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Nephrolithiasis and renal calcifications in primary hyperparathyroidism.
Lars Rejnmark1, Peter Vestergaard, Leif Mosekilde
1Department of Endocrinology and Internal Medicine, Tage-Hansens Gade, Aarhus University Hospital, DK-8000 Aarhus C, Denmark. rejnmark@post6.tele.dk
The Journal of Clinical Endocrinology and Metabolism
|June 8, 2011
Summary
Primary hyperparathyroidism (PHPT) increases the risk of kidney stones and calcifications. Early evaluation and parathyroidectomy are recommended for PHPT patients with renal complications.
Area of Science:
- Nephrology
- Endocrinology
- Mineral Metabolism
Background:
- Primary hyperparathyroidism (PHPT) is associated with significant renal complications, including hypercalciuria, nephrolithiasis, and nephrocalcinosis.
- These renal issues can lead to impaired kidney function in PHPT patients.
Purpose of the Study:
- To review the occurrence, pathophysiology, and consequences of renal complications in PHPT.
- To identify areas requiring further research regarding renal involvement in PHPT.
Main Methods:
- Systematic review of published evidence on renal complications in PHPT.
- Analysis of the prevalence, risk factors, and outcomes of renal issues in PHPT patients.
Main Results:
- Asymptomatic PHPT patients have a higher prevalence of kidney stones (7%) compared to the general population (1.6%).
- PHPT increases hospital admission risk for kidney stones, persisting even 10 years post-parathyroidectomy.
- Parathyroidectomy reduces recurrent stone episodes, but some PHPT patients exhibit persistent mineral disorders.
Conclusions:
- Initial evaluation for renal calcifications using unenhanced helical computed tomography is recommended for all PHPT patients.
- Parathyroidectomy is advised for PHPT patients with existing renal calcifications.
- Post-parathyroidectomy symptomatic patients should be managed similarly to those with idiopathic kidney stones.
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