INTRODUCTION: The effect of parathyroidectomy on the incidence of recurrent stone formation is uncertain. We aimed to compare the biochemistry and recurrence rate of urolithiasis in patients with primary hyperparathyroidism (pHPT) and stone formation (SF) and non-stone formation (NSF) with idiopathic stone formers (ISF). METHODS: Patients with pHPT and SF (Group 1) were identified from a prospective database. pHPT patients and NSF (Group 2) and ISFs (Group 3) were randomly selected from respective databases to form three equal groups. Preoperative and postoperative biochemical data were analysed and recurrent urolithiasis diagnosed if present on follow-up radiology. Out-of-area patients were asked about recurrence via telephone. RESULTS: From July 2002 to October 2011, 640 patients had parathyroidectomy for pHPT. Of these, 66 (10.3%) had a history of renal colic; one was lost to follow-up. Patient demographics were similar across all three groups. Three months post-parathyroidectomy, Groups 1 and 2 had significantly reduced serum calcium concentrations (p<0.01). Group 1 had lower urinary calcium excretion after parathyroidectomy (p<0.01), but estimated glomerular filtration rate did not change following surgery. During median follow-up of 4.33 years (0.25-9 years) in Groups 1 and 2 and 5.08 years (0.810-8 years) in Group 3, one patient (1.5%) in Group 1 and 16 patients (25%) in Group 3 had recurrent urolithiasis (p<0.01). No Group 2 patients developed stones. CONCLUSION: Curative parathyroidectomy confers a low recurrence rate for urolithiasis, but does not prevent recurrence in all patients. Further research should aim to identify the risk factors for continued SF in these patients.
INTRODUCTION: The effect of parathyroidectomy on the incidence of recurrent stone formation is uncertain. We aimed to compare the biochemistry and recurrence rate of urolithiasis in patients with primary hyperparathyroidism (pHPT) and stone formation (SF) and non-stone formation (NSF) with idiopathic stone formers (ISF). METHODS:Patients with pHPT and SF (Group 1) were identified from a prospective database. pHPT patients and NSF (Group 2) and ISFs (Group 3) were randomly selected from respective databases to form three equal groups. Preoperative and postoperative biochemical data were analysed and recurrent urolithiasis diagnosed if present on follow-up radiology. Out-of-area patients were asked about recurrence via telephone. RESULTS: From July 2002 to October 2011, 640 patients had parathyroidectomy for pHPT. Of these, 66 (10.3%) had a history of renal colic; one was lost to follow-up. Patient demographics were similar across all three groups. Three months post-parathyroidectomy, Groups 1 and 2 had significantly reduced serum calcium concentrations (p<0.01). Group 1 had lower urinary calcium excretion after parathyroidectomy (p<0.01), but estimated glomerular filtration rate did not change following surgery. During median follow-up of 4.33 years (0.25-9 years) in Groups 1 and 2 and 5.08 years (0.810-8 years) in Group 3, one patient (1.5%) in Group 1 and 16 patients (25%) in Group 3 had recurrent urolithiasis (p<0.01). No Group 2 patients developed stones. CONCLUSION: Curative parathyroidectomy confers a low recurrence rate for urolithiasis, but does not prevent recurrence in all patients. Further research should aim to identify the risk factors for continued SF in these patients.
Authors: Aaron D Berger; Wilfred Wu; Brian H Eisner; Matthew R Cooperberg; Quan-Yang Duh; Marshall L Stoller Journal: J Urol Date: 2009-03-17 Impact factor: 7.450
Authors: Yoshiro Suzuki; Andreas Pasch; Olivier Bonny; Markus G Mohaupt; Matthias A Hediger; Felix J Frey Journal: Hum Mol Genet Date: 2008-02-13 Impact factor: 6.150
Authors: Calyani Ganesan; Benjamin Weia; I-Chun Thomas; Shen Song; Kyla Velaer; Carolyn D Seib; Simon Conti; Chris Elliott; Glenn M Chertow; Manjula Kurella Tamura; John T Leppert; Alan C Pao Journal: JAMA Surg Date: 2020-09-01 Impact factor: 16.681
Authors: A A Khan; D A Hanley; R Rizzoli; J Bollerslev; J E M Young; L Rejnmark; R Thakker; P D'Amour; T Paul; S Van Uum; M Zakaria Shrayyef; D Goltzman; S Kaiser; N E Cusano; R Bouillon; L Mosekilde; A W Kung; S D Rao; S K Bhadada; B L Clarke; J Liu; Q Duh; E Michael Lewiecki; F Bandeira; R Eastell; C Marcocci; S J Silverberg; R Udelsman; K Shawn Davison; J T Potts; M L Brandi; J P Bilezikian Journal: Osteoporos Int Date: 2016-09-09 Impact factor: 4.507
Authors: Andreas Selberherr; Marcus Hörmann; Gerhard Prager; Philipp Riss; Christian Scheuba; Bruno Niederle Journal: Langenbecks Arch Surg Date: 2016-10-12 Impact factor: 3.445