Phosphate Treatment of Recurrent Calcium Stone Disease

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Abstract
A group of 38 male recurrent idiopathic Ca stone formers were treated with oral supplements of Pi (1 g P extra in the diet per day) and followed at intervals up to 4 yr. The urinary excretion of Ca decreased (P < 0.001) and that of Pi increased (P < 0.001) during treatment. These changes resulted in a small decrease in the supersaturation of urine with respect to calcium oxalate sufficient to reduce the percentage of urines which exceeded the upper limit of solubility of that salt, and a small increase in the supersaturation of urine with respect to calcium phosphate. The stone episode rate on treatment fell in 35 of the 38 patients from a mean pretreatment value of 0.66 episodes/yr to 0.22. The 3 initially most prolific stone formers increased their rate of stone formation during treatment. Plasma biochemistry showed no evidence of parathyroid stimulation.