Kidney stone recurrence in hypercalcemic and normocalcemic primary hyperparathyroidism without parathyroidectomy

Area of Science:

• Nephrology
• Endocrinology
• Urology

Background:

• Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
• Kidney stone formation is a known complication of PHPT.
• Distinguishing between typical PHPT (TPHPT) and normocalcemic PHPT (NPHPT) is crucial for patient management.

Purpose of the Study:

• To compare kidney stone recurrence rates in patients with TPHPT versus NPHPT who did not undergo parathyroidectomy (PTX).
• To identify risk factors for kidney stone recurrence in patients with PHPT.

Main Methods:

• Retrospective analysis of 288 patients undergoing surgical management for kidney stones.
• Patients categorized into TPHPT, NPHPT, and control groups based on serum calcium and parathyroid hormone (PTH) levels.
• Postoperative kidney stone recurrence assessed during follow-up.

Main Results:

• Both TPHPT and NPHPT groups showed significantly higher kidney stone recurrence rates compared to controls (42.7% and 36.5% vs. 19.8%, respectively).
• No significant difference in recurrence rates was observed between the TPHPT and NPHPT groups.
• Cox regression analysis identified NPHPT as an independent risk factor for kidney stone recurrence (HR: 2.31).

Conclusions:

• Patients with TPHPT and NPHPT without PTX have increased kidney stone recurrence.
• Clinicians should be vigilant regarding kidney stone recurrence in NPHPT patients.
• Further research may elucidate specific mechanisms driving recurrence in NPHPT.