long-lasting advanced primary hyperparathyroidism associeted with end-stage renal failure in a diabetic patient

in this report we explain a case of primary hyperparathyroidism in a 45 years old diabetic woman that was initially presented with recurrent nephrolithiasis of more than 10 years duration leading to right complete and left partial nephrectomy and complicated by end-stage renal failure. after diagnosis of primary hyperparathyroidism and parathyroid adenectomy, she developed severe hypocalcaemia due to severe and advanced osteitis fibrosa cystica. despite starting hemodialysis and treatment by high dose calcium the general condition did not improve and the hypocalcemia was not corrected. severe hungry bone syndrome did not get better and the patient died finally.