Renolithiasis
Renal stones develop primarily in individuals who, for whatever reason, lack a solution abilizer in their urine. In such individuals, solute concentration, calcium loads, and oxalate oad are some of the risk factors for oxaiate stone formation (the most common variety in NorthAmerica today). Normally, 75 - 85% of the renal oxalate burden comes from endogenous i.e., metabolic) sources, and the remainder is dietary in origin, coming mainly from vegetable Renal oxalate load is a more powerful risk factor for stone formation than is the renal calcium load, which explains the seemingly paradoxical effect of calcium intake on calcium stone risk. It should be noted that this is not a new observation. Therapeutic nutritionists have long used very high calcium intakes (up to several grams per day) to treat patients with short bowel syndromes who develop the syndrome of intestinal hyperoxalosis, the principal manifestation of which is severe renal calcinosis and renolithiasis. There have, to date, been no clinical trials of calcium supplementation in stone formers, but two prospective studies have reported an inverse relationship between stone incidence and calcium intake.
Renal stones develop primarily in individuals who, for whatever reason, lack a solution abilizer in their urine. In such individuals, solute concentration, calcium loads, and oxalate oad are some of the risk factors for oxaiate stone formation (the most common variety in NorthAmerica today). Normally, 75 - 85% of the renal oxalate burden comes from endogenous i.e., metabolic) sources, and the remainder is dietary in origin, coming mainly from vegetable Renal oxalate load is a more powerful risk factor for stone formation than is the renal calcium load, which explains the seemingly paradoxical effect of calcium intake on calcium stone risk. It should be noted that this is not a new observation. Therapeutic nutritionists have long used very high calcium intakes (up to several grams per day) to treat patients with short bowel syndromes who develop the syndrome of intestinal hyperoxalosis, the principal manifestation of which is severe renal calcinosis and renolithiasis. There have, to date, been no clinical trials of calcium supplementation in stone formers, but two prospective studies have reported an inverse relationship between stone incidence and calcium intake.
