Screening for asymptomatic nephrolithiasis in primary hyperparathyroidism patients is warranted

Area of Science:

• Endocrinology
• Nephrology
• Urology

Background:

• Primary hyperparathyroidism (PHPT) is associated with various complications.
• Nephrolithiasis is a known complication of PHPT, but its prevalence and management require further investigation.

Purpose of the Study:

• To investigate the prevalence, characteristics, and management of nephrolithiasis in patients with PHPT.
• To identify risk factors for stone formation and the need for urological intervention in PHPT patients.

Main Methods:

• Retrospective review of medical records for 413 PHPT patients who underwent parathyroidectomy.
• Analysis of demographic data, laboratory results, imaging, and urologic consultations.
• Descriptive statistics and logistic regression were used for data analysis.

Main Results:

• 41.9% of PHPT patients had renal stones; 48.6% required urological interventions.
• Independent risk factors for stone formation included male sex, elevated serum ionized calcium (iCa), and elevated 24-hour urinary calcium.
• Male sex, younger age, and lower serum 25-hydroxyvitamin D (25(OH)D) were associated with higher odds of requiring intervention.

Conclusions:

• A significant prevalence of asymptomatic renal calcifications exists in PHPT patients.
• A substantial proportion of these patients necessitate urological intervention.
• Screening and treatment of renal stones should be integrated into PHPT patient management.