Clinical significance of phosphate in calcium oxalate renal stones.

Abstract

We analysed calcium, magnesium, oxalate, citrate, urate and creatinine in urine and calculated risk factors in patients who had formed stones composed of calcium oxalate, and calcium phosphate, alone or as a mixture. Patients producing pure calcium oxalate stones (less than 0.1% phosphate) had a higher oxalate, and lower calcium excretion than stone-free subjects and patients forming other stone types. In contrast, patients producing calcium oxalate stones containing phosphate, even in trace amounts (greater than 0.1%) had no increase in oxalate excretion, but a higher calcium excretion than stone-free subjects. We could not correlate any computed variable (e.g. AP(CaOx) index) to stone composition. We conclude that pure CaOx stones may be the result of a high oxalate excretion, and that other calcium containing stones may have another and probably more complex aetiology, including primary precipitation of calcium phosphates.