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Persistence of high urinary excretion of calcium in patients with renal stones operated for pHPT.
- Vibe G. Frøkjær (11 October 2002)
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Vibe G. Frøkjær, Clinical assistant, MD Rigshospitalet, 2100DK
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Thanks to Henrik Ancher Sørensen for the editorial on surgery for primary hyperparathyroidism and for commenting on our study on the risk of renal stone events in primary hyperparathyroidism (pHPT) before and after parathyroid surgery. Henrik Ancher Sørensen mention that after successful parathyroidectomy urinary excretion of calcium, intestinal calcium absorption and serum calcium levels are believed to be restored to normal, and refers to a study by Kaplan et al from 1976. I find it interesting to point out that in a recent study of ours we found that in patients operated for pHPT, the patients with a history of renal stone disease prior to surgery had a persistent higher urinary calcium excretion than patients not presenting with renal stones despite normalization of serum calcium levels by surgery in both groups. Patients were followed up 1 to 3 years after surgery. Reference: Froekjaer V, Mollerup CL. Primary hyperparathyroidism: renal calcium excretion in patients with and without renal stones before and after parathyroidectomy. World J Surg 2002; 26: 532- 535[Medline]. This might indicate that also on the biochemical level disturbances in calcium excretion independent on the hyperparathyroid state may be present. Therefore again one cannot automatically expect that renal stone disease is cured by parathyroidectomy and normalization of serum calcium levels in patients with coexisting renal stone disease and pHPT. Vibe G. Frøkjær |
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