Contribution to Therapeutic Decisions of Ratios, Absolute Values and Other Measures of Calcium, Magnesium, Urate or Oxalate Balance in Stone Formers

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Abstract
Investigation of multiple serum and urinary factors in 44 patients with Ca urinary stone disease confirmed a number of defects that were described previously: elevation of mean serum Ca and uric acid above normal, and depression of mean serum Mg. Urinary excretion of Ca and uric acid was increased and was probably related to food ingestion. Urinary Mg also increased after eating but less than Ca, with the result that for most patients the Mg to Ca .times. 100 ratio approached levels observed in stone formation. Urinary oxalate excretion was constant during the entire observation period and apparently was not affected by ingestion of a defined diet. Nine additional patients had persistent hypercalcemia owing to hyperparathyroidism (5 confirmed, 1 suspected), malignancy (2) and drug ingestion (1). Metabolic evaluation of patients with Ca urinary calculi continues to contribute to decisions regarding their best therapeutic regimen.

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