Halabé A, Sutton R A
Miner Electrolyte Metab. 1987;13(4):235-41.
Primary hyperparathyroidism and idiopathic hypercalciuria are important causes of calcium stone disease. Hypercalcemia is usually the clue to the presence of primary hyperparathyroidism, but a minority of patients are intermittently or persistently normocalcemic. In these patients there appears to be a resistance to the effect of parathyroid hormone on renal calcium transport, to which calcitriol may contribute. Such patients mimic those with idiopathic hypercalciuria, the commonest metabolic cause of stone formation. The pathophysiology of idiopathic hypercalciuria remains controversial, but abnormalities of renal tubule function and disordered vitamin D metabolism are commonly present. The separation into so-called renal and absorptive types does not appear to be of practical importance, since thiazide diuretics provide effective prophylaxis regardless of type.
原发性甲状旁腺功能亢进症和特发性高钙尿症是钙结石病的重要病因。高钙血症通常是原发性甲状旁腺功能亢进症存在的线索，但少数患者血钙水平间歇性或持续性正常。在这些患者中，似乎对甲状旁腺激素对肾钙转运的作用存在抵抗，而骨化三醇可能起了一定作用。这些患者类似于特发性高钙尿症患者，后者是结石形成最常见的代谢原因。特发性高钙尿症的病理生理学仍存在争议，但肾小管功能异常和维生素D代谢紊乱普遍存在。分为所谓的肾性和吸收性类型似乎并无实际意义，因为噻嗪类利尿剂无论哪种类型都能提供有效的预防作用。
