Abstract
BackgroundPrimary hyperparathyroidism (PHPT) is a common endocrinopathy that may increase fracture risk and decrease bone mineral density (BMD). Some patients develop distal renal tubular acidification dysfunction under conditions of hyperchloraemia or hyperchloraemic acidosis. To examine whether this dysfunction influences the clinical outcome, we explored the distal renal tubular acidification function in patients with PHPT and its effects on the clinical manifestations of the disease.MethodsWe retrospectively analysed 75 PHPT patients with regard to renal tubular acidification and blood gas analysis. The patients were divided into two groups, the renal tubular acidification dysfunction group and normal function group.ResultsSerum phosphate level and total hip bone density were significantly decreased and 25OHD level was significantly increased in the renal tubular acidification dysfunction group in comparison to the normal function group. Female patients in the renal tubular acidification dysfunction group showed significantly decreased femoral neck and total hip BMD and increased susceptibility to fracture. However, there were no such differences in male patients between the two groups.ConclusionsAbout 54.6 % of PHPT patients in our study population had abnormal distal renal tubular acidification. PHPT patients with abnormal distal renal tubular acidification may have lower hip bone density. Female PHPT patients with abnormal distal renal tubular acidification showed increased susceptibility to fractures and the development of osteoporosis.
Highlights
Primary hyperparathyroidism (PHPT) is a common endocrinopathy that may increase fracture risk and decrease bone mineral density (BMD)
Urine PH was significantly increased, urine ammonium ion and titratable acid were significantly decreased in renal tubular acidification dysfunction group (P < 0.01)
Serum phosphate was significantly decreased and 25 hydroxyvitamin D (25OHD) was significantly increased in the renal tubular acidification dysfunction group compared with the normal function group (P < 0.05)
Summary
Primary hyperparathyroidism (PHPT) is a common endocrinopathy that may increase fracture risk and decrease bone mineral density (BMD). Some patients develop distal renal tubular acidification dysfunction under conditions of hyperchloraemia or hyperchloraemic acidosis. To examine whether this dysfunction influences the clinical outcome, we explored the distal renal tubular acidification function in patients with PHPT and its effects on the clinical manifestations of the disease. Chronic acid retention may decrease bone mineral density (BMD). Studies [1, 2] showed that dysfunction of distal renal tubular acidosis may cause bone loss. Patients with abnormal distal renal tubular acidification may not manifest in significant systemic acidosis, the increased of acid loading may trigger the release of alkali. Tang et al BMC Musculoskeletal Disorders (2021) 22:69 tubular acidification function in PHPT patients and to examine its potential impact on bone and whether it affects the clinical presentation
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