We investigated the correlations between each parameters of
24-hour urine assessed ordinary in patients with
nephrolithiasis. In our study we found a different aspect of
biochemical values in nephrolithiasis.
It is known that while the raised excretion of oxalate,
uric acid, calcium and phosphorus in the urine increase the
formation of nephrolithiasis; raised excretion of citrate,
magnesium, albumin and alkali urine decrease this process. In
our patients with nephrolithiasis the levels of urine citrate,
calcium, uric acid, phosphorus, sodium (up limit in men),
potassium, chlorine and creatininee were within normal limits
but the levels of 24-hour urine volume, and urinary magnesium
and oxalate excretion were higher than normal.
Several reports claim that idiopathic stone formers
excrete significantly less citrate in their urine than normal subjects 5-7,9-15. Others, however, have not confirmed this
difference 16-19. One of the problems with citrate excretion
is that it depends on age and sex; it changes with age 4 and is
generally higher in women than in man 4-9. Our results were
in agreement with this data.
The levels of all serum parameters were within normal
intervals but only IPTH was higher than normal in female
patients. Primary hyperparathyroidism is related with stone
formation in patients with nephrolithiasis. We also observed
positive correlations between urine and serum levels of
creatininee with urine and serum levels of uric acid; urine
levels of phosphorus with urine levels of urea; urine levels of
uric acid with urine levels of calcium and among the urine
levels of chlorine with uric acid and creatinine.
Either Fellstrom et al. 20 in patients (n= 467) with
calcium lithiasis or Dumoulin et al. 21 in patients (n= 49)
with pure and mixed CaOx (calcium-oxalate) lithiasis found
out a positive correlation between urine values of uric acid and
oxalate. Although Duranti et al. in patients (n= 30) with
calcium lithiasis found a positive correlation between urine
values of calcium and phosphorus, they did not find correlation
among creatininee, uric acid, urea, chlorine and magnesium
excretions 22. Futhermore Conta A et al. 23 and Welshman
et al. 4 in patients with CaOx lithiasis found that patients
with hypocitraturia also had hypercalciuria. But Menon and
Mahle described no significant correlation between calcium
and citrate excretion in their controls or patients with stone
14. As a different relationship Oehlschlager et al. 24 found
a combination of hypercalciuria and hyperoxaluria in patients
(n= 22) after extracorporeal shock wave lithotripsy treatment.
Both Tefekli A et al. and Ogava Y et al. found that levels of
urine calcium were higher in patients with CaOx stones than
normal patients; level of urine citrate, magnesium and
creatinine were lower than normal (n= 155 and n= 222)
25,26, but Scholz et al. 27 found out that concentrations of
magnesium, uric acid and phosphate were within normal limits
in urine. These different results may result from the special
characteristics of a particular region (diet, climate, genetics,
socio-economic factors, etc.). The dietary differences may be
the most important factor to explain the deviation among the
various studies.
In conclusion, it is obvious that there are correlations
among some urine parameters and this may be clinically useful
for a more effective treatment planning.
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