ABNORMALITIES OF CALCIUM METABOLISM IN PATIENTS WITH "IDIOPATHIC" URINARY CALCULI

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Abstract
The daily urinary excretion of calcium in 148 patients with urinary calculi was compared with that in 37 healthy people who had no personal or familial history of such calculi. Patients under home-life conditions on selfselected diets did not differ from healthy subjects as to dietary calcium intake, yet their average urinary calcium output was significantly higher. The effectiveness of sodium phytate in hindering the absorption of calcium from the intestine was studied by comparing the urinary calcium excretion of 104 patients who received phytate with that of 74 subjects who did not; the oral administration of sodium phytate in doses of 125-175 mg. per kilogram of body weight per day caused a distinct and sustained reduction of urinary calcium. Regression or disappearance of existing calcified stones was never observed, and no convincing evidence was obtained as to the efficiency of low-calcium diet and orally administered phytate in preventing stone formation. The complexity of the factors involved in stone formation is illustrated in five case histories. The data indicate, however, that individual differences and derangements of calcium metabolism exist, that a regimen of low-calcium, lowvitamin D intake with sodium phytate by mouth sometimes affords helpful diagnostic clues, and that this regimen has possibilities in both the preoperative and the postoperative care of patients with urinary calculi.