Hyperparathyroidism (HPT) is a condition that causes one or more parathyroid glands to produce excess parathyroid hormone (PTH). Increased PTH can disrupt the blood calcium level in the body and lead to kidney failure. To understand the correlation between hyperparathyroidism and chronic kidney disease (CKD), let’s examine how HPT and kidney disease are related.
Parathyroid and Kidney Disease
The parathyroid glands regulate calcium levels in the bloodstream through PTH production. When calcium levels drop, the glands release more PTH, prompting the bones to release additional calcium into the bloodstream, the kidneys to retain calcium, and the intestines to absorb more calcium.
HPT develops when parathyroid glands produce excessive PTH, leading to elevated calcium levels in the blood (hypercalcemia). High calcium levels can result in the formation of kidney stones, which may impair kidney function. Over time, patients may require treatment for hyperparathyroidism and kidney disease.
Kidney Stones, Chronic Renal Failure, and Hyperparathyroidism
Kidney stones are hard deposits of minerals and salts that form in the kidneys. Calcium is one of the most common kidney stones, explaining their link to elevated calcium levels from HPT. They can affect any portion of the urinary tract and cause a wide range of symptoms, including:
- Pain in the side, abdomen, or back
- Cloudy, foul-smelling, pink, red, or brown urine
- Nausea and vomiting
- Frequent urge to urinate
It can be painful for a patient to pass a stone and often requires significant amounts of water and pain medication. Stones that lodge in the urinary tract can become exceedingly difficult to pass, requiring surgery to remove them in some cases. A treatment that breaks down the stone into smaller pieces can make it easier to pass.
A single kidney stone caused by hyperparathyroidism is unlikely to cause kidney failure if it is properly diagnosed and treated. However, a kidney stone that remains in the body increases the risk of chronic kidney disease, which can lead to kidney failure.
Recognizing Symptoms of Hyperparathyroidism
Hyperparathyroidism can manifest with a variety of vague symptoms, making diagnosis challenging. Common hyperparathyroidism symptoms include:
- Joint and bone pain
- Frequent bone fractures
- Fatigue and muscle weakness
- More frequent urination
- Nausea and loss of appetite
The Complex Relationship Between CKD and Hyperparathyroidism
HPT rarely causes kidney disease. Prolonged CKD can also lead to secondary hyperparathyroidism. In this condition, kidney dysfunction impairs the body’s ability to convert vitamin D into its active form, reducing calcium absorption and causing calcium levels to drop. This triggers the parathyroid glands to overproduce PHT in an attempt to restore balance.
Low vitamin D levels and high PHT levels are hallmark features of secondary hyperparathyroidism. Medical evaluation is crucial to distinguish between primary and secondary hyperparathyroidism, as the treatments differ, and determining whether a patient has sufficient vitamin D and calcium, if kidney stones are present, and if HPT has occurred.
Hyperparathyroidism and Chronic Kidney Disease: Diagnosis and Treatment Options
A blood test can analyze vitamin D, creatinine, PTH, and calcium levels. If excess calcium, PTH and creatinine are present, the patient likely has hyperparathyroidism and an ailing kidney.
Additional tests may aid the diagnostic process, including:
- Urine Test: A 24-hour urine collection to evaluate kidney function and calcium excretion.
- Bone Mineral Density Test: An X-ray to measure calcium and other minerals packed into a segment of bone.
- Imaging Tests: To confirm the presence of one or more kidney stones and assess kidney health.
A nephrologist (kidney specialist) should be immediately engaged if there are any signs of kidney malfunction. If HPT is diagnosed, localization studies can detect which parathyroid glands are abnormal for targeted treatment.
The most effective treatment for hyperparathyroidism is a minimally invasive parathyroidectomy (MIP), which offers higher cure rates, a lower risk of complications than other HPT treatments, and minimal scarring. The procedure takes less than 20 minutes, and patients can return to normal activities shortly after. Dr. Babak Larian from the CENTER for Advanced Parathyroid Surgery performs this procedure with high patient satisfaction rates.
Seeking Expert Care for Hyperparathyroidism and Kidney Disease
As a parathyroid surgery expert with many years of industry experience, Dr. Larian educates HPT patients about the benefits of MIP and provides personalized care to help patients avoid future parathyroid-related issues that may contribute to kidney failure. To learn more about MIP or schedule a consultation with Dr. Larian, please get in touch with us today or book your appointment online.
