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Recurrent Nephrolithiasis Leading to Renal Failure: A Neglected Primary Hyperparathyroidism Publisher



Yaghoubi F1 ; Yarmohamadi M2
Authors
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Authors Affiliations
  1. 1. Nephrology Research Center, Department of Nephrology, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran

Source: Nephro-Urology Monthly Published:2018


Abstract

Introduction: Nephrolithiasis occurs in 7% to 40% of patients with primary hyperparathyroidism (PHPT). Approximately 5% of patients with nephrolithiasis will have hyperparathyroidism. This study presents a rare case of hypercalcemia secondary to PHPT, which eventually led to renal failure Case Presentation: This report presents a 55-year-old male presented with history of multiple kidney stones from 6 years ago, who had undergone multiple interventions by extracorporeal shock wave lithotripsy (ESWL). The result of lab exams were: BUN: 48 mg/dL, Cr: 2.83 mg/dL, calcium: 15.8 mg/dL, phosphorus: 4.4, serum intact parathyroid hormone (iPTH) = 1046pg/mL. At T99scan MIBI, the nuclear showed parathyroid adenoma in the inferior pole of the right thyroid. The patient underwent parathyroidectomy. Serum calcium level returned to normal range within 3 days after surgery. Conclusions: More attention must be paid to patients with recurrent nephrolithiasis, and such patients must be evaluated for PHPT before progressing to CKD. © 2018, Nephro-Urology Monthly.