Kidney stone recurrence in hypercalcemic and normocalcemic primary hyperparathyroidism without parathyroidectomy

This study aimed to compare the differences in kidney stone recurrence between typical primary hyperparathyroidism (TPHPT) and normocalcemic primary hyperparathyroidism (NPHPT) patients who did not receive parathyroidectomy (PTX) treatment.

We conducted a retrospective analysis of patients hospitalized for surgical management of kidney stones between September 2015 and March 2023. Patients' demographic data, blood test parameters, stone parameters, and surgical interventions were collected. Based on serum calcium and parathyroid hormone (PTH) levels, patients were categorized into TPHPT, NPHPT, and control groups. Postoperative stone recurrence was assessed during follow-up.

A total of 288 patients (139 males and 149 females) were analyzed, with 96 patients in each group. PTH and serum calcium levels were significantly higher in the TPHPT group than in both NPHPT and control groups (P < 0.001). The recurrence probability of kidney stones after surgery was higher in patients with both TPHPT and NPHPT than in the control group (42.7 vs 19.8% and 36.5 vs 19.8%, P < 0.05, respectively). However, no significant difference was found between TPHPT and NPHPT groups (P > 0.05). After adjusting for covariates, the Cox regression analysis revealed that NPHPT was a risk factor for kidney stone recurrence (HR: 2.31, 95% CI: 1.26-4.26, P = 0.007).

Patients with TPHPT and NPHPT who have not undergone PTX treatment both exhibit a higher recurrence rate of kidney stones, with no significant difference between the two groups. Nevertheless, clinicians should place more emphasis on the recurrence of kidney stones in patients with NPHPT.