The Main Risk Factor for Calcium Oxalate Stone Disease in Man: Hypercalciuria or Mild Hyperoxaluria?
For over 40 years now it has been considered by many workers that hypercalciuria is the main cause of idiopathic calcium oxalate stone disease in man. Indeed it is a frequent biochemical finding in most series of calcium stone-formers1–7. Other investigators, however, have failed to find any increase in urinary calcium excretion in this group of patients and do not consider it to be of importance either in the initiation8–11 or in the recurrent formation12 of these stones. They emphasize that many recurrent calcium oxalate stone-formers are not hypercalciuric and, even of those who initially present as being hypercalciuric, many continue to form stones even after normalization of their urinary calcium. Furthermore, there are many hypercalciuric individuals, including normal subjects and patients with some metabolic disorder, predisposing to a high urinary calcium excretion, who never form stones at all. The importance, therefore, of hypercalciuria in stone- formation is far from clear.
KeywordsUrinary Calcium Urinary Calcium Excretion Urinary Oxalate Calcium Oxalate Crystal Calcium Oxalate Stone
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