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Related Experiment Video

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Effects of Transcranial Alternating Current Stimulation on the Primary Motor Cortex by Online Combined Approach with Transcranial Magnetic Stimulation
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Current opinions on nephrolithiasis associated with primary hyperparathyroidism.

Xiaoming Cong1, Luming Shen1, Xiaojian Gu2

  • 1Department of Urology, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.

Urolithiasis
|January 20, 2018
PubMed
Summary

Nephrolithiasis (kidney stones) is linked to primary hyperparathyroidism (PHPT). Even normocalcemic PHPT, a newly recognized form, is associated with kidney stones, requiring parathyroidectomy or medical management.

Keywords:
DiagnosisHypercalcaemiaManagementNephrolithiasisNormocalcemiaPathophysiologyPrimary hyperparathyroidism

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Area of Science:

  • Urology
  • Endocrinology
  • Nephrology

Background:

  • Nephrolithiasis is a common urological condition often secondary to primary hyperparathyroidism (PHPT).
  • PHPT traditionally presents with hypercalcemia, but normocalcemic PHPT is a recognized phenotype.
  • The relationship between normocalcemic PHPT and nephrolithiasis is understudied, despite frequent stone occurrence in patients with low bone mass.

Purpose of the Study:

  • To clarify the precise relationships between hypercalcemic PHPT and nephrolithiasis.
  • To investigate the association between normocalcemic PHPT and nephrolithiasis.
  • To understand the implications of PHPT on stone formation and recurrence.

Main Methods:

  • Review of existing literature on PHPT and nephrolithiasis.
  • Analysis of studies evaluating low bone mass in relation to normocalcemic PHPT.
  • Comparison of stone recurrence rates in hypercalcemic PHPT patients post-parathyroidectomy with healthy controls.

Main Results:

  • Hypercalciuria in PHPT is a risk factor for stone formation.
  • In hypercalcemic PHPT, parathyroidectomy reduces but does not eliminate renal calcium excretion and stone recurrence.
  • Normocalcemic PHPT is increasingly recognized as a factor in nephrolithiasis, necessitating consideration in etiological evaluations.

Conclusions:

  • The presence of kidney stones indicates a need for parathyroidectomy in both hypercalcemic and normocalcemic PHPT patients, barring contraindications.
  • Patients with contraindications or those declining surgery require monitoring and medical management.
  • Post-parathyroidectomy, patients with nephrolithiasis associated with PHPT should pursue preventative strategies due to persistently higher stone frequencies than in healthy individuals.