Treatment of primary hypercalciuria
Idiopathic hypercalciuria is the most frequent metabolic abnormality since up to 40 to 60% of patients with nephrolithiasis are hypercalciuric. Fasting hypercalciuria, accompanies idiopathic hypercalciuria in up to 50% of the patients. It is widely agreed that high calcium excretion may be causative for stone disease, because the higher calcium concentration, the higher the state of saturation with the calcium forming salts. However, a more general involvement of mineral metabolism, and in particular bone turnover, comes from the fact that virtually all of these patients tend to develop a negative external balance of calcium, because renal loss overtakes net calcium absorption at the intestine. We care about you health
The mechanisms of hypercalciuria are complex and not fully clarified as yet, and this issue is the object of another article in the Journal. Anyway, a better understanding of the pathogenesis of hypercalciuria represents the basis of the different therapeutic options so far pursued, which will be the object of the present review. These are listed in Table I. The points concerning the dependence of calcium excretion on dietary factors will be omitted, being treated elsewhere in this issue. Table I – Therapeutic options in primary hypercalciuria.
Diet and Fluid intake Thiazides