PREVALENCE AND PREDICTORS OF PRIMARY HYPERPARATHYROIDISM AMONGPATIENTS WITH UROLITHIASIS

Urolithiasis may be the only presenting manifestation of primary hyperparathyroidism (PHPT), and early detection of PHPT in such patients may prevent future urolithiasis and other PHPT complications.

To study the prevalence and predictors of PHPT in patients presenting with urolithiasis.

Consecutive patients presenting with urolithiasis were evaluated for clinical and biochemical manifestations of PHPT with serum and urine calcium, serum intact parathyroid hormone and 25 (OH) vitamin D. We then compared the clinical and biochemical characteristics of patients presenting with urolithiasis with (group A) and without (group B) PHPT.

During the 3-year study period, 381 patients with urolithiasis were seen with a mean age of 38.5±13.9yrs. Nineteen of the 381 patients (5%) had histologically proven PHPT (Group A). Four patients in group A (21%) and 8 in group B (2%) had nephrocalcinosis (p<0.0001), multiple stones (n=>3), calcific pancreatitis and neuropsychiatric manifestations were more common in group A (p<0.0001). Presence of multiple or bilateral stones, and recurrent stone episodes predicted PHPT [OR 3.06 (CI: 0.87, 0.7)].

One out of every 20 patients with urolithiasis had PHPT, which is higher than the prevalence of PHPT in general population. Presence of nephrocalcinosis, multiple, bilateral and recurrent stone disease increased the risk of PHPT among stoneformers.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2017 Aug 17 [Epub ahead of print]

S Sharma, A Rastogi, S K Bhadada, P Singh, S Varshney, A Behera, A Bhansali, S K Singh, D S Rao

From: Department of Urology1, Chandigarh-160012, India., Endocrinology2, Chandigarh-160012, India., Surgery3, PGIMER, Chandigarh-160012, India., Bone and Mineral Metabolism Unit, Henry Ford Hospital, Detroit, USA.