2249 PREVALENCE OF UROLITHIASIS AND METABOLIC ABNORMALITIES OF PATIENTS WITH SURGICALLY CONFIRMED PRIMARY HYPERPARATHYROIDISM
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: Evaluation & Medical Management (II)1 Apr 20132249 PREVALENCE OF UROLITHIASIS AND METABOLIC ABNORMALITIES OF PATIENTS WITH SURGICALLY CONFIRMED PRIMARY HYPERPARATHYROIDISM Mohamed Elkoushy, Alice Yu, Roger Tabah, Richard Payne, and Sero Andonian Mohamed ElkoushyMohamed Elkoushy Montreal, Canada More articles by this author , Alice YuAlice Yu Montreal, Canada More articles by this author , Roger TabahRoger Tabah Montreal, Canada More articles by this author , Richard PayneRichard Payne Montreal, Canada More articles by this author , and Sero AndonianSero Andonian Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2158AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Primary hyperparathyroidism (PHPT) is well-known to cause nephrolithiasis and nephrocalcinosis which may ultimately result in impaired renal function. The reported prevalence of stone formation in patients with PHPT varies widely among different studies. Moreover, there is sparse data comparing metabolic stone parameters before and following successful Parathyroidectomy (PTX). Therefore, the aim of the present study was to determine the prevalence of urolithiasis in patients with PHPT and to evaluate their metabolic stone work-up before and after PTX. METHODS Institutional Research Ethics approval was obtained. A retrospective review of prospectively collected data was performed for patients presenting with PHPT to the stone, surgical oncology, and otolaryngology clinics at two tertiary centers from January 2006 until November 2011. Data was collected regarding patient characteristics, operative records, pathology (hyperplasia vs. adenoma), and presence of urolithiasis together with 24-hour urine collections before and after PTX, when available. RESULTS Of 333 patients undergoing PTX, 255 patients had surgically-confirmed PHPT and were included in this study. Mean (range) age was 60.3 (18-91) years and 68.2% were females. Preoperative renal calcification was detected in 51 (20%) patients; urolithiasis in 48(18.8%) and nephrocalcinosis in 3 (1.2%) patients. Compared with PHPT patients without urolithiasis, PHPT patients with urolithiasis were significantly younger (61.3 vs. 55.9 years, p=0.02), less likely to be female (71.5% vs. 54.2%, p=0.025) and had significantly lower levels of 25-hydroxyl vitamin D (23.9 vs. 19.7 ng/ml, p=0.03). Nine patients (3.5%) developed recurrent urolithiasis post-PTX and were found to have significantly higher post-PTX total serum calcium levels when compared with patients without recurrent urolithiasis (12.6 vs. 10.9 mg/dl, p=0.01). Similarly, there were significantly more males in the post-PTX recurrent urolithiasis cohort (66.7% vs. 30.5%, p=0.03). Whereas 62% of stone-former were hypercalciuric pre-PTX, no patient had hypercalciuria post-PTX (p<0.001). On multivariate regression, male gender (aOR (95%CI): 6.8 (5.3-7.2), p=0.01) and post-PTX total serum calcium level independently predicted stone recurrence post-PTX (aOR (95%CI): 1.48 (1.33?2.12, p = 0.02). CONCLUSIONS A high prevalence of urolithiasis was detected in patients presenting with PHPT. Male gender and post-PTX total serum calcium level independently predicted stone recurrence. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e922-e923 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamed Elkoushy Montreal, Canada More articles by this author Alice Yu Montreal, Canada More articles by this author Roger Tabah Montreal, Canada More articles by this author Richard Payne Montreal, Canada More articles by this author Sero Andonian Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".