Guimerà Jordi, Martínez Ana, Quetglas José Luis Bauzá, Sanchis Pilar, Costa-Bauzá Antonia, Pieras Enrique, Grases Felix
Urology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain.
Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain.
J Clin Med. 2024 Aug 26;13(17):5059. doi: 10.3390/jcm13175059.
Adults who have incomplete distal renal tubular acidosis (dRTA) may present with recurrent urolithiasis due to metabolic acidosis, leading to bone resorption, which in turn causes hypercalciuria and urine alkalinization (pH > 6.0). Oral potassium citrate is the most commonly used treatment for dRTA, but some patients cannot tolerate this treatment. The objective of this single-arm study was to evaluate the effect of phytate, an inhibitor of bone resorption, on calciuria of patients with incomplete dRTA. The calciuria levels of 16 patients who had incomplete dRTA with urolithiasis and could not tolerate potassium citrate treatment were recorded before (baseline) and after 6 months of treatment with oral calcium magnesium phytate (380 mg every 12 h). There were no dietary modifications or other treatments. The baseline calciuria was 317 ± 81 mg/24 h and the level after 6 months was 221 ± 38 mg/24 h ( < 0.005). Our results suggest that calcium magnesium phytate should be considered as an alternative or adjunctive treatment for hypercalciuria in patients with incomplete dRTA.
患有不完全性远端肾小管酸中毒（dRTA）的成年人可能会因代谢性酸中毒而反复出现尿石症，进而导致骨质吸收，这反过来又会引起高钙尿症和尿液碱化（pH>6.0）。口服柠檬酸钾是治疗dRTA最常用的方法，但有些患者无法耐受这种治疗。这项单臂研究的目的是评估骨吸收抑制剂植酸盐对不完全性dRTA患者钙尿症的影响。记录了16例患有不完全性dRTA并伴有尿石症且无法耐受柠檬酸钾治疗的患者在口服植酸钙镁（每12小时380毫克）治疗6个月之前（基线）和之后的钙尿症水平。未进行饮食调整或其他治疗。基线钙尿症为317±81毫克/24小时，6个月后的水平为221±38毫克/24小时（<0.005）。我们的结果表明，植酸钙镁应被视为不完全性dRTA患者高钙尿症的替代或辅助治疗方法。
