ABSTRACT
The lifetime prevalence of nephrolithiasis is 15% for men, with a 5-year recurrence rate of 35% to 50% after an initial event. Although it was initially recommended to limit calcium intake in these patients, a number of studies have reported association between lower total dietary calcium intake and increased risk of incident kidney stones, and that increased calcium intake might reduce the risk of incident kidney stones. We report a 35-year-old male who presented recurrent 8-years of nephrolithiasis and urine crystal with calcium intake restriction, and had no recurrence after 5 years of follow-up after intensive calcium and vitamin D supplementation.
ABSTRACT
Metastatic vascular calcification and calcinosis universalis, as severe complications of parathyroid hyperfunction and hyperparathyroidism, have attracted more attention in patients with renal secondary hyperparathyroidism and primary hyperparathyroidism. But, they are of little concern in patients with long-term negative calcium balance related parathyroid hyperfunction or hyperparathyroidism caused by calcium and/or vitamin D insufficiency (CVI). CVI is common in the population. Relatively low level of serum calcium and negative calcium balance caused by long-term CVI result in parathyroid hyperfunction or hyperparathyroidism, which may cause secretion of PTH beyond the physiological level, leading to bone absorption and release of a large amount of bone calcium into the blood. It may not only cause bone loss and osteoporosis, but also form metastatic vascular calcification or calcinosis universalis presented by cardiovascular diseases and other multi-organ lesions. Early calcium deposition can gradually fade after reasonable treatment, but middle arterial calcification is not easy to fade once it occurs. Therefore, vascular calcification and calcium deposition should be actively prevented and early screened and diagnosed. The early prevention, diagnosis and treatment of parathyroid hyperfunction or hyperparathyroidism can prevent, delay, or even reverse the occurrence and development of metastatic vascular calcification and calcinosis universalis, which is significant for disease prevention and protecting the patients' health influenced by these diseases.
ABSTRACT
Differentiated thyroid cancer is one of the most common endocrine malignant tumors, and thyroidectomy is its basic treatment measures. Insufficient attention is paid to its postoperative bone hungry syndrome and parathyroid hyperfunction or hyperparathyroidism, which will seriously affect the patient’s life quality and prognosis. This paper will explore the etiology, dangers, diagnosis, prevention, and treatment for hungry bone syndrome, parathyroid hyperfunction and hyperparathyroidism of thyroid cancer patients after thyroidectomy.
ABSTRACT
Osteoporosis (OP) is a common systemic bone disease which has become a serious public health problem in China. In clinical practice, we found that some primary osteoporosis may be due to parathyroid hyperfunction (subclinical hyperparathyroidism) or hyperparathyroidism which is the result of negative calcium balance and hypocalcemia caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, which is preventable and controllable. Therefore, we call this kind of osteoporosis parathyroid hyperfunction or hyperparathyroidism associated osteoporosis. The daily calcium intake of Chinese people is generally insufficient, and vitamin D deficiency/insufficiency is also a worldwide public health problem. Parathyroid hyperfunction or hyperparathyroidism associated osteopenia and osteoporosis which are results of hypocalcemia and negative calcium balance caused by long-term insufficient calcium intake and/or vitamin D deficiency/insufficiency exist extensively in clinical practice. Its prevention and treatment can effectively prevent and treat osteopenia and osteoporosis, so as to effectively prevent and treat diseases such as short stature, rachiokyphosis, backache, fatigue, bone pain, fracture, metastatic vascular calcification and systemic calcinosis, improve people’s health and help achieve the goal of "Healthy China 2030" .
ABSTRACT
Hyperparathyroidism is a common endocrine disease that seriously affects human health, depending on its etiology, which can be divided into three types: primary, secondary and tertiary. In clinical practice, we found that some primary hyperparathyroidism may be secondary or tertiary hyperparathyroidism caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, and become a common type of hyperparathyroidism. The daily calcium intake of Chinese people is generally insufficient. Vitamin D can promote the absorption of calcium, but vitamin D deficiency/insufficiency is also a worldwide public health problem. Long-term hypocalcemia will stimulate parathyroid hyperplasia and secrete excessive parathyroid hormone, resulting in parathyroid hyperfunction (pre-hyperparathyroidism) and then secondary hyperparathyroidism, both of which may damage bone and release calcium into blood, leading to diseases of multiple organs and tissues. The detection of bone metabolism indexes such as calcium, magnesium, phosphorus, parathyroid hormone and vitamin D may be helpful for the early diagnosis of pre-hyperparathyroidism and hyperparathyroidism. Supplementation of calcium and vitamin D in early stage can control the development of the disease and change "unpreventable and uncontrollable" into "preventable and controllable" . The health screening of bone metabolism indexes and parathyroid ultrasonography should be advocated, and the prevention and treatment of calcium and/or vitamin D insufficiency associated parathyroid hyperfunction and hyperparathyroidism should be strengthened, so as to greatly improve the bone health, urinary calculus, metastatic vascular calcification and systemic abnormal calcium migration and precipitation in the population.