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The cause of idiopathic calcium stone disease: hypercalciuria or hyperoxaluria?

W G Robertson, M Peacock

    Nephron
    |January 1, 1980
    PubMed

    Insights

    Hypercalciuria is common in patients who form calcium oxalate urinary stones. This review suggests that elevated urinary oxalate, not calcium, is more critical in the development of these stones.

    Area of Science:

    • Nephrology
    • Urology
    • Biochemistry

    Background:

    • Hypercalciuria is frequently observed in patients with calcium oxalate urinary stones.
    • It is widely believed that hypercalciuria is the primary cause of calcium oxalate stone formation.

    Purpose of the Study:

    • To evaluate the relationship between urinary calcium and oxalate excretion and the rate of calcium oxalate stone formation.
    • To determine the relative importance of hypercalciuria versus hyperoxaluria in the genesis of calcium oxalate stones.

    Main Methods:

    • Review of existing literature and data on urinary stone formers and normal individuals.
    • Analysis of the correlation between urinary calcium and oxalate levels and stone formation rates or crystalluria.

    Main Results:

    • A weak correlation was found between urinary calcium excretion and the rate of stone formation or calcium oxalate crystalluria.
    • A significant, albeit slight, elevation in urinary oxalate was observed in stone-forming patients compared to normal individuals.
    • Urinary oxalate excretion showed a strong relationship with stone formation parameters.

    Conclusions:

    • The study suggests that hypercalciuria may play a less significant role in calcium oxalate stone formation than previously thought.
    • Slightly elevated urinary oxalate levels (hyperoxaluria) appear to be more critical in the development of calcium oxalate stones.
    • This finding has implications for understanding the pathophysiology and potential treatment strategies for calcium oxalate urolithiasis.

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