[Tubular dysfunction in renal lithiasis: cause or consequence?].

Abstract

To investigate whether overall tubular dysfunction is encountered in a particular subgroup of patients with urolithiasis, the following parameters of renal tubular function have been measured in fasting morning urine in 124 male stone formers: excretion of lysozyme and gamma-glutamyl transpeptidase (gamma-GT), fractional excretion (FE) or glucose, insulin, bicarbonate after an alkali load, and theoretical phosphate threshold (TmP/GFR). The following have been diagnosed: primary hyperparathyroidism (n = 3), medullary sponge kidneys (n = 5), hyperuricemia (n = 8), cystinuria (n = 1), struvite nephrolithiasis (n = 2), idiopathic hypercalciuria of the absorptive (n = 16), dietary (n = 46) or renal (n = 5) type, and normocalciuric idiopathic urolithiasis (n = 38). Urinary excretion of lysozyme and of gamma-GT were elevated in 14% and 21% of patients respectively; FE glucose and FE insulin were elevated in 6% and 8% of patients respectively. In 62% of the patients TmP/GFR was below 0.95 mmol/l and in 52% of the patients FE HCO3 after alkali load was above normal. The findings show that a large number of stone formers have signs of renal tubular dysfunction; apparent renal leaks of phosphate and of bicarbonate are the most frequently encountered defects; while they are not specific for a given etiologic group of patients, they have been found in each group. The latter observation suggests that nephrolithiasis itself can damage renal tubular function.

• Authors: P Jaeger, L Portmann, P Burckhardt
• Journal: Schweizerische medizinische Wochenschrift (Schweiz Med Wochenschr) Vol. 115 Issue 5 Pg. 160-2 (Feb 02 1985) ISSN: 0036-7672 [Print] Switzerland
• Vernacular Title: Dysfonction tubulaire dans la lithiase rénale: cause ou conséquence?
• PMID: 2858124 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bicarbonates
• Insulin
• gamma-Glutamyltransferase
• Muramidase

Topics

• Adult
• Bicarbonates (urine)
• Glycosuria (diagnosis)
• Humans
• Insulin (urine)
• Kidney Calculi (physiopathology)
• Kidney Tubules (physiopathology)
• Male
• Muramidase (urine)
• gamma-Glutamyltransferase (urine)