Ulmann A
Nephrologie. 1984;5(5):232-4.
Three studies have been undertaken to evaluate the predictive value for new stone formation of urinary calcium excretion. In study 1, 24-hr calciuria was similar in 52 patients with benign stone disease (less than 3 new stones or 1 staghorn calculus in the 5 preceeding years) and in 46 patients with severe lithiasis (more than 3 stones or 1 staghorn calculus), based on a retrospective assessment of stone disease evolution. In study 2, urinary fasting Ca/Creat was identical in 43 non-hyperparathyroid stone formers (including 31 with severe lithiasis) and in 35 patients with proven or suspected primary hyperparathyroidism (including 19 with benign lithiasis, 8 with severe lithiasis and 8 with no stone). In study 3, stone recurrence, assessed prospectively, felt significantly in patients given a high fluid intake alone or associated with 50 mg/d of hydrochlorothiazide, independently of urinary calcium excretion. Urinary calcium determination therefore appears useless for stone recurrence prediction.
已经开展了三项研究来评估尿钙排泄对新结石形成的预测价值。在研究1中，基于对结石病演变的回顾性评估，52例良性结石病患者（在之前5年中形成少于3颗新结石或1颗鹿角形结石）和46例严重结石病患者（超过3颗结石或1颗鹿角形结石）的24小时尿钙排泄量相似。在研究2中，43例非甲状旁腺功能亢进结石形成者（包括31例严重结石病患者）与35例已证实或疑似原发性甲状旁腺功能亢进患者（包括19例良性结石病患者、8例严重结石病患者和8例无结石患者）的空腹尿钙/肌酐比值相同。在研究3中，前瞻性评估显示，仅给予高液体摄入量或联合50mg/d氢氯噻嗪治疗的患者结石复发情况显著，且与尿钙排泄无关。因此，尿钙测定对于预测结石复发似乎并无用处。
