{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T02:07:04Z","timestamp":1786241224898,"version":"build-2736575974"},"reference-count":27,"publisher":"The Endocrine Society","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>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 increased risk of cardiovascular disease and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify risk factors for nephrolithiasis, osteoporosis, and mortality in PHPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University teaching hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Presented with PHPT between 2006 and 2014 (n = 611).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p>Assessment of nephrolithiasis, osteoporosis, and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of patients with PHPT, 13.9% had nephrolithiasis. Most had previously documented stone disease, and only 4.7% of asymptomatic patients who were screened for renal stones had calculi identified, not very dissimilar to the rate in the non-PHPT population. Younger age (P &lt; 0.001) and male sex (P = 0.003) were the only independent predictors of nephrolithiasis. Of patients with dual-energy X-ray absorptiometry data, 48.4% had osteoporosis (223\/461). Older age (P &lt; 0.001), lower body mass index (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); otherwise, calcium and PTH were not associated with lower z scores. Mortality in PHPT was associated with older age (P &lt; 0.008), social deprivation (P = 0.028), and adjusted calcium (P = 0.009) but not independently with PTH at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2018-02483","type":"journal-article","created":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T22:34:34Z","timestamp":1553726074000},"page":"3692-3700","source":"Crossref","is-referenced-by-count":47,"title":["Predictors of Nephrolithiasis, Osteoporosis, and Mortality in Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"104","author":[{"given":"Laura J","family":"Reid","sequence":"first","affiliation":[{"name":"Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bala","family":"Muthukrishnan","sequence":"additional","affiliation":[{"name":"Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, United 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sites in Danish patients","volume":"21","author":"Christiansen","year":"1997","journal-title":"Bone"},{"issue":"3","key":"2019072014595040300_bib4","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/jbmr.5650040302","article-title":"Skeletal disease in primary hyperparathyroidism","volume":"4","author":"Silverberg","year":"1989","journal-title":"J Bone Miner Res"},{"issue":"3","key":"2019072014595040300_bib5","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1530\/eje.1.02225","article-title":"The risk of fractures in postmenopausal women with primary hyperparathyroidism","volume":"155","author":"De Geronimo","year":"2006","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"2019072014595040300_bib6","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0039-6060(05)80017-0","article-title":"Fracture incidence in postmenopausal women with primary 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study","volume":"104","author":"Wermers","year":"1998","journal-title":"Am J Med"},{"issue":"1","key":"2019072014595040300_bib17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/cen.12206","article-title":"What predicts adverse outcomes in untreated primary hyperparathyroidism? 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