Hyperoxaluria in Idiopathic Calcium Stone Disease: Further Evidence of Intestinal Hyperabsorption of Oxalate

1982 ◽  
Vol 63 (4) ◽  
pp. 381-385 ◽  
Author(s):  
M. Marangella ◽  
B. Fruttero ◽  
M. Bruno ◽  
F. Linari
Keyword(s):  
Intestinal Absorption ◽  
Direct Relationship ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Oxalate Absorption ◽  
Stone Formers ◽  
Kinetics Of

1. Seventeen healthy controls and 63 patients with idiopathic calcium stone disease of the urinary tract were investigated for urinary calcium and oxalate excretion and for [14C]oxalate intestinal absorption. 2. Under comparable controlled dietary intake a significant increase in calcium excretion was found in patients with stone disease. Oxalate excretion and [14C]oxalate intestinal absorption were mildly but not significantly increased. When patients with stone disease were subdivided into normocalciuric and hypercalciuric subjects, oxalate excretion and [14C]oxalate absorption were significantly increased in the latter. There was a significant direct relationship between calcium excretion and both oxalate excretion and [14C]oxalate absorption. 3. [14C]Oxalate absorption increased significantly in 22 stone-formers when dietary calcium was changed from normal to low. 4. The kinetics of [14C]oxalate intestinal absorption showed that the main difference between normocalciuric and hypercalciuric subjects occurred within the first 6 h after the oxalate-labelled meal. 5. These results confirm that mild hyperoxaluria is a frequent feature of idiopathic calcium stone disease even when patients and controls are studied under controlled dietary conditions. Our data are consistent with the hypothesis that hyperoxaluria is secondary to calcium hyperabsorption and is upper intestinal in origin.

scholarly journals The Variability and Dietary Dependence of Urinary Oxalate Excretion in Recurrent Calcium Stone Formers

1987 ◽  
Vol 24 (4) ◽  
pp. 385-390 ◽  
Author(s):  
J M Brown ◽  
G Stratmann ◽  
D M Cowley ◽  
B M Mottram ◽  
A H Chalmers
Keyword(s):  
Calcium Intake ◽  
Normal Subjects ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Urinary Oxalate ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Stone Formers ◽  
Urinary Oxalate Excretion

Twenty-two recurrent calcium stone formers had 24-h urinary oxalate excretions on their home diets which were significantly greater than those of 30 normal subjects (0·48±0·23 mmol/d; mean±SD compared with 0·31±0·11; P<0·01). The stone formers also demonstrated marked day to day variability in oxalate excretion indicating that a single normal urinary oxalate measurement did not exclude significant hyperoxaluria at other times. On a hospital diet containing 1000 mg calcium per day, urinary oxalate excretion fell significantly from 0·48±0·23 mmol/d to 0·32±0·12; P<0·01. As the urinary calcium excretion in and out of hospital was similar, it seems unlikely that low calcium intake at home was responsible for the hyperoxaluria. All patients had recurrent symptomatic stone disease and had been advised to avoid foods rich in oxalate. Whilst poor compliance is a possible explanation for the variability in oxalate excretion, we believe it is more likely that there is an inadvertent intake of oxalogenic precursors in their diet. As normal subjects do not demonstrate hyperoxaluria on similar home diets, stone formers may have a metabolic defect in the handling of these precursors.

scholarly journals Hyperinsulinemia and Urinary Calcium Excretion in Calcium Stone Formers With Idiopathic Hypercalciuria

2013 ◽  
Vol 98 (6) ◽  
pp. 2589-2594 ◽  
Author(s):  
Vivienne Yoon ◽  
Beverley Adams-Huet ◽  
Khashayar Sakhaee ◽  
Naim M. Maalouf
Keyword(s):  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Idiopathic Hypercalciuria ◽  
Calcium Excretion ◽  
Calcium Stone ◽  
Stone Formers

scholarly journals CALCIUM

2010 ◽  
Vol 17 (04) ◽  
pp. 698-701
Author(s):  
MUHAMMAD ISHAQ ◽  
ISRAR AHMED AKHUND ◽  
MOULA BUX LAGHARI ◽  
Muhammad Sabir
Keyword(s):  
Urinary Tract ◽  
Serum Calcium ◽  
Upper Urinary Tract ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Stone Formers ◽  
Study Results ◽  
Urinary Tract Stone

Aims & Objectives: To evaluate the effects of Serum Calcium and Urinary Calcium excretion on upper urinary tract stone diseases in the Peshawar (a high stone incidence belt). Subjects & Methods: One hundred patients (age 20-60years) who were suffering severely from upper urinary tract stone disease were selected from LRH and Hayatabad Medical Complex Hospitals of Peshawar, same numbers of healthy controls from the same region were also selected for the study. Results: When results were summed up and testParameters were compared, it was seen that mean Serum Calcium in stone formers was greater than that of non-stone formers (P<0.001). Same pattern was also observed (P< 0.001) in both groups regarding mean urinary calcium excretion. Conclusions: We concluded that calcium is a definitive risk factor in upper urinary tract stone disease. However we suggest further work and research on wide scale population inorder to evaluate this relation. 

scholarly journals Role of 1,25-Dihydroxy Vitamin D3and Parathyroid Hormone in Urinary Calcium Excretion in Calcium Stone Formers

2014 ◽  
Vol 55 (5) ◽  
pp. 1326 ◽  
Author(s):  
Won Tae Kim ◽  
Yong-June Kim ◽  
Seok Joong Yun ◽  
Kyung-Sub Shin ◽  
Young Deuk Choi ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Calcium Stone ◽  
Stone Formers

Effect of citrate on the urinary excretion of calcium and oxalate: relevance to calcium oxalate nephrolithiasis.

1989 ◽  
Vol 35 (1) ◽  
pp. 23-28 ◽  
Author(s):  
D M Cowley ◽  
B C McWhinney ◽  
J M Brown ◽  
A H Chalmers
Keyword(s):  
Calcium Oxalate ◽  
Normal Subjects ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Molar Ratios ◽  
Oxalate Absorption ◽  
Stone Formers ◽  
Calcium Loading ◽  
High Calcium

Abstract Studies in 24 recurrent oxalate stone-formers have shown that values for urinary calcium excretion for this group on at-home diets vary significantly (P less than 0.001) more than values for creatinine excretions. By placing stone-formers on controlled in-hospital diets and measuring their calcium excretions, we were able to predict probable outpatient hypercalciuria (greater than 7.5 mmol/day) with a sensitivity of 95% and a specificity of 95%. In this study, the renal loss of calcium during low-calcium diets was proportional to the absorptive hypercalciuria during high-calcium diets. Calcium loading experiments in fasted stone-formers and normal subjects indicated that citrate, at citrate:calcium molar ratios ranging from 0.12 to 1, stimulated urinary calcium excretion more than did calcium carbonate loading alone. In addition, citrate also significantly (P less than 0.05) increased the excretion of urinary oxalate by two normal subjects for a given load of calcium oxalate. Malabsorption of citrate and possibly other hydroxycarboxylic acids may thus predispose to oxalate nephrolithiasis by promoting calcium and oxalate absorption.

The Role of Inhibitors and other Factors in the Pathogenesis of Recurrent Calcium-Containing Renal Stones

1977 ◽  
Vol 53 (2) ◽  
pp. 141-148 ◽  
Author(s):  
J. M. Baumann ◽  
S. Bisaz ◽  
R. Felix ◽  
H. Fleisch ◽  
U. Ganz ◽  
...  
Keyword(s):  
Inhibitory Activity ◽  
Stone Formation ◽  
Renal Stones ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Crystal Formation ◽  
Inorganic Pyrophosphate ◽  
Control Subjects ◽  
Stone Formers

1. In order to assess the relative importance of possible pathogenetic factors in the formation of calcium-containing renal stones, a group of 18 patients (12 men, six women) with active, recurrent stone disease were compared with 16 age-matched control subjects (10 men, six women) given an identical diet. 2. Fifteen (83%) of the patients showed at least one, eight (44%) showed two, and one (6%) patient showed three abnormalities that might predispose to stone formation. 3. Increased urinary calcium excretion was the most common abnormality (11 patients, 61%), particularly in the women (83%). 4. A diminished excretion of inhibitors of crystal formation of calcium phosphate was the next most common abnormality, which occurred in eight patients (44%), all of whom were men. It was largely attributable to a diminished excretion of inorganic pyrophosphate (PPi). The PPi/orthophosphate ratios were also lower in the stone-formers. Significant differences in residual inhibitory activity after enzymatic removal of PPi between control subjects and stone-formers could not be found in 24 h urine samples but were present during certain times of the day. Pyrophosphate showed a higher inhibitory activity in urine than in control solutions, this enhancement being absent in stone-formers. 5. Nine (50%) of the patients, but only one of the control subjects, produced crystal aggregates greater than 50 μm in diameter after an oral load of oxalate.

MO113CALCULATED URINARY CALCIUM-OXALATE SATURATION (ßCAOX) IS NOT SPECIFICALLY ELEVATED IN PATIENTS WITH PRIMARY HYPEROXALURIA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Bernd Hoppe ◽  
Wolfgang Böhm ◽  
Cristina Martin Higueras
Keyword(s):  
Calcium Oxalate ◽  
Primary Hyperoxaluria ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Urinary Calcium Excretion ◽  
Urine Specimen ◽  
Calcium Excretion ◽  
Stone Formers ◽  
Enzyme Defects ◽  
Urinary Oxalate Excretion

Abstract Background and Aims In the primary hyperoxalurias (PH; types 1-3) recurrent urolithiasis (UL) and/or progressive nephrocalcinosis (NC) are the clinical hallmarks. Three different enzyme defects lead to endogenous oxalate overproduction and to extremely elevated urinary oxalate excretion (UOx). Thus, it seems logical that urine is supersaturated for calcium-oxalate (CaOx). It was, hence, speculated that urinary CaOx saturation (ßCaOx), calculated by computed programs, is significantly higher as compared to that of patients with idiopathic CaOx stones. We now aimed to evaluate and calculate urinary ßCaOx in PH patients according to type, as well as in non-PH patients with UL or NC. Method The computed equilibrium program EQUIL2 was used for the calculation of ßCaOx. For this, 24 h urine specimen of 70 patients with non-PH NC (46 male, 24 female, median age 6.06 (range 0.3-31.4 years)), of 149 idiopathic CaOx UL (90/59 m/f, age 8.5 (0.1-68.6)), of 51 PH 1 patients (31/21, age 12.33 (0.8-63.8)), of 5 PH 2 patients (3/2, age 5.41 (4.3-12.9)) and of 14 PH 3 patients (8/6, age 8.5 (2.9-29.3)) were analyzed for all necessary components. All patients were in stable kidney function (eGFR &gt; 45 ml/min). Results Uox was higher in the PH patients as compared to the non-PH UL or NC patients (p &lt; 0.05). However, there was no statistical difference between the Uox in PH 1 vs PH 2 or PH 3 patients, although, a clear effect of B6 medication was visible in PH1 patients. Urinary calcium excretion was lower (not significant) in PH patients as compared to NC/UL. There was no difference in ßCaOx when PH were compared to non-PH patients and it mostly remained in the normal range. Conclusion Urine ßCaOx is similar in PH and non-PH stone formers. Therefore, calculation of ßCaOx using computed programs is not a reliable parameter to define the definitively extreme CaOx supersaturation of urine from PH patients. This miscalculation is related to a rather lowish urinary calcium excretion in PH as compared to other UL/NC patients. Therefore, we recommend not to use such programs to express the risk of recurrent stone disease or nephrocalcinosis in PH.

Effects of Eicosapentaenoic Acid on Urinary Calcium Excretion in Calcium Stone Formers

2001 ◽  
Vol 39 (5) ◽  
pp. 580-585 ◽  
Author(s):  
Takahiro Yasui ◽  
Hajime Tanaka ◽  
Keiji Fujita ◽  
Masanori Iguchi ◽  
Kenjiro Kohri
Keyword(s):  
Eicosapentaenoic Acid ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Calcium Stone ◽  
Stone Formers
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