Abstract
The majority of patients who form stones within the urinary tract have an associated metabolic disorder. A relationship between the increased excretion of calcium in the urine in patients with renal and ureteric calculi was first noted by Flocks1,2 but it was Albright3 who, in 1953, first coined the term ‘idiopathic hypercalciuria’, suggesting that the condition might have a tubular origin and drawing attention to the hypophosphataemia which is often present. A few years later, Henneman et al.4 demonstrated high calcium absorption, and, subsequently, Jackson and Dancaster5 suggested that this hyper-absorpiion was an adaptation to the increased urinary calcium loss. No cause can be identified in nearly all normocalcaemic hypercalciuric patienss and an autosomal dominant mode of inheritance has been suggested6. The prevalence of hypercalciuria is approximately 5% in otherwise normal adults, and, in 95% of these subjects, hypercalciuria is silent and not associated with stone formation.
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References
Flocks, R. H. (1939). Calcium and phosphorus excretion in the urine of patients with renal or ureteral calculi. J. Am. Med. Assoc., 113, 1466–7l
Flocks, R. H. (1940). Calcium urolithiasis: the role of calcium and metabolism in the pathogenesis and treatment of calcium urolithiasis. J. Urol. (Baltimore), 43, 214–33
Albright, F., Henneman, P., Benedict, P. H. and Forbes A. P. (1953). Idiopathic hypercalciuria. Proc. R. Soc. Med., 46, 1077–81
Henneman, P. H., Benedict, P. H., Forbes, A. P. and Dudley H. R. (1958). Idiopathic hypercalciuria: importance of dietary calcium in the definition of hypercalciuria. N. Engl. J. Med., 259, 802–7
Jackson, W. P. U. and Dancaster, C. (1959). A consideration of the hypercalciuria in sarcoidosis, idiopathic hypercalciuria and that produced by vitamin D. A new suggestion regarding calcium metabolism. J. Clin. Endocrinol. Metab., 19, 658–80
Mehes, K. and Szelid, Z. (1980). Autosomal dominant inheritance of hypercalciuria. Eur. J. Paediatr., 133, 239–42
Sutton, R. A. L. and Dirks, J. H. (1978). Renal handling of calcium. Fed. Proc., 37, 2112–19
Costanzo, L. S. and Windhager, E. E. (1980). Effects of PTH ADH and cyclic AMP on distal tubular Ca and Na reabsorption. Am. J. Physiol., 239, f478–85
Shareghi, G. R. and Stoner, L. C. (1978). Calcium transport across segments of the rabbit distal nephron in vitro. Am. J. Physiol., 235, f367–75
Broadus, A. E. and Thier, S. O. (1979). The metabolic basis of renal stone disease. N. Engl. J. Med., 300, 839–45
Robertson, W. G., Peacock, M., Marshall, D. H. and Speed R. (1981). The prevalence of urinary stone disease in practising vegetarians. Fortschr. Urol. Nephrol., 17, 6–14
Lemann, J., Adams, N. D. and Gray R. W. (1979). Urinary calcium excretion in human beings. N. Engl. J. Med., 301, 535–41
Whiting, S. J. and Draper, H. H. (1980). The role of sulphate in the calciuria of high protein diet in the rat J. Nutr., 110, 212–22
Linkswiler, H. M., Joyce, C. L. and Arnaud, C. R. (1974). Calcium retention of young adult males as affected by level of protein and of calcium intake. Trans. N.Y. Acad. Sci., 36, 333–40
Goldfarb, S., Westby, G. R., Goldberg, M. and Agus, Z. S. (1977). Renal tubular effects of chronic phosphate depletion. J. Clin. Invest., 59, 770–8
Dominguez, J. H., Gray, R. W. and Lemann, J. Jr. (1976). Dietary phosphate deprivation in women and men: effects on mineral and acid balances, parathyroid hormone and the metabolism of 25(OH) vitamin D. J. Clin. Endocrinol. Metab., 43, 1056–68
Lemann, J. Jr., Lennon, E. J., Piering, W. R., Prien, E. L. Jr. and Ricanati, E. S. (1970). Evidence that glucose ingestion inhibits net renal tubular reabsorption of calcium and magnesium in man. J. Lab. Clin. Med., 75, 578–85
Sutton, R. A. L., Wong, N. L. M. and Dirks, J. H. (1979). Effects of metabolic acidosis and alkalosis on sodium and calcium transport in the dog kidney. Kidney Int., 15, 520–33
Batlle, D. C., Itsarayounguen, K., Hays, S., Arruda, J. A. L. and Kurtzman, N. A. (1982). Parathyroid hormone is not anticalciuric during chronic metabolic acidosis. Kidney Int., 22, 264–71
Peraino, R. A. and Suki, W. N. (1980). Urine HCO3- augments renal Ca++ absorption independent of systemic acid based changes. Am. J. Physiol., 238, f394–8
Robertson, W. G., Gallagher, J. C., Marshall, D. H., Peacock, M. and Nordin, B. E. C. (1974). Seasonal variations in urinary excretion of calcium. Br. Med. J., 41, 436–7
Robertson, W. G. and Morgan D. B. (1972). The distribution of urinary calcium excretions in normal persons and stone formers. Clin. Chim. Acta, 37, 503–8
Evans, R. A., Hills, E., Wong, S. Y. P., Wyndham, L. E., Eade, Y. and Dunstan, C. R. (1984). The pathogenesis of idiopathic hypercalciuria: evidence for parathyroid hyperfunction. Q. J. Med., 53, 41–53
Stanbury, S. W. (1980). Idiopathic hypercalciuria (absorptive hypercalciuria). In Norman, A. W. (ed.) Vitamin D: Molecular Biology and Clinical Nutrition, pp. 300–2. (New York: Marcel Dekker)
Shen, F. H., Baylink, D. J., Nielsen, R. L., Sherrard, D. J., Ivey, J. L. and Haussler, M. R. (1977). Increased serum 1,25-dihydroxy vitamin D in idiopathic hypercalciuria. J. Lab. Clin. Med., 90, 955–62
Gray, R. W., Wilz, D. R., Caldas A. E. and Lemann, J. (1977). The importance of phosphate in regulating plasma 1,25-(OH)2-vitamin D levels in humans: studies in healthy subjects in calcium-stone formers and in patients with primary hyperparathyroidism. J. Clin. Endocrinol. Metab., 45, 299–306
Broadus, A. E., Dominguez, M. and Bartter, F. C. (1978). Pathophysiological studies in idiopathic hypercalciuria: use of an oral calcium tolerance test to characterise distinctive hypercalciuric groups. J. Clin. Endocrinol. Metab., 47, 751–60
Pak C. Y. C., Britton F., Peterson R., Ward D., Northcutt C., Breslau N. A., McGuire J., Sakhaee K., Bush S., Nicar M., Norman D.A., and Peters P. (1980). Ambulatory evaluation of nephrolithiasis. Am. J. Med., 69, 19–30
Broadus A. E., Horst R. L., Littledike E. T., Mahaffey J. E. and Rasmussen H. (1980). Primary hyperparathyroidism with intermittent hypercalcaemia: serial observations and simple diagnosis by means of an oral calcium tolerance test. Clin. Endocrinol., 12, 225–35
Broadus, A. E., Horst, R. L., Lang, R., Littledike, E. T. and Rasmussen, H. (1980). The importance of circulating 1,25-dihydroxy vitamin D in the pathogenesis of hypercalciuria and renal stone formation in primary hyperparathyroidism. N. Engl. J. Med., 302, 421–6
Pak, C. Y. C., Kaplan, R., Bone, H., Townsend, J. and Waters, O. (1975). A simple test for the diagnosis of absorptive, resorptive and renal hypercalciurias. N. Engl. J. Med., 292, 497–500
Tschöpe, W. and Ritz, E. (1985). Hypercalciuria and nephrolithiasis. Contr. Nephrol., 49, 94–103
Marshall, V., White, R. H., Chaput de Saintonge, D. M., Tresidder, G. C. and Blandy, J. P. (1975). The natural history of renal and ureteric calculi. Br. J. Urol., 47, 117–24
Laerum, E. and Larsen, S. (1984). Thiazide prophylaxis of urolithiasis: a double-blind study in general practice. Acta Med. Scand., 215, 383–9
Backman, U., Danielson, B. G., Johansson, S., Ljunghall, S. and Wilkström, B. (1979). Effects of therapy with bendroflumethiazide in patients with recurrent renal calcium stones. Br. J. Urol., 51, 175–80
Scholz, D., Schwille, P. O. and Sigel, A. (1982). Double-blind study with thiazide in recurrent calcium lithiasis. J. Urol., 128, 903–7
Ettinger, B. (1979). Recurrence of nephrolithiasis. A six-year prospective study. Am. J. Med., 67, 245–8
Pak, C. Y. C., Sakhaee, K., Crowther, C. and Brinkley, L. (1980). Evidence justifying a high fluid intake in treatment of nephrolithiasis. Ann. Intern. Med., 93, 36–9
Robertson, W. G., Peacock, M., Heyburn, P. J. and Hanes, F. A. (1980). Epidemiologccal risk factors in calcium stone disease. Scand. J. Urol. Nephrol. (Suppl.), 53, 15–28
Frank, M. and De Vries, A. (1966). Prevention of urolithiasis. Arch. Environ. Health, 13, 625–30
Baker, L. R. I. and Mallinson, W. J. W. (1979). Dietary treatment of idiopathic hypercalciuria. Br. J. Urol., 51, 181–3
Brockis, J. G., Levitt, A. J. and Cruthers, S. M. (1982). The effects of vegetable and animal protein diets on calcium, urate and oxalate excretion. Br. J. Urol., 54, 590–3
Heaton K. W. and Pomare E. W. (1974). Effect of bran on blood lipids and calcium. Lancet, 1, 49–50
Shah, P. J. R., Williams, G. and Green, N. A. (1980). Idiopathic hypercalciuria: its control with unprocessed bran. Br. J. Urol., 52, 426–9
Yendt E. R. and Cohanim M. (1978). Thiazides in calcium urolithiasis. Can. Med. Assoc. J., 118, 755–8
Zerwekh J. E. and Pak C. Y. C. (1980) Selective effects of thiazide therapy on serum 1α, 25-dihydroxy vitamin D and intestinal calcium absorption in renal absorptive hypercalciurias. Metabolism, 29, 13–17
Barilla, D. E., Tolentino, R., Kaplan, R. A. and Pak, C. Y. C. (1978). Selective effects of thiazide on intestinal absorption of calcium in absorptive and renal hypercalciuria. Metabolism, 27, 125–31
Brocks P., Dahl C., Wolf H. and Transbol I. (1981). Do thiazides prevent recurrent idiopathic renal calcium stones? Lancet, 2, 124–5
Pak C. Y. C., Nicar M., and Northcutt C. (1982). The definition of the mechanism of hypercalciuria is necessary for the treatment of recurrent stone formers. Contrib. Nephrol., 33, 136–51
Meyer, J. L. and Thomas, W. C. Jr. (1982). Trace metal-citric acid complexes as inhibitors of calcification and crystal growth. I. Effects of Fe(III), Cr(III), and Al(III) complexes on calcium phosphate crystal growth. J. Urol., 128, 1372–5
Bisaz, S., Felix, R., Neuman, W. and Fleisch, H. (1978). Quantitative determination of inhibitors of calcium phosphate precipitation in whole urine. Min. Electrolyte Metab., 1, 74–83
Meyer, J. L. and Smith, L. H. (1975). Growth of calcium oxalate crystals. II. Inhibition by natural urinary crystal growth inhibitors. Invest. Urol., 13, 36–9
Meyer, J. L. and Thomas, W. C. (1982). Trace metal-citric acid complexes as inhibitoss of calcification and crystal growth. II. Effects of Fe(III), Cr(III), and Al(III), complexes on calcium oxalate crystal growth. J. Urol., 128, 1376–8
Nicar, M.J., Peterson, R. and Pak, C. Y. C. (1984). Use of potassium citrate as potassium supplement during thiazide therapy of calcium nephrolithiasis. J. Urol., 131, 430–3
Pak, C. Y. C. (1973). Sodium cellulose phosphate: mechanism of action and effect on mineral metabolism. J. Clin. Pharmacol., 13, 15–27
Backman, U., Danielson, B. G., Johansson, G., Ljunghall, S. and Wikström, B. (1980). Treatment of recurrent calcium stone formation with cellulose phosphate. J. Urol., 123, 9–13
Pak, C. Y. C. (1981). A cautious use of sodium cellulose phosphate in the management of calcium nephrolithiasis. Invest. Urol., 19, 187–90
Fleisch, H., Bisaz, S. and Care, A. D. (1964). Effect of orthophosphates on urinary pyrophosphate excretion and the prevention of urolithiasis. Lancet, 1, 1065–7
Thomas, W. C. Jr. (1971). Effectiveness and mode of action of orthophosphates in patients with calcareous renal calculi. Trans. Am. Clin. Climatol. Assoc., 83, 113–24
Ettinger, B. (1976). Recurrent nephrolithiasis: natural history and effect of phosphate therapy. Am. J. Med., 61, 200–6
Lau, K., Wolf, C., Nussbaum, P., Weiner, B., De Oreo, P., Slatopolsky, E., Agus, Z. and Goldfarb, S. (1979). Differing effects of acid versus neutral phosphate therapy of hypercalciuria. Kidney Int., 16, 736–42
Fraser D., Russell R. G. G., Pohler O., Robertson W. G. and Fleisch H. (1972). The influence of disodium ethane 1-hydroxy-1,1-diphosphonate (EHDP) on the development of experimentally induced urinary stones in rats. Clin. Sci. Mol. Med., 42, 197–207
Jowsey, J., Riggs, B. L., Kelly, P. J., Hoffman, D. L. and Bordier, P. (1971). The treatment of osteoporosis with disodium ethane-1-hydroxy-1,1-diphosphonate. J. Lab. Clin. Med., 78, 574–84
Pak C. Y. C., Peters P., Hurt G., Kadesky M., Fine M., Reisman, D., Splann, F., Caramela, C., Freeman, A., Britton, F., Sakhaee, K. and Breslau, N. (1981). Is selective therapy of recurrent nephrolithiasis possible? Am. J. Med., 71, 615–22
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Sharman, V.L. (1988). Hypercalciuria. In: Catto, G.R.D. (eds) Calculus Disease. New Clinical Applications, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2617-2_2
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DOI: https://doi.org/10.1007/978-94-009-2617-2_2
Publisher Name: Springer, Dordrecht
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