Renal Acidifying Ability in Subjects with Recurrent Stone Formation

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Abstract
To determine the incidence of an acidification defect in men in whom Ca stones form and its relationship to parathyroid function 120 patients were given an acute dosage of 0.1 g/kg oral NH4Cl and circulating immunoreactive parathyroid hormone [PTH] was determined. The subjects were divided into 2 groups, according to normal or high PTH levels. Group 1 consisted of 46 men in whom immunoreactive PTH was less than or equal to 60 .mu.leq/ml and group 2 consisted of 74 men with immunoreactive PTH greater than 60 .mu.leq/ml. Of 8 men in whom the urine failed to acidify to less than a pH of 5.3, 3 were from group 1 and 5 were from group 2. None of the patients had an active urinary tract infection. There was no difference in minimal urine pH among the patients in whom the urine acidified normally regardless of immunoreactive PTH. The incidence of abnormal acidification was 6% and all of these patients had the incomplete form of renal tubular acidosis. These findings have important therapeutic implications.