Skip to main content
SpringerLink
Log in

Renal phosphate leak in patients with idiopathic hypercalciuria and calcium nephrolithiasis

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

Although urine phosphate loss has been associated with hypercalciuria, it is debated how frequently renal phosphate leak is present in hypercalciuric patients. We reviewed the records of 100 consecutive adult patients who were diagnosed with idiopathic hypercalciuria and calcium urolithiasis, searching for the presence of renal phosphate leak. The renal phosphate threshold, normalized for the glomerular filtration rate (TmPO4/GFR), of the hypercalciuric patients followed a normal distribution and had a good correlation with serum phosphate (r=0.77; p<0.0001). There were no correlations between TmPO4/GFR and urinary calcium or between serum phosphorus and urinary calcium. We found only nine patients (9%) with renal phosphate leak. These patients had a mean TmPO4/GFR of 2.19 mg% (0.70 mmol/l) and serum phosphorus of 2.65 mg% (0.85 mmol/l). Nevertheless, urinary calcium was not significantly different between patients with or without low TmPO4/GFR. We conclude that renal phosphate leak is an infrequent finding in patients with idiopathic hypercalciuria and is not associated with a higher urinary calcium loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Barilla SE, Zerwekh JE, Pak CYC (1979) A critical evaluation of the role of phosphate in the pathogenesis of absorptive hypercalciuria. Min Electrolyte Metab 2: 302

    CAS  Google Scholar 

  2. Breslau NA, Preminger MG, Adams BV, Oty J, Pak CYC (1992) Use of ketoconazole to probe the pathogenetic importance of 1,25-dihydroxyvitamin D in absorptive hypercalciuria. J Clin Endocrinol Metab 75: 1446

    CAS  PubMed  Google Scholar 

  3. Bushinsky DA, Parker WR, Asplin JR (2000) Calcium phosphate super saturation regulates stone formation in genetic hypercalciuric stone-forming rats. Kidney Int 57: 550

    Article  CAS  PubMed  Google Scholar 

  4. Friedlander G, Couette S, Coureau C, Amiel C (1992) Mechanisms whereby extracellular adenosine 3', 5'-momophosphate inhibits phosphate transport in cultured opossum kidney cells and in the rat kidney. J Clin Invest 90: 848

    CAS  PubMed  Google Scholar 

  5. Gray RW, Wilz DR, Caldas AE, Lemann J Jr (1977) The importance of phosphate in regulating plasma 1,25-(OH) 2D levels in humans: studies of healthy subjects, in calcium stone formers and in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 45: 299

    CAS  PubMed  Google Scholar 

  6. Lemann J Jr (1992) Pathogenesis of idiopathic hypercalciuria and nephrolithiasis. In: Coe FL, Favus MJ (eds) Disorders of bone and mineral metabolism. Raven Press, New York, p 685

  7. Lerolle N, Lantz B, Paillard F et al (2002) Risk factors for nephrolithiasis in patients with familial idiopathic hypercalciuria. Am J Med 113: 99

    Article  PubMed  Google Scholar 

  8. Michaut P, Prié D, Amiel C, Friedlander G (1994) Dipyridamole for renal phosphate leak? N Engl J Med 331: 58

    Article  CAS  Google Scholar 

  9. Pak CYC (1991) Etiology and treatment of urolithiasis. Am J Kidney Dis 18: 624

    CAS  PubMed  Google Scholar 

  10. Pak CYC, Britton F, Peterson R et al (1980) Ambulatory evaluation of nephrolithiasis: classification, clinical presentation and diagnostic criteria. Am J Med 69: 19

    CAS  PubMed  Google Scholar 

  11. Prié D, Blanchet FB, Essig M, Jourdain J-P, Friedlander G (1998) Dipyridamole decreases renal phosphate leak and augments serum phosphorus in patients with low renal phosphate threshold. J Am Soc Nephrol 9: 1264

    PubMed  Google Scholar 

  12. Prié D, Ravery V, Boccon-Gibod L, Friedlander G (2001) Frequency of renal phosphate leak among patients with calcium nephrolithiasis, Kidney Int 60: 272

    Google Scholar 

  13. Sakhaee K, Nicar MJ, Brater DC, Pak CYC (1985) Exaggerated natriuretic and calciuric response to hydrochlorothiazide in renal hypercalciuria but not in absorptive hypercalciuria. J Clin Endocrinol Metab 61: 825

    CAS  PubMed  Google Scholar 

  14. Walton RJ, Bijvoet OL (1975) Nomogram for derivation of renal threshold phosphate concentration. Lancet 2: 309

    CAS  PubMed  Google Scholar 

  15. Williams CP, Child DP, Hudson PR et al (1995) Inappropriate phosphate excretion in idiopathic hypercalciuria: the key to a common cause and future treatments. J Clin Pathol 49: 881

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836 1 piso, Buenos Aires 10 12, Argentina

    Armando Luis Negri, Rodolfo Spivacow, Elisa Del Valle, Erich Fradinger, Alicia Marino & Jose Ruben Zanchetta

Authors
  1. Armando Luis Negri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rodolfo Spivacow
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elisa Del Valle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Erich Fradinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alicia Marino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jose Ruben Zanchetta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Armando Luis Negri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Negri, A.L., Spivacow, R., Del Valle, E. et al. Renal phosphate leak in patients with idiopathic hypercalciuria and calcium nephrolithiasis. Urol Res 31, 378–381 (2003). https://doi.org/10.1007/s00240-003-0353-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-003-0353-y

Keywords

Search

Navigation