title: Primary hyperparathyroidism in patients with renal stones.
abstract: There has been an observed decline in the incidence of renal stones in patients with primary hyperparathyroidism. Some believe that this is related to earlier surgical intervention. Two studies from the 1950s examined the reverse questions to determine the prevalence of primary hyperparathyroidism in patients with renal stones. This report examined 1,500 consecutive patients treated by lithotripsy seen at the Georgetown University Medical Center and found, using the historical criterion for diagnosis of hyperparathyroidism (a serum calcium level of 10.5 milligrams per deciliter or greater) that the prevalence had decreased significantly from 8.0 per cent to our level of 3.02 per cent. Neither age nor sex contributed significantly to this decrease, and there were significantly more calcium stones than in the previous studies. Using an elevated calcium level with an elevated chloride to phosphate ratio as criteria for a diagnosis of probable primary hyperparathyroidism, a true prevalence of 1.65 per cent (+/- 0.6 per cent) was found. We believe that there has been a significant decrease in the frequency of primary hyperparathyroidism in the general population of patients with renal stones.
authors.affiliation: Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia 10007.
authors.forename: J D
authors.initials: JD
authors.lastname: Sedlack
authors.forename: J
authors.initials: J
authors.lastname: Kenkel
authors.forename: B J
authors.initials: BJ
authors.lastname: Czarapata
authors.forename: M G
authors.initials: MG
authors.lastname: Paul
authors.forename: J J
authors.initials: JJ
authors.lastname: Pahira
authors.forename: T C
authors.initials: TC
authors.lastname: Lee
mesh_terms: D002118:Calcium / Q000097:blood; D002712:Chlorides / Q000097:blood; D004219:District of Columbia / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D007669:Kidney Calculi / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D015995:Prevalence
chemical_list: D002712:Chlorides; D010710:Phosphates; D002118:Calcium