Abstract: TH-PO1070
Effect of Parathyroidectomy on Albuminuria: Presurgical and Postsurgical Analysis
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Ramos, Everly, Mass General Brigham Inc, Boston, Massachusetts, United States
- Wulczyn, Kendra E., Massachusetts General Hospital, Boston, Massachusetts, United States
- Simic, Petra, Massachusetts General Hospital, Boston, Massachusetts, United States
- Rhee, Eugene P., Massachusetts General Hospital, Boston, Massachusetts, United States
- Wen, Donghai, Massachusetts General Hospital, Boston, Massachusetts, United States
Background
Hyperparathyroidism is associated with chronic kidney disease (CKD), and albuminuria is a risk factor for CKD progression. The PTH receptor is known to be expressed on podocytes, in addition to the tubular epithelium, but its functional role in the glomerulus is unclear. Parathyroidectomy is the definitive treatment for primary hyperparathyroidism and a treatment option in secondary and tertiary hyperparathyroidism. Studies examining the impact of parathyroidectomy on eGFR decline have conflicting results, but albuminuria remains unexplored as a marker of CKD progression in relation to hyperparathyroidism.
Methods
This retrospective cohort study included adults (≥18 years) with albuminuria identified via Mass General Brigham electronic medical record who underwent parathyroidectomy (1996-2024). Patients with end-stage kidney disease, subsequent kidney transplant, missing pre- or post-surgery urine albumin-creatinine ratio (UACR) were excluded. The primary outcome was UACR change from baseline to six months post-surgery, analyzed using Wilcoxon signed-rank test, paired t-test and linear mixed-effects models.
Results
The cohort included 148 patients (mean age 66±10 years; 68% female; 13% African American; 10% Hispanic). Pre-surgery, mean PTH was 141±169 pg/mL, median UACR was 59.4 mg/g (IQR 27.1–182.9), median eGFR was 62.4 mL/min/1.73 m2 (IQR 42.9–82.6). After parathyroidectomy, the median UACR percentage reduction was 34.3% (IQR -66.8% to +22.4%). Adjusted analysis showed that post-surgery, UACR is reduced by ~50% compared to levels pre-surgery (coefficient:-0.69; 95% CI -0.75 to -0.64)(Table 1).
Conclusion
Parathyroidectomy is associated with a reduction in albuminuria six months post-surgery. Further studies comparing albuminuria in untreated, medically, or surgically treated hyperparathyroidism patients, and research on glomerular PTH receptor function, are needed.