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Defining hypercalciuria in nephrolithiasis.

Abstract：

:The classic definition of hypercalciuria, an upper normal limit of 200  mg/day, is based on a constant diet restricted in calcium, sodium, and animal protein; however, random diet data challenge this. Here our retrospective study determined the validity of the classic definition of hypercalciuria by comparing data from 39 publications analyzing urinary calcium excretion on a constant restricted diet and testing whether hypercalciuria could be defined when extraneous dietary influences were controlled. These papers encompassed 300 non-stone-forming patients, 208 patients with absorptive hypercalciuria type I (presumed due to high intestinal calcium absorption), and 234 stone formers without absorptive hypercalciuria; all evaluated on a constant restricted diet. In non-stone formers, the mean urinary calcium was well below 200  mg/day, and the mean for all patients was 127±46  mg/day with an upper limit of 219  mg/day. In absorptive hypercalciuria type I, the mean urinary calcium significantly exceeded 200  mg/day in all studies with a combined mean of 259±55  mg/day. Receiver operating characteristic curve analysis showed the optimal cutoff point for urinary calcium excretion was 172  mg/day on a restricted diet, a value that approximates the traditional limit of 200  mg/day. Thus, on a restricted diet, a clear demarcation was seen between urinary calcium excretion of kidney stone formers with absorptive hypercalciuria type I and normal individuals. When dietary variables are controlled, the classic definition of hypercalciuria of nephrolithiasis appears valid.

journal_name

Kidney Int

journal_title

Kidney international

authors

Pak CY,Sakhaee K,Moe OW,Poindexter J,Adams-Huet B,Pearle MS,Zerwekh JE,Preminger GM,Wills MR,Breslau NA,Bartter FC,Brater DC,Heller HJ,Odvina CV,Wabner CL,Fordtran JS,Oh M,Garg A,Harvey JA,Alpern RJ,Snyder WH,Pe

doi

10.1038/ki.2011.227

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

777-82

issue

7

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)55123-5

journal_volume

80

pub_type

杂志文章,meta分析,评审

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