Endocrine Abstracts

Aim: The main aim of this study was to evaluate the prevalence of kidney stones and osteoporosis in a cohort of patients with a confirmed diagnosis of primary hyperparathyroidism (PHPT).

Study design: This retrospective study reviewed the clinical records of patients with a confirmed diagnosis of PHPT in a single tertiary referral centre for metabolic bone disease over a period of 6 years (January 2010 – December 2015).

Patients: There were a total of 258 patients included in the study. 206 women (173 post-menopausal and 33 pre-menopausal) and 52 men with mean age of 63.5+14.84 years.

Method: The clinical records of 258 patients were scrutinised to determine the prevalence of kidney stones (as identified by abdominal ultrasound or X-ray or computed tomography scan) and osteoporosis (defined as bone mineral density T-score of <−2.5 measured by dual-energy X-ray absorptiometry [DXA]). The prevalence of kidney stones and osteoporosis were compared between the symptomatic and asymptomatic PHPT patients.

Results: The prevalence of kidney stones in those who had undergone renal imaging was 13.86% (28 out of 202). There was no difference in the prevalence of kidney stones between the symptomatic and asymptomatic patients (15.45% versus 11.96%, P=0.5428). The prevalence of osteoporosis was found to be 43.62% (from 188 patients who had bone DXA scan). There was also no difference in the prevalence of osteoporosis between the symptomatic and asymptomatic patients (43.43% versus 43.82%, P=1.0000). Although only 27.13% of patients (70 out of 258) had urinary calcium excretion screening completed, symptomatic patients were found to have higher levels of urinary calcium compared with the asymptomatic patients (7.8 mmol/24 hours versus 4.4 mmol/24 hours, P=0.0089).

Conclusion: Kidney stones and osteoporosis are common in both symptomatic and asymptomatic PHPT patients. The results from this study provide further evidence of the need for a more rigorous and consistent evaluation of the kidneys and skeleton of patients diagnosed with PHPT in order to identify and manage these well- known end-organ complications appropriately.