Misgar Raiz Ahmad, Sehgal Ashish, Masoodi Shariq Rashid, Wani Arshad Iqbal, Bashir Mir Iftikhar, Malik Ajaz Ahmad, Wani Munir Ahmad, Wani Muzaffar Maqsood, Wani Imtiyaz Ahmad
Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
Indian J Endocrinol Metab. 2019 Jan-Feb;23(1):46-49. doi: 10.4103/ijem.IJEM_558_18.
Nephrolithiasis is a common complication of primary hyperparathyroidism (PHPT), and in a subgroup of patients stones are clinically silent. Patients with silent and symptomatic stones may differ biochemically. There is a scarcity of data available comparing patients with silent and symptomatic renal stones in PHPT.
To characterize patients with PHPT with nephrolithiais and to compare patients with silent and symptomatic stones.
We reviewed clinical data of 186 patients with PHPT managed at our center from January 1996 to December 2017. Silent renal stones were defined as ultrasonography finding of renal stones without symptoms. Symptomatic renal stones were defined as those with symptoms or a history of graveluria or any procedure for nephrolithiasis. A 5-mm diameter was set as the cut-off between micro- and macrolithiasis. We compared those with ( = 95) and without ( = 91) stones, and, among stone formers, those with symptoms ( = 66) and silent ( = 29) were compared.
There was no significant difference between stone formers and nonstone formers with respect to biochemical parameters. Patients with silent renal stones had significantly lower serum calcium and higher phosphate, than those with symptomatic stones. Most (75%) patients with silent renal stones had microlithiais, while only a fifth (22%) with symptomatic renal stones had microlithiasis.
Nephrolithiasis is a common complication of PHPT. Most patients with silent renal stones had microlithiasis and biochemical features of less severe disease. Patients with silent renal stones may represent early mild stage of PHPT.
肾结石是原发性甲状旁腺功能亢进症（PHPT）的常见并发症，在一部分患者中结石在临床上并无症状。无症状和有症状结石的患者在生化指标上可能存在差异。目前缺乏比较PHPT中无症状和有症状肾结石患者的数据。
对患有肾结石的PHPT患者进行特征描述，并比较无症状和有症状结石的患者。
我们回顾了1996年1月至2017年12月在本中心接受治疗的186例PHPT患者的临床资料。无症状肾结石定义为超声检查发现肾结石但无相关症状。有症状肾结石定义为有症状或有血尿病史或接受过任何肾结石治疗的患者。将直径5毫米设定为微结石和大结石的分界点。我们比较了有结石（n = 95）和无结石（n = 91）的患者，并且在有结石的患者中，比较了有症状（n = 66）和无症状（n = 29）的患者。
有结石患者和无结石患者在生化参数方面无显著差异。无症状肾结石患者的血清钙显著低于有症状结石患者，而磷酸盐水平则较高。大多数（75%）无症状肾结石患者为微结石，而有症状肾结石患者中只有五分之一（22%）为微结石。
肾结石是PHPT的常见并发症。大多数无症状肾结石患者为微结石，且疾病的生化特征较轻。无症状肾结石患者可能代表PHPT的早期轻度阶段。
