title: Hypoparathyroidism and pseudohypoparathyroidism: etiology, laboratory features and complications.
abstract: OBJECTIVE
  To identify a clinical profile and laboratory findings of a cohort of hypoparathyroidism patients and determine the prevalence and predictors for renal abnormalities.
  
  
  METHODS
  Data from medical records of five different visits were obtained, focusing on therapeutic doses of calcium and vitamin D, on laboratory tests and renal ultrasonography (USG).
  
  
  RESULTS
  Fifty-five patients were identified, 42 females and 13 males; mean age of 44.5 and average time of the disease of 11.2 years. The most frequent etiology was post-surgical. Levels of serum calcium and creatinine increased between the first and last visits (p < 0.001 and p < 0.05, respectively); and serum levels of phosphate decreased during the same period (p < 0.001). Out of the 55 patients, 40 had USG, and 10 (25%) presented with kidney calcifications. There was no significant difference in the amount of calcium and vitamin D doses among patients with kidney calcifications and others. No correlation between serum and urinary levels of calcium and the presence of calcification was found. Urinary calcium excretion in 24h was significantly higher in patients with kidney calcification (3.3 mg/kg/d) than in those without calcification (1.8 mg/kg/d) (p < 0.05).
  
  
  CONCLUSIONS
  The reduction of hypocalcemia and hyperphosphatemia suggest an effectiveness of the treatment, and the increase in serum creatinine demonstrates an impairment of renal function during follow-up. Kidney calcifications were prevalent in this cohort, and higher urinary calcium excretion, even if still within the normal range, was associated with development of calcification. These findings suggest that lower rates of urinary calcium excretion should be aimed for in the management of hypoparathyroidism.
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Maicon Piana
authors.initials: MP
authors.lastname: Lopes
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Breno S
authors.initials: BS
authors.lastname: Kliemann
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Ileana Borsato
authors.initials: IB
authors.lastname: Bini
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Kulchetscki
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Victor
authors.initials: V
authors.lastname: Borsani
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Larissa
authors.initials: L
authors.lastname: Savi
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.|Departamento de Medicina Interna da Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.
authors.forename: Victoria Z C
authors.initials: VZ
authors.lastname: Borba
authors.affiliation: Serviço de Endocrinologia e Metabologia do Paraná (SEMPR), Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.|Departamento de Medicina Interna da Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil.|Laboratório P. R .O., Divisão de Histomorfometria Óssea, Fundação Pró-Renal, Curitiba, PR, Brasil.
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Moreira
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000175:diagnosis; D002118:Calcium / Q000097:blood / Q000627:therapeutic use / Q000652:urine; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D007674:Kidney Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009397:Nephrocalcinosis / Q000150:complications / Q000000981:diagnostic imaging; D010710:Phosphates / Q000097:blood; D011547:Pseudohypoparathyroidism / Q000097:blood*; D012189:Retrospective Studies; D014463:Ultrasonography; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D010710:Phosphates; D014807:Vitamin D; D003404:Creatinine; D002118:Calcium