陳一中¹、江百凱¹、陳建志¹、林文榮¹、邱文祥^1,2

馬偕紀念醫院 泌尿科¹；馬偕醫學院；陽明醫學院²

Yi-Zhong Chen¹, Pai-Kai Chiang ¹, Marcelo Chen¹, Wun-Rong Lin¹, Allen W. Chiu^{1, 2}

Department of Urology, MacKay Memorial Hospital¹; Mackay Medical College¹;

School of Medican, National Yang-Ming University²

 

Background: Urolithiasis was found in patients with symptomatic or asymptomatic hyperparathyroidism. The aim of the study is to analyze urolithiasis in patients with primary hyperparathyroidism and the correlation with clinical and biochemical features in a retrospective study of primary hyperparathyroidism.

Materials and methods: A retrospective review of medical records was performed of 64 patients with hyperparathyroidism who underwent parathyroidectomy from 2009 and 2017. The demographic data and urology intervention were evaluated.

Results: Among the 64 patients, the male/female ratio of patients was 15:49. The incidence of urolithiasis with hyperthyroidism was 57% (33/58). Male has a higher incidence rate of renal stones than female. (80% vs.42%, p=0.029). Renal dysfunction was found significantly in patient with renal stones. (p=0.008) There was no significant difference in age, serium calcium, creatinine and parathyroid hormone between urolithiasis and non-urolithiasis group. Renal stones occurred more in bilateral side than unilateral side (70%vs.30%). About 45% (15/33) of patient with renal stones had flank pain and received urological intervention, such as extracorporeal shock wave lithotripsy (87%, 13/15), percutaneous nephrolithotomy(7%, 1/15) and ureter renal scopy lithotripsy(47%, 7/15).

Conclusion: Our study showed male patient with hyperparathyroidism had a higher incidence of urolithiasis than female and bilateral involvement was more frequent. Renal dysfunction might be an early predictive factor for nephrolithiasis.