Hypercalciuria FREE

DANIEL T. BARAN, MD

Am J Dis Child. 1982;136(8):667-669. doi:10.1001/archpedi.1982.03970440011002.

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ABSTRACT

ABSTRACT | REFERENCES

Hypercalciuria probably accounts for the majority of renal stones recovered from patients in the United States.¹ Knowledge of the pathophysiologic mechanisms responsible for hypercalciuria has increased dramatically with advances in our understanding of the regulation of calcium and vitamin D metabolism. Depending on dietary calcium intake, approximately one third to one half of ingested calcium is absorbed. The absorbed calcium is distributed in the extracellular fluid. Exchanges occur between the extracellular pool, intracellular pool, and bone. Calcium is lost from the body in urine and in the gut, but the rate of loss of calcium approximates the rate of entry, and thus balance is maintained. Hence, the control of this balance resides in regulation of intestinal absorption and urinary excretion.

Intestinal absorption is regulated by 1,25-dihydroxyvitamin D (1,25-[OH]₂D), the most potent metabolite of vitamin D; 1,25-(OH)₂D is the product of the 1-hydroxylation of 25-hydroxyvitamin D,

REFERENCES

ABSTRACT | REFERENCES

Williams HE, Prien EL Jr: Nephrolithiasis , in Avioli LV, Krane SM (eds): Metabolic Bone Disease . New York, Academic Press Inc, 1977;, vol 1, pp 387-423.

Coe FL, Canterbury JM, Firpo JJ, et al: Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria . J Clin Invest 1973;; 52:134-142.

Pak CYC, Barilla D, Bone H, et al: Medical management of renal calculi , in Rose LI, Lavine RL (eds): New Concepts in Endocrinology and Metabolism . New York, Grune & Stratton Inc, 1977;, p 77.

Burckhardt P, Jaeger P: Secondary hyperparathyroidism in idiopathic renal hypercalciuria: Fact or theory . J Clin Endocrinol Metab 1981;;53:550-555.

Lawayin S, Sismilich S, Browne R, et al: Bone mineral content in patients with calcium urolithiasis . Metabolism 1979;;28:1250-1254.

Parfitt AM: The interactions of thiazide diuretics with parathyroid hormone and vitamin D . J Clin Invest 1972;;51:1879-1888.

Sutton RAL, Walker VR: Responses to hydrochlorothiazide and acetazolamide in patients with calcium stones: Evidence suggesting a defect in renal tubular function . N Engl J Med 1980;;302:709-713.

Insogna K, Lang R, Kliger AS, et al: Concerning the hormonal basis, the phosphate leak hypothesis, and regulation of the parathyroid hormone: 1,25-Dihydroxyvitamin D axis in absorptive hypercalciuria , abstracted. Clin Res 1981;;29:682.

Insogna KL, Lewis AM, Lipinski BA, et al: Effect of age on immunoreactive parathyroid hormone and its bioactivity in human beings . J Clin Endocrinol Metab 1981;;53:1072-1075.

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