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Long-term complications of permanent hypoparathyroidism in adults: prevalence and associated factors

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Abstract

Introduction

Patients with Chronic hypoparathyroidism (CHPT) receiving conventional treatment are exposed to several long-term complications including basal ganglia calcifications, posterior subcapsular cataract, kidney stones, and renal insufficiency. The aim of this study was to assess the prevalence and the associated factors of these complications in patients with CHPT.

Methods

We conducted a cross-sectional study including 58 patients with CHPT. All participants underwent physical examination, biochemical assessment (total serum calcium, serum phosphorus, serum albumin, intact-PTH, serum magnesium, 25-hydroxy-vitamin D, serum creatinine, thyroid stimulating hormone (TSH), and 24-hour urinary calcium), slit lamp examination, brain computed tomography scan (CT-scan), and renal ultrasound.

Results

Participants had a mean age of 52.6 ± 16.4 years and a gender ratio (women/men) of 3.5. Fahr syndrome, cataract, urolithiasis, and renal failure were found in 55%, 62%, 12%, and 17% of cases, respectively. CHPT duration >15 years (Adjusted-OR = 43.1, 95-CI: 2.63–703.06, p = 0.008) and poor adherence to treatment (Adjusted-OR = 8.04, 95%-CI: 1.52–42.42, p = 0.014) were independently associated with the risk of Fahr syndrome. Age >55 years (adjusted-OR = 5.07, 95-CI: 1.10–23.42, p = 0.037), disease duration >15 years (adjusted-OR = 20.21, 95-CI: 1.54–265.84, p = 0.022), and magnesium level <0.8 mmol/l (adjusted-OR = 36.46, 95-CI: 3.75–354.08, p = 0.002) were independently associated with the risk of subcapsular cataract. Only hypercalciuria (Adjusted-OR = 21.27, 95-CI: 2.31–195.91, p = 0.007) was an independent risk factor for kidney stones. Renal failure was not associated with kidney stones (p = 1). However, creatinine clearance was negatively correlated with age (r = −0.784; p < 10−3) and disease duration (r = −0.352; p = 0.007).

Conclusion

Our results revealed high prevalences of neurological, ocular, and renal complications in patients with CHPT and emphasized the importance of regular biological monitoring, therapeutic adjustments, screening, and adherence to treatment in the prevention of these complications.

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Authors and Affiliations

  1. Department of Endocrinology, La Rabta university hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia

    Faten Cherchir, Ibtissem Oueslati, Meriem Yazidi, Fatma Chaker & Melika Chihaoui

  2. Department of Radiology, La Rabta university hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia

    Habiba Mizouni

  3. Laboratory of Biochemistry, La Rabta university hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia

    Moncef Feki

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  1. Faten Cherchir
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Correspondence to Ibtissem Oueslati.

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This study was approved by the ethics committee of La Rabta university hospital (CEBM.EPS.HR/06/2020). All enrolled patients provided written informed consent before starting the study.

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Cherchir, F., Oueslati, I., Yazidi, M. et al. Long-term complications of permanent hypoparathyroidism in adults: prevalence and associated factors. Endocrine (2024). https://doi.org/10.1007/s12020-024-03765-9

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