Laminski N A, Meyers A M, Kruger M, Sonnekus M I, Margolius L P
Metabolic Stone Clinic, Johannesburg Hospital, South Africa.
Br J Urol. 1991 Nov;68(5):454-8. doi: 10.1111/j.1464-410x.1991.tb15383.x.
The presence of mild hyperoxaluria in recurrent calcium oxalate stone formers is controversial. The aim of this study was to identify recurrent stone formers with mild hyperoxaluria and to classify them further by assessing their response to a low oxalate diet. In addition, the prevalence of other risk factors for stone formation in this group of patients was investigated. A total of 207 consecutive patients with recurrent renal calculi were screened and 40 (19%) were found to have mild hyperoxaluria. Of these, 18 (45%) responded to dietary oxalate restriction by normalising their urinary oxalate. The remaining 22 patients were classified as having idiopathic hyperoxaluria and were subdivided into those in whom urinary oxalate excretion was consistently elevated in all specimens measured and those in whom the elevation was intermittent in nature. Dietary oxalate restriction had a partially beneficial effect in lowering oxalate excretion in the patients with persistent hyperoxaluria. No difference in urinary oxalate excretion was found after dietary restriction in the patients with intermittent hyperoxaluria. Other risk factors, including dietary, absorptive and renal hypercalciuria and hypocitraturia, were documented, the prevalence of which (65%) was not significantly different from that (62.5%) found in 40 age- and sex-matched calcium stone formers without hyperoxaluria. The prevalence of hyperuricosuria was significantly greater in patients with hyperoxaluria when compared with stone controls. Further studies are required to elucidate the underlying mechanisms of hyperoxaluria in recurrent stone formers.
复发性草酸钙结石患者中轻度高草酸尿症的存在存在争议。本研究的目的是识别患有轻度高草酸尿症的复发性结石患者，并通过评估他们对低草酸饮食的反应进一步对其进行分类。此外，还调查了该组患者中其他结石形成危险因素的患病率。对总共207例连续的复发性肾结石患者进行了筛查，发现40例（19%）有轻度高草酸尿症。其中，18例（45%）通过使尿草酸正常化对饮食草酸限制有反应。其余22例患者被归类为特发性高草酸尿症，并细分为所有测量标本中尿草酸排泄持续升高的患者和尿草酸升高为间歇性的患者。饮食草酸限制对持续性高草酸尿症患者降低草酸排泄有部分有益作用。间歇性高草酸尿症患者饮食限制后尿草酸排泄无差异。记录了其他危险因素，包括饮食性、吸收性和肾性高钙尿症及低枸橼酸尿症，其患病率（65%）与40例年龄和性别匹配的无高草酸尿症的钙结石患者中发现的患病率（62.5%）无显著差异。与结石对照组相比，高草酸尿症患者中高尿酸尿症的患病率显著更高。需要进一步研究以阐明复发性结石患者高草酸尿症的潜在机制。
