Hypoparathyroidism secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
Effective measures for the secondary prevention of hypoparathyroidism is monitoring of patients on conventional therapy. Monitoring guidelines on conventional therapy include measurement of serum calcium (corrected for albumin), phosphorus, and creatinine concentrations; 24 hour urinary calcium excretion and creatinine, and other imaging studies and examinations.
Secondary Prevention
- Effective measures for the secondary prevention of hypoparathyroidism is monitoring of patients on conventional therapy. Monitoring guidelines on conventional therapy include:[1][2]
- Serum calcium (corrected for albumin), phosphorus, and creatinine concentrations should be measured weekly to monthly during dose adjustments, and twice annually once a stable regimen has been reached.
- 24 Hour urinary calcium excretion and creatinine should be considered during dose adjustments and should be measured twice annually on a stable regimen to evaluate for renal toxicity.
- Estimated glomerular filtration rate (eGFR) should be monitored yearly or more frequently if the clinical situation is appropriate.
- Other imaging studies and examinations may be done as clinically indicated including:
- Renal imaging may be done to rule out nephrolithiasis/nephrocalcinosis.
- Ophthalmological exam may be done to rule out cataracts.
- Central nervous system imaging may be done to rule out basal ganglia and other sites of calcification.
- Bone mineral density (BMD) by Dual energy X-ray absorptiometry (DXA) may be done to rule out to rule out skeletal abnormalities.
References
- ↑ Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke BL, Thakker RV, Khan AA, Potts JT (2016). "Management of Hypoparathyroidism: Summary Statement and Guidelines". J. Clin. Endocrinol. Metab. 101 (6): 2273–83. doi:10.1210/jc.2015-3907. PMID 26943719.
- ↑ Bilezikian JP, Brandi ML, Cusano NE, Mannstadt M, Rejnmark L, Rizzoli R, Rubin MR, Winer KK, Liberman UA, Potts JT (2016). "Management of Hypoparathyroidism: Present and Future". J. Clin. Endocrinol. Metab. 101 (6): 2313–24. doi:10.1210/jc.2015-3910. PMC 5393596. PMID 26938200.