Data from: Predictors of nephrolithiasis, osteoporosis and mortality in primary hyperparathyroidism

Context: Primary Hyperparathyroidism (PHPT) has a prevalence of 0.86% and
is associated with increased risk of nephrolithiasis and osteoporosis.
PHPT may also be associated with an increased risk of cardiovascular
disease and mortality. Objective: To identify risk factors for
nephrolithiasis, osteoporosis and mortality in PHPT. Design: Retrospective
cohort study. Setting: University teaching hospital. Patients: PHPT
presenting between 2006 – 2014 (n = 611). Main outcome measures:
Assessment of nephrolithiasis, osteoporosis and mortality. Results: 13.9%
of PHPT patients had nephrolithiasis. Most had already documented stone
disease and only 4.7% of asymptomatic patients screened for renal stones
had calculi identified, not very dissimilar to the rate in the non-PHPT
population. Younger age (P < 0.001) and male gender (P = 0.003)
were the only independent predictors of nephrolithiasis. 48.4% of patients
with DXA data had osteoporosis (223/461). Older age (P < 0.001),
lower BMI (P = 0.002) and lower creatinine (P = 0.006) were independently
associated with a diagnosis of osteoporosis. Higher PTH was independently
associated with lower Z-score at the hip (P = 0.009), but otherwise
calcium and PTH were not associated with lower Z-score. Mortality in PHPT
was associated with older age (P < 0.008), social deprivation (P =
0.028) and adjusted calcium (P = 0.009) but not independently with PTH at
diagnosis. Conclusions: Screening for nephrolithiasis has a low yield,
particularly in lower risk patients. Osteoporosis is only minimally
associated with biochemical indices of PHPT. Mortality is associated with
higher calcium (and possibly vitamin D deficiency) but not PTH.