Urological Research

, Volume 21, Issue 3, pp 169–173 | Cite as

Pathophysiology of incomplete renal tubular acidosis in recurrent renal stone formers: evidence of disturbed calcium, bone and citrate metabolism

  • P. J. Osther
  • J. Bollerslev
  • A. B. Hansen
  • K. Engel
  • P. Kildeberg
Original Articles

Summary

Urinary acidification, bone metabolism and urinary excretion of calcium and citrate were evaluated in 10 recurrent stone formers with incomplete renal tubular acidosis (RTA), 10 recurrent stone formers with normal urinary acidification (NUA) and 10 normal controls (NC). Patients with iRTA had lower plasma standard bicarbonate after fasting (P<0.01) and lower urinary excretion of titratable acid (P<0.05) and citrate (P<0.01) compared with NUA patients and NC, and higher urinary excretion of ammonia (P<0.05) compared with NC (P<0.05). Hypercalciuria was found in 6 of 10 patients with iRTA compared with 3 of 10 with NUA, and O of 10 NC. The citrate/calcium ratio in urine was significantly reduced in iRTA compared with the value in NUA (P<0.01), and in NUA compared with NC (P<0.05). Biochemical markers of bone formation (serum osteocalcin) and bone resorption (urinary hydroxyproline) were significantly increased in iRTA compared with NUA and NC (P<0.01), indicating increased bone turnover in stone formers with iRTA. Stone formers with iRTA thus presented with disturbed calcium, bone and citrate metabolism-the same metabolic abnormalities which characterize classic type 1 RTA. Mild non-carbonic acidosis during fasting may be a pathophysilogical factor of both nephrolithiasis and disturbed bone metabolism in stone formers with iRTA

Key words

Bone turnover Calcium Citrate Renal stones Renal tubular acidosis 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • P. J. Osther
    • 1
  • J. Bollerslev
    • 2
  • A. B. Hansen
    • 3
  • K. Engel
    • 3
  • P. Kildeberg
    • 4
  1. 1.Department of UrologyOdense University HospitalOdenseDenmark
  2. 2.Department of Medical EndocrinologyOdense University HospitalOdenseDenmark
  3. 3.Department of Clinical ChemistryOdense University HospitalOdenseDenmark
  4. 4.Department of PediatricsOdense University HospitalOdenseDenmark
  5. 5.Institute of Clinical ResearchOdense University HospitalOdense CDenmark

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