{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:09:10Z","timestamp":1783004950932,"version":"3.54.5"},"reference-count":7,"publisher":"The Endocrine Society","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,11,1]]},"abstract":"<jats:p>Context: The recent Third International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism (PHPT) set 60 ml\/min as the precise level of glomerular filtration rate (GFR) below which surgery is recommended because it is considered a threshold of concern in patients with PHPT.<\/jats:p>\n               <jats:p>Objective: The aim of the study was to investigate the relationship between different stages of renal insufficiency and PTH levels in PHPT patients.<\/jats:p>\n               <jats:p>Design: We conducted a cross-sectional study.<\/jats:p>\n               <jats:p>Patients and Methods: We studied 294 consecutive PHPT patients. Biochemical evaluation included total and ionized serum calcium, phosphate, creatinine, immunoreactive intact PTH, and 25-hydroxyvitamin D3 levels in the fasting state. GFR was assessed with the Modification of Diet in Renal Disease Study formula.<\/jats:p>\n               <jats:p>Results: The mean GFR of the whole group of PHPT patients was 92.3 \u00b1 31.6 ml\/min \u00b7 1.73 m2. The patients were divided into four groups according to National Kidney Foundation Disease Outcomes Quality Initiative (K\/DOQI) guidelines: group 1 with normal or increased GRF (&amp;gt;90 ml\/min \u00b7 1.73 m2; n = 153); group 2 with mild decreased GFR (60\u201389 ml\/min \u00b7 1.73 m2; n = 90); group 3 with moderately decreased GFR (30\u201359 ml\/min \u00b7 1.73 m2; n = 45); and group 4 with severely decreased GFR (&amp;lt;30 ml\/min \u00b7 1.73 m2; n = 6). PTH levels were comparable across groups 1\u20133, whereas group 4 showed significantly higher PTH levels (P &amp;lt; 0.0001).<\/jats:p>\n               <jats:p>Conclusion: In our series of PHPT patients, only a severe impairment of GFR was characterized by a further PTH increase. These findings challenge the concept of a PTH elevation below the threshold of 60 ml\/min of GFR.<\/jats:p>\n               <jats:p>In a large series of contemporary PHPT patients, only a severe impairment of glomerular filtration rate (i.e., &amp;lt;30 ml\/min\/1.73 m2) is characterized by a further PTH elevation.<\/jats:p>","DOI":"10.1210\/jc.2009-0587","type":"journal-article","created":{"date-parts":[[2009,10,7]],"date-time":"2009-10-07T03:33:35Z","timestamp":1254886415000},"page":"4458-4461","source":"Crossref","is-referenced-by-count":41,"title":["Glomerular Filtration Rate and Parathyroid Hormone Secretion in Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"94","author":[{"given":"F.","family":"Tassone","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Gianotti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Emmolo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ghio","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Borretta","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071614054437500_R1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1210\/jc.2008-1763","article-title":"Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Third International Workshop.","volume":"94","author":"Bilezikian","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614054437500_R2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.7326\/0003-4819-139-2-200307150-00013","article-title":"National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification.","volume":"139","author":"Levey","year":"2003","journal-title":"Ann Intern Med"},{"key":"2020071614054437500_R3","doi-asserted-by":"crossref","first-page":"5353","DOI":"10.1210\/jc.2002-021370","article-title":"Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century.","volume":"87","author":"Bilezikian","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614054437500_R4","doi-asserted-by":"crossref","first-page":"593","DOI":"10.7326\/0003-4819-114-7-593","volume":"114","journal-title":"Ann Intern Med"},{"key":"2020071614054437500_R5","doi-asserted-by":"crossref","first-page":"247","DOI":"10.7326\/0003-4819-145-4-200608150-00004","article-title":"Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate.","volume":"145","author":"Levey","year":"2006","journal-title":"Ann Intern Med"},{"key":"2020071614054437500_R6","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1210\/jc.2004-1772","article-title":"Vitamin D repletion in patients with primary hyperparathyroidism and coexistent vitamin D insufficiency.","volume":"90","author":"Grey","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614054437500_R7","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.1210\/jc.2006-0070","article-title":"A slight decrease in renal function further impairs bone mineral density in primary hyperparathyroidism.","volume":"91","author":"Gianotti","year":"2006","journal-title":"J Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/94\/11\/4458\/9060108\/jcem4458.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/94\/11\/4458\/9060108\/jcem4458.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T01:23:28Z","timestamp":1594949008000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/94\/11\/4458\/2596858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11,1]]},"references-count":7,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2009,11,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2009-0587","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11,1]]}}}