CLINICAL AND LABORATORY PARAMETERS IN PATIENTS WITH UROLITHIASIS IN THE PRESENCE AND ABSENCE OF PRIMARY HYPERPARATHYROIDISM


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Abstract

The clinical and laboratory findings in 78 patients with various forms of urolithiasis depending on the presence of primary hyperparathyroidism (PHPT) were analyzed. PHPT was diagnosed in 17 patients. Group «without PHPT» and group «with PHPT» differed significantly in terms of parathyroid hormone (PTH) level, serum calcium, phosphorus, chloride, alkaline phosphatase, calciuria and kaliuria. In patients with staghorn calculi, PHPT was diagnosed in 12,5%, and staghorn calculi in the presence of PHPT were identified in 17,7% of cases. Hypercalciuria in the group «with PHPT» was detected in 82,4% of patients (all 3 patients with staghorn calculi), and in the group «without PHPT» — in 18% of patients (2 of 21 patients with staghorn calculi). Hyperoxaluria was observed in 42.3% of patients «without PHPT» and in 35,3% of patients «with PHPT», in 36,8% of patients with simple stones and in 57,2% — with staghorn calculi. In 39% of patients «without PHPT», secondary hyperparathyroidism (SHPT) was diagnosed. SHPT prevalence was 28% in patients with staghorn calculi, and 45% in patients with simple stones. In 87,5% of patients with hypomagnesemia, staghorn calculi were observed. Significant relationship between magnesium and triglycerides (r s=-0,296; P=0,041), and magnesium and high-density lipoproteins (r s=0,339; P=0,032) in all patients with urolithiasis were revealed. Thus, the study found no association between staghorn nephrolithiasis and PHPT. Elevated PTH levels usually indicate SHPT rather than PHPT. In hypocalcemia, there was more strong association between PTH and calcium, in normocalcaemia — between PTH and magnesium.

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