Hyperuricosuric Calcium Urolithiasis
The term “normocalciuric nephrolithiasis” 1 was initially used to describe patients with recurrent Ca urolithiasis in whom a 24-hr urinary Ca was within the normal range. This condition may be subdivided into the different groups listed in Table VIII. Absorptive hypercalciuria Type II was discussed in Chapter 3. Hyperoxaluria will be covered in Chapter 6. The idiopathic group comprises those patients in whom there is no obvious abnormality for stone formation. Some of these patients give a history of low fluid intake. In others, the formation product ratios (FPRs) (limit of metastability) of brushite and Ca oxalate in urine may be significantly reduced. 2 Thus, urinary supersaturation with respect to Ca salts, resulting from the passage of concentrated urine, and deficiency of inhibitors or presence of promoters of nucleation, or both, may be etiologically important in stone formation in the idiopathic group. This chapter will focus principally on Ca stone formation associated with hyperuricosuria.
KeywordsUric Acid Stone Formation Calcium Oxalate Idiopathic Hypercalciuria Monosodium Urate
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