Journal Article

Impact of primary aldosteronism on calcium phosphate homeostasis. Results from the SPAIN-ALDO

Vicente, Almudena, Caja, Laura, Michalopoulou, Theodora, Perdomo, Carolina M., Ruiz-Sanchez, Jorge Gabriel, Gonzalvo Diaz, Cesar, Manjón-Miguélez, Laura, Calatayud, María, Rebollo Román, Ángel, García Cano, Ana M, Barahona San Millan, Rebeca, Paja Fano, Miguel, Parra Ramírez, Paola, Iriarte-Durán, María Bernarda, Tenes Rodrigo, Susana, Jaén Aguila, Fernando, Hanzu, Felicia Alexandra, Recio, José María, Lamas, Cristina, González-Boillos, Marga, Sampedro Nuñez, Miguel, Jiménez López, Noemi, Rizo Gellida, Alicia, Serrano, Joaquín, Araujo-Castro, Marta, Díaz Guardiola, Patricia, Gutiérrez-Medina, Sonsoles, Recasens, Mònica, Robles Lázaro, Cristina, Moya Mateo, Eva María, Gómez-Hoyos, Emilia, Picón César, María José, Mena Ribas, Elena, Sanmartín Sánchez, Alicia, Martín Rojas-Marcos, Patricia

2025

Overview

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.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Adult / Aged / Aldosterone / Body mass index / Bone density / Calcium (urinary) / Calcium - blood / Calcium homeostasis / Calcium phosphates / Calcium Phosphates - blood / Calcium Phosphates - metabolism / Cardiac arrhythmia / Cardiovascular disease / Chronic illnesses / Diabetes / Diagnosis / Endocrinology / Female / Fibrillation / Follow-Up Studies / Fractures / Heart failure / Homeostasis / Humans / Hyperaldosteronism - blood / Hyperaldosteronism - complications / Hyperaldosteronism - epidemiology / Hyperaldosteronism - metabolism / Hyperparathyroidism / Hyperparathyroidism - epidemiology / Hyperparathyroidism - etiology / Hypokalemia / Internal Medicine / Ischemia / Kidney diseases / Male / Medicine / Medicine & Public Health / Metabolic Diseases / Metabolism / Middle Aged / Original Article / Osteoporosis / Parathyroid hormone / Patients / Population / Prevalence / Prognosis / Registries / Retrospective Studies / Spain - epidemiology / Vitamin D / Vitamin deficiency