As a nephrologist, I frequently see patients with kidney stones, and one finding that appears with striking regularity on metabolic evaluations is hypocitraturia, defined as urine citrate <320 mg/day. In large-scale urine studies, hypocitraturia is now the third most common metabolic abnormality in stone formers, surpassed only by high urine calcium (>250mg/day) and low urine volume (< 2 L/day), significant risk factors for kidney stone formation (1). Over the past two decade

Primary hyperparathyroidism (PHPT) is the most common cause of parathyroid mediated hypercalcemia (high normal or high PTH) while...