Skip to main content

Advertisement

Log in

Calcium Nephrolithiasis

  • Original Paper
  • Published:
Clinical Reviews in Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Nephrolithiasis is a major cause of morbidity involving the urinary tract. The prevalence of this disease in the United States increased from 3.8% in the 1970s to 5.2% in the 1990s. There were nearly 2 million physician office visits for nephrolithiasis in 2000, and estimated annual costs totaled $2 billion. About 80% of stones are composed of calcium oxalate with variable amounts of calcium phosphate. New information has become available on the clinical presentation, epidemiologic risk factors, evaluative approach, and outcome of various therapeutic strategies. In this report, we will review the epidemiology and mechanisms of calcium kidney stones formation and outline management aimed at preventing recurrences. Improved awareness and education in both the general population and among health care providers about these modifiable risk factors has the potential to improve general health and decrease morbidity and mortality secondary to renal stone disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ramello A, Vitale C, Marangella M. Epidemiology of nephrolithiasis. J Nephrol. 2000;13(Suppl 3):S45–50.

    PubMed  Google Scholar 

  2. Coe FL, Parks, JH. Pathogenesis and treatment of nephrolithiasis. In: The Kidney. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 1841–67.

  3. Chow K, Dixon J, Gilpin S, Kavanagh JP, Rao PN. Citrate inhibits growth of residual fragments in an in vitro model of calcium oxalate renal stones. Kidney Int. 2004;65:1724–30.

    Article  PubMed  CAS  Google Scholar 

  4. Curhan GC, Willett WC, Knight EL, Stampfer M. Dietary factors and the risk of incident kidney stones in younger women: nurses’ health study II. Arch Int Med. 2004;164:885–91.

    Article  Google Scholar 

  5. Stamatelou KK, Francos ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States; 1976–1994. Kidney Int. 2003;63:1817–23.

    Article  PubMed  Google Scholar 

  6. Curhan GC, Rimm EB, Willett WC, Stampfer MJ. Regional variation in nephrolithiasis incidence and prevalence among United States men. J Urol. 1994;151:838–41.

    PubMed  CAS  Google Scholar 

  7. Curhan GC. Epidemiology of stone disease. Urol Clin North Am. 2007;34(3):287–93.

    Article  PubMed  Google Scholar 

  8. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005;293:455–62.

    Article  PubMed  CAS  Google Scholar 

  9. Taylor EN, Curhan GC. Body size and 24-hour urine composition. Am J Kidney Dis. 2006;48(6):905–15.

    Article  PubMed  CAS  Google Scholar 

  10. Taylor EN, Curhan GC. Differences in 24-hour urine composition between black and white women. J Am Soc Nephrol. 2007;18:654–9.

    Article  PubMed  CAS  Google Scholar 

  11. Moe OW. Kidney stones: pathophysiology and medical management. Lancet. 2006;367:333–44.

    Article  PubMed  CAS  Google Scholar 

  12. Coe FL, Favus MJ, Pak CY, et al. Kidney stones: medical and surgical management. Philadelphia: Lippincott Williams & Wilkins; 1996.

    Google Scholar 

  13. Brennan S, Hering-Smith K, Hamm LL. Effect of pH on citrate reabsorption in the proximal convoluted tubule. Am J Physiol. 1988;255:F301–6.

    PubMed  CAS  Google Scholar 

  14. Evan A, Lingeman J, Coe FL, Worcester E. Randall’s plaque: pathogenesis and role in calcium oxalate nephrolithiasis. Kidney Int. 2006;69(8):1313–8.

    PubMed  CAS  Google Scholar 

  15. Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest. 2005;115(10):2598–608.

    Article  PubMed  CAS  Google Scholar 

  16. Stechman MJ, Loh NY, Thakker RV. Genetics of hypercalciuric nephrolithiasis: renal stone disease. Ann NY Acad Sci. 2007;1116:461–84.

    Article  PubMed  CAS  Google Scholar 

  17. Haleblian GE, Cantor DA, Sur RL, Assimos DG, Preminger GM. Nephrolithiasis in identical twins: the impact of nature vs nurture. BJU Int. 2007;100(3):621–3.

    Article  PubMed  CAS  Google Scholar 

  18. Popovtzer MM. Disorders of calcium, phosphorus, vitamin D, and parathyroid hormone activity. Renal and electrolyte disorders. 6th ed. Lippincott: By Schrier WS; 2003. p. 217–77.

    Google Scholar 

  19. Müller D, Hoenderop JG, van Os CH JM, Bindels R. The epithelial calcium channel, ECaC1: molecular details of a novel player in renal calcium handling. Nephrol Dial Transplant. 2001;16(7):1329–35.

    Article  PubMed  Google Scholar 

  20. Posen S, Clifton-Bligh P, Reeve TS, Wagstaffe C, Wilkinson M. Is parathyroidectomy of benefit in primary hyperparathyroidism? Q J Med. 1985;54(215):241–51.

    PubMed  CAS  Google Scholar 

  21. Broadus AE, Horst RL, Lang R, Littledike ET, Rasmussen H. The importance of circulating 1, 25-dihydroxyvitamin D in the pathogenesis of hypercalciuria and renal-stone formation in primary hyperparathyroidism. N Engl J Med. 1980;302(8):421–6.

    Article  PubMed  CAS  Google Scholar 

  22. Reiner M, Sigurdsson G, Nunziata V, Malik MA, Poole GW, Joplin GF. Abnormal calcium metabolism in normocalcaemic sarcoidosis. Br Med J. 1976;2(6050):1473–6.

    Article  PubMed  CAS  Google Scholar 

  23. Adams JS, Sharma OP, Gacad MA, Singer FR. Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. J Clin Invest. 1983;72(5):1856–60.

    Article  PubMed  CAS  Google Scholar 

  24. Bilezikian JP. Management of acute hypercalcemia. NEJM. 1992;326(18):1196–203.

    Article  PubMed  CAS  Google Scholar 

  25. Baxter JD, Bondy PK. Hypercalcemia in thyrotoxicosis. Ann Intern Med. 1966;65(3):429–42.

    PubMed  CAS  Google Scholar 

  26. Bilezikian JP. Parathyroid hormone-related peptide in sickness and in health. N Engl J Med. 1990;322(16):1151–3.

    Article  PubMed  CAS  Google Scholar 

  27. Eiam-ong S, Kurtzman NA. Metabolic acidosis and bone disease. Miner Electrolyte Metab. 1994;20(1–2):72–80.

    PubMed  CAS  Google Scholar 

  28. Worcester EM, Gillen DL, Evan AP, Parks JH, Wright K, Trumbore L, Nakagawa Y, Coe FL. Evidence that postprandial reduction of renal calcium reabsorption mediates hypercalciuria of patients with calcium nephrolithiasis. Am J Physiol Renal Physiol. 2007;292(1):F66–75.

    Article  PubMed  CAS  Google Scholar 

  29. Jaeger P, Robertson WG. Role of dietary intake and intestinal absorption of oxalate in calcium stone formation. Nephron Physiol. 2004;98(2):64–71.

    Article  Google Scholar 

  30. Brennan S, Hering-Smith K, Hamm LL. Effect of pH on citrate reabsorption in the proximal convoluted tubule. Am J Physiol. 1988;255:F301–6.

    PubMed  CAS  Google Scholar 

  31. Meschi T, Schianchi T, Ridolo E, Adorni G, Allegri F, Guerra A, Novarini A, Borghi L. Body weight, diet and water intake in preventing stone disease. Urol Int. 2004;72:29–33.

    Article  PubMed  CAS  Google Scholar 

  32. Heller HJ, Doerner MF, Brinkley LJ, Adams-Huet B, Pak CY. Effect of dietary calcium on stone forming propensity. J Urol. 2003;169:470–4.

    Article  PubMed  CAS  Google Scholar 

  33. Domrongkitchaiporn S, Sopassathit W, Stitchantrakul W, Prapaipanich S, Ingsathit A, Rajatanavin R. Schedule of taking calcium supplement and the risk of nephrolithiasis. Kidney Int. 2004;65:1835–41.

    Article  PubMed  CAS  Google Scholar 

  34. Chai W, Liebman M. Assessment of oxalate absorption from almonds and black beans with and without the use of an extrinsic label. J Urol. 2004;172(3):953–7.

    Article  PubMed  Google Scholar 

  35. Mittal RD, Kumar R, Mittal B, Prasad R, Bhandari M. Stone composition, metabolic profile and the presence of the gut-inhabiting bacterium Oxalobacter formigenes as risk factors for renal stone formation. Med Princ Pract. 2003;12(4):208–13.

    Article  PubMed  CAS  Google Scholar 

  36. Reddy ST, Wang CY, Sakhaee K, Pak CY. Effect of low-carbohydrate, high-protein diets on acid-base balance, stone forming propensity, and calcium metabolism. Am J Kidney Dis. 2002;40:265–74.

    Article  PubMed  CAS  Google Scholar 

  37. Kerstetter JE, O’Brien KO, Insogna KLJ. Nutr. Low protein intake: the impact on calcium and bone homeostasis in humans. 2003;133(3):855S–61S.

    CAS  Google Scholar 

  38. Meschi T, Maggiore U, Fiaccadori E, Schianchi T, Bosi S, Adorni G, Ridolo E, Guerra A, Allegri F, Novarini A, Borghi L. The effect of fruits and vegetables on urinary stone risk factors. Kidney Int. 2004;66(6):2402–10.

    Article  PubMed  CAS  Google Scholar 

  39. Hall PM. Nephrolithiasis: treatment, causes and prevention. Cleve Clin J Med. 2009;76(10):583–91.

    Article  PubMed  Google Scholar 

  40. Fielding JR, Steele G, Fox LA, Heller H, Loughlin KR. Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol. 1997;157:2071–3.

    Article  PubMed  CAS  Google Scholar 

  41. Fowler KAB, Locken JA, Dushesne JH, Williamson MR. US for detecting renal calculi with nonenhanced CT as a reference standard. Radiology. 2002;222:109–13.

    Article  PubMed  Google Scholar 

  42. Butler EL, Cox SM, Eberts EG, Cunningham FG. Symptomatic nephrolithiasis complicating pregnancy. Obstet Gynecol. 2000;96(5):753–6.

    Article  PubMed  CAS  Google Scholar 

  43. Labrecque M, Dostaler LP, Rousselle R, Nguyen T, Poirier S. Efficacy of nonsteroidal anti-inflammatory drugs in the treatment of acute renal colic. A meta-analysis. Arch Intern Med. 1994;154:1381–7.

    Article  PubMed  CAS  Google Scholar 

  44. Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine, and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol. 2005;174:167–72.

    Article  PubMed  CAS  Google Scholar 

  45. Hollingsworth JM, Rogers MA, Kaufman SR, Bradford TJ, Saint S, Wei JT, Hollenbeck BK. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet. 2006;368:1171–9.

    Article  PubMed  Google Scholar 

  46. Goldfarb DS. Reconsideration of the 1988 NIH consensus statement on prevention and treatment of kidney stones: are the recommendations out of date? Rev Urol. 2002;4:53–60.

    PubMed  Google Scholar 

  47. Burtis W, Gay L, Insogna K, Ellison A, Broadus AE. Dietary hypercalciuria in patients with calcium oxalate kidney stones. Am J Clin Nutr. 1994;60(3):424–9.

    PubMed  CAS  Google Scholar 

  48. Hess B, Ackermann D, Essig M, Takkinen R, Jaeger P. Renal mass and serum calcitriol in male idiopathic calcium renal stone formers: role of protein intake. J Clin Endocrinol Metab. 1995;80:1916–21.

    Article  PubMed  CAS  Google Scholar 

  49. Coe FL, Parks JH, Bushinsky DA, Langman CB, Favus MJ. Chlorthalidone promotes mineral retention in patients with idiopathic hypercalciuria. Kidney Int. 1988;33:1140–6.

    Article  PubMed  CAS  Google Scholar 

  50. Ettinger B, Tang A, Citron JT, Livermore B, Williams T. Randomized trial of allopurinol in the prevention of calcium oxalate calculi. N Engl J Med. 1986;315:1386–9.

    Article  PubMed  CAS  Google Scholar 

  51. Samplaski MK, Irwin BH, Desai M. Less-invasive ways to remove stones from the kidneys and ureters. Cleve Clin J Med. 2009;76(10):592–8.

    Article  PubMed  Google Scholar 

  52. Glowacki LS, Beecroft ML, Cook RJ, Pahl D, Churchill DN. The natural history of asymptomatic urolithiasis. J Urol. 1992;147:319–21.

    PubMed  CAS  Google Scholar 

  53. Inci K, Sahin A, Islamoglu E, Eren MT, Bakkaloglu M, Ozen H. Prospective long-term follow-up of patients with asymptomatic lower pole caliceal stones. J Urol. 2007;177:2189–92.

    Article  PubMed  Google Scholar 

  54. Abdel-Khalek M, Sheir KZ, Mokhtar AA, Eraky I, Kenawy M, Bazeed M. Prediction of success rate after extracorporeal shock-wave lithotripsy of renal stones–a multivariate analysis model. Scand J Urol Nephrol. 2004;38:161–7.

    Article  PubMed  Google Scholar 

  55. Krambeck AE, Gettman MT, Rohlinger AL, Lohse CM, Patterson DE, Segura JW. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup. J Urol. 2006;175:1742–7.

    Article  PubMed  Google Scholar 

  56. Brener ZZ, Wincester JF, Salman H, Bergman M. Nephrolithiasis: evaluation and management. South Med J. 2011;104:133–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zachary Z. Brener.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brener, Z.Z., Winchester, J.F. & Bergman, M. Calcium Nephrolithiasis. Clinic Rev Bone Miner Metab 9, 198–206 (2011). https://doi.org/10.1007/s12018-011-9103-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12018-011-9103-9

Keywords

Navigation