Impact of primary aldosteronism on calcium phosphate homeostasis. Results from the SPAIN-ALDO
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...
| Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | article |
| Publication Date: | 2025 |
| Country: | España |
| Institution: | Consejo Superior de Investigaciones Científicas (CSIC) |
| Repository: | Dadun. Depósito Académico Digital de la Universidad de Navarra |
| Language: | English |
| OAI Identifier: | oai:dadun.unav.edu:10171/122168 |
| Online Access: | https://hdl.handle.net/10171/122168 |
| Access Level: | Open access |
| Keyword: | Primary aldosteronism Hyperparathyroidism Aldosterone Parathyroid hormone Calcium |
| Summary: | 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. |
|---|