Summary
389 consecutive renal stone formers (275 males, 114 females) were investigated in an out-patient stone clinic. Renal tubular acidosis (RTA) was found in 83 patients (22%). Proximal RTA was twice as common as the distal tubular type. The acidification defects were exclusively of the incomplete form with normal basal blood acid-base status. Main diagnoses besides RTA were primary hyperparathyroidism (3.5%), medullary sponge kidney (3.5%), infection induced stones (3%), urate stones (2%), intestinal disorder (1.5%) and cystinuria (0.5%).
The metabolic evaluation was mainly based on 24 h urine sampling on a free diet. In 248 patients (64%) no distinct abnormality was considered to be primarily responsible for stone formation. Clinical and biochemical analysis of these so-called idiopathic stone formers disclosed a male preponderance (80%) and, compared to a non-stone-forming control group, a higher urinary calcium excretion, yet with a considerable overlap between the two groups. Hyperuricosuria and hyperoxaluria were rare findings.
The conclusion of the study is given as a proposal for clinical classification and ambulatory investigation of renal stone formers.
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Wikström, B., Backman, U., Danielson, B.G. et al. Ambulatory diagnostic evaluation of 389 recurrent renal stone formers. Klin Wochenschr 61, 85–90 (1983). https://doi.org/10.1007/BF01496659
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DOI: https://doi.org/10.1007/BF01496659