Cassibba Sara, Pellegrino Micaela, Gianotti Laura, Baffoni Claudia, Baralis Enrico, Attanasio Roberto, Guarnieri Andrea, Borretta Giorgio, Tassone Francesco
Division of Endocrinology, Diabetes, and Metabolism, Santa Croce and Carle, Cuneo, Italy.
Department of Radiology, Santa Croce and Carle, Cuneo, Italy.
Endocr Pract. 2014 Nov;20(11):1137-42. doi: 10.4158/EP14074.OR.
(1) To evaluate the prevalence of silent nephrolithiasis in patients with primary hyperparathyroidism (PHPT) compared with controls, and (2) To characterize clinically PHPT patients with silent renal stones.
We reviewed clinical data for 141 patients with PHPT and without symptoms or history of nephrolithiasis in whom renal ultrasonography was performed at diagnosis. A total of 141 sex- and age- matched subjects with abdomen ultrasonography obtained for reasons different from urinary symptoms served as controls.
Silent nephrolithiasis was more prevalent in PHPT patients than in controls (11.35% vs. 2.13%; P = .003). Among patients with PHPT, those with silent renal stones showed higher serum calcium and parathyroid hormone levels and met surgical criteria, regardless of nephrolithiasis, more frequently than those without renal stones.
The prevalence of silent nephrolithiasis is increased in patients with PHPT as compared with controls. Moreover, it seems likely that silent renal stone disease could identify a subset of PHPT patients with more severe disease. Accordingly, we suggest ultrasonographic screening of nephrolithiasis in all PHPT patients. Further studies are needed to better characterize this clinical entity.
（1）评估原发性甲状旁腺功能亢进症（PHPT）患者与对照组相比无症状肾结石的患病率，以及（2）对患有无症状肾结石的PHPT患者进行临床特征分析。
我们回顾了141例PHPT患者的临床资料，这些患者在诊断时进行了肾脏超声检查，且无肾结石症状或病史。总共141名性别和年龄匹配的受试者因与泌尿系统症状不同的原因进行了腹部超声检查，作为对照组。
PHPT患者中无症状肾结石的患病率高于对照组（11.35%对2.13%；P = .003）。在PHPT患者中，有无症状肾结石的患者血清钙和甲状旁腺激素水平较高，且无论有无肾结石，符合手术标准的频率均高于无肾结石的患者。
与对照组相比，PHPT患者中无症状肾结石的患病率增加。此外，无症状肾结石疾病似乎可能识别出一部分病情更严重的PHPT患者。因此，我们建议对所有PHPT患者进行肾结石的超声筛查。需要进一步研究以更好地描述这一临床实体。
