Nephrolithiasis Associated with Normocalcemic or Hypercalcemic Primary Hyperparathyroidism: An Update on Medical Management
Journal Title: Archives of Renal Diseases and Management - Year 2016, Vol 2, Issue 1
Abstract
Primary hyperparathyroidism (PHPT) is a disease involving a broad range of alterations of calcium homeostasis, sustained by parathyroid hormone (PTH) levels that are clearly abnormal. The anomalies directly associated with hyperparathyroidism are nephrolithiasis and fibrocystic bone disease. Since PHPT resolves when abnormal parathyroid tissue is removed, surgery is clearly the only definitive approach to this type of hyperparathyroidism. However there are large subgroups of patients for whom medical therapy should be considered instead of surgery. Pharmacological therapy consists largely of biphosphonates, or calciomimetics such as cinacalcet. Recent preliminary data suggests however that cinacalcet could also be effective in the specific group of patients with primary hyperparathyroidism associated with nephrolithiasis. Finally, since cinacalcet reduces calcemia in most PHPT patients without improving bone mass, whereas biphosphonates and especially alendronate improve bone mass, it could make sense to combine the two drugs in PHPT patients with concomitant bone loss and possibly nephrolithiasis who cannot or do not wish to undergo surgery.
Authors and Affiliations
Brardi Simone, Duranti Ennio
Keywords
Related Articles
- EP ID EP343405
- DOI 10.17352/2455-5495.000010
- Views 85
- Downloads 0
Use of Interpreters for non-native English speaking Kidney Allograft Recipients and outcomes after Kidney Transplantation
Background: Language barriers are associated with worse health outcomes in the general population but data in kidney transplantation is lacking. This study tested the hypothesis that non-native English speakers using int...
Nephrolithiasis Associated with Normocalcemic or Hypercalcemic Primary Hyperparathyroidism: An Update on Medical Management
Primary hyperparathyroidism (PHPT) is a disease involving a broad range of alterations of calcium homeostasis, sustained by parathyroid hormone (PTH) levels that are clearly abnormal. The anomalies directly associated wi...
Potential Impact of Dialysate Magnesium on Intradialytic Hypotension
Numerous beneficial effects on cardiovascular health have been described for magnesium (Mg). Intradialytic hypotension (IDH) is a common complication in hemodialysis patients which contributes to cardiovascular mortality...
Does Acute Kidney Injury Alter Energy Metabolism of Septic Patients?
Background: The determination of resting energy expenditure (REE) in critically ill patients is essential to prevent hypo and hyper alimentation. Objectives: This study aims to describe the REE in septic patients with a...
Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposition: Report of Two Cases and Review of Literature
Here we report two cases of proliferative glomerulonephritis with monoclonal IgG deposits, a form of renal involvement by monoclonal gammopathy that mimics immune complex glomerulonephritis. Case 1 presented with inciden...