Summary
Ninety-seven male patients with idiopathic calcium urolithiasis and 17 normal male subjects were studied to evaluate the mechanism of idiopathic hypercalciuria with an oral calcium tolerance test, which has been useful in differentiating hypercalciuria. The changes in parathyroid function, such as parathormone and urinary cyclic AMP, and calcium after calcium load differed between absorptive hypercalciuria and renal hypercalciuria. We have confirmed that the change in serum calcitonin after calcium load was also different in these two hypercalciurias. The increase in serum calcium was sufficient to reduce parathyroid function but serum calcitonin was unchanged after calcium load in the control group, in patients with normocalciuria, and those with renal hypercalciuria. Although serum and urinary calcium were more elevated in absorptive hypercalciuria than in the other three groups, parathyroid function was not significantly reduced after loading in absorptive hypercalciuria. In this group only, the serum calcitonin was significantly elevated after calcium load. It is reasonable to suggest that, in this group, because parathyroid function is usually suppressed by intestinal hyperabsorption of calcium, parathyroid function may not be further suppressed by even calcium load. Possibly the significant stimulation of calcitonin may compensate for the lack of suppression of parathyroid function and maintain normal serum calcium levels in absorptive hypercalciuria. These results suggest that the change in serum calcitonin is also useful to differentiate abnormalities of calcium metabolism in patients with hypercalciuria.
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Bordier P, Ryckewart A, Gueris J, Rasmussen H (1977) On the pathogenesis of so-called idiopathic hypercalciuria. Am J Med 63:398
Broadus AE (1979) Nephrogenous cyclic AMP as a parathyroid function test. Nephron 23:136
Flocks RH (1939) Calcium and phosphorus excretion in the urine of patients with renal and ureteral calculi. JAMA 113: 1466
Fuss M, Verbeelen D, Geurts J, Simon J, Bergans A, De Backer M, Six R, Corvilain J (1978) The use of a test for the differential diagnosis of hypercalciuria. Eur Urol 4:324
Kohri K (1980) Endocrinological studies on pathogenesis of urolithiasis. IV. Pathophysiological studies in hypercalciuric stone formers: Use of calcium restricted test and an oral calcium tolerance test. Jpn J Urol 71:1349
Kohri K, Yachiku S, Kurita T (1980) Endo crinological studies on pathogenesis of urolithiasis. V. Effect of calcitonin in urinary electrolytes excretion and serum electrolytes. Jpn J Urol 71: 1515
Nelson JH III, Rehm RA, Riemenschneider HW, Wise HA, Pelug B, Kemple K, Whitehouse WK, Winter CC (1978) Oral calcium tolerance and urinary cyclic AMP in urolithiasis. Urology 12:519
Nordin BEC, Peacock E, Wilkinson R (1972) Hypercalciuria and calcium stone disease. In: Clinics in endocrinology and metabolism. Saunders Company, Philadelphia 1:169
Pak CYC, Ohata M, Lawrence EC, Snyder W (1974) The hypercalciurias. Causes, parathyroid functions, and diagnostic creteria. J Clin Invest 54:387
Pak CYC, Kaplan R, Bone H, Townsend J, Waters O (1975) A simple test for the diagnosis of absorptive, resorptive and renal hypercalciurias. N Engl J Med 292:497
Sakhaee K, Peterson R, Northcutt C, Pak CYC (1979) Critical appraisal of oral calcium load test for indirect assessment of intestinal calcium absorption. Urology 14:251
Yachiku S, Iguchi M, Kohri K, Kurita T (1979) Studies on urinary oxalate. 2. Excretion of oxalic acid in patients with urinary calculi. Jpn J Urol 70:291
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Kohri, K., Kataoka, K., Iguchi, M. et al. Oral calcium tolerance test and serum calcitonin in calcium stone formers. Urol. Res. 11, 33–37 (1983). https://doi.org/10.1007/BF00272707
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DOI: https://doi.org/10.1007/BF00272707