Hyperoxaluria or hypercalciuria in nephrolithiasis: the importance of renal tubular functions

European Journal of Clinical Investigation
M LindsjöS Ljunghall

Abstract

The role of the kidney in states of hyperoxaluria and hypercalciuria was investigated in seven patients with hyperoxaluria after jejunoileal bypass (JIB) and six patients with idiopathic hypercalciuria (IHC). Eight apparently healthy persons formed a control group. Besides hyperoxaluria, the patients with JIB displayed an elevated plasma concentration of oxalate and the oxalate clearance was increased and higher than creatinine clearance, indicating a net tubular secretion of oxalate. The JIB patients had lower 24-h urinary excretions of calcium, phosphate, magnesium and citrate and higher serum parathyroid hormone (PTH) than controls, indicating increased secretion of PTH to compensate for calcium malabsorption. IHC patients exhibited increased fasting urinary calcium even though their serum values were similar to those in the controls. These results indicate a reduced tubular calcium reabsorption, which was most pronounced in patients with highest PTH values. We conclude that hyperoxaluria in JIB patients is associated both with intestinal hyperabsorption and with enhanced tubular secretion of oxalate, and that in some patients with IHC hypercalciuria is due to reduced tubular reabsorption of calcium.

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Citations

Dec 12, 2002·Endocrinology and Metabolism Clinics of North America·John R Asplin
Apr 1, 1997·Scandinavian Journal of Gastroenterology·S JørgensenE Gudman-Høyer
Jan 1, 1992·Scandinavian Journal of Urology and Nephrology·M LindsjöS Ljunghall
Sep 23, 2000·Journal of the American Academy of Nurse Practitioners·J Olmstead

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