Prevalence of fasting hypercalciuria associated with increased citraturia in the ambulatory evaluation of nephrolithiasis

Maria Beatrice Damasio, Fabio Massarino, Felice Durand, Riccardo Banchero, Paolo Bottino, Vincenzina De Franchis, Giorgio Carmignani, Giuseppe Cannella

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Nephrolithiasis is a common, high costing pathology of the urinary tract. The most common urinary abnormalities are fasting hypercalciuria, hypercalciuria and hypocitraturia. This study aimed to identify the principal urinary abnormalities in our patients. Methods: Ninety-eight patients (pts) (43 females, 55 males) with recurrent calcium nephrolithiasis underwent metabolic evaluation. In two 24-hr urine collections the following parameters were evaluated: calcium, phosphate, sodium, potassium, chloride, magnesium, citrate, oxalate, uric acid, creatinine (Cr), urea, ammonium and pH; blood measurement of calcium, phosphate, sodium, potassium, chloride, magnesium, uric add, Cr, urea, acid-base balance ionized calcium and intact parathyroid hormone (iPTH) were also performed. A first morning voided urine sample was collected for measuring the urinary cross-links and fasting calciuria. The tubular threshold of phosphate (TmP) was calculated according to Walton and Bijovet. Metabolic evaluation was repeated in 63/98 pts after 7 days on a low calcium diet. Results: The most common urinary abnormalities were fasting hypercalciuria in 51/96 pts (53.1 %), hypercalciuria in 33/97 pts (34%) and hypocitraturia in 29/98 pts (29%); 24/33 pts (73%) with hypercalciuria. had fasting hypercalciuria. Hypercalciuria was partially corrected on the calcium-restricted diet, while fasting hypercalciuria was not. Urine citrate levels were significantly higher in patients with fasting hypercalciuria. Conclusions: Fasting hypercalciuria was the most frequent urinary abnormality and it was not corrected with a calcium-restricted diet. In fasting hypercalciuric patients, increased bone resorption activity could be responsible for higher citraturia levels.

Original languageEnglish
Pages (from-to)262-266
Number of pages5
JournalJournal of Nephrology
Volume18
Issue number3
Publication statusPublished - May 2005

Keywords

  • Fasting calciuria
  • Hypercalciuria
  • Hypocitraturia
  • Nephrolithiasis

ASJC Scopus subject areas

  • Nephrology

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