Volume 13, Issue 1
Original Article / Published: September 2025
DOI: https://www.doi.org/10.57045/jemis/1310925.pp52-53
M. Nistorova¹,³, V. Racheva¹,³, A. Ruseva²,³, V. Dunev¹,³, Zh. Atanasov¹,³
¹ University Hospital “St. Marina” , Pleven,² University Hospital “Dr. Georgi Stranski”, Pleven, ³ Medical University, Pleven
Abstract
Background: Primary hyperparathyroidism (PHPT) is a common cause of hypercalcemia and a significant etiological factor in urolithiasis. Timely identification of biochemical abnormalities is crucial for diagnosis and management.
Objective: To assess the diagnostic value of serum calcium, phosphorus, parathyroid hormone (PTH), and vitamin D in detecting PHPT in patients with urolithiasis.
Methods: The study included 210 patients with ultrasonographically confirmed urolithiasis. Serum calcium, phosphorus, PTH, and Vit. D levels were measured. Statistical analysis was performed using SPSS and Excel.
Results: Mean values were as follows: PTH – 35.7 ± 26.3 pg/mL; calcium – 2.42 ± 0.20 mmol/L; phosphorus – 1.25 ± 0.25 mmol/L; vitamin D – 21.2 ng/mL. Vitamin D deficiency (<20 ng/mL) was observed in 50% of patients. A biochemical profile suggestive of normocalcemic PHPT was present in 10%. A weak but statistically significant correlation was found between serum calcium and PTH (r = 0.25; p = 0.00028).
Conclusion: A significant proportion of patients with urolithiasis have laboratory findings indicative of PHPT, including the normocalcemic form. Routine measurement of calcium and PTH is recommended, especially in recurrent stone formers.
References
1.Marcocci C, Cetani F. Primary hyperparathyroidism. Lancet Diabetes Endocrinol. 2021;9(2):109–118.
2. Silverberg SJ, Bilezikian JP. Non-classical target organs in primary hyperparathyroidism. J Clin Endocrinol Metab. 2020;105(12):dgaa551.
3. Bilezikian JP, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(10):3561–3569.
4. Walker MD, Silverberg SJ. Primary hyperparathyroidism. NatRev Endocrinol. 2018;14(2):115–125.
5. Yeh MW, Ituarte PHG, et al. Incidence and prevalence of primary hyperparathyroidism in a racially diverse population. JClin Endocrinol Metab. 2013;98(3):1122–1129.
6. Cipriani C, et al. Normocalcemic primary hyperparathyroidism. J Clin Densitom. 2017;20(4):402–413.
7. Ferraro PM, et al. The role of vitamin D in nephrolithiasis. J Endocrinol Invest. 2020;43(4):413–419.
Keywords:
primary hyperparathyroidism, urolithiasis, parathyroid hormone,
vitamin D, calcium
How to cite this article:
M. Nistorova, V. Racheva, A. Ruseva, V. Dunev, Zh. Atanasov. Laboratory Evaluation of Primary Hyperparathyroidism in Patients with urolithiasis . Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2025; 13(1): 52-53
Corresponding author:
Dr. L. El-Tal
Clinic of Hepatobiliary, Pancreatic and General Surgery
Acibadem City Clinic Tokuda Hospital
51B Nikola Vaptsarov Blvd
e-mail: luben.eltal@gmail.com