Renal function and hypertension in primary hyperparathyroidism

Abstract

Fifteen patients with histologically proven primary hyperparathyroidism have been investigated with special reference to renal function and the occurrence of hypertension. The patients have been followed up clinically, biochemically, and radiographically for a period of 8 months to 5 years after surgery. In all cases the serum-calcium levels returned to normal immediately after parathyroid adenectomy. Satisfactory renal function was maintained in all but I of the cases who had had normal preoperative renal function tests. However, renal damage once established persisted and even progressed after parathyroid adenectomy. Renal function, therefore, did not improve after operation. At follow-up examination a decrease in the number of renal calculi was found in only 2 cases. None of the patients showed formation of new renal calculi or increase in size of those present preoperatively. Hypertension was present in 6 patients preoperatively. Six months after operation 2 more patients became hypertensive. Both of these patients had shown evidence of renal damage preoperatively. In another case the patient became normotensive 3 months after operation. The severity of renal functional impairment did not bear any relationship to the degree of hypertension although it is possible that the hypertension is secondary to the renal lesion.