{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:19:46Z","timestamp":1772205586404,"version":"3.50.1"},"reference-count":140,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,13]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism (PHPT) is characterised by overactive parathyroid glands and consequent calcium dysregulation. Renal stones (RS) are a recognised complication and are associated with substantial morbidity. However, RS risk factors in PHPT are not well established, and recent international guidelines identify \u2018renal stone risk\u2019 as a research priority. We aim to summarise and meta-analyse evidence on prespecified risk factors for RS in adults with PHPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      This Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols-aligned protocol describes a systematic review and meta-analysis. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials will be searched from inception. Eligible designs include prospective and retrospective cohort, case\u2013control and cross-sectional studies of adults (\u226518 years) with PHPT; randomised trials, case reports, commentaries and conference abstracts will be excluded. Two reviewers will independently screen records, extract data and assess risk of bias using the Quality in Prognostic Studies tool. Prespecified risk factors are age, sex, urinary calcium, serum calcium, serum parathyroid hormone and serum 25-hydroxyvitamin D. We will pool adjusted ORs (primary) and unadjusted estimates (secondary) using random-effects models, assess heterogeneity with the\n                      <jats:italic>I\u00b2<\/jats:italic>\n                      statistic and rate certainty with Grading of Recommendations Assessment, Development and Evaluation. Publication bias will be explored when \u226510 studies are available. Literature searches will be updated prior to analyses to ensure currency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval is not required as only published data will be used. Findings will be disseminated through a peer-reviewed publication and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42024608180.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109747","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:26Z","timestamp":1772203226000},"page":"e109747","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for renal stone development in adults with primary hyperparathyroidism: a protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7299-4342","authenticated-orcid":false,"given":"Mohammad","family":"Jay","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorina","family":"Andrei","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Hoang","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussein","family":"Samhat","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Fu","sequence":"additional","affiliation":[{"name":"Departments of Community Health Sciences, Surgery and Oncology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Jones","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorraine L","family":"Lipscombe","sequence":"additional","affiliation":[{"name":"Women\u2019s College Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Eskander","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022706402094000_16.2.e109747.1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/cen.12569","article-title":"Characteristics of hyperparathyroid states in the Canadian multicentre osteoporosis study (CaMos) and relationship to skeletal markers","volume":"82","author":"Berger","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2026022706402094000_16.2.e109747.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00198-016-3716-2","article-title":"Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. 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