Grant: Project Grant

Primary hyperparathyroidism is a common hormone disorder in which small glands in the neck produce too much hormone, causing calcium levels in the blood to rise. Excess calcium can pass into the urine and form kidney stones, which can lead to severe pain, infections, emergency department visits, missed work, reduced quality of life, and long-term kidney damage. In Canada, kidney stones account for over 70,000 hospital encounters each year and substantial health care costs. Although a simple urine test for calcium can help identify people at higher risk, it is not used consistently in routine care, and it is unclear whether patients most likely to benefit from surgery are being identified and treated in a timely manner, leading to potentially preventable kidney stones and complications. As an interdisciplinary team of clinicians, scientists, health system leaders, and patient partners, we will use Ontario's health data to address four key aims: (1) understand which medical and social factors increase kidney stone risk in people with primary hyperparathyroidism; (2) determine whether earlier parathyroid surgery lowers this risk, especially in high-risk patients; (3) identify gaps and differences in urine calcium testing across patients and providers using health data and interviews; and (4) work with patients and clinicians to develop practical ways to improve testing and timely access to surgery. Results will be shared in partnership with patients and health care providers so they are easy to understand and can be used to improve care. This research will help improve testing and surgical decision-making, prevent kidney stone complications, reduce health care costs, and support fairer care for people living with primary hyperparathyroidism in Ontario and beyond.