Significance of Urinary Excretion of Stone Components in Long-Term Follow-Up of Calcium-Oxalate Stone Patients
Daily urinary volume and urinary excretion of calcium, urate, and oxalate are of major clinical interest in predicting the propensity for calcium-oxalate (CaOx) stone formation. For prevention of recurrence, we have treated idiopathic hypercalciuria with trichlormethiazide by estimating the drug effect on the basis of the 24-h urinary excretion of stone components. However, the therapy failed in a considerable number of subjects over a three- to five-year period, and recurrent stones developed in about one third of the treated patients despite continued medication. In order to detect causes of treatment failures, we conducted a urinary saturation study. We reported at the International Meeting on Diuretics held at Sorrento in 1986 that, in some patients, the urinary saturation with respect to Ca and oxalate increased inversely while the urinary excretion of Ca decreased, a contributing factor to treatment failure (1).
KeywordsRenal Stone Recurrent Stone Idiopathic Hypercalciuria Uric Acid Excretion CaOx Stone
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- 1.K Matsushita, K Tanikawa, and N Kawamura, Causes of failure in thiazide diuretic therapy of hypercalciuric nephrolithiasis, in: “Diuretics: Basic, Pharmacological, and Clinical Aspects,” VE Andreucci and Antonio Dal Canton, eds., Martinus Nijhoff Publishing Co., Boston (1987).Google Scholar