Calcium to magnesium ratio can be a new marker for predicting nephrolithiasis in patients with primary hyperparathyroidism

Ekin Yiğit Koroğlu; Abbas Ali Tam; Sevgul Fakı; Balsak Belma Tural; Ozdemir Fatma Ayca Edis; Didem Ozdemir; Oya Topaloğlu; Reyhan Ersoy; Bekir Cakır

doi:10.1530/endoabs.99.OC10.3

OC10.3

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Endocrine Abstracts (2024) 99 OC10.3 | DOI: 10.1530/endoabs.99.OC10.3

ECE2024 Oral Communications Oral Communications 10: Calcium and Bone | Part II (6 abstracts)

Calcium to magnesium ratio can be a new marker for predicting nephrolithiasis in patients with primary hyperparathyroidism

Ekin Yiğit Köroğlu ¹ , Abbas Ali Tam ² , Sevgül Fakı ¹ , Belma Tural Balsak ¹ , Fatma Ayça Edis Özdemir ³ , Didem Özdemir ² , Oya Topaloğlu ² , Reyhan Ersoy ² & Bekir Çakır ²

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¹Ankara Bilkent City Hospital, Endocrinology and Metabolism, Ankara; ²Ankara Yıldırım Beyazıt University Faculty Of Medicine, Endocrinology and Metabolism, Ankara; ³Ankara Bilkent City Hospital, Radiology, Ankara

Purpose: In previous studies, magnesium (Mg) was found to be lower in cases with more severe primary hyperparathyroidism (PHPT) and higher calcium (Ca) levels. This study evaluated the relationship between serum Mg and serum Ca and phosphorus (P) levels in PHPT and their utility in discriminating osteoporosis and nephrolithiasis.

Methods: Patients who were followed up with PHPT between March 2019 and March 2023 were analyzed retrospectively. Biochemical data, renal ultrasonography results, dual-energy x-ray absorptiometry reports, and technetium 99m sestamibi parathyroid scintigraphy reports were obtained. MgxP, Mg/P, Ca/P, and corrected Ca (cCa)/P values were calculated. The relationships between biochemical parameters and clinical outcomes were evaluated statistically.

Results: A total of 543 patients were included in the study. For Ca/Mg, a cut-off value of 5.47 had a sensitivity of 74% and a specificity of 73% for the presence of nephrolithiasis. The cut-off value for cCa/Mg that can be used to predict nephrolithiasis was 5.24, with a sensitivity of 73.3% and a specificity of 73%. No statistically significant correlation existed between the Mg/P, MgxP, cCa/Mg, Ca/Mg values, and DEXA results.

Conclusion: Ca/Mg and cCa/Mg ratios especially seem more valuable in discriminating nephrolithiasis than the currently used 24-hour urine Ca measurement. Unlike urinary Ca measurements, they are cheaper, more practical, and more accessible.