Five-year Estimated Glomerular Filtration Rate in Patients With Hypoparathyroidism Treated With and Without rhPTH(1-84)

J Clin Endocrinol Metab. 2020 Oct 1;105(10):e3557-e3565. doi: 10.1210/clinem/dgaa490.


Context: Chronic hypoparathyroidism (HypoPT) is conventionally managed with oral calcium and active vitamin D. Recombinant human parathyroid hormone (1-84) (rhPTH[1-84]) is a therapy targeting the pathophysiology of HypoPT by replacing parathyroid hormone.

Objective: To compare changes in the estimated glomerular filtration rate (eGFR) in patients with chronic HypoPT receiving or not receiving rhPTH(1-84) during a 5-year period.

Design/setting: A retrospective analysis of patients with chronic HypoPT treated with or without rhPTH(1-84).

Patients: Sixty-nine patients with chronic HypoPT from 4 open-label, long-term trials (NCT00732615, NCT01268098, NCT01297309, and NCT02910466) composed the rhPTH(1-84) cohort and 53 patients with chronic HypoPT not receiving rhPTH(1-84) from the Geisinger Healthcare Database (01/2004-06/2016) composed the historical control cohort.

Interventions: The rhPTH(1-84) cohort (N = 69) received rhPTH(1-84) therapy; the historical control cohort (N = 53) did not receive rhPTH(1-84).

Main outcome measures: Changes in eGFR from baseline during a 5-year follow-up were examined in multivariate regression analyses.

Results: At baseline, demographic characteristics and eGFR were similar between cohorts, though the proportions with diabetes and cardiac disorders were lower in the rhPTH(1-84) cohort. At the end of follow-up, mean eGFR increased by 2.8 mL/min/1.73 m2 in the rhPTH(1-84) cohort, while mean eGFR fell by 8.0 mL/min/1.73 m2 in the control cohort. In the adjusted model, the difference in the annual eGFR change between the rhPTH(1-84) cohort and the control cohort was 1.7 mL/min/1.73 m2 per year (P = 0.009).

Conclusions: Estimated glomerular filtration rate was preserved for over 5 years among patients with chronic HypoPT receiving rhPTH(1-84) treatment, contrasting with an eGFR decline among those not receiving rhPTH(1-84).

Keywords: chronic hypoparathyroidism; kidney function; recombinant human parathyroid hormone (1-84); retrospective study.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Calcitriol / administration & dosage
  • Calcium / administration & dosage
  • Chronic Disease / drug therapy
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects*
  • Glomerular Filtration Rate / physiology
  • Humans
  • Hydroxycholecalciferols / administration & dosage
  • Hypoparathyroidism / drug therapy*
  • Hypoparathyroidism / physiopathology
  • Male
  • Middle Aged
  • Parathyroid Hormone / administration & dosage*
  • Randomized Controlled Trials as Topic
  • Recombinant Proteins / administration & dosage
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult


  • Hydroxycholecalciferols
  • PTH protein, human
  • Parathyroid Hormone
  • Recombinant Proteins
  • Calcitriol
  • Calcium
  • alfacalcidol

Associated data