Low gastrointestial absorption of alkali as a cause of idiopathic hypocitraturia
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:101A 1997
The causes of hypocitraturia, a condition that affects as many as 40% of calcium stone formers, is most often unknown. Acidosis and acid loads clearly leads to stimulation of tubular citrate reabsorption. Another possible explanation for some patients in some previous studies could be reduced gastrointestinal absorption of alkali, in the form of organic anions. The authors measured urinary electrolytes to estimate gastrointestinal absorption in a well- accepted method. They defined patients with hypocitraturia as those with 24 hour excretion of < 300 mg, exluding those with RTA or known gastrointestinal disease. Though 7 of the 72 patients studied had clearly low values for gastrointestinal absorption, the range and distribution of net GI absorption of alkali was not different in the patients and the 23 controls.
Comment: The patients also apparently had normal citrate absorption when given oral citrate supplementation. The effect of different diets (i.e. differing amounts of ingested alkali) would probably not account for the lack of an effect given the similarity of results in the 2 groups. (David S. Goldfarb, M.D., NYU School of Medicine)
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ASN 30th Annual Meeting, San Antonio
Nephrolithiasis : Renal Stones: Diagnosis