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In patients with primary hyperparathyroidism (PHPT) and nephrolithiasis, we tend to assume that parathyroid surgery will lower risk for future symptomatic stone events substantially. But three recent observational studies have called that assumption into question. In all three studies, patients who underwent parathyroidectomy were compared with patients who were observed without surgery, and all studies were adjusted extensively for potentially confounding variables.
In a study drawn from the U.S. Veterans Affairs Healthcare database, researchers identified 5600 patients with PHPT and clinical histories of kidney stones. Compared with observed patients, those who underwent parathyroidectomy had a slightly higher rate of recurrent symptomatic…