Urinary oxalic acid excretion was determined in 21 healthy people and 70 patients with renal stones. In the group of 31 patients with calcium oxalate-containing renal stones the mean value of urinary oxalate exretion was significantly higher than both in the normals and the patients with non-oxalate renal stones. Urinary oxalate excretion above the upper limit was found in 12 patients with calcium oxalate-containing renal stones (38.7%) and in one patient with radio-paque renal stones and nephrocalcinosis. In the patients with hyperoxaluria great variability in oxalate excretion was found. There was no relationship between urinary oxalate and calcium excretion and between urinary oxalate excretion and 24-hour volume of urine. It is suggested that there is relationship between the increased urinary oxalate excretion and recurrent calcium oxalate-containing renal stones formation in the investigated group of patients.
In a group of 57 children with urolithiasis hypomagnesaemia was found in 15 cases (26.3%). All children but one with abnormally low serum magnesium levels had recurrent or bilateral nephrolithiasis or nephrocalcinosis. Prevalence of hyperoxaluria and hypercalciuria, marked severity of the clinical features, abnormality of Ca metabolism and its responsiveness to MgO treatment were demonstrable in Mg deficiency.
Hypomagnesemia, hypocalcemia and hypophosphatemia after renal transplantation in an 18-year-old patient is described. Serum magnesium decreased in consequence of increased renal transplant function with high urinary magnesium excretion. At the time of serum magnesium depletion, pretransplantation hypocalcemia persisted and severe hypophosphatemia developed. Magnesium oxide treatment was followed by the increment not only in serum magnesium but also in serum calcium and phosphate to normal level. Causal relationship between magnesium deficit and impaired renal transplant tubular reabsorption of magnesium and between magnesium deficit and serum calcium and phosphate depletion in the patient is suggested.
Urinary zinc, calcium, creatinine and osmolar excretion per 24 hours was measured in 21 healthy subjects and 49 patients with urolithiasis. Urinary zinc excretion in kidney-stone formers was lower than in healthy subjects, but the difference was not statistically significant. In healthy subjects, there was a normal relationship between urinary zinc excretion and urine volume, creatinine and osmolar excretion, which was not found, with some exceptions, in the groups of patients. There was no relationship between urinary zinc and calcium excretion in healthy subjects or in patients with normocalciuria or hypercalciuria. A possible role of relative hypozincuria in kidney-stone formation in patients with hypercalciuria and/or hyperoxaluria is suggested.
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