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Renal stone disease, elevated iPTH level and normocalcemia.

Nada B Dimkovic1, Abdul Aziz Wallele, Dimitrios G Oreopoulos

  • 1Division of Nephrology, University Health Network and University of Toronto, Ontario, Canada.

International Urology and Nephrology
|January 29, 2003
PubMed
Summary

Nearly 10% of patients with recurrent kidney stones have elevated intact parathyroid hormone (iPTH) with normal calcium levels. This study found no distinct pattern of abnormalities explaining stone formation in these cases.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Biochemistry

Background:

  • Primary hyperparathyroidism is linked to calcium-containing kidney stones.
  • Diagnosis typically involves elevated intact parathyroid hormone (iPTH) and serum calcium.
  • The role of elevated iPTH in normocalcemic patients with renal stones is unclear.

Purpose of the Study:

  • To investigate the characteristics of patients with renal stone disease, elevated iPTH, and normocalcemia.

Main Methods:

  • Retrospective analysis of 414 renal stone patients over a decade.
  • Identified 40 patients (9.6%) with elevated iPTH and normal serum calcium.
  • Clinical and laboratory investigations, correlation, and multiple regression analyses were performed.

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Main Results:

  • Patients had a mean stone disease history of 12 years.
  • Elevated iPTH levels ranged from 3% to 134% above normal, with normal calcium.
  • Additional risk factors like low vitamin D, high urine sodium, and low citrate excretion were noted in some patients.

Conclusions:

  • A significant percentage of renal stone patients exhibit elevated iPTH with normocalcemia.
  • No specific pattern of abnormalities clearly explained stone formation in this cohort.
  • Further research is needed to understand the significance of elevated iPTH in normocalcemic stone formers and consider parathyroidectomy.