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Hypocitraturia in calcium nephrolithiasis
The Journal of Clinical Endocrinology and Metabolism
|December 1, 1982
Summary
Hypocitraturia, or low urinary citrate, is common in men with idiopathic kidney stones. This may stem from increased kidney citrate reabsorption, suggesting a predisposing factor for calcium stones.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Idiopathic kidney stones are frequently linked to hypocitraturia.
- Previous studies lacked control for key variables like GFR, diet, and medication.
Purpose of the Study:
- To investigate the role of hypocitraturia in idiopathic calcium oxalate stones in men.
- To determine if altered citrate handling by the kidneys contributes to stone formation.
Main Methods:
- Studied 15 men with recurrent idiopathic calcium oxalate stones and 15 controls.
- Excluded patients with hyperparathyroidism, RTA, low creatinine clearance, or UTI.
- Controlled diet and medications; analyzed 8-h urine collections for calcium and citrate.
Main Results:
- Elevated urinary calcium in 8 stone formers; depressed citrate excretion in 7.
- 5 patients had both hypercalciuria and hypocitraturia.
- Hypocitraturia resulted from increased tubular reabsorption of citrate.
Conclusions:
- Hypocitraturia may be a common predisposing factor for calcium nephrolithiasis in adult men.
- Increased renal citrate reabsorption, not a reduced filtered load, underlies hypocitraturia.