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Renal stones common in primary hyperparathyroidism
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Patients with primary hyperparathyroidism commonly develop renal stones and have high urinary calcium levels, study data show.
Elena Castellano, MD, of the division of endocrinology and metabolism at Santa Croce and Carle Hospital in Italy, and colleagues evaluated adults with primary hyperparathyroidism with renal stones (n = 109) and without renal stones (n = 125). Patients who developed stones were further divided into two groups: silent stone formers (n = 16) and symptomatic stone formers (n = 93).
Compared with participants who did not develop stones, those who did were significantly younger, had higher urinary calcium levels, and lower creatinine and higher estimated glomerular filtration rate.
Among participants who developed stones, no difference was found for eGFR for silent or symptomatic stone formers. Compared with symptomatic stone formers, silent stone formers had higher parathyroid hormone and lower 25-hydroxyvitamin D levels and a significantly higher percentage of microcalculi.
“Our study also underlines some distinctive features of patients with silent nephrolithiasis in comparison to overt renal stones,” the researchers wrote. “The most intriguing peculiarity is that most patients of the silent group had microlithiasis, while this was the case in only a minority of patients in the overt group. In addition, silent renal stones were associated with some features of more severe disease. Lower 25-(OH)D levels in silent stone formers raises the hypothesis that vitamin D status can influence the clinical expression of nephrolithiasis in [primary hyperparathyroidism] patients.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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