Correlation of hypercalcemia with kidney stone formation and calcium-regulating hormone changes in patients with acute pancreatitis

Abstract

BACKGROUND

Acute pancreatitis (AP) is a severe inflammatory condition of the pancreas that leads to significant morbidity and metabolic disturbances. Hypercalcemia, or elevated serum calcium levels, is a concerning complication that may contribute to kidney stone formation and exacerbate renal issues. Calcium homeostasis is regulated by hormones, such as parathyroid hormone (PTH), calcitonin, and vitamin D, which can be altered in AP. Understanding the interplay among hypercalcemia, kidney stones, and hormonal changes is crucial for improving management strategies and clinical outcomes in patients with AP.

AIM

To investigate the relationship between hypercalcemia and kidney stone formation in patients with AP, along with changes in calcium-regulating hormone levels.

METHODS

This study was conducted in 200 patients diagnosed with AP at Ningbo Urology and Nephrology Hospital. The participants underwent regular monitoring of serum calcium levels and kidney stone formation using imaging. Additionally, blood samples were analyzed to measure the levels of calcium-regulating hormones, including PTH, calcitonin, and vitamin D, at baseline and during the course of the disease.

RESULTS

Of the 185 patients who completed the study, 31 (16.8%) developed kidney stones during the 7-day follow-up period. Hypercalcemia occurred in 53 patients (28.6%), with a peak incidence on day 3. Among hypercalcemic patients, 41.5% developed kidney stones compared to 6.8% in normocalcemic patients (odds ratio = 9.67, 95% confidence interval: 4.12-22.68, P < 0.001). A significant positive correlation was found between hypercalcemia and kidney stone formation (P < 0.001). Elevated PTH levels were noted in 60% of the patients with hypercalcemia, indicating a strong association between increased PTH levels, hypercalcemia, and kidney stone formation.

CONCLUSION

This study highlights the complex interplay between AP, calcium metabolism, and renal complications, providing insights that may guide future therapeutic strategies.

Keywords: Acute pancreatitis; Hypercalcemia; Kidney stones; Calcium-regulating hormones; Parathyroid hormone; Metabolic disturbance

Core Tip: This study aimed to examine the relationship between hypercalcemia and kidney stone formation in patients with acute pancreatitis. Of the 200 patients, 35% developed kidney stones, with a significant correlation between hypercalcemia and stone formation (P < 0.001). Notably, elevated parathyroid hormone levels were observed in 60% of patients with hypercalcemia, underscoring the complex interactions between calcium metabolism and renal complications in acute pancreatitis. Understanding these relationships is essential for enhancing management strategies and improving clinical outcomes.