Environmental factors in the pathophysiology of recurrent idiopathic calcium urolithiasis (RCU), with emphasis on nutrition

Schwille, P. O.; Herrmann, U.

doi:10.1007/bf00294342

Cited by 19 publications

(11 citation statements)

References 78 publications

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“…In pre-lithotripsy patients we found that the surface of stones in situ is smaller in the presence of high urinary Mg ion concentration, and vice versa (53); however, these patients were older, and obesity and calciuria were not strictly controlled. In the present work, a role of Mg in the aetiology of crystals or stones remains uncertain, considering the unaltered Mg in urine (tab.…”

Section: Calcifications and Mgmentioning

confidence: 80%

Magnesium Status in Idiopathic Calcium Urolithiasis — An Orientational Study in Younger Males

Schmiedl

Schwille²

1996

CCLM

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Summary:With the aim of revealing a possible magnesium (Mg) deficiency in the aetiology of idiopathic recurrent calcium urolithiasis we studied the Mg content of red blood cells, serum total, protein-bound, ionised and complexed fractions of Mg, and urinary Mg after an overnight fast. The two study groups comprised 12 male recurrent calcium urolithiasis patients and 12 healthy male controls (mean age 31 and 29 years, respectively). In recurrent calcium urolithiasis, serum albumin and Mg of erythrocytes were significantly decreased, as was serum total and proteinbound Mg, whereas serum ultrafiltrable, ionised and complexed Mg were statistically indistinguishable from values in controls. Urinary Mg (per unit creatinine) in recurrent calcium urolithiasis (mean 0.188 vs 0.209 in controls; p = 0.386) was not statistically different, whereas urinary total protein, glucose, and pH were significantly increased. The renal clearances of Mg and glucose were positively correlated (r = 0.56; p < 0.01), with a steeper slope in recurrent calcium urolithiasis than controls. Further fractionation of serum and urinary Mg into ions and complexes in recurrent calcium urolithiasis subjects with identical creatinine clearance revealed no statistical difference between 1) Mg ions and complexes filtered by renal glomeruli; 2) Mg ions and complexes excreted in urine; 3) fractional Mg excretion.Median urine supersaturation with respect to calcium oxalate was insignificantly lower (1.5 vs 2.2), with respect to hydroxyapatite insignificantly higher (3.3 vs 1.8), than in controls.It is concluded that relatively young recurrent calcium urolithiasis patients exhibit a deficiency of Mg in erythrocytes and serum total Mg, but no alteration of renal Mg handling. Thus, in recurrent calcium urolithiasis, a role of Mg deficiency in urine as a factor initiating stone formation may be ruled out, whereas a possible link between cellular Mg deficiency and the impairment of renal tubular functions involved in reabsorption of glucose and proteins, and in urine acidification, deserves further studies.

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Section: Calcifications and Mgmentioning

confidence: 80%

Magnesium Status in Idiopathic Calcium Urolithiasis — An Orientational Study in Younger Males

Schmiedl

Schwille²

1996

CCLM

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“…On the other hand, there are carbohydrates among the precursors of the endogenous synthesis of oxalate, so hyperoxaluria can be generated by this route too [5]. This is the reason why a limited intake of simple sugars is recommended in the diet.…”

Section: The Diet Problemmentioning

confidence: 99%

“…Excessive fat intake, except for foods containing high quantities of omega-3 fatty acids [5], has also been proven to increase oxaluria, perhaps due to an increase in the intestinal absorption of oxalate. The traditional advice given to stone formers to reduce foods containing calcium by eliminating milk and milk derivatives is no longer accepted as valid [6].…”

Section: The Diet Problemmentioning

confidence: 99%

Body Weight, Diet and Water Intake in Preventing Stone Disease

et al. 2004

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Nutrition plays a major role in the pathogenesis of the most widespread forms of nephrolithiasis, i.e. calcium (calcium oxalate and phosphate) and uric acid stone disease. For this reason, dietary measures are the first level of intervention in primary prevention, as well as in secondary prevention of recurrences. An unbalanced diet or particular sensitivity to various foods in stone formers can lead to urinary alterations such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and an excessively acid urinary pH. Over the course of time, these conditions contribute to the formation or recurrence of kidney stones, due to the effect they exert on the lithogenous salt profile. The fundamental aspects of the nutritional approach to the treatment of idiopathic nephrolithiasis are body weight, diet and water intake. This paper will present data resulting from our own investigations and the most significant evidence in literature.

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“…It is controversial whether it produces calcification of soft tissues and parathyroid stimulation, and it is contraindicated in infected nephrolithiasis [19,20] .…”

Section: Absorptive Hypercalciuriamentioning

confidence: 99%

Metaphylaxis of Nephrolithiasis

Jacobellis

2007

Urol Int

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The introduction of extracorporeal shockwave lithotripsy (ESWL), with its noninvasive removal of stones and considerable reduction in the morbidity of stone disease, has revolutionized the therapy of urolithiasis. Unfortunately the propensity for stone recurrence is not altered by removal of stones with ESWL and stone recurrence is still about 50%. Progress in medical treatment has shown how different therapies can prevent the stone recurrence, even though it is often difficult to predict which patient will go on to become a recurrent stone former. With the right evaluation, however, the cause of calculi formation can be treated in 97% of the patients. Primary prevention of urolithiasis includes general prophylaxis in a no-risk population that has never been affected by urinary tract stones, is without familial predisposition, metabolic or genetic alterations, or urinary tract abnormalities or infections and who live in a geographical area that is at risk. Secondary prevention or metaphylaxis of stone disease is aimed at the population at risk, that is patients already affected by the stone disease, with familial predisposition, with urinary tract alterations, with metabolic or genetic alterations (gout, bone or bowel diseases) and urinary infection.

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Environmental factors in the pathophysiology of recurrent idiopathic calcium urolithiasis (RCU), with emphasis on nutrition

Cited by 19 publications

References 78 publications

Magnesium Status in Idiopathic Calcium Urolithiasis — An Orientational Study in Younger Males

Magnesium Status in Idiopathic Calcium Urolithiasis — An Orientational Study in Younger Males

Body Weight, Diet and Water Intake in Preventing Stone Disease

Metaphylaxis of Nephrolithiasis

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