TY - JOUR
T1 - Increased risk of chronic kidney disease after total thyroidectomy
T2 - A nationwide matched cohort study
AU - Reinke, Rasmus
AU - Udholm, Sebastian
AU - Christiansen, Christian Fynbo
AU - Almquist, Martin
AU - Londero, Stefano
AU - Rejnmark, Lars
AU - Rasmussen, Thomas Bøjer
AU - Rolighed, Lars
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]. See the journal About page for additional terms.
PY - 2025/5/1
Y1 - 2025/5/1
N2 - Background: Development of hypoparathyroidism (hypoPT) after total thyroidectomy (TT) may increase the risk of kidney-related morbidity. We aimed to examine the risk of hypoPT and chronic kidney disease (CKD) in patients undergoing TT in Denmark over a 20-year period. Materials and Methods: Using population-based registries, we identified all Danish individuals with TT between January 1998 and December 2017. We included a matched comparison cohort by randomly selecting 10 citizens for each patient by sex and birth year. We calculated the cumulative incidence and hazard ratio (HR) of CKD by Cox regression in patients with TT compared with the comparison cohort. Further, CKD risks were stratified by indications for TT and comorbidity groups according to the Charlson Comorbidity Index. Results: We included 2421 patients with TT; 21.5% had hypoPT. After 10 years, the risk of developing CKD for hypoPT patients was 13.5% [95% confidence interval (CI): 9.8-17.7], 11.6% (95% CI: 9.7-13.7) for patients without hypoPT, and 5.8% (95% CI: 5.3-6.2) for the comparison cohort. When compared with the matched comparison cohort, the adjusted HR for CKD in hypoPT patients was 3.23 (95% CI: 2.37-4.41) and 2.27 (95% CI: 1.87-2.75) for patients without hypoPT. For patients without previous comorbidities, the adjusted HR of CKD was higher than in patients with several comorbidities. Conclusion: HypoPT was a frequent complication after TT and was associated with an increased risk of CKD. We also found an increased risk of CKD in patients with a normal parathyroid function after TT, which needs to be further evaluated.
AB - Background: Development of hypoparathyroidism (hypoPT) after total thyroidectomy (TT) may increase the risk of kidney-related morbidity. We aimed to examine the risk of hypoPT and chronic kidney disease (CKD) in patients undergoing TT in Denmark over a 20-year period. Materials and Methods: Using population-based registries, we identified all Danish individuals with TT between January 1998 and December 2017. We included a matched comparison cohort by randomly selecting 10 citizens for each patient by sex and birth year. We calculated the cumulative incidence and hazard ratio (HR) of CKD by Cox regression in patients with TT compared with the comparison cohort. Further, CKD risks were stratified by indications for TT and comorbidity groups according to the Charlson Comorbidity Index. Results: We included 2421 patients with TT; 21.5% had hypoPT. After 10 years, the risk of developing CKD for hypoPT patients was 13.5% [95% confidence interval (CI): 9.8-17.7], 11.6% (95% CI: 9.7-13.7) for patients without hypoPT, and 5.8% (95% CI: 5.3-6.2) for the comparison cohort. When compared with the matched comparison cohort, the adjusted HR for CKD in hypoPT patients was 3.23 (95% CI: 2.37-4.41) and 2.27 (95% CI: 1.87-2.75) for patients without hypoPT. For patients without previous comorbidities, the adjusted HR of CKD was higher than in patients with several comorbidities. Conclusion: HypoPT was a frequent complication after TT and was associated with an increased risk of CKD. We also found an increased risk of CKD in patients with a normal parathyroid function after TT, which needs to be further evaluated.
KW - Charlson Comorbidity Index
KW - chronic kidney disease
KW - hypoparathyroidism
KW - thyrotoxicosis
KW - total thyroidectomy
UR - http://www.scopus.com/inward/record.url?scp=105003775722&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgae534
DO - 10.1210/clinem/dgae534
M3 - Journal article
C2 - 39126399
SN - 0021-972X
VL - 110
SP - e1466-e1472
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
IS - 5
ER -