Surgery for primary hyperparathyroidism: patients continue to be at increased risk of renal stone disease 10 years after surgery.(Editorial)

A decade ago, Broadus reviewed the historical data on the clinical manifestations of primary hyperparathyroidism. (1) Previously renal stone disease was recognised to be a far more frequent complication than bone disease--about half the patients with primary hyperparathyroidism in clinical series published through the 1970s presented with renal stones. (1) Modern diagnostic tools for recognising hypercalcaemia and serum concentrations of parathyroid hormone have had a dramatic impact on the frequency with which primary hyperparathyroidism is diagnosed, especially in older people with non-specific symptoms of the disease. Renal stone disease is considered a less frequent complication by some investigators, (2 3) although others have reported that up to 75% of patients undergoing surgical treatment for primary hyperparathyroidism present with nephrolithiasis. (4) Now, a study by Mollerup et al in this issue shows that patients with primary hyperparathyroidism not only have a greater risk of renal stone disease but …