Orthophosphate Treatment of Calcium Lithiasis Associated with Idiopathic Hypercalciuria

Abstract

Oral orthophosphate treatment was given to 33 subjects with idiopathic hypercalciuria, 28 of them with calcium salt lithiasis. A decrease in urinary calcium excretion was observed in 31 of the subjects. The treatment appeared clinically beneficial in 8 out of 11 patients with metabolically active stone disease. Indications and contraindications to oral orthophosphate treatment are discussed.

Relationship of Stone Growth and Urinary Biochemistry in Long‐term Follow‐up of Stone Patients with Idiopathic Hypercalciuria

“…Whether or not urinary calcium is raised in patients with calcium oxalate/phosphate urolithiasis without other clear metabolic cause is still a matter of controversy (Gill and Rose, 1985). Most workers consider it desirable to lower urinary calcium for the treatment of such urolithasis and various methods have been used: dietary manipulation (Rao et al, 1982;Rose, 1982), thiazide diuretics (Yendt et al, 1970;Rose and Harrison, 1974;Marickar et al, 1985), cellulose phosphate (Dent et al, 1964;Blacklock and Macleod, 1974;Pak et al, 1974;Rose and Harrison, 1974), orthophosphate (Bernstein and Newton, 1966;Oliver et al, 1974), bran (Shah et al, 1980) and more recently flurbiprofen (Rao and Blacklock, 1983). While most of these methods lower urinary calcium, there is much less evidence that this lowering decreases the stone formation rate (Pak et al, 1974;Backman et al, 1979Backman et al, , 1980Brocks et al, 1981;Scholz et al, 1982;Churchill and Taylor, 1985).…”