Document Detail


Differences in metabolic urinary abnormalities in stone forming and nonstone forming patients with primary hyperparathyroidism.
MedLine Citation:
PMID:  21893327     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Hyperparathyroidism is associated with hypercalciuria and nephrolithiasis. Urine calcium excretion decreases after parathyroidectomy, but whether there is a differential decrease between stone and nonstone formers remains controversial. We evaluated differences between stone formers and non-stone formers in serum and urinary parameters before and after parathyroidectomy. METHODS: 90 patients, 40 with and 50 without a history of nephrolithiasis underwent parathyroidectomy for hyperparathyroidism; 24-hour urine samples were collected before and after parathyroidectomy. Overall, 92% of patients provided samples before parathyroidectomy and 63% after parathyroidectomy. Preoperative, postoperative and changes in urinary parameters were evaluated. RESULTS: Preoperative hypercalciuria was present in ∼65% in both groups (P = .68). Parathyroidectomy decreased serum levels of calcium, parathyroid hormone, and urinary calcium, but there were no differences between stone formers and nonstone formers. Stone formers were 12-fold (P = .001) more likely to resolve an increase in supersaturation of calcium oxalate (SSCaOx), and after adjustment for age, sex, and BMI were 46-fold (P = .002) more likely to resolve an increase in SSCaOx. After parathyroidectomy, the rate of stone recurrence was 23% and male sex (aOR 20, P = .032) and increasing BMI (aOR 1.23, P = .038) were the only independent predictors of stone recurrence after adjusting for age. No other factor evaluated preoperatively, postoperatively, or the change after parathyroidectomy differentiated stone and nonstone formers or predicted stone recurrence. CONCLUSION: Metabolic evaluation did not differentiate stone formers from nonstone formers reliably. Stone formers were more likely to resolve an increase in SSCaOx after parathyroidectomy. Male sex and increasing BMI were independently associated with stone recurrence after parathyroidectomy.
Authors:
Mathew D Sorensen; Quan-Yang Duh; Raymon H Grogan; Thanh C Tran; Marshall L Stoller
Related Documents :
8120847 - Vaginal pessaries and their use in pelvic relaxation.
6727587 - Discount functions and the measurement of patients' values. women's decisions during ch...
16108737 - Comparison of the efficacy of the pulsed bipolar system and conventional bipolar electr...
8677087 - Treatment of vulvar varicosities by injection-compression sclerotherapy and a pelvic su...
23769277 - The effect of radachlorin(®) pdt in advanced nsclc: a pilot study.
24633067 - Women's perspective: intra-detrusor botox versus sacral neuromodulation for overactive ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-3
Journal Detail:
Title:  Surgery     Volume:  -     ISSN:  1532-7361     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, University of California, San Francisco, CA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Pitfalls in avoiding operation for autoimmune pancreatitis.
Next Document:  The angiogenic factor Del1 prevents apoptosis of endothelial cells through integrin binding.