Vanishing hypercalciuric kidney stones after treating underlying acromegaly

A 53-year-old male presented with recurrent calcium oxalate kidney stones as a first sign of underlying acromegaly, which vanished when his acromegaly was controlled. The exact mechanism behind hypercalciuria and urolithiasis in acromegaly is not yet clear. By discussing this case, a short overview of the pathophysiology of hypercalciuria in acromegaly and practical insights are given. LEARNING POINTS: Hypercalciuria is a common finding in acromegaly. There are only few reports describing hypercalciuric kidney stones in acromegaly. We assume that in acromegaly there is a primary role of IGF1-mediated, PTH-independent increase in calcitriol synthesis resulting in hypercalciuric kidney stones.