Which of the following complications is Sam at risk of developing?

In the context of altered hormonal regulation, the risk of developing kidney stones relates closely to conditions that increase calcium levels in the urine or alterations in urinary pH. For instance, conditions like hyperparathyroidism lead to elevated levels of parathyroid hormone, which can increase calcium release from the bones and enhance renal calcium reabsorption, consequently leading to hypercalciuria and the formation of calcium stones.

Additionally, other hormonal changes can affect water balance and concentration of various solutes in the urine, further contributing to stone formation. Individuals with altered hormonal regulation often experience shifts in body fluid and mineral homeostasis, which can significantly increase their risk for kidney stones.

Other listed complications, while potentially relevant in different contexts, do not align as directly with the physiological processes involved in hormonal regulation as kidney stones do. Peptic ulcer disease, hypertension, and allergic reactions can occur for various reasons unrelated to hormonal imbalances, making kidney stones the more relevant risk in this scenario.