Renal surgery can "precipitate" stone disease in mild asymptomatic primary hyperparathyroidism

We report on a patient in whom 3 large renal calculi formed within 12 weeks after pyeloplasty. Subsequently, a parathyroid adenoma was found. This report illustrates the need to evaluate thoroughly a patient with borderline elevation of serum calcium before renal surgery. Current research indicates that primary hyperparathyroidism is more prevalent than thought previously. A majority of patients with primary hyperparathyroidism have mild asymptomatic disease detected solely by routine serum chemistry screening tests.