Parathyroidectomy (PTX) is routinely performed in hypercalciuric renal stone patients with primary hyperparathyroidism (PHPT). However, some data indicate a persistent stone activity following PTX, raising the issue of the link between PHPT and stone disease. We performed an observational study on 30 renal stone patients diagnosed with PHPT. Patients were selected among 1448 hypercalciuric patients referred in our department for a diagnostic evaluation. Patients with no parathyroid surgery or any biological follow-up were excluded. Clinical and biological data (including 24-h urine collection and a calcium load test) were collected before and within 12 months following surgery. Stone recurrence was evaluated by direct phone contact (median 43 months). Comparison of biological data before and after surgery showed a significant decrease of ionized calcium and serum parathyroid hormone after PTX. All stones contained calcium-dependent species such as carbapatite, brushite or dihydrate calcium oxalate. Urine saturation indexes and calciuria significantly decreased after surgery (from 9.9 to 5.9 mmol/d, p < 0.0001), but a persistent hypercalciuria was detected in 47% of patients. The other stone risk factors including diuresis stayed similar. Stone activity that was increasing (from 0.20–0.30 to 0.50–0.75/year) the 2 years before PTX, significantly decreased after surgery [0.05–0.15/year (p < 0.001)]. PTX in calcium-dependent renal stone formers with PHPT significantly decreases both stone recurrence and urine saturation indexes. However, PTX unmasked an underlying renal stone disease related to idiopathic hypercalciuria in half of patients with a remaining stone activity, testifying the need for patient’s follow-up to prevent stone recurrence.

甲状旁腺切除术 (PTX) 常规用于患有原发性甲状旁腺功能亢进 (PHPT) 的高钙尿性肾结石患者。然而，一些数据表明 PTX 后结石持续活动，引发了 PHPT 与结石病之间联系的问题。我们对 30 名诊断为 PHPT 的肾结石患者进行了观察性研究。从我们科转诊的 1448 名高钙尿症患者中选择患者进行诊断评估。没有进行甲状旁腺手术或任何生物学随访的患者被排除在外。在手术前和手术后 12 个月内收集临床和生物学数据（包括 24 小时尿液收集和钙负荷测试）。通过直接电话联系评估结石复发（中位数为 43 个月）。手术前后生物学数据比较显示，PTX后离子钙和血清甲状旁腺激素显着降低。所有结石都含有钙依赖性物质，如碳磷灰石、透钙磷石或二水草酸钙。手术后尿饱和指数和尿钙显着降低（从 9.9 到 5.9 mmol/d，p  < 0.0001)，但在 47% 的患者中检测到持续性高钙尿症。包括利尿在内的其他结石风险因素保持相似。PTX 前 2 年结石活动增加（从 0.20-0.30 到 0.50-0.75/年），手术后显着降低 [0.05-0.15/年 ( p  < 0.001)]。钙依赖性肾结石形成者中的 PTX 与 PHPT 显着降低结石复发和尿饱和指数。然而，PTX 在一半仍有结石活动的患者中揭示了与特发性高钙尿症相关的潜在肾结石疾病，证明需要对患者进行随访以防止结石复发。