Doctors Lounge - Nephrology Answers
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Forum Name: Miscellaneous Nephrology Topics
|bean2p - Wed Oct 29, 2008 2:32 pm||
I am a Caucasian 38yr old female. Since the age of 14 I have been getting Kidney stones. I was diagnosed at age 22 with Hyperthyroidism. Once i received the diagnosis i had one parathyroid removed. Though still get stones.
At the age of 14 they told me one of my kidneys, my left was deformed. Nothing was really said much about it other than it was misshapen. When I was 21 just before my diagnosis. I received another ultrasound and was told both my kidneys are deformed.
At 38 again I have been diagnosed again with kidney stones.( I should point out that between age 14 and 32 i would get kidney stones approx every 2 years. This time it was 6 yrs before i got one again.)
I saw on one of the forms that i have a eGFR level of 52. I am just wondering if this is something i should be concerned about considering my history of kidney stones etc
|Dr. Safaa Mahmoud - Tue Nov 04, 2008 10:27 pm||
It would be helpful if you can provide us information about the results of the last blood tests done for PTH level and the calcium level or any other investigations done. You also mentioned that surgery included removal of part of the parathyroid gland, so information about the pathology of the removed gland is important to know whether it was hyperplasia or a parathyroid adenoma.
Hyperparathyroidism can be due to disorder in the gland the so called primary parathyroidism or secondary to low calcium level and high phosphate level in patients with chronic renal problems. Tertiary hyperparathyroidism may occur after prolonged secondary hyperparathyroidismand this like other causes would result in hypercalcemia and also stone formation.
Nephrologists and endocrinologists recommend periodic assay for parathyroid hormone (PTH) serum concentration to check for a secondary HPT once the estimated glomerular filtration rate (eGFR) declines to < 60 mL/min/1.73 m2. Secondary hyperparathyroidism usually resolve after correction of the underlying cause as well as using medications to block PTH release. While primary and tertiary types may mandate surgical intervention.
If you have recurrent stones this means that the underlying cause is still not treated and checking both renal and the parathyroid function tests are essential for proper management.
It is not clear for me the kidney problem you have been diagnosed with but it is essential to follow up the kidney function tests regularly.
Your family history is also of consideration and causes related to familial conditions should be explored too.
I would advise you to follow up with your doctor he may recommend new PTH, serum calcium, phosphate, and radiological investigations for the remaining parathyroid glands.
Please keep us updated
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