A thorough evaluation for primary hyperparathyroidism: More than a stone's throw away.

Autor: Green RL; Temple University Lewis Katz School of Medicine, Department of General Surgery, 3401 N. Broad St., Philadelphia, PA, 19140, United States. Electronic address: Rebecca.green@tuhs.temple.edu., Raghavan R; Temple University Lewis Katz School of Medicine, Department of Urology, 3401 N. Broad St., Philadelphia, PA, 19140, United States., Douglass LM; Temple University Lewis Katz School of Medicine, Department of Urology, 3401 N. Broad St., Philadelphia, PA, 19140, United States., Sykes J; Temple University Lewis Katz School of Medicine, 3500 N. Broad St., Philadelphia, PA, 19140, United States., Dunham P; Temple University Lewis Katz School of Medicine, 3500 N. Broad St., Philadelphia, PA, 19140, United States., Gao TP; Temple University Lewis Katz School of Medicine, Department of General Surgery, 3401 N. Broad St., Philadelphia, PA, 19140, United States., Talemal L; Temple University Lewis Katz School of Medicine, 3500 N. Broad St., Philadelphia, PA, 19140, United States., Taylor GA; Temple University Lewis Katz School of Medicine, Department of General Surgery, 3401 N. Broad St., Philadelphia, PA, 19140, United States., Kuo LE; Temple University Lewis Katz School of Medicine, Department of General Surgery, 3401 N. Broad St., Philadelphia, PA, 19140, United States.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Dec; Vol. 238, pp. 115978. Date of Electronic Publication: 2024 Sep 17.
DOI: 10.1016/j.amjsurg.2024.115978
Abstrakt: 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.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships, with respect to employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, research grants or other funding, that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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