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

Abstract

One hundred and twenty-four male stone formers with idiopathic hypercalciuria were followed up for 4 to 27 years (mean 12.2). Twenty-eight received restricted calcium diet alone, 52 also received bendrofluazide, 11 cellulose phosphate, and 33 received mixtures of those drugs. Although urinary calcium values fell in all groups, the stone recurrence rate remained unacceptably high. Patients on cellulose phosphate fared worst and this drug seems unsatisfactory as a sole agent. Urinary calcium was highest in patients without stone recurrences, but in patients with stone activity a higher stone recurrence rate was associated with higher urinary calcium and lower urinary volume.

What on Earth are we Drinking?

“…Our results regarding the calcium content of drinking tap water are in broad agreement with those published by the British Regional Heart Study (Pocock et al, 1980). However, of the 44 bottled waters analysed, 50% could be described as moderately hard and 12% were harder than the hardest tap water from within the British Isles.…”

Possibilities for preventing recurrent calcium stone formation: principles for the metabolic evaluation of patients with calcium stone disease

“…There are three studies on treatment with cellulose phosphate and six on treatment with sodium cellulose phosphate. In none of these studies was a control or placebo group included [32–40]. In two of the studies all and 78% (mean 89%) of the patients, respectively, had no recurrences.…”

A Urinary Detergent and Urolithiasis

“…In a carefully supervised group of 124 stone formers with idiopathic hypercalciuria studied at the Institute of Urology in London (Marickar and Rose, 1985), the urinary calcium was brought into the normal range, yet over one-half continued to develop new or larger calculi. It follows that there must be other unidentified factors which are partly responsible for the continued urolithiasis and a possible explanation for this lies in the sixth listed risk factor, the urinary mucopolysaccharides.…”

“…Of further interest is the possible relationship between the anatomical findings described above and the changes observed in the fibrinolytic activity of the Bantu and arterial disease. The Bantu living in South Africa are remarkably free from cardiovascular disease and the blood fibrinolytic activity of the male Bantu is greater than that of his Caucasian counterpart (Walker, 1961); when the former becomes Westernised, however, the prevalence of heart disease rises, with a relative decrease in circulating fibrinolytic activity compared with that of their forefathers (Meade et al, 1978). Similarly, renal stone disease is virtually unknown in the Bantu living in South Africa (Vermooten, 1941).…”