorter duration of disease. The rate of nephrocalcinosis was up to 38%. Some studies reported a combined nephrolithiasis/nephrocalcinosis outcome of 19% to 31%. Data for renal disease that encompassed a range of renal insufficiency to chronic kidney disease were reported in 10 articles; the reported rates ranged from 2.5% to 41%. In patients who receive long-term treatment with oral calcium and active vitamin D, chronic hypoparathyroidism may be associated with an increased risk of renal complications compared with the general population.

Keywords: Chronic kidney disease; Hypoparathyroidism; Nephrocalcinosis; Nephrolithiasis.

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Conflict of interest statement

E. Gosmanova has served as a consultant for Shire, a Takeda company; P. Houillier has served as an advisory board member, speaker, and research investigator for Shire, a Takeda company; C. Marelli is an employee of Takeda Pharmaceuticals International AG, Zurich, Switzerland; L. Rejnmark has served as a consultant and speaker for Shire, a Takeda company; J. Bilezikian has served as an advisory committee/board member, received consulting fees and grant/research support, and acted as speaker for Shire, a Takeda company.

Figures

Fig. 1
Fig. 1
Flow Diagram of Article Selection for Data Extraction
Fig. 2
Fig. 2
Percentages of Patients With Renal Calcifications. Bars and values represent the percentage of patients with nephrolithiasis or nephrocalcinosis. Patient numbers (N) refer to the number of patients with hypoparathyroidism in the study. aPatients self-reporting in a cross-sectional survey. bIncluded patients with severe hypoparathyroidism (22%) and patients with milder hypoparathyroidism (6%). NR, not reported
Fig. 3
Fig. 3
Percentages of Patients With Chronic Kidney Disease. Bars and values represent the percentage of patients with chronic kidney disease determined by eGFR <60 mL/min/1.73 m2, ≥ stage 3, or renal insufficiency ICD-8 and ICD-10 codes. The methods used by each study are detailed in Table 6. Patient numbers (N) refer to the number of patients with hypoparathyroidism in the study. aPatients self-reporting in a cross-sectional survey. eGFR, estimated glomerular filtration rate; ICD, international classification of diseases and related health problems
See this image and copyright information in PMC

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