A Risk Factor Model of Stone-Formation: Application to the Study of Epidemiological Factors in the Genesis of Calcium Stones
Within the last few years a new concept has evolved to account for calcium stone-formation in the urinary tract. This attributes the disorder to a combination of “risks” derived from the slightly (or sometimes grossly) abnormal excretion of one or more urinary constituents1,2. The six main risk factors identified so far are a high urinary pH, an increased urinary excretion of calcium, oxalate or uric acid, a low urinary volume or a reduced excretion of alcian blue precipitable inhibitors of crystallization (mainly acidic glycosaminoglycans (GAGS)). The relative potency of these risk factors is in the order ↓ volume ≈ ↑ oxalate > ↓ GAGS > ↑ uric acid > ↑ pH > ↓ calcium.
KeywordsUric Acid Calcium Oxalate Renal Tubular Acidosis Urinary Calculus Calcium Stone
Unable to display preview. Download preview PDF.
- 2.W. G. Robertson, M. Peacock, P. J. Heyburn, and C. P. Bambach, in: “Urinary Calculi, Proceedings of the International Urinary Stone Conference, 1979,” J. G. Brockis and B. Finlayson, eds., PSG Publishing Co. Inc., Littleton, MA (1980) (in press).Google Scholar
- 3.D. A. Andersen, in: “Urinary Calculi,” L. Cifuentes-Delatte, A. Rapado, and A. Hodgkinson, eds. Karger, Basel (1973).Google Scholar
- 4.N. J. Blacklock, in: “Scientific Foundations of Urology,” Vol. 1, D. I. Williams and G. D. Chisholm, eds., Heinemann, London (1976).Google Scholar
- 5.W. G. Robertson, M. Peacock, P. J. Heyburn, D. H. Marshall, and F. Hanes, Fortschr. Urol. Nephrol. 11:5 (1978).Google Scholar
- 6.W. G. Robertson, M. Peacock, P. J. Heyburn, F. A. Hanes, and R. Swaminathan, in: “Urinary Calculi, Proceedings of the International Urinary Stone Conference, 1979,” J. G. Brockis and B. Finlayson, eds., PSG Publishing Co. Inc., Littleton, MA (1980) (in press).Google Scholar
- 9.M. Frank and A. De Vries, Arch. Environ. Hlth. 13:625 (1966).Google Scholar
- 10.N. J. Blacklock, in: “Proceedings of the Renal Stone Research Symposium,” B. E. C. Nordin and A. Hodgkinson, eds., Churchill, London (1969).Google Scholar
- 11.O. S. Better, M. Shabtai, S. Kedar, A. Melamud, J. Berenheim and C. Chaimovitz, Mineral Electrolyte Metabolism 2:208 (1979).Google Scholar
- 12.W. G. Robertson, M. Peacock, R. W. Marshall, R. Speed, and B. E. C. Nordin, Clin. Sei. Molec. Med. 49:597 (1975).Google Scholar