[総説］尿路結石の基礎と臨床

概要

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Oxalate is well known to exert a very important effect on urinary calcium oxalate saturation. There are a variety of factors which influence the urinary concentration of oxalate, calcium, and other stone-related substances. In addition, there is a diurnal variation in the saturation of urinary calcium oxalate. Oral intake of oxalate-containing food increases urinary oxalate excretion in three ways, i.e., direct oxalate absorption, endogenous metabolism from vitamin C and glycollate. The latter path seems to be most important. Magnesium and citrate salts are shown to have inhibiotory activity against stone formation, in particular, alkaline salts being more potent. It is hard to predict the level of calcium-oxalate saturation using single parameters. Hypomagnesiuria, a high Ca/Mg ratio, and hypocitraturia were previously believed to be associated with stone formation, but these risk factors seem to be less associated with stone formation. Since delicious food has been implicated in stone formation, continuous fluid intake and moderate exercise are essential to make stone-formers free of stone recurrence.
琉球医学会の論文