recurrent nephrolithiasis leading to renal failure: a neglected primary hyperparathyroidism

Introduction: nephrolithiasis occurs in 7% to 40% of patients with primary hyperparathyroidism (phpt). approximately 5% of patients with nephrolithiasis will have hyperparathyroidism. this study presents a rare case of hypercalcemia secondary to phpt, which eventually led to renal failure case presentation: this report presents a 55-year-old male presented with history of multiple kidney stones from 6 years ago, who had undergone multiple interventions by extracorporeal shock wave lithotripsy (eswl). the result of lab exams were: bun: 48 mg/dl, cr: 2.83 mg/dl, calcium: 15.8 mg/dl, phosphorus: 4.4, serum intact parathyroid hormone (ipth) = 1046pg/ml. at t99scan mibi, the nuclear showed parathyroid adenoma in the inferior pole of the right thyroid. the patient underwent parathyroidectomy. serum calcium level returned to normal range within 3 days after surgery. conclusions: more attention must be paid to patients with recurrent nephrolithiasis, and such patients must be evaluated for phpt before pro- gressing to ckd.