尿路結石の発生原因に関する検討(第1報) : カルシウム代謝とくに血清イオン化カルシウムを中心として

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To clarify the causes of urolithiasis, the authors routinely measure calcium, phosphate, magnesium and uric acid in blood and urine, as well as oxalate and citrate in urine of patients with urolithiasis. This report concerns with such investigations with special reference to calcium and ionized calcium. The subjects were 51 patients, 20-59 years of age, with urolithiasis in whom calcium stones were clearly revealed by infrared spectroscopy (excluding cases with clear causes such as primary hyperparathyroidism and renal tubular acidosis). The urinary excretion of calcium showed significant differences from that of controls (28 persons) (p<0.001). In the control group, the urinary excretion of calcium was 99.6±68mg/day (mean±SD). So therefore, we designated 168mg/day as the normal upper limit. On the basis of these results, the patients were divided into the hypercalciuric stone group (HSG: above 168 mg/day) and the normocalciuric stone group (NSG: below 168mg/day). Comparative studies were performed on these two groups and controls with respect to total serum calcium, ionized calcium (measured with an Orion ionized calcium analyzer, Model SS-20), ionized calcium/calcium ratio, filtered calcium and the reabsorption rate of calcium. The HSG showed significant differences from the other two groups in total serum calcium and urinary excretion of calcium, but there were no significant differences between the NSG and controls. In the case of ionized calcium, there was no significant difference between the HSG and NSG, but both groups did show a significant difference from the controls. For the ionization rate, there was no significant difference between the HSG and controls, while there was a significant difference between the NSG and controls.

尿路結石の発生原因に関する検討(第1報) : カルシウム代謝とくに血清イオン化カルシウムを中心として

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