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Risk factors for renal stone development in adults with primary hyperparathyroidism: a protocol for a systematic
Mohammad Jay1, Sorina Andrei2, Peter Hoang3
1Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada mohammad.jay@mail.utoronto.ca.
BMJ Open
|February 27, 2026
Summary
This study investigates risk factors for renal stones in primary hyperparathyroidism (PHPT). Identifying these factors is crucial for managing PHPT complications and improving patient outcomes.
Area of Science:
- Endocrinology
- Nephrology
- Medical Research Methodology
Background:
- Primary hyperparathyroidism (PHPT) involves parathyroid gland overactivity and calcium imbalance.
- Renal stones (RS) are a known complication of PHPT, causing significant morbidity.
- Risk factors for RS in PHPT are not well-established, highlighting a research gap.
Purpose of the Study:
- To systematically review and meta-analyze evidence on risk factors for renal stones in adults with primary hyperparathyroidism.
- To address the research priority identified in international guidelines regarding renal stone risk in PHPT.
Main Methods:
- A systematic review and meta-analysis protocol aligned with PRISMA standards.
- Searches of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials.
- Inclusion of prospective/retrospective cohort, case-control, and cross-sectional studies; exclusion of RCTs, case reports, commentaries, and abstracts.
- Independent data extraction and risk of bias assessment using the Quality in Prognostic Studies tool.
- Pooling of adjusted and unadjusted odds ratios using random-effects models.
- Assessment of heterogeneity with I² statistic and certainty of evidence with GRADE.
Main Results:
- The study protocol outlines the methodology for identifying and analyzing prespecified risk factors.
- Key risk factors to be investigated include age, sex, urinary calcium, serum calcium, serum parathyroid hormone, and serum 25-hydroxyvitamin D.
- The meta-analysis will provide pooled estimates of association and assess the certainty of evidence.
Conclusions:
- This systematic review and meta-analysis will provide a comprehensive summary of evidence on renal stone risk factors in primary hyperparathyroidism.
- The findings are expected to inform clinical practice and guide future research priorities in managing PHPT.
- Dissemination will occur through peer-reviewed publication and conference presentations.
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