Endocrine Abstracts

Background: Primary Hyperparathyroidism (PHPT) is a common endocrine disorder that is characterized by hypercalcaemia and elevated or inappropriately normal serum levels of parathyroid hormone. Most often, the presentation of PHPT is asymptomatic. PHPT can manifest with osteoporosis and hypercalciuria as well as with vertebral fractures and nephrolithiasis, both of which can be asymptomatic. Our aim in this study; to determine the frequency of kidney stones in patients operated for primary hyperparathyroidism and to compare the biochemical values of symptomatic and asymptomatic patients with kidney stones.

Methods: It was planned to include patients who had undergone parathyroidectomy, who applied to Ankara Yıldırım Beyazıt University Atatürk Training and Research Hospital between December 2006 and January 2019 and to Ankara City Hospital Endocrinology and Metabolic Diseases Clinic between February 2019 and November 2021.

Results: Of 886 patients who were operated for primary hyperparathyroidism, 15.9% (n: 141) were male. 189 (%21.3) patients had symptoms at the time of diagnosis. Diffuse body pain (37%), flank pain (22.2%), fatigue (11.6%), dyspepsia (6.9%), polyuria and polydipsia (4.2%) were the most common symptoms. Of the patients, 45.6% (n:388) had osteoporosis, 24.6% (n:253) had osteopenia, and 30.3% (n:257) kidney stones. Urinary symptoms were present in 133 (16.5%) patients. Genetic analysis was performed on 83 patients. 7.2% of the patients who underwent genetic analysis were men-1. The mean age of the patients was 53.6±11.9 (18-85) years. The mean preoperative total calcium of the patients was 11.1±1.1 (6.3-18.6) mg/dl. The mean preoperative phosphorus was 2.6±0.7 (0.7-9.0) mg/dl. The mean preoperative 24-hour urinary calcium of the patients was 380.5±198.2 (24-1438) mg/24-hour. The mean preoperative 24-hour urine phosphorus was 797.9±350.4 (30.2-3798) g/24 hour. 257 patients with kidney stones were divided into two groups according to urinary symptoms. 70.2% (n:92) of 131 patients with urinary symptoms and 82.7% (n:91) of 110 patients without urinary symptoms were women. The proportion of women was significantly higher in the group without urinary symptoms (P:0.035). The median age was significantly higher in the group without urinary symptoms compared to urinary symptoms group (54.7 years vs 51.5 years, P:0.039). osteoporosis rate, total calcium value, phosphorus value, parathormone value, 24-hour urinary calcium and 24-hour urine phosphorus value were similar for the two groups.

Conclusion: Patients with symptomatic nephrolithiasis were younger and more male dominated.