Fellström B
Scand J Urol Nephrol Suppl. 1981;62:1-59.
Both hyperuricaemia and hyperuricosuria have been considered to be common in renal calcium stone disease. Abnormalities in serum or urinary urate was not more common in 450 investigated patients than in 90 healthy controls, but when present it was often associated with a more complicated course of the disease, particularly in combination with renal acidification defects. Hyperuricosuria was not explained by a renal tubular dysfunction of urate transport. A decreased urate clearance in proximal renal acidification dysfunction was associated with a high tubular reabsorption of filtered urate. Sodium urate or uric acid crystals did not adsorb urinary macro-molecular inhibitors of crystal growth other than in calcium oxalate solution, whereby a substantial loss of the inhibitory activity was detected. A high intake of dietary animal protein had a unfavourable effect, as several urinary constituents potentially important for calcium stone formation were aggravated. The urinary excretion of calcium and urate increased, whereas urine pH and urinary citrate decreased. It was concluded that the protein content of the diet may be an important factor contributing to the increase in the renal calcium stone disease in the industrialized world.
高尿酸血症和高尿酸尿症在肾钙结石病中都被认为很常见。在450例受调查患者中，血清或尿酸异常并不比90例健康对照更常见，但一旦出现，往往与更复杂的病程相关，特别是与肾酸化缺陷同时出现时。高尿酸尿症不能用肾小管尿酸转运功能障碍来解释。近端肾酸化功能障碍时尿酸清除率降低与滤过尿酸的肾小管重吸收增加有关。除了在草酸钙溶液中，尿酸钠或尿酸晶体不会吸附尿液中晶体生长的大分子抑制剂，从而检测到抑制活性的大量丧失。高摄入膳食动物蛋白有不利影响，因为几种对钙结石形成潜在重要的尿液成分会加重。钙和尿酸的尿排泄增加，而尿液pH值和尿枸橼酸盐降低。得出的结论是，饮食中的蛋白质含量可能是工业化世界中肾钙结石病增加的一个重要因素。
