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Hyperoxaluria or hypercalciuria in nephrolithiasis: the importance of renal tubular functions
Author(s) -
LINDSJÖ M.,
FELLSTRÖM B.,
DANIELSON B. G.,
KASIDAS G. P.,
ROSE G. A.,
LJUNGHALL S.
Publication year - 1990
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1990.tb01900.x
Subject(s) - hypercalciuria , medicine , endocrinology , reabsorption , calcium , urinary system , jejunoileal bypass , calcium oxalate , oxalate , urinary calcium , parathyroid hormone , excretion , creatinine , renal function , kidney , chemistry , weight loss , obesity , organic chemistry , morbid obesity
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.