Table 4.
Nephrocalcinosis (4 studies)
| Article Study Design |
Population | Disease Duration/Follow-Up (years) | Supplementation (%) | Methods | Nephrocalcinosis (% of patients) |
Reported Association Data Between Those Renal Outcomes and the Predefined Biochemical-Related Outcomes | Serum Calcium | Urinary Calcium | Serum Phosphate | Urine Phosphate | Calcium-Phosphate Product |
|---|---|---|---|---|---|---|---|---|---|---|---|
|
Arlt et al. 2002 [20] Cross-sectional study |
25 women with postsurgical HypoPT, mean (SD) age, 48.4 (13.6) years 25 sex-, age-, and surgery-matched controls,a mean (SD) age, 49.5 (13.2) years |
Median (range) duration of disease: 3 (0.5–38) | Calcium and oral vitamin D, vitamin D metabolites or analogs, 100% | Renal ultrasound | 0 | Not reported | 2.15 ± 0.21 mmol/L | 5.51 ± 4.17 mmol/24 h | 1.32 ± 0.22 mmol/L | 26.1 ± 8.8 mmol/24 h | Not reported |
|
Outcome Hypocalcemiab: 12% pts (3 pts) |
Outcome Hypercalciuriac: 23% pts (5/22 pts) |
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|
Meola et al. 2018 [21] Prospective study |
90 pts with postsurgical HypoPT Mean (SD) age, females: 50 (14) years; males: 57 (14) years 142 sex- and age-matched healthy normative controls, mean (SD) age, females: 53 (8) years; males: 50 (6) years |
Mean ± SD disease duration: 9 ± 7 |
Calcium, 38.9% Calcitriol, 100% |
Renal ultrasound | 0 | Not reported |
Alb-sCa 8.9 ± 0.5 mg/dL (range 7.5–10.1) |
Male: 359 ± 178 mg/24 h Female: 290 ± 155 mg/24 h |
3.6 ± 0.7 mg/dL (range 2.2–5.9) | Not reported | Normal, <55 mg2/dL2 in all pts |
|
Outcome Hypocalcemiad: 14% pts (13 pts) |
Outcome Hypercalciuriae: Female: 52% pts (33/63 pts) Male: 63% pts (12/19 pts) |
Outcome Hyperphosphatemia: 8% pts (7 pts) |
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|
Hypercalcemiad: 20% pts (18 pts) | |||||||||||
|
Hadker et al. 2014 [19] Patient self reporting in a cross-sectional survey |
374 pts with chronic HypoPT, mean (SD) age, 49.4 (11.6) years |
Mean ± SD duration of disease: 12.6 ± 12.4 |
Calcium, 25% Calcitriol, 44% Ergocalciferol vitamin D2 or cholecalciferol vitamin D3, 20% Combination of calcium/calcitriol, 67% |
Self-report | Pts with severe HypoPT: 22% vs pts with milder HypoPT: 6% (P ≤ 0.05) | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported |
|
Levy et al. 2015 [10] Long-term retrospective follow-up study |
29 pediatric pts with chronic HypoPT, mean (SD) age, 11.1 (5.9) years |
Mean ± SD duration of disease: 9.1 ± 5.5 Mean ± SD duration of follow-up: 7.4 ± 5.0 |
Calcitriol/calcium, 100% Cholecalciferol, 79% |
Renal ultrasound | 38% |
Multivariate analysis: degrees of relative hypercalcemiaf and hyperphosphatemiag most significant predictors for nephrocalcinosis (R2 = 0.47, P < 0.01) Relevant finding stated in the article: Nephrocalcinosis resolved after initial ultrasound (n = 2); remained in early stage I (n = 3), progressed to stage III (n = 6) Pts with non-resolved (n = 9) vs w/o (n = 18) nephrocalcinosis had a greater: degree of hypercalcemiaf (P = 0.005); degree of hypocalcemiah (P = 0.004); duration of hypocalcemia (P = 0.003); degree of hyperphosphatemiag (P = 0.01) |
Total calcium: 8.9 ± 0.8 mg/dL Ionized calcium: 4.6 ± 0.5 mg/dL Total calcium: Pts with nephrocalcinosis: 8.5 ± 1.1 mg/dL Pts w/o nephrocalcinosis: 9.2 ± 0.6 mg/dL |
Average urine calcium/creatinine ratio: 0.27 ± 0.25 mg/mg |
5.9 ± 1.2 mg/dL Pts with nephrocalcinosis: 6.0 ± 1.9 mg/dL Pts w/o nephrocalcinosis: 5.8 ± 0.9 mg/dL |
Not reported | Not reported |
|
Outcome Hypocalcemiai: Percentage of time with total calcium <8.0 mg/dL: Pts with nephrocalcinosis: 29.4 ± 20.4% Pts w/o nephrocalcinosis: 10.5 ± 11.3% |
Outcome Hyperphosphatemiak: Percentage of time with phosphate concentrations above age-adjusted levels: Pts with nephrocalcinosis: 50 ± 36.2% Pts w/o nephrocalcinosis: 29 ± 29.4% |
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|
Outcome Hypercalcemiaj: Percentage of time with total calcium >9.6 mg/dL: Pts with nephrocalcinosis: 22.8 ± 23.8% Pts w/o nephrocalcinosis: 35.3 ± 31.7% |
Alb-sCa, albumin-corrected serum calcium; AUC, area under the curve; HypoPT, hypoparathyroidism; pt, patient; ULN, upper limit of normal
Note: the following superscripted-letter footnotes are based on information contained in the indicated manuscript
aSubtotal thyroidectomy for goiter with intact parathyroid function (n = 23) or parathyroid surgery for hyperparathyroidism (n = 2)
bBelow 2.00 mmol/L
c>ULN 3–8 mmol/day
dESE target ranges used with hypocalcemia being below the recommended ranges and hypercalcemia above
eValues above the ULN (≥300 mg/24 h in males and ≥ 250 mg/24 h in females)
fAUC of total calcium concentrations >9.6 mg/dL
gAUC above age-adjusted phosphate levels
hAUC of total calcium concentrations <8.0 mg/dL
iPercentage of time with total calcium <8.0 mg/dL
jPercentage of time with total calcium >9.6 mg/dL
kPercentage of time with phosphate concentrations above age-adjusted levels