Biochemical characterization of primary hyperparathyroidism with and without kidney stones

Clarita V. Odvina; Khashayar Sakhaee; Howard J. Heller; Roy D. Peterson; John R. Poindexter; Paulette K. Padalino; Charles Y C Pak

doi:10.1007/s00240-007-0096-2

Biochemical characterization of primary hyperparathyroidism with and without kidney stones

Clarita V. Odvina, Khashayar Sakhaee, Howard J. Heller, Roy D. Peterson, John R. Poindexter, Paulette K. Padalino, Charles Y C Pak

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48 Scopus citations

Abstract

The exact metabolic-physiological background for kidney stone formation in primary hyperparathyroidism (PHPT) is unclear. To obtain clarification, this retrospective data analysis was conducted in 131 patients with PHPT who had undergone a detailed ambulatory evaluation on a random diet since 1980. The baseline biochemical presentation of 78 patients with PHPT with stones was compared with that of 53 patients without stones. Compared to those without stones, the stone-forming patients had a more marked hypercalciuria (343 ± 148 vs. 273 ± 148 mg/day, P < 0.01). Urinary saturation of calcium oxalate and brushite was significantly higher in stone-formers. Serum PTH and fasting urinary calcium were similar between the two groups, but serum phosphorus was significantly lower in stone-formers. Serum calcitriol (available in some patients) showed a slightly higher mean value in stone-formers but the difference was not significant. The increment in urinary calcium after oral load of 1-g calcium was twofold higher among stone-formers. Radial shaft and L2-L4 bone mineral densities resided within the normal ranges. Stone-formers with PHPT display exaggerated urinary calcium excretion due to intestinal hyperabsorption of calcium, contributing to a greater enhancement of the saturation of stone-forming calcium salts.

Original language	English (US)
Pages (from-to)	123-128
Number of pages	6
Journal	Urological Research
Volume	35
Issue number	3
DOIs	https://doi.org/10.1007/s00240-007-0096-2
State	Published - Jun 2007

Keywords

Calcium absorption
Hypercalciuria
Nephrolithiasis
Primary hyperparathyroidism

ASJC Scopus subject areas

Urology

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10.1007/s00240-007-0096-2

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title = "Biochemical characterization of primary hyperparathyroidism with and without kidney stones",

abstract = "The exact metabolic-physiological background for kidney stone formation in primary hyperparathyroidism (PHPT) is unclear. To obtain clarification, this retrospective data analysis was conducted in 131 patients with PHPT who had undergone a detailed ambulatory evaluation on a random diet since 1980. The baseline biochemical presentation of 78 patients with PHPT with stones was compared with that of 53 patients without stones. Compared to those without stones, the stone-forming patients had a more marked hypercalciuria (343 ± 148 vs. 273 ± 148 mg/day, P < 0.01). Urinary saturation of calcium oxalate and brushite was significantly higher in stone-formers. Serum PTH and fasting urinary calcium were similar between the two groups, but serum phosphorus was significantly lower in stone-formers. Serum calcitriol (available in some patients) showed a slightly higher mean value in stone-formers but the difference was not significant. The increment in urinary calcium after oral load of 1-g calcium was twofold higher among stone-formers. Radial shaft and L2-L4 bone mineral densities resided within the normal ranges. Stone-formers with PHPT display exaggerated urinary calcium excretion due to intestinal hyperabsorption of calcium, contributing to a greater enhancement of the saturation of stone-forming calcium salts.",

keywords = "Calcium absorption, Hypercalciuria, Nephrolithiasis, Primary hyperparathyroidism",

author = "Odvina, {Clarita V.} and Khashayar Sakhaee and Heller, {Howard J.} and Peterson, {Roy D.} and Poindexter, {John R.} and Padalino, {Paulette K.} and Pak, {Charles Y C}",

note = "Funding Information: Acknowledgments This study was supported by grants from the National Institutes of Health, P01-DK20543 and M01-RR00633. The authors are grateful to Dr William Snyder and his group from the Department of Surgery for their assistance in patient care.",

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AU - Odvina, Clarita V.

AU - Sakhaee, Khashayar

AU - Heller, Howard J.

AU - Peterson, Roy D.

AU - Poindexter, John R.

AU - Padalino, Paulette K.

AU - Pak, Charles Y C

N1 - Funding Information: Acknowledgments This study was supported by grants from the National Institutes of Health, P01-DK20543 and M01-RR00633. The authors are grateful to Dr William Snyder and his group from the Department of Surgery for their assistance in patient care.

PY - 2007/6

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N2 - The exact metabolic-physiological background for kidney stone formation in primary hyperparathyroidism (PHPT) is unclear. To obtain clarification, this retrospective data analysis was conducted in 131 patients with PHPT who had undergone a detailed ambulatory evaluation on a random diet since 1980. The baseline biochemical presentation of 78 patients with PHPT with stones was compared with that of 53 patients without stones. Compared to those without stones, the stone-forming patients had a more marked hypercalciuria (343 ± 148 vs. 273 ± 148 mg/day, P < 0.01). Urinary saturation of calcium oxalate and brushite was significantly higher in stone-formers. Serum PTH and fasting urinary calcium were similar between the two groups, but serum phosphorus was significantly lower in stone-formers. Serum calcitriol (available in some patients) showed a slightly higher mean value in stone-formers but the difference was not significant. The increment in urinary calcium after oral load of 1-g calcium was twofold higher among stone-formers. Radial shaft and L2-L4 bone mineral densities resided within the normal ranges. Stone-formers with PHPT display exaggerated urinary calcium excretion due to intestinal hyperabsorption of calcium, contributing to a greater enhancement of the saturation of stone-forming calcium salts.

AB - The exact metabolic-physiological background for kidney stone formation in primary hyperparathyroidism (PHPT) is unclear. To obtain clarification, this retrospective data analysis was conducted in 131 patients with PHPT who had undergone a detailed ambulatory evaluation on a random diet since 1980. The baseline biochemical presentation of 78 patients with PHPT with stones was compared with that of 53 patients without stones. Compared to those without stones, the stone-forming patients had a more marked hypercalciuria (343 ± 148 vs. 273 ± 148 mg/day, P < 0.01). Urinary saturation of calcium oxalate and brushite was significantly higher in stone-formers. Serum PTH and fasting urinary calcium were similar between the two groups, but serum phosphorus was significantly lower in stone-formers. Serum calcitriol (available in some patients) showed a slightly higher mean value in stone-formers but the difference was not significant. The increment in urinary calcium after oral load of 1-g calcium was twofold higher among stone-formers. Radial shaft and L2-L4 bone mineral densities resided within the normal ranges. Stone-formers with PHPT display exaggerated urinary calcium excretion due to intestinal hyperabsorption of calcium, contributing to a greater enhancement of the saturation of stone-forming calcium salts.

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KW - Hypercalciuria

KW - Nephrolithiasis

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Biochemical characterization of primary hyperparathyroidism with and without kidney stones

Abstract

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