Recurrent Urolithiasis Revealing Primary Hyperparathyroidism in a Nephrology Department.

Case Reports in Nephrology Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI:10.1155/2024/1265364
Hajji Meriam, Hayet Kaaroud, Rahma Karray, Fethi Ben Hamida, Kahena Bouzid, Ezzeddine Abderrahim
{"title":"Recurrent Urolithiasis Revealing Primary Hyperparathyroidism in a Nephrology Department.","authors":"Hajji Meriam, Hayet Kaaroud, Rahma Karray, Fethi Ben Hamida, Kahena Bouzid, Ezzeddine Abderrahim","doi":"10.1155/2024/1265364","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Urinary lithiasis constitutes a recurrent pathology affecting a relatively young population. The risk of progression to chronic renal failure and the cost of treatment are the most important issues. Primary hyperparathyroidism (PHPT) is responsible for urolithiasis and nephrocalcinosis in 7% of patients, and it represents the 7th cause of urolithiasis in Tunisia. Unfortunately, it remains an underdiagnosed pathology although it is curable. We aim to determine the clinical, biological, therapeutic, and evolutionary particularities of urinary lithiasis associated with PHPT in a nephrology setting.</p><p><strong>Methods: </strong>This is a monocentric, retrospective, descriptive study which took place in our nephrology department during the period from January 2010 to January 2023. Ten patients were included. All of them underwent blood and urine tests and a morphoconstitutional study of the urinary stones if possible.</p><p><strong>Results: </strong>The median age at diagnosis of PHPT was 42 years (34-54). The median time from the onset of kidney stones to the diagnosis of PHPT was 6.2 years (1-17). The male/female gender ratio was 0.66. Five patients had hypertension, two patients had obesity, one patient had diabetes, and three patients had urinary tract infections. Kidney stones were bilateral in eight cases and unilateral in two cases. Nine patients underwent urological intervention: surgery in 5 cases associated with nephrectomy in one case, extracorporeal lithotripsy in 4 cases, and percutaneous nephrolithotomy in two cases. The diagnosis of PHPT was retained with high or uncontrolled PTH associated with hypercalcemia in 8 cases and normocalcemic PHPT was found in 2 patients. Two patients had parathyroid adenoma and one patient had mediastinal adenoma. Radiology exploration was normal for the others patients. Surgery was performed in 7 patients and histology revealed an adenoma in 5 cases and hyperplasia in one case. The predominant urinary risk factors in our study were hypercalciuria in 6 cases and insufficient diuresis in 4 cases.</p><p><strong>Conclusion: </strong>This study underlines the role of the nephrologist in the exploration of urinary lithiasis and the prevention of recurrences, especially as PHPT is a curable aetiology of urolithiasis and affects a relatively young population. The determination of the epidemiological profile of patients with stones associated with primary PHPT and lithogenic risk factors allows the primary and secondary prevention of stone formation.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901575/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Nephrology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2024/1265364","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Urinary lithiasis constitutes a recurrent pathology affecting a relatively young population. The risk of progression to chronic renal failure and the cost of treatment are the most important issues. Primary hyperparathyroidism (PHPT) is responsible for urolithiasis and nephrocalcinosis in 7% of patients, and it represents the 7th cause of urolithiasis in Tunisia. Unfortunately, it remains an underdiagnosed pathology although it is curable. We aim to determine the clinical, biological, therapeutic, and evolutionary particularities of urinary lithiasis associated with PHPT in a nephrology setting.

Methods: This is a monocentric, retrospective, descriptive study which took place in our nephrology department during the period from January 2010 to January 2023. Ten patients were included. All of them underwent blood and urine tests and a morphoconstitutional study of the urinary stones if possible.

Results: The median age at diagnosis of PHPT was 42 years (34-54). The median time from the onset of kidney stones to the diagnosis of PHPT was 6.2 years (1-17). The male/female gender ratio was 0.66. Five patients had hypertension, two patients had obesity, one patient had diabetes, and three patients had urinary tract infections. Kidney stones were bilateral in eight cases and unilateral in two cases. Nine patients underwent urological intervention: surgery in 5 cases associated with nephrectomy in one case, extracorporeal lithotripsy in 4 cases, and percutaneous nephrolithotomy in two cases. The diagnosis of PHPT was retained with high or uncontrolled PTH associated with hypercalcemia in 8 cases and normocalcemic PHPT was found in 2 patients. Two patients had parathyroid adenoma and one patient had mediastinal adenoma. Radiology exploration was normal for the others patients. Surgery was performed in 7 patients and histology revealed an adenoma in 5 cases and hyperplasia in one case. The predominant urinary risk factors in our study were hypercalciuria in 6 cases and insufficient diuresis in 4 cases.

Conclusion: This study underlines the role of the nephrologist in the exploration of urinary lithiasis and the prevention of recurrences, especially as PHPT is a curable aetiology of urolithiasis and affects a relatively young population. The determination of the epidemiological profile of patients with stones associated with primary PHPT and lithogenic risk factors allows the primary and secondary prevention of stone formation.

肾内科复发性尿路结石揭示原发性甲状旁腺功能亢进症
背景:尿路结石是一种反复发作的病症,影响着相对年轻的人群。恶化为慢性肾衰竭的风险和治疗费用是最重要的问题。原发性甲状旁腺功能亢进症(PHPT)导致7%的患者出现尿路结石和肾钙化,是突尼斯第七大尿路结石病因。遗憾的是,尽管该病可以治愈,但诊断率仍然很低。我们的目的是在肾内科确定与 PHPT 相关的尿路结石的临床、生物、治疗和演变特点:这是一项单中心、回顾性、描述性研究,于 2010 年 1 月至 2023 年 1 月期间在我院肾内科进行。共纳入 10 名患者。所有患者都接受了血液和尿液检查,并在可能的情况下进行了尿路结石形态学研究:PHPT 诊断时的中位年龄为 42 岁(34-54 岁)。从出现肾结石到确诊为 PHPT 的中位时间为 6.2 年(1-17 年)。男女性别比为 0.66。五名患者患有高血压,两名患者患有肥胖症,一名患者患有糖尿病,三名患者患有尿路感染。8例患者为双侧肾结石,2例患者为单侧肾结石。九名患者接受了泌尿科介入治疗:其中五名患者接受了手术治疗,一名患者接受了肾切除术,四名患者接受了体外碎石术,两名患者接受了经皮肾镜取石术。8例患者的PTH偏高或不受控制,伴有高钙血症,PHPT的诊断得以保留,2例患者为正常钙血症性PHPT。两名患者患有甲状旁腺腺瘤,一名患者患有纵隔腺瘤。其他患者的放射检查结果正常。7名患者接受了手术治疗,组织学检查结果显示,5例为腺瘤,1例为增生。在我们的研究中,主要的泌尿系统危险因素是高钙尿症(6 例)和利尿不足(4 例):本研究强调了肾科医生在探查尿路结石和预防复发方面的作用,尤其是因为 PHPT 是一种可治愈的尿路结石病因,而且影响的人群相对年轻。确定与原发性 PHPT 相关的结石患者的流行病学特征和致石风险因素,可对结石的形成进行一级和二级预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信