Primary hyperparathyroidism and nephrolithiasis

Vestergaard, Peter

doi:10.1016/j.ando.2015.03.002

Cited by 25 publications

(12 citation statements)

References 12 publications

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“…In spite of increased renal reabsorption of calcium, hypercalciuria is produced from the excess calcium load. Thus, one may find hypercalciuria in all patients with untreated HPT, and place all patients at an increased risk of renal calculi (19,20). In the present study, there was a positive correlation between PTH levels and urinary calcium level which is in agreement with the previous studies (21).…”

Section: Discussionsupporting

confidence: 83%

Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Venkatesan¹,

Chakkarai²,

Arulvijayavani³

et al. 2017

J Renal Inj Prev

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Implication for health policy/practice/research/medical education:As urolithiasis patients are at a constant inflammatory insult caused by the calculi, the levels of inflammatory markers can be used to monitor the success of treatment. Vitamin D and anti-inflammatory agents may be used in the management of nephrolithiasis patients. Please cite this paper as: Introduction:Hypercalciuria plays an important role in the pathogenesis of renal calculi. The role of vitamin D, parathyroid hormone (PTH), inflammatory markers highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the development of renal calculi has not well defined. Objectives: To assess the serum levels of vitamin D, PTH, hs-CRP and IL-6, urinary and serum calcium and phosphorus levels in patients with renal calculi and to compare these parameters with healthy controls Patients and methods: It was a cross-sectional study. About 41 confirmed renal calculi patients and 41 age and sex matched controls were recruited. Patients with malignancies, hyperparathyroidism, chronic disease, and patients taking vitamin D supplementations were excluded. Serum levels of 25(OH) vitamin D, i-PTH, hs-CRP, IL-6, calcium and phosphorous, 24 hours urine levels of calcium and phosphorus were estimated Results: There was a statistical significant difference in the serum levels of 25(OH) vitamin D (12.26 vs 19.61 ng/mL), i-PTH (75.5 vs. 33.5 pg/mL), hsCRP (5117.05 vs. 1721.87 ng/mL), IL-6 (13.49 vs. 1.47 pg/mL) calcium (11.5 vs. 9.4 mg/dL) and urinary calcium (370.5 vs. 342 mg/d) and phosphorous levels (1172 vs. 1432 mg/d) between the cases and the control. There was negative correlation between the levels of i-PTH and vitamin D (r = -0.765) and positive correlation between i-PTH and hsCRP, IL-6, Serum calcium and urine calcium (r = 0.353, 0.340, 0.522, 0.501 respectively) Conclusion: There was vitamin D inadequacy and increased levels of PTH, IL-6 and C-reactive protein, calcium in patients with renal calculi when compared with healthy controls.

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Section: Discussionsupporting

confidence: 83%

Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Venkatesan¹,

Chakkarai²,

Arulvijayavani³

et al. 2017

J Renal Inj Prev

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“…(5) The patients underwent US-guided thermal ablation for therapy and the study compared preablative and post-ablative clinical results such as PTH, serum calcium and volume of the parathyroid gland (VPG). (6) The study demonstrated the clinical value of thermal ablation for PHPT. 7A follow-up period of at least 3 months was required after ablation.…”

Section: Eligibility Criteriamentioning

confidence: 76%

“…However, the disease has the potential to become symptomatic, resulting in complications that are mainly presented as skeletal, kidney and gastrointestinal involvement [3]. It has been reported that PHPT is responsible for renal, skeletal and cardiovascular damage and increased risk of nephrolithiasis, osteoporosis, bone fractures, hypertension, arrhythmias, ventricular hypertrophy, vascular calcification, and mortality [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis

Huang

et al. 2020

International Journal of Hyperthermia

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Purpose: To summarize the published literature on thermal ablation for primary hyperparathyroidism (PHPT) and to evaluate the effectiveness and safety of thermal ablation as a novel treatment strategy. Materials and methods: Two authors carried out the literature search using four databases independently, including PubMed, Embase, Cochrane, and Web of Science. The meta-analysis included prospective and retrospective data that compared post-ablative outcomes to pre-ablative values. The primary outcomes were parathyroid hormone (PTH), serum calcium and volume of the parathyroid gland (VPG). Results: From the 184 original articles, five studies (4 retrospective studies and 1 prospective study) examining 84 patients met the inclusion criteria. The meta-analysis showed significant reduction of PTH at 3 (standardized mean difference (SMD) ¼ À1.09, 95% confidence index (CI) ¼ À1.42 to À0.76, p < 0.001) and 6 months (SMD ¼ À1.13, 95% CI ¼ À1.46 to À0.80, p < 0.001) after thermal ablation. Serum calcium level was significantly reduced at 3 (mean difference (MD) ¼ À0.31, 95% CI ¼ À0.50 to À0.12, p ¼ 0.001) and 6 months (MD ¼ À0.31, 95% CI ¼ À0.46 to À0.17, p < 0.001) after thermal ablation. There was no significant difference between pre-ablative VPG and that of 6 months after ablation (MD ¼ À0.30, 95% CI ¼ À0.70 to 0.09, p ¼ 0.13). The most common complications were transient dysphonia and subcutaneous edema. No major complications or death occurred. Conclusion: Thermal ablation is effective and safe for treatment of PHPT. PTH and calcium levels were reduced significantly at 3 and 6 months after thermal ablation.

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“…A elevação da concentração plasmática de cálcio, sobretudo grave quando superior a 14mg/dL, pode causar sintomas marcados que incluem poliúria, polidipsia, desidratação, anorexia, fraqueza muscular. [3][4][5] De um modo geral, a generalização das determinações de cálcio sérico leva a que muitos doentes sejam identificados em fases precoces e assintomáticas ou com sintomatologia inespecífica. No entanto, em casos mais graves, esta entidade pode cursar com uma grande diversidade de manifestações clínicas que incluem dores difusas, nefrolitíase ou extensa reabsorção óssea com fraturas (Quadro I).…”

Section: Rev Port Med Geral Fam 2018;34:224-8unclassified

Hiperparatiroidismo primário: caso clínico

Tavares

Nogueira

Costa

et al. 2018

RPMGF

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The diagnosis of primary hyperparathyroidism may occur incidentally in asymptomatic phases or appear late in the context of nonspecific and prolonged complaints. Case report: We describe the case of a 32-year-old female without relevant previous medical history. In February 2012, she suffered an episode of severe renal colic, requiring nephrostomy. Further investigation identified exuberant renal lithiasis, with indication for a preventive double J catheter. In December 2012, the patient had a rupture of the quadriceps tendon due to a fall, and in March 2013, had a new fall due to imbalance with a resulting fracture of the humeral neck. The patient maintained progressive complaints of back pain, bone and joint pain and generalised muscle weakness, and eventually became wheelchairdependent in 2014. The patient was referred to the hospital for severe hypercalcemia and raised parathyroid hormone (PTH 4300 pg/ml). Cervical ultrasound and parathyroid scintigraphy confirmed the clinical suspicion of primary hyperparathyroidism due to a parathyroid adenoma. Left parathyroidectomy was performed in May 2014, complicated with a Hungry-Bone syndrome. Clinical and analytical evolution was favorable. Comment: This clinical case seeks to alert to primary hyperparathyroidism as a differential diagnosis when facing non-specific and prolonged osteoarticular complaints. Due to the prevalence of these complaints in clinical practice and the importance of an early diagnosis, the family physician should be alert to this potential diagnosis.

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Primary hyperparathyroidism and nephrolithiasis

Cited by 25 publications

References 12 publications

Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis

Hiperparatiroidismo primário: caso clínico

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