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. 1968 Dec;47(12):2580–2590. doi: 10.1172/JCI105940

Metabolic and calcium kinetic studies in idiopathic hypercalciuria

U A Liberman 1, O Sperling 1, A Atsmon 1, M Frank 1, M Modan 1, A De Vries 1
PMCID: PMC297428  PMID: 16695955

Abstract

Calcium balances and calcium kinetic studies using 47Ca were performed in nine male patients with idiopathic hypercalciuria and in three normal male subjects. A sharp reduction in calcium intake in eight patients with idiopathic hypercalciuria caused a decrease in urinary calcium excretion, the latter remaining elevated above that reported for normal subjects on a low calcium diet. The hypercalciuric patients had an enlarged miscible calcium pool size, an increased calcium turnover rate, increased bone formation and bone resorption rates, and an elevated true intestinal calcium absorption rate, the increase of the latter three parameters being proportional to the increase of the turnover rate. The fraction of the calcium turnover rate excreted in the urine was elevated whereas that constituted by the endogenous fecal calcium excretion was decreased. Arguments are presented for the concept that the primary abnormality in idiopathic hypercalciuria is neither renal calcium hyperexcretion nor intestinal calcium hyperreabsorption, but a more fundamental disturbance in calcium metabolism of as yet unknown cause, leading to a high calcium turnover.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALBRIGHT F., CARROLL E. L., DEMPSEY E. F., HENNEMAN P. H. The cause of hypercalcuria in sarcoid and its treatment with cortisone and sodium phytate. J Clin Invest. 1956 Nov;35(11):1229–1242. doi: 10.1172/JCI103378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. ALBRIGHT F., HENNEMAN P., BENEDICT P. H., FORBES A. P. Idiopathic hypercalciuria: a preliminary report. Proc R Soc Med. 1953 Dec;46(12):1077–1081. [PMC free article] [PubMed] [Google Scholar]
  3. ANDERSON J., HARPER C., DENT C. E., PHILPOT G. R. Effect of cortisone on calcium metabolism in sarcoidosis with hypercalcaemia; possibly antagonistic actions of cortisone and vitamin D. Lancet. 1954 Oct 9;267(6841):720–724. doi: 10.1016/s0140-6736(54)90492-4. [DOI] [PubMed] [Google Scholar]
  4. AUBERT J. P., BRONNER F., RICHELLE L. J. Quantitation of calcium metabolism. Theory. J Clin Invest. 1963 Jun;42:885–897. doi: 10.1172/JCI104781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. AUBERT J. P., MILHAUD G. [Method for the measurement of the principal routes of calcium metabolism in man]. Biochim Biophys Acta. 1960 Mar 25;39:122–139. doi: 10.1016/0006-3002(60)90128-1. [DOI] [PubMed] [Google Scholar]
  6. AVIOLI L. V., MCDONALD J. E., SINGER R. A., HENNEMAN P. H. A NEW ORAL ISOTOPIC TEST OF CALCIUM ABSORPTION. J Clin Invest. 1965 Jan;44:128–139. doi: 10.1172/JCI105119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Anderson J., Lee H. A., Tomlinson R. W. Some metabolic aspects of idiopathic hypercalciuria. Nephron. 1967;4(3):129–138. doi: 10.1159/000179579. [DOI] [PubMed] [Google Scholar]
  8. BAUER G. C., CARLSSON A., LINDQUIST B. Bone salt metabolism in humans studied by means of radiocalcium. Acta Med Scand. 1957 Aug 13;158(2):143–150. doi: 10.1111/j.0954-6820.1957.tb15756.x. [DOI] [PubMed] [Google Scholar]
  9. Brodwall E. K., Laake H. The renal utilization of citric acid in idiopathic hypercalciuria. Acta Med Scand. 1967 Jan;181(6):725–728. doi: 10.1111/j.0954-6820.1967.tb07992.x. [DOI] [PubMed] [Google Scholar]
  10. CANIGGIA A., GENNARI C., CESARI L. INTESTINAL ABSORPTION OF 45CA DYNAMICS OF 45CA IN GASTRECTOMY OSTEOPOROSIS. Acta Med Scand. 1964 Nov;176:599–605. doi: 10.1111/j.0954-6820.1964.tb00663.x. [DOI] [PubMed] [Google Scholar]
  11. Caniggia A., Gennari C., Guideri R., Cesari L. Comparison between the results of radiocalcium studies and histological findings in a case of primary hyperparathyroidism (osteitis fibrosa cystica generalisata of von Recklinghausen) before and after removal of parathyroid adenoma. J Clin Endocrinol Metab. 1966 Aug;26(8):867–874. doi: 10.1210/jcem-26-8-867. [DOI] [PubMed] [Google Scholar]
  12. DE DEUXCHAISNES C. N., KRANE S. M. PAGET'S DISEASE OF BONE: CLINICAL AND METABOLIC OBSERVATIONS. Medicine (Baltimore) 1964 May;43:233–266. [PubMed] [Google Scholar]
  13. DENT C. E., WATSON L. METABOLIC STUDIES IN A PATIENT WITH IDIOPATHIC HYPERCALCIURIA. Br Med J. 1965 Aug 21;2(5459):449–452. doi: 10.1136/bmj.2.5459.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. DeGrazia J. A., Ivanovich P., Fellows H., Rich C. A double isotope method for measurement of intestinal absorption of calcium in man. J Lab Clin Med. 1965 Nov;66(5):822–829. [PubMed] [Google Scholar]
  15. Edwards N. A., Hodgkinson A. Metabolic studies in patients with idiopathic hypercalciuria. Clin Sci. 1965 Aug;29(1):143–157. [PubMed] [Google Scholar]
  16. Edwards N. A., Hodgkinson A. Metabolic studies in patients with idiopathic hypercalciuria. Clin Sci. 1965 Aug;29(1):143–157. [PubMed] [Google Scholar]
  17. Edwards N. A., Hodgkinson A. Studies of renal function in patients with idiopathic hypercalciuria. Clin Sci. 1965 Oct;29(2):327–338. [PubMed] [Google Scholar]
  18. FANCONI A., ROSE G. A. The ionized, complexed, and protein-bound fractions of calcium in plasma; an investigation of patients with various diseases which affect calcium metabolism, with an additional study of the role of calcium ions in the prevention of tetany. Q J Med. 1958 Oct;27(108):463–494. [PubMed] [Google Scholar]
  19. GILL J. R., Jr, BARTTER F. C. On the impairment of renal concentrating ability in prolonged hypercalcemia and hypercalciuria in man. J Clin Invest. 1961 Apr;40:716–722. doi: 10.1172/JCI104305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. HAYMOVITZ A., HORWITH M. THE MISCIBLE CALCIUM POOL IN METABOLIC BONE DISEASE--IN PARTICULAR, ACROMEGALY. J Clin Endocrinol Metab. 1964 Jan;24:4–14. doi: 10.1210/jcem-24-1-4. [DOI] [PubMed] [Google Scholar]
  21. HEANEY R. P., BAUER G. C., BRONNER F., DYMLING J. F., LAFFERTY F. W., NORDIN B. E., RICH C. A NORMAL REFERENCE STANDARD FOR RADIOCALCIUM TURNOVER AND EXCRETION IN HUMANS. J Lab Clin Med. 1964 Jul;64:21–28. [PubMed] [Google Scholar]
  22. HEANEY R. P. Radiocalcium metabolism in disuse osteoporosis in man. Am J Med. 1962 Aug;33:188–200. doi: 10.1016/0002-9343(62)90017-7. [DOI] [PubMed] [Google Scholar]
  23. HEANEY R. P., WHEDON G. D. Radiocalcium studies of bone formation rate in human metabolic bone disease. J Clin Endocrinol Metab. 1958 Nov;18(11):1246–1267. doi: 10.1210/jcem-18-11-1246. [DOI] [PubMed] [Google Scholar]
  24. HENNEMAN P. H., BENEDICT P. H., FORBES A. P., DUDLEY H. R. Idiopathic hypercaicuria. N Engl J Med. 1958 Oct 23;259(17):802–807. doi: 10.1056/NEJM195810232591702. [DOI] [PubMed] [Google Scholar]
  25. HODGKINSON A., PURTON M. J., PYRAH L. N. Some observations on the mode of formation of oxalate-containing urinary calculi. Lancet. 1961 Aug 26;2(7200):451–454. doi: 10.1016/s0140-6736(61)92428-x. [DOI] [PubMed] [Google Scholar]
  26. HODGKINSON A., PYRAH L. N. The urinary excretion of calcium and inorganic phosphate in 344 patients with calcium stone of renal origin. Br J Surg. 1958 Jul;46(195):10–18. doi: 10.1002/bjs.18004619504. [DOI] [PubMed] [Google Scholar]
  27. HODGKINSON A. The relation between citric acid and calcium metabolism with particular reference to primary hyper-parathyroidism and idiopathic hypercalciuria. Clin Sci. 1963 Apr;24:167–178. [PubMed] [Google Scholar]
  28. Heaney R. P. Evaluation and interpretation of calcium-kinetic data in man. Clin Orthop Relat Res. 1963;31:153–183. [PubMed] [Google Scholar]
  29. Hodgkinson A., Zarembski P. M., Nordin B. E. Non-exchangeable calcium in human urine. Nature. 1967 Jun 3;214(5092):1045–1046. doi: 10.1038/2141045a0. [DOI] [PubMed] [Google Scholar]
  30. JACKSON W. P., DANCASTER C. A consideration of the hypercalciuria in sarcoidosis, idiopathic hypercalciuria, and that produced by vitamin D; a new suggestion regarding calcium metabolism. J Clin Endocrinol Metab. 1959 Jun;19(6):658–680. doi: 10.1210/jcem-19-6-658. [DOI] [PubMed] [Google Scholar]
  31. KLOTZ H. P., TUTIN M., ROBEL P. L'hypercalciurie idiopathique; à propos de 28 cas personnels. Sem Hop. 1958 Oct 28;34(50):2553–2560. [PubMed] [Google Scholar]
  32. LAFFERTY F. W., PEARSON O. H. SKELETAL, INTESTINAL AND RENAL CALCIUM DYNAMICS IN HYPERPARATHYROIDISM. J Clin Endocrinol Metab. 1963 Sep;23:891–902. doi: 10.1210/jcem-23-9-891. [DOI] [PubMed] [Google Scholar]
  33. LITIN R. B., DIESSNER G. R., KEATING F. R., Jr Urinary excretion of calcium in patients with renal lithiasis. J Urol. 1961 Jul;86:17–23. doi: 10.1016/S0022-5347(17)65098-5. [DOI] [PubMed] [Google Scholar]
  34. Liberman U. A., Barzel U., De Vries A., Ellis H. Myositis ossificans traumatica with unusual course. Effect of EDTA on calcium, phosphorus and manganese excretion. Am J Med Sci. 1967 Jul;254(1):35–47. doi: 10.1097/00000441-196707000-00004. [DOI] [PubMed] [Google Scholar]
  35. PARFITT A. M., HIGGINS B. A., NASSIM J. R., COLLINS J. A., HILB A. METABOLIC STUDIES IN PATIENTS WITH HYPERCALCIURIA. Clin Sci. 1964 Dec;27:463–482. [PubMed] [Google Scholar]
  36. PEARSON J. D. EVIDENCE FOR THE EXISTENCE OF NON-EXCHANGEABLE CALCIUM IN HUMAN URINE. Nature. 1965 Jan 23;205:410–411. doi: 10.1038/205410a0. [DOI] [PubMed] [Google Scholar]
  37. Pyrah L. N. The Calcium-containing Renal Stone. Proc R Soc Med. 1958 Mar;51(3):183–200. [PMC free article] [PubMed] [Google Scholar]
  38. SCHWARTZ E., PANARIELLO V. A., SAELI J. RADIOACTIVE CALCIUM KINETICS DURING HIGH CALCIUM INTAKE IN OSTEOPOROSIS. J Clin Invest. 1965 Sep;44:1547–1560. doi: 10.1172/JCI105261. [DOI] [PMC free article] [PubMed] [Google Scholar]

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