Stones More Common in Hyperparathyroid Patients

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Patients with surgically proven primary hyperparathyroidism have a fourfold increased prevalence of asymptomatic renal stone disease compared with patients not affected by hyperparathyroidism, researchers found.

Jane M. Suh, MD, of The Warren Alpert Medical School of Brown University and Rhode Island Hospital in Providence, and colleagues reviewed the renal sonograms of 271 patients with surgically proven primary hyperparathyroidism. All had undergone imaging within six months prior to parathyroid surgery.

The researchers compared these patients with 500 age-matched controls who had right upper-quadrant sonograms obtained for various reasons. Of the 271 patients with hyperparathyroidism, 19 (7%) had renal stones compared with only eight controls (1.6%), a significant difference in prevalence, the investigators reported in the American Journal of Roentgenology (2008;191:908-911).

The authors said that an NIH consensus conference on asymptomatic primary hyperparathyroidism recommended that patients with renal stone disease have parathyroid surgery even if they have minimal or no elevation of total serum calcium value and no other metabolic manifestations of hyperparathyroidism.

“Nephrocalcinosis or nephrolithiasis, therefore, is a significant finding in evaluating patients for parathyroid surgery,” Dr. Suh's team wrote.

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