甲状腺切除术后永久性甲状旁腺功能减退患者的肾功能受损:西班牙全国队列分析。

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Endocrine Pub Date : 2025-06-01 Epub Date: 2025-03-03 DOI:10.1007/s12020-025-04187-x
Juan J Díez, Emma Anda, Begoña Pérez-Corral, Miguel Paja, Victoria Alcázar, Cecilia Sánchez-Ragnarsson, Aida Orois, Ana R Romero-Lluch, Marcel Sambo, Amelia Oleaga, Águeda Caballero, María R Alhambra, Virginia Urquijo, Ana M Delgado-Lucio, José C Fernández-García, Viyey K Doulatram-Gamgaram, Suset Dueñas-Disotuar, Tomás Martín, Mercedes Peinado, Julia Sastre
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引用次数: 0

摘要

目的:我们旨在评估慢性术后甲状旁腺功能减退患者的肾功能下降。方法:我们进行了一项多中心、回顾性队列研究,包括持续≥3年的慢性甲状旁腺功能减退症患者。我们评估了术前和最后一次就诊时血清肌酐和肾小球滤过率(eGFR)的变化。评估变化的绝对值(ΔeGFR =最后一次就诊时的eGFR -甲状腺切除术前的eGFR),并校正时间(ΔeGFR/yr = ΔeGFR/年时间)。结果:纳入236例甲状旁腺功能减退患者(女性85.6%,中位年龄47[37-58]岁,中位随访时间7.3[5.0-11.0]年)和458例年龄、性别、随访时间相近的对照组。在甲状腺切除术前,我们发现患者和对照组之间血清肌酐水平或eGFR没有显著差异。随访结束时,甲状旁腺功能减退患者的ΔeGFR和ΔeGFR/yr分别为-4.87 (-17.0-0.00)ml/min/1.73 m2 /年和-0.68 (-2.31-0.00)ml/min/1.73 m2 /年,而对照组的这些变化为0.00 (-10.10-4.00)ml/min/1.73 m2 /年(P /年)。结论:甲状腺切除术后慢性甲状旁腺功能减退患者的肾功能随时间的下降明显高于甲状腺切除术后无甲状旁腺功能减退患者。年龄、术前eGFR和肾结石是这些患者肾功能丧失的主要决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impaired renal function in patients with permanent hypoparathyroidism after thyroidectomy: analysis of a nationwide cohort in Spain.

Purpose: We aimed to assess the decline in renal function in patients with chronic postoperative hypoparathyroidism.

Methods: We performed a multicenter, retrospective cohort study including patients with chronic hypoparathyroidism lasting ≥ 3 years. We evaluated the changes in serum creatinine and estimated glomerular filtration rate (eGFR) before surgery and at the last visit. Changes were evaluated in absolute value (ΔeGFR = eGFR at last visit - eGFR before thyroidectomy) and corrected for time (ΔeGFR/yr = ΔeGFR / time in years).

Results: We included 236 patients with hypoparathyroidism (85.6% women, median age 47 [37-58] years, median time of follow-up 7.3 [5.0-11.0] years), and 458 control subjects with similar age, gender, and time of follow-up. Before thyroidectomy we found no significant differences in serum creatinine levels or eGFR between patients and controls. At the end of follow-up, ΔeGFR and ΔeGFR/yr in the patients with hypoparathyroidism were -4.87 (-17.0-0.00) ml/min/1.73 m2 and -0.68 (-2.31-0.00) ml/min/1.73 m2 per year, respectively, whereas in the control subjects these changes were 0.00 (-10.10-4.00) ml/min/1.73 m2 (P < 0.001), and 0.00 (-1.34-0.54) ml/min/1.73 m2 per year (P < 0.001). In multivariable regression analysis the annual eGFR decline in patients with hypoparathyroidism was related to age (P < 0.001), eGFR before thyroidectomy (P < 0.001), and incident nephrolithiasis (P = 0.028).

Conclusion: The decline in renal function over time is significantly higher in patients with chronic hypoparathyroidism after thyroidectomy compared to thyroidectomized patients without hypoparathyroidism. Age, preoperative eGFR and nephrolithiasis are the main determinants of renal function loss in these patients.

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来源期刊
Endocrine
Endocrine ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
5.40%
发文量
295
审稿时长
1.5 months
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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