A thorough evaluation for primary hyperparathyroidism: More than a stone's throw away - 21/11/24
, Rajiv Raghavan b, Laura M. Douglass b, Jennifer Sykes c, Patricia Dunham c, Terry P. Gao a, Lindsay Talemal c, George A. Taylor a, Lindsay E. Kuo aAbstract |
Background |
Primary hyperparathyroidism (PHPT) is a treatable cause of nephrolithiasis. However, PHPT is not consistently evaluated in nephrolithiasis patients. Symptoms of parathyroid disease were explored in relation to evaluation of PHPT in nephrolithiasis patients.
Methods |
Patients with nephrolithiasis on imaging between 2017 and 2021 were identified. Measurement of serum calcium levels after nephrolithiasis diagnosis was determined. Patients with hypercalcemia (
10.2 mg/dL) were identified. Characteristics associated with parathyroid hormone (PTH) evaluation and specialist referral were assessed.
Results |
Of 2264 nephrolithiasis patients with calcium levels measured, 383 (17.1 %) had hypercalcemia. Of those, 107 (27.9 %) had PTH levels drawn. PTH was more often assessed in patients with higher median calcium levels, recurrent nephrolithiasis, depression, and osteopenia/osteoporosis. PTH was elevated (>64 pg/mL) or non-suppressed (40–64 pg/mL) in 68 (63.6 %) patients. Of those, 31 (45.6 %) were referred to a parathyroid specialist. Referred patients had higher PTH and calcium levels than those without referral, and higher rates of osteopenia/osteoporosis.
Conclusions |
PTH evaluation in hypercalcemic nephrolithiasis patients was low. The majority of patients evaluated had elevated or non-suppressed PTH levels, but only a fraction were referred to a specialist.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | PTH is infrequently assessed in hypercalcemic nephrolithiasis patients. |
• | More often assessed if higher serum calcium, recurrent nephrolithiasis, and multiple symptoms of hyperparathyroidism. |
• | The majority of hypercalcemic nephrolithiasis patients have elevated PTH levels. |
• | Patients are seldom referred to a parathyroid specialist for definitive management. |
Keywords : Primary hyperparathyroidism, Hypercalcemia, Kidney stones
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Vol 238
Articolo 115978- dicembre 2024 Ritorno al numero
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