Renal calculi in primary hyperaldosteronism

Increased urinary calcium (Ca++) excretion and the presence of negative Ca++ balance is well documented in primary hyperaldosteronism. However, renal calculi as a major manifestation of this disorder is not previously described. This report describes probably the first patient who presented with renal calculi in association with primary hyperaldosteronism. We believe that primary hyperaldosteronism was a major pathogenetic factor in formation of renal calculi since increased urinary excretion of Ca++ and uric acid noted at the onset declined following short-term spironolactone administration and remission from renal calculi has persisted following initial nephrolithotomy and continued spironolactone therapy which also corrected hypertension and hyperkalemia, a hallmark of this disorder.