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Crystal formation in whole urine was studied by the technique of rapid evaporation to 1,250 mosmol/l with and without raising citrate concentration by 40–50%. The added citrate reduced calcium oxalate crystal formation at pH 5.3 by about 25 % and reduced calcium phosphate crystal formation at pH 6.8 by some 42%. These results support the view that citrate is important in maintaining calcium in solution in whole urine, and that raising the urinary citrate could be effective treatment for calcium oxalate/phosphate urolithiasis.

Three cases of mild metabolic hyperoxaluria (with glycollaturia) are described. They showed different types of response to pyridoxine. One responded to low dose, one responded at first to low dose but became resistant, and the third showed temporary response to high dose. One case also had primary hyperparathyroidism and one had medullary sponge kidneys and hypercalciuria. It is important to measure urinary oxalate (and glycoUate) in all cases of calcium oxalate urolithiasis.

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