Features of the clinical course of nephrolithiasis in patients with hyperparathyroidism

Aim. To assess the incidence of kidney stone disease and to identify its clinical course in patients with primary hyperparathyroidism. Methods. 48 medical records of patients hospitalized with primary hyperparathyroidism were retrospectively analyzed. The average age of the patients was 57 [53; 61] years. The medical history, complaints upon admission, the clinical presentation, the results of laboratory test and instrumental examination were studied in evaluating the medical records. The patients were divided into the group with nephrolithiasis (n=33) and the group without nephrolithiasis (n=15). The differences between the two groups were tested for statistical significance by the MannWhitney U test. Results. Among patients with primary hyperparathyroidism, nephrolithiasis was detected in 69% of patients, of which 90% were women in the postmenopausal period. The course of the kidney stone disease in these patients was characterized by frequent recurrence with a predominance of bilateral renal impairment (62%). The duration of nephrolithiasis before the diagnosis of primary hyperparathyroidism was 6 [1; 19] years, and this complication was often the first manifestation of the disease. According to the instrumental examination of kidney in patients with nephrolithiasis, small stones up to 5 mm in diameter were detected in 42% of cases, asymptomatic kidney stones in 15% of cases. A severe complication of primary hyperparathyroidism staghorn calculi were found in 2 (10%) patients. The patients in the group with nephrolithiasis showed higher serum calcium (p=0.022) and parathyroid hormone (p=0.007) levels compared with patients in the group without nephrolithiasis. Conclusion. Nephrolithiasis is a common complication of primary hyperparathyroidism; the presence of nephrolithiasis is associated with more significant changes in calcium and phosphate metabolism and is also characterized by a frequent asymptomatic course, thus requiring attention of specialists to this type of complications in primary hyperparathyroidism.

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Faculty Opinions recommendation of High urinary calcium excretion and genetic susceptibility to hypertension and kidney stone disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.31371.487862 ◽

2006 ◽

Author(s):

Alan Yu

Keyword(s):

Genetic Susceptibility ◽

Kidney Stone ◽

Urinary Calcium ◽

Stone Disease ◽

Urinary Calcium Excretion ◽

Calcium Excretion ◽

Kidney Stone Disease

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Faculty Opinions recommendation of Evaluation of the economic burden of kidney stone disease in the UK: a retrospective cohort study with a mean follow-up of 19 years.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737186277.793570254 ◽

2020 ◽

Author(s):

Walter Strohmaier

Keyword(s):

Cohort Study ◽

Economic Burden ◽

Retrospective Cohort Study ◽

Kidney Stone ◽

Retrospective Cohort ◽

Stone Disease ◽

Kidney Stone Disease ◽

The Uk

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An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease: Figure 1.

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.11191210 ◽

2011 ◽

Vol 6 (8) ◽

pp. 2062-2068 ◽

Cited By ~ 74

Author(s):

David J. Sas

Keyword(s):

Risk Factors ◽

Kidney Stone ◽

Stone Disease ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Kidney Stone Disease

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Somatosensory and trophic findings in the referred pain area in patients with kidney stone disease

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2013.03.001 ◽

2013 ◽

Vol 4 (3) ◽

pp. 165-170 ◽

Cited By ~ 1

Author(s):

Katja Venborg Pedersen ◽

Asbjørn Mohr Drewes ◽

Ole Graumann ◽

Susanne Sloth Osther ◽

Anne Estrup Olesen ◽

...

Keyword(s):

Ct Scan ◽

Kidney Stone ◽

Stone Disease ◽

Referred Pain ◽

Lateral Side ◽

Pain Thresholds ◽

Kidney Stone Disease ◽

Trophic Changes ◽

Electrical Stimuli ◽

Pain Area

AbstractBackground and purposeVisceral and somatic afferents activate the same neuronal structures in the central nervous system. Assessing somatosensory function and trophic changes in the referred pain area may therefore indirectly increase information on mechanisms involved in painful visceral diseases. The aim of this study was to evaluate the sensory and trophic changes in the flank corresponding to the referred pain area in patients with kidney stone disease.MethodsA total of 24 patients with unilateral pain-causing kidney stone disease were studied before and after endoscopic percutaneous kidney stone surgery. Trophic changes and sensitivity on the affected and on the contra-lateral side in the pain free period were investigated. For this purpose we used standardized experimental sensory testing including pressure stimulation and electrical (single and repeated) skin stimulation. Five repeated stimuli were used to investigate temporal summation (increased responses to repeated stimuli). To investigate trophic changes ultrasound as well as CT-scan was used, since the latter is considered more precise for exact tissue layer measurements.ResultsThe pain tolerance thresholds to pressure and pain thresholds to electrical stimulation were not significantly different on the two sides (all P>0.1). After surgery no significant alterations in sensitivity were detected, but there was a tendency to higher pain thresholds to electrical stimuli on the affected side (single stimuli P=0.06; repeated stimuli P=0.09). No trophic changes were observed (all P>0.3), and there were no relations between the pain thresholds or trophic findings and the number of colics (all P >0.08).ConclusionIn patients with unilateral pain-causing kidney stone disease the pain to experimental pressure and electrical stimuli were comparable on the affected and contra-lateral side. For the first time a CT-scan was used to evaluate tissue thickness in the referred pain area. No trophic changes were seen in the muscle or subcutaneous tissue at the affected side, and there were no correlations between the pain thresholds or trophic findings and the patients history of number of colics. After the operation no significant alterations in sensitivity were detected.ImplicationsThis study could not confirm previous studies showing referred hyperalgesia in the skin and trophic changes in the referred pain area to painful visceral disease. Differences in the pain intensity/duration between different diseases and hence the corresponding central neuronal changes may explain the negative findings in the present study.

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Nutrition and Kidney Stone Disease

Nutrients ◽

10.3390/nu13061917 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1917

Author(s):

Roswitha Siener

Keyword(s):

Kidney Stone ◽

Fluid Intake ◽

Stone Formation ◽

Urinary Stone ◽

Stone Disease ◽

Urinary Stones ◽

Dietary Therapy ◽

Effective Prevention ◽

Kidney Stone Disease ◽

Nutrition And Diet

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.

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