尿路結石症における生化学的検索とくに過カルシウム尿症とPhosphates

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In one hundred and fourteen cases of normal subjects, and in eighty-six patients with upper urinary calculi, daily excretions of urinary calcium, orthophosphate, pyrophosphate, cirtic acid, magnesium, creatinine, uric acid and alkaline phosphatase activity were estimated. The results of urine analysis in both groups were respectively compared. In the calculous patient group, significantly higher levels of urinary pyrophosphate and citric acid, but significantly lower levels of urinary magnesium were demonstrated. Urinary excretions of the remaining compositions, especially urinary calcium levels showed no significant differences between both groups. But idiopathic hypercalcinuria, in which over 300 mg of calcium are excreted in the 24 hour urine with normal serum levels of calcium and phosphorus, was found in 11 percent of normal subjects over 20 years old, whereas the group of calculous patients showed higher incidence of 19 percent hypercalcinuria. Also it is interesting that hypercalcinuria is not demonstrated in thirty-nine normal subjects under twenty years old. The inhibitor index proposed by Fleisch. H. et al., which is expressed in the ratio of pyrophosphate : calcium × orthophosphate, showed significantly higher value in the calculi group. This difference was more distinctly observed in the comparison between calculous patients with hypercalcinuria and normal subjects. Moreover, the chronological values of the ratio in the control group show the interesting variations, which conversely correspond to the age distribution of the urinary calculus. These findings are supposed to indicate that the ratio possibly correlates to the formation of the urinary calcareous stone. In eleven cases of calculous patients and five cases of normal adults, orthophosphates (Na_2HPO_4 + KH_2PO_4) in daily dosis of 2 gm were administered by mouth. Before and after administration the consecutive biochemical analysis was performed and was compared. The results definitely demostrated that the administration of the phosphates preparation caused significant increase of urinary citric acid, pyrophosphate and the inhibitor index expressed in the ratio of pyrophosphate : calcium × orthophosphate, but significant decrease of urinary calcium and magnesium. These changes of urine compositions caused by administration of phosphates, suggests that orthophosphates have clinical usefullness in prevention of the formation of the urinary calcareous stone.
社団法人日本泌尿器科学会の論文
1968-11-20

尿路結石症における生化学的検索とくに過カルシウム尿症とPhosphates

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