ALDOSTERONE SECRETION IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM WITHOUT ARTERIAL HYPERTENSION.

BACKGROUND There is a direct bidirectional link between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone-system (RAAS) but few studies evaluated the RAAS in patients with primary hyperparathyroidism (PHPT), mainly biased from concomitant antihypertensive treatment. METHODS We retrospectively evaluated a consecutive series of 130 normotensive PHPT patients comparing aldosterone (ALD) levels and plasma renin activity (PRA) with the demographic, biochemical or clinical features of PHPT. RESULTS No correlation was found between ALD and PRA and the demographic, biochemical and bone densitometry parameters in PHPT patients without hypertension, with the exception of a negative correlation between age and serum PRA. Moreover, there was no significant correlation between PTH and ALD levels even in patients whose PTH level was >100 ng/L (p = 0.088). CONCLUSION In our normotensive PHPT patients, ALD, PRA and ARR were not correlated to PTH and calcium levels. In addition, they were neither related to PHPT clinical presentation, nor to renal function, vitamin D status, bone mass loss or the presence of comorbidities such as diabetes and obesity. Further studies are needed to clarify the complex interplay between PTH and the RAAS in the modern PHPT presentation.