Does vitamin D supplementation in primary hyperparathyroidism increase the risk of kidney stones?

Hyperparathyroidism does increase the risk of developing kidney stones. A study in New England Journal of Medicine, Broadus et al., PMID 7351950, reported that patients with elevated concentrations of 1,25-dihydroxyvitamin D are at increased risk for kidney stones. The reason is that 1,25-dihydroxyvitamin D3 increases intestinal calcium absorption increasing the risk for hypercalciuria and kidney stone development. The elevated concentrations of 1,25-dihydroxyvitamin D increased 24 hydroxylase activity thereby increasing the destruction of 25-hydroxyvitamin D which is why patients with hyperparathyroidism are often vitamin D deficient. I have treated my patients with hyperparathyroidism with an adequate amount of calcium 1,000 mg/day and vi...