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Patients with calcium kidney stones generally should be screened for hypercalcemia and primary hyperparathyroidism — a remediable cause of stone formation. Researchers used the U.S. Veterans Affairs (VA) database to find out the extent of this practice in 158,000 patients who had kidney stones during a 6-year period. The following outcomes were noted:
Serum calcium was measured in 88% of patients with kidney stones.
Serum calcium was elevated (i.e., >10.5 mg/dL) in 7561 patients — roughly 5% of those whose serum calcium was measured. About half these patients had directly measured hypercalcemia, and about half had hypercalcemia only after correction for serum albumin.
Serum parathyroid hormone levels were measured in only 25% of patients with …