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Peroraler Calcium-Belastungstest unter freier Diät bei idiopathischer Calcium-Nephrolithiasis — Möglichkeiten und Grenzen

Oral calcium load during free diet in idiopathic calcium nephrolithiasis — utility and limitations

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Summary

Seventeen patients who recurrently formed idiopathic calcium kidney stones (SF) and 25 age- and sex-matched healthy blood donors (H) were challenged by an oral calcium load (1 g) after an overnight fast. Their usual diet was not changed before the test. Urine samples were taken before, 2 1/2, and 4 h after the calcium load. A blood sample was drawn 3 3/4 h after calcium loading. Before and 2 1/2 h after calcium dosage urinary measurements of calcium, magnesium, phosphate, oxalate, uric acid, and creatinine did not reveal any differences between SF and H. According to the calciuria after 4 h SF were separated in normocalciurics (NCSF) and hypercalciurics (HCSF). Ninetenths of the NCSF had higher serum ionic calcium levels than H after calcium load (P<0.001), whereas HCSF were not different from H. Serum phosphate in SF was lower than in H (P<0.001). Carboxy-terminal parathormone, measured in 3 NCSF and in 2 HCSF, was normal. Depending on the calciuria or calcemia 4 h after an oral calcium load, 16 of 17 SF showed a metabolic abnormality (hypercalcemia or hypercalciuria). It is concluded that intestinal calcium absorption in SF might be increased to variable rates.

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Abbreviations

SF:

Steinformer

G:

gesunde Blutspender

HCSF:

hypercalciurische Steinformer

NCSF:

normocalciurische Steinformer

AMP:

Adenosin-Monophosphat

Ca:

Calcium

CaE:

ausgeschiedenes Calcium

CaF:

filtriertes Calcium

CaR:

rückresorbiertes Calcium

GF:

Glomerulumfiltrat

Mg:

Magnesium

P:

Phosphat

Hs:

Harnsäure

Ox:

Oxalsäure

Kr:

Kreatinin

ΔCa/Krmax :

maximaler Anstieg von Ca/Kr

ΔCaEmax :

maximaler Anstieg von CaE

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Arbeit mit Unterstützung der EMDO-Stiftung, Zürich

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Hess, B., Winter, A., Gautschi, K. et al. Peroraler Calcium-Belastungstest unter freier Diät bei idiopathischer Calcium-Nephrolithiasis — Möglichkeiten und Grenzen. Klin Wochenschr 64, 1013–1020 (1986). https://doi.org/10.1007/BF01757208

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Key words

  • Idiopathic calcium nephrolithiasis
  • Oral calcium loading test
  • Hypercalcemia/hypercalciuria
  • Increased intestinal calcium absorption