Nephrolithiasis in primary hyperparathyroidism

Renal stones are common in primary hyperparathyroidism (PHPT), thought to be secondary to hypercalcemia, although correlation between biochemical factors including serum calcium levels and renal stones is inconsistent in studies. Stones in PHPT patients are associated with younger age and male gender. Renal stone risk decreases after parathyroidectomy, but probably remains elevated compared to the general population for up to 10 years. Thus parathyroid hormone (PTH) should be tested in stone formers with hypercalcemia. Among patients diagnosed with PHPT, a history of clinical stone events and/or the presence of radiologic stones is an indication for parathyroidectomy.