MON-766 Risk Factors for Renal Stone Development in Adults with Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
Abstract Disclosure: M. Jay: None. S. Andrei: None. P. Hoang: None. A. Samani: None. T. Anpalagan: None. H. Samhat: None. D. Nguyen: None. R. Jones: None. R. Fu: None. N. Villemure-Poliquin: None. G. Gore: None. L.L. Lipscombe: None. A. Eskander: None. Background: Renal stones (RS) are a common complication of primary hyperparathyroidism (PHPT), posing significant clinical and economic burdens. Identifying RS risk factors is crucial for targeted prevention, monitoring, and prioritizing parathyroidectomy. However, no systematic review has evaluated RS risk factors in PHPT. Objective: We evaluated prespecified risk factors (age, sex, serum calcium, parathyroid hormone [PTH], vitamin D, and urine calcium) for incident and recurrent RS in adults with PHPT. Methods: We searched MEDLINE, Embase, and Cochrane CENTRAL through September 2024. Two reviewers independently selected cohort, case-control, and cross-sectional studies involving adults (≥18 years) with PHPT, excluding clinical trials, abstracts, and case reports. We extracted data on participants, risk factors and RS outcomes. Random-effects meta-analyses estimated adjusted (aOR) and crude (cOR) odds ratios. We used the Quality in Prognostic Studies and GRADE frameworks to assess risk of bias and evidence certainty, respectively. Sensitivity analyses excluded cross-sectional and high-risk-of-bias studies. Subgroup analyses explored heterogeneity by design, risk of bias, and osteoporosis. Meta-regression assessed serum calcium’s effect on other risk factors. The protocol was registered in PROSPERO (CRD42024608180). Results: Of 5,925 records, 53 studies (N=40,310; 8,311 RS cases) were included; 36 were cross-sectional. Median age was 58.4 years (IQR 55.7-61.9), and 77.9% were female (IQR 72.6-81.6). High-certainty evidence indicated male sex (aOR 2.04; 95% CI, 1.67-2.56; I² = 0%, N = 5 studies, 3,793 patients) and elevated urine calcium (aOR 2.38; 95% CI, 1.65-3.46; I² = 37.9%, N = 6 studies, 3,345 patients) were associated with increased RS risk. Moderate-certainty evidence suggested that younger age was associated with increased recurrent RS (uOR 12.50; 95% CI, 4.55-33.33; I² = 89.3%, N = 4 studies, 2,910 patients). Associations with serum calcium (aOR 1.42; 95% CI, 0.66-3.05; I² = 67.3%, N = 4 studies, 8,189 patients), PTH (aOR 0.99; 95% CI, 0.82-1.20; I² = 0%, N = 3 studies, 1,883 patients), and vitamin D (cOR 1.14; 95% CI, 0.71-1.81; I² = 61.8%, N = 12 studies, 2,274 patients) were informed by low- or very low-certainty evidence. Findings were consistent across sensitivity analyses. No subgroup differences emerged, and meta-regression found no modifying effect of serum calcium. Discussion: Our findings establish a distinct RS risk profile in PHPT compared with the general RS population. Male sex and elevated urinary calcium are key RS risk factors in PHPT, while younger age is pertinent to recurrence. These results support vigilant RS surveillance and timely parathyroidectomy in high-risk patients. Further research should refine RS risk factors, differentiate incident from recurrent RS, and assess the impact of early parathyroidectomy on RS morbidity and costs. Presentation: Monday, July 14, 2025
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».