Yuksel S. Acute pancreatitis, hypercalcemia, and kidney stones: True incidence or unveiled prevalence? World J Gastrointest Surg 2026; 18(8): 116300 [DOI: 10.4240/wjgs.116300]
Corresponding Author of This Article
Selcuk Yuksel, Professor, Department of Internal Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale 17020, Türkiye. selcukyuksel.nephrology@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
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World J Gastrointest Surg. Aug 27, 2026; 18(8): 116300 Published online Aug 27, 2026. doi: 10.4240/wjgs.116300
Acute pancreatitis, hypercalcemia, and kidney stones: True incidence or unveiled prevalence?
Selcuk Yuksel
Selcuk Yuksel, Department of Internal Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale 17020, Türkiye
Selcuk Yuksel, Chair of the Department of Internal Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale 17020, Türkiye
Author contributions: Yuksel S conceptualized the opinion review; performed the literature review and critical appraisal; drafted, revised, and approved the final manuscript.
AI contribution statement: AI-assisted writing and language support tools were used during manuscript preparation. AI tools were used for writing assistance and language support. They were not used as an independent source of scientific judgment. The author takes full responsibility for the scientific content, interpretation, wording, and final form of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Selcuk Yuksel, Professor, Department of Internal Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale 17020, Türkiye. selcukyuksel.nephrology@gmail.com
Received: November 13, 2025 Revised: December 10, 2025 Accepted: January 15, 2026 Published online: August 27, 2026 Processing time: 276 Days and 10.1 Hours
Abstract
Recent study reported an association between hypercalcemia and nephrolithiasis in acute pancreatitis and proposed a striking rate of de novo stone formation during a 7-day hospitalization. Their work is valuable because it draws attention to the endocrine-metabolic dimension of acute pancreatic injury and to a potentially vulnerable subgroup of patients. However, the reported endpoint raises major biological and methodological concerns. Lithogenesis is a multistep process requiring urinary supersaturation, nucleation, aggregation, epithelial interaction, and retention; clinically meaningful stones generally evolve over weeks to months, not days. Moreover, although contrast-enhanced computed tomography was available at baseline and day 7, renal stone assessment relied on serial ultrasonography and on echogenic foci > 2 mm with posterior acoustic shadowing, a definition closer to microlithiasis than to established calculi. The absence of baseline non-contrast computed tomography analysis and 24-hour urinary biochemical profiling further weakens the inference of true incident nephrolithiasis. We therefore argue that the findings are more plausibly explained by the acute unmasking of prevalent, previously unrecognized microlithiasis under inflammatory-metabolic stress rather than by genuine de novo stone formation.
Core Tip: The association between hypercalcemia and renal stone detection in acute pancreatitis is clinically important, but a 7-day timeline is biologically inconsistent with established lithogenesis. Serial ultrasonography during acute illness is more likely to reveal pre-existing silent microlithiasis or transient crystal aggregates than true de novo nephrolithiasis. Distinguishing unveiled prevalence from true incidence is essential because it changes both the interpretation of the study and subsequent patient management.
