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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three patients with nephrolithiasis were found to have both medullary sponge kidney (MSK) and primary hyperparathyroidism. In all cases, urine calcium excretion returned to normal after parathyroidectomy. The passage of stones was abolished for more than 20 years in one case and for more than 12 years in another. The available data suggest that many patients with MSK are asymptomatic and that the risk of stone formation is increased by an associated metabolic abnormality such as hypercalciuria or hyperparathyroidism.
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PMID:Primary hyperparathyroidism. A cause of hypercalciuria and renal stones in patients with medullary sponge kidney. 57 83

The etiological role of primary hyperparathyroidism in stone formation in medullary sponge kidney was studied. The necessity of carrying out special biochemical tests for primary hyperparathyroidism has been shown. The combination of two diseases in cases of stones and nephrocalcinosis is explained by the genetic nature of sponge kidney and primary hyperparathyroidism. 4 patients have been under observation; all underwent successful parathyroidectomy.
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PMID:Primary hyperparathyroidism and stone formation in medullary sponge kidneys. 71 Apr 62

An increase in the average calcium oxalate content and decrease in average calcium phosphate content of stones received for analysis has been noted in a 9-year study. These changes appear to be due to a progressive increase in the number of patients with noninfected upper urinary tract stone and to the gradual elimination of phosphatic stones as a result of improved diagnosis and treatment. Some of the conditions associated with calcium phosphate stones are examined, particularly primary hyperparathyroidism, renal tubular acidosis, and medullary sponge kidney. These results further emphasize the importance of calcium oxalate in idiopathic stone disease and the need for a fuller understanding of the factors influencing calcium oxalate crystallization.
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PMID:Changes in the composition of urinary tract stones. 118 36

Previous associations of primary hyperparathyroidism-induced hypercalcemia and medullary sponge kidney (MSK) have been reported. In this report, we describe a lactating woman MSK noted to be hypercalcemic throughout lactation, without evidence of hyperparathyroidism. After the baby was weaned, the serum calcium returned to normal. A bone biopsy performed while the patient was hypercalcemic was consistent with hyperparathyroidism, suggesting the presence of a parathyroid-like protein produced during lactation.
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PMID:Postpartum hypercalcemia in a patient with medullary sponge kidneys. 202 62

Medullary sponge kidney (MSK), parathyroid adenoma, renal cell carcinoma, and renal-leak hypercalciuria coincided in 1 female patient. Renal-leak hypercalciuria was not corrected by removal of a parathyroid adenoma. Since the patient had renal tubular acidosis (RTA), alkali treatment was conducted and resulted in the correction of hypercalciuria. Renal cell carcinoma eventually developed and MSK was confirmed histologically. This case suggests that MSK and primary hyperparathyroidism occurred independently.
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PMID:Medullary sponge kidney and hyperparathyroidism. 334 Nov 5

389 consecutive renal stone formers (275 males, 114 females) were investigated in an out-patient stone clinic. Renal tubular acidosis (RTA) was found in 83 patients (22%). Proximal RTA was twice as common as the distal tubular type. The acidification defects were exclusively of the incomplete form with normal basal blood acidbase status. Main diagnoses besides RTA were primary hyperparathyroidism (3.5%), medullary sponge kidney (3.5%), infection induced stones (3%), urate stones (2%), intestinal disorder (1.5%) and cystinuria (0.5%). The metabolic evaluation was mainly based on 24 h urine sampling on a free diet. In 248 patients (64%) no distinct abnormality was considered to be primarily responsible for stone formation. Clinical and biochemical analysis of these so-called idiopathic stone formers disclosed a male preponderance (80%) and, compared to a non-stone-forming control group, a higher urinary calcium excretion, yet with a considerable overlap between the two groups. Hyperuricosuria and hyperoxaluria were rare findings. The conclusion of the study is given as a proposal for clinical classification and ambulatory investigation of renal stone formers.
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PMID:Ambulatory diagnostic evaluation of 389 recurrent renal stone formers. A proposal for clinical classification and investigation. 684 37

28 adult patients with radiological evidence of medullary sponge kidney (MSK) were studied. Hypercalcemia and increased serum parathyroid hormone (PTH) values were found in 10 patients (36%). In 7 of them, parathyroid surgery was performed: a single adenoma was found in 6 cases and multiple-gland hyperplasia in 1 case. After surgery, 3 patients had normalization of calcium metabolism; 4 patients had persistence of hypercalciuria with progressive increase in serum PTH values (and recurrence of the adenoma in 1 case). Of the remaining patients, 10 (36%) had definite or marginal hypercalciuria, resulting from renal calcium leak in 8 and from intestinal calcium hyperabsorption in 2 of them. In 8 patients (28%), no evidence of disordered calcium metabolism was found. The association of MSK and hyperparathyroidism is not a chance occurrence. MSK might be a renal anatomical complication of primary hyperparathyroidism, or it might be regarded as an anatomic substrate--or rather as a consequence--of prolonged hypercalciuria, regardless of its pathogenesis. The lack of disordered calcium metabolism in a considerable number of patients, however, shows that the enigma of MSK is still far from being solved.
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PMID:Medullary sponge kidney and hyperparathyroidism--a puzzling association. 718 Sep 4

Seventeen patients with documented medullary sponge kidney and nephrolithiasis underwent metabolic evaluation. These patients constituted 3.6% of our stone-forming population. Fifteen (88%) of 17 were hypercalciuric. The most common abnormality was absorptive hypercalciuria, occurring in 59%. Only three patients (18%) had renal hypercalciuria. None of the patients had primary hyperparathyroidism. Hyperuricosuria occurred together with hypercalciuria in five patients. In two patients, the precise cause of hypercalciuria could not be determined, and in another two patients, no metabolic abnormality could be detected. Thus, the patients with medullary sponge kidney and renal stones had the same spectrum of metabolic abnormalities as the overall population of stone formers. While these patients may theoretically have a greater anatomic propensity to form stones because of their anatomic abnormality, they should be evaluated and treated appropriately for any metabolic defect.
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PMID:Metabolic evaluation of nephrolithiasis in patients with medullary sponge kidney. 720 12

The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidney disease and in whom they discovered a primary hyperparathyroidism. Further investigations discovered a medullary thyroid carcinoma. So this patient present multiple endocrine neoplasia (MEN) type 2A confirmed by microscopic and genetic analysis. This observation enlarged the discussion upon the nature of the relationship between kidney disease and primary hyperparathyroidism. Elsewhere it recommended to check systematically genetic markers of MEN type 2A if there is an association with sponge kidney disease and primary hyperparathyroidism.
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PMID:[Description of a case of Cacchi Ricci disease associated with hyperparathyroidism in the setting of multiple endocrine disease]. 1195 91

With the aim of assessing if biochemical changes occur in the follow up of patients with renal lithiasis, 237 patients were studied (115 women and 122 men, mean age 39 +/- 8 and 42 +/- 7 years, respectively) and controlled during 27.3 +/- 19.3 months. All of them had previously undergone metabolic evaluations at baseline and one or more than one control studies afterwards. Patients with a diagnosis of sponge kidney, renal tubular acidosis, primary hyperparathyroidism, anatomical malformations of the urinary tract, or urinary infections were not included. Two populations were identified: those who presented changes in the baseline diagnosis (139 patients, Group I) and those who presented no changes (98 patients, Group II). In these groups, no differences were observed in baseline metabolic diagnoses or in the follow-up period. Hypocitraturia was the additional diagnosis most frequently observed (43.1%), followed by Idiopatic hypercalciuria (20.8%) and abnormalities of uric acid (16.5%). In the group of 110 patients followed up for more than 3 years, 37 patients recurred (33%). Among the latter, 25 (23%) changed the baseline metabolic diagnosis vs. 12 (11%) that maintained the same diagnosis (p < 0.002). Changes in metabolic disorders were frequently observed in the follow up of patients with nephrolithiasis. These changes are not necessarily associated with the diet indicated or drug treatment. Hypocitraturia was the additional metabolic disorder most frequently found. In general, there is a higher recurrence rate in those patients who present changes in their biochemical parameters and undergo no treatment.
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PMID:[Renal lithiasis. Biochemical changes in the follow-up]. 1687 5


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