カルシウム含有上部尿路結石患者の尿中カルシウム排泄量に関して 日本人における特発性高カルシウム尿症の境界値設定の試み
日本人における特発性高カルシウム尿症 (IH) の境界値を設定する目的で, カルシウム (Ca) 含有上部尿路結石患者 (SF) 113例と正常対照者 (Normal) 10名に対して, 普通食下およびCa制限食下 (Ca 400mg/day) において, 尿中Ca排泄量を測定した. SFは, 経口Ca負荷試験施行後, Pak et al. の分類に準拠してグループ分類した. 113例中, normocalciuric nephrolithiasis (NN) 82例, absorptive hypercalciuria (AH) 11例, renal hypercalciuria (RH)...
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| Published in | 日本泌尿器科學會雑誌 Vol. 77; no. 11; pp. 1831 - 1839 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本泌尿器科学会
20.11.1986
The Japanese Urological Association 社団法人日本泌尿器科学会 |
| Online Access | Get full text |
| ISSN | 0021-5287 1884-7110 |
| DOI | 10.5980/jpnjurol1928.77.11_1831 |
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| Abstract | 日本人における特発性高カルシウム尿症 (IH) の境界値を設定する目的で, カルシウム (Ca) 含有上部尿路結石患者 (SF) 113例と正常対照者 (Normal) 10名に対して, 普通食下およびCa制限食下 (Ca 400mg/day) において, 尿中Ca排泄量を測定した. SFは, 経口Ca負荷試験施行後, Pak et al. の分類に準拠してグループ分類した. 113例中, normocalciuric nephrolithiasis (NN) 82例, absorptive hypercalciuria (AH) 11例, renal hypercalciuria (RH) 20例であった. 尿中Ca排泄量は, mg/24hr, mg/kg BW/24hr, mg/mg creatinine の3種の表記法にて表した. 特発性高Ca尿症の境界値に関しては, NormalおよびNNとの overlap は大きいものの, 普通食では3.6mg/kg BW/24hr, Ca制限食では2.1mg/kg BW/24hrが妥当と考えられた. 尿中Ca排泄量は, mg/24hrで表すと男子に多く, mg/mg creatinine で表すと女子に多い傾向がみられたので, 尿中Ca排泄量はmg/kg BW/24hrで表すのが適当と考えられた. |
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| AbstractList | 日本人における特発性高カルシウム尿症 (IH) の境界値を設定する目的で, カルシウム (Ca) 含有上部尿路結石患者 (SF) 113例と正常対照者 (Normal) 10名に対して, 普通食下およびCa制限食下 (Ca 400mg/day) において, 尿中Ca排泄量を測定した. SFは, 経口Ca負荷試験施行後, Pak et al. の分類に準拠してグループ分類した. 113例中, normocalciuric nephrolithiasis (NN) 82例, absorptive hypercalciuria (AH) 11例, renal hypercalciuria (RH) 20例であった. 尿中Ca排泄量は, mg/24hr, mg/kg BW/24hr, mg/mg creatinine の3種の表記法にて表した. 特発性高Ca尿症の境界値に関しては, NormalおよびNNとの overlap は大きいものの, 普通食では3.6mg/kg BW/24hr, Ca制限食では2.1mg/kg BW/24hrが妥当と考えられた. 尿中Ca排泄量は, mg/24hrで表すと男子に多く, mg/mg creatinine で表すと女子に多い傾向がみられたので, 尿中Ca排泄量はmg/kg BW/24hrで表すのが適当と考えられた. 日本人における特発性高カルシウム尿症(IH)の境界値を設定する目的で,カルシウム(Ca)含有上部尿路結石患者(SF)113例と正常対照者(Normal)10名に対して,普通食下およびCa制限食下(Ca 400mg/day)において,尿中Ca排泄量を測定した.SFは,経口Ca負荷試験施行後,Pak et al.の分類に準拠してグループ分類した.113例中,normocalciuric nephrolithiasis(NN)82例,absorptive hypercalciuria(AH)11例,renal hypercalciuria(RH)20例であった.尿中Ca排泄量は,mg/24hr,mg/kg BW/24hr,mg/mg creatinineの3種の表記法にて表した.特発性高Ca尿症の境界値に関しては,NormalおよびNNとのoverlapは大きいものの,普通食では3.6mg/kg BW/24hr,Ca制限食では2.1mg/kg BW/24hrが妥当と考えられた.尿中Ca排泄量は,mg/24hrで表すと男子に多く,mg/mg creatinineで表すと女子に多い傾向がみられたので,尿中Ca排泄量はmg/kg BW/24hrで表すのが適当と考えられた. The purpose of this study is to try to decide the borderline between normocalciuria and idiopathic hypercalciuria (IH) in Japanese who have calcium-containing nephrolithiasis. Daily urinary calcium excretions were determined both on usual diet and on a calcium restricted diet in 113 calcium-containing urinary stone formers (SF) and 10 normal subjects. After oral calcium load test, 113 SF were divided into 3 groups according to the criteria reported by Pak et al. There were 82 patients with normocalciuric nephrolithiasis (NN), 11 patients with absorptive hypercalciuria (AH) and 20 patients with renal hypercalciuria (RH). Daily urinary calcium excretion was expressed by three different parameters. i.e., mg/24hr, mg/kg BW/24hr and mg/mg creatinine. As a result, 3.6mg/kg BW/24hr on usual diet and 2.1mg/kg BW/24hr on a calcium restricted diet were thought to be the appropriate borderline between normocalciuria and IH in Japanese although there were large overlaps. Furthermore, it was proved that it would be better to express daily urinary calcium excretion as mg/kg BW/24hr than as mg/24hr or mg/mg creatinine because daily urinary calcium excretion was tend to be higher in males when expressed as mg/24hr and lower in males when expressed as mg/mg creatinine. |
| Author | 新島, 端夫 北村, 唯一 上田, 大介 平野, 美和 河村, 毅 |
| Author_FL | Ueda Daisuke Niijima Tadao Hirano Yoshikazu Kitamura Tadaichi Kawamura Takeshi |
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| References | 3) Pak C. Y. C., Ohata, M., Lawrence, E. C. and Snyder, W.: The hypercalciurias. Causes, Parathyroid functions, and diagnostic criteria. J. Clin. Invest., 54, 387-400, 1974. 20) Evans, R. A., Hills, E., Wong, S. Y. P., Wyndham, L. E., Eade, Y. and Dunstan, C. R.: The pathogenesis of idiopathic hypercalciuria: Evidence for parathyroid hyperfunction. Quart. J. Med., 53 (New Series), 41-53, 1984. 12) 戎野庄一: 特発性過カルシウム尿症を伴う尿路結石症に対する rice-bran 療法の研究. I. 臨床的検討. 日泌尿会誌, 75, 1-9, 1984. 9) Broadus, A. E., Dominguez, M. and Bartter, F. C.: Pathophysiological studies in idiopathic hypercalciuria: Use of an oral calcium tolerance test to characterize distinctive hypercalciuric subgroups. J. Clin. Endocrinol. Metab., 47, 751-760, 1978. 2) Henneman, P. H., Benedict, P. H., Forbes, A. P. and Dudley, H. R.: Idiopathic hypercalciuria. N. Engl. J. Med., 259, 802-807, 1958. 11) 郡健二郎: 尿路結石症の発生原因に対する内分泌学的検討. 第III報. カルシウム結石症に於けるカルシウム代謝と上皮小体機能について. 日泌尿会誌, 71, 1335-1348, 1980. 8) Coe, F. L., Canterbury, J. M., Firpo, J. J. and Reiss, E.: Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria. J. Clin. Invest., 52, 134-142, 1973. 25) Bulusu, L., Hodgkinson, A., Nordin, B. E. C. and Peacock, M.: Urinary excretion of calcium and creatinine in relation to age and body weight in normal subjects and patients with renal calculus. Clin. Science, 38, 601-612, 1970. 4) Kaplan, R. A., Haussler, M. R., Deftos, L. J., Bone, H. and Pak, C. Y. C.: The role of 1 α, 25-dihydroxyvitamin D in the mediation of intestinal hyperabsorption of calcium in primary hyperparathyroidism and absorptive hypercalciuria. J. Clin. Invest., 59, 756-760, 1977. 26) Kitamura, T., Hirano, Y., Ueda, D. and Niijima, T.: Possibility of elevated parathyroid function in patients with calcium-containing nephrolithiasis as compared with normal controls. Eur. Urol. in press. 15) Robertson, W. G. and Morgan, D. B.: The distribution of urinary calcium excretions in normal persons and stone-formers. Clin. Chim. Acta, 37, 503-508, 1972. 5) 北村唯一: 上部尿路結石と原発性副甲状腺機能亢進症. 腎と透析, 4, 509-516, 1978. 24) Rose G. A. and Harrison, A. R.: The incidence, investigation and treatment of idiopathic hypercalciuria. Brit. J. Urol., 46, 261-274, 1974. 17) 高橋悦司: 尿路結石の再発 ―尿石患者700例735結石の分析を基礎として―. 日泌尿会誌, 65, 423-436, 1974. 1) Flocks, R. H.: Calcium and phosphate excretion in the urine of patients with renal or ureteral calculi. J. Am. Med. Ass., 114, 1466-1471, 1939. 6) Hodgkinson, A. and Pyrah, L. N.: The urinary excretion of calcium and inorganic phosphate in 344 patients with calcium stone of renal origin. Brit. J. Surg., 46, 10-18, 1958. 18) Muldowney, F. P., Freaney, R., McMullin, J. P., Towers, R. P., Spillane A., O'Connor, P., O'Donohoe, P. and Moloney, M.: Serum ionized calcium and parathyroid hormone in renal stone disease. Quart. J. Med., 45 (New Series), 75-86, 1976. 22) 「五十八年国民栄養調査の概況」. 厚生省, 1983年. 14) 八田栄造: 尿路結石症の燐・石灰代謝に関する研究. 第I編, 尿路結石症患者の血清尿中燐・石灰量に関する研究. 泌尿紀要, 5, 637-666, 1959. 16) 相戸賢二: 尿路結石患者におけるカルシウムおよび燐の代謝 ―カルシウムおよび燐摂取量の意義―. 西日泌, 34, 369-376, 1972. 21) Smith, L. H., Werness, P. G. and Wilson, D. M.: Metabolic and clinical disturbances in patients with calcium urolithiasis. Scand. J. Urol. Nephrol., 53 (Suppl), 213-220, 1980. 13) Pak, C. Y. C., Kaplan, R., Bone, H., Townsend, J. and Waters, O.: A simple test for the diagnosis of absorptive, resorptive and renal hypercalciurias. N. Engl. J. Med., 292, 497-500, 1975. 7) Yendt, E. R.: Renal calculi. Can. Med. Assoc. J., 102, 479-489, 1970. 23) Ehrig, U., Harrison, J. E. and Wilson, D. R.: Effect.of long-term thiazide therapy on intestinal calcium absorption in patients with recurrent renal calculi. Metabolism, 23, 139-149, 1974. 19) Bordier, P., Ryckewart, A., Gueris, J. and Rasmussen, H.: On the pathogenesis of so-called idiopathic hypercalciuria. Am. J. Med., 63, 398-409, 1977. 10) 樋口照夫: 泌尿器科領域に於けるカルシウム代謝の臨床的研究. 日泌尿会誌, 50, 345-393, 1959. |
| References_xml | – reference: 11) 郡健二郎: 尿路結石症の発生原因に対する内分泌学的検討. 第III報. カルシウム結石症に於けるカルシウム代謝と上皮小体機能について. 日泌尿会誌, 71, 1335-1348, 1980. – reference: 8) Coe, F. L., Canterbury, J. M., Firpo, J. J. and Reiss, E.: Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria. J. Clin. Invest., 52, 134-142, 1973. – reference: 16) 相戸賢二: 尿路結石患者におけるカルシウムおよび燐の代謝 ―カルシウムおよび燐摂取量の意義―. 西日泌, 34, 369-376, 1972. – reference: 3) Pak C. Y. C., Ohata, M., Lawrence, E. C. and Snyder, W.: The hypercalciurias. Causes, Parathyroid functions, and diagnostic criteria. J. Clin. Invest., 54, 387-400, 1974. – reference: 14) 八田栄造: 尿路結石症の燐・石灰代謝に関する研究. 第I編, 尿路結石症患者の血清尿中燐・石灰量に関する研究. 泌尿紀要, 5, 637-666, 1959. – reference: 12) 戎野庄一: 特発性過カルシウム尿症を伴う尿路結石症に対する rice-bran 療法の研究. I. 臨床的検討. 日泌尿会誌, 75, 1-9, 1984. – reference: 2) Henneman, P. H., Benedict, P. H., Forbes, A. P. and Dudley, H. R.: Idiopathic hypercalciuria. N. Engl. J. Med., 259, 802-807, 1958. – reference: 25) Bulusu, L., Hodgkinson, A., Nordin, B. E. C. and Peacock, M.: Urinary excretion of calcium and creatinine in relation to age and body weight in normal subjects and patients with renal calculus. Clin. Science, 38, 601-612, 1970. – reference: 13) Pak, C. Y. C., Kaplan, R., Bone, H., Townsend, J. and Waters, O.: A simple test for the diagnosis of absorptive, resorptive and renal hypercalciurias. N. Engl. J. Med., 292, 497-500, 1975. – reference: 10) 樋口照夫: 泌尿器科領域に於けるカルシウム代謝の臨床的研究. 日泌尿会誌, 50, 345-393, 1959. – reference: 18) Muldowney, F. P., Freaney, R., McMullin, J. P., Towers, R. P., Spillane A., O'Connor, P., O'Donohoe, P. and Moloney, M.: Serum ionized calcium and parathyroid hormone in renal stone disease. Quart. J. Med., 45 (New Series), 75-86, 1976. – reference: 23) Ehrig, U., Harrison, J. E. and Wilson, D. R.: Effect.of long-term thiazide therapy on intestinal calcium absorption in patients with recurrent renal calculi. Metabolism, 23, 139-149, 1974. – reference: 7) Yendt, E. R.: Renal calculi. Can. Med. Assoc. J., 102, 479-489, 1970. – reference: 9) Broadus, A. E., Dominguez, M. and Bartter, F. C.: Pathophysiological studies in idiopathic hypercalciuria: Use of an oral calcium tolerance test to characterize distinctive hypercalciuric subgroups. J. Clin. Endocrinol. Metab., 47, 751-760, 1978. – reference: 22) 「五十八年国民栄養調査の概況」. 厚生省, 1983年. – reference: 24) Rose G. A. and Harrison, A. R.: The incidence, investigation and treatment of idiopathic hypercalciuria. Brit. J. Urol., 46, 261-274, 1974. – reference: 19) Bordier, P., Ryckewart, A., Gueris, J. and Rasmussen, H.: On the pathogenesis of so-called idiopathic hypercalciuria. Am. J. Med., 63, 398-409, 1977. – reference: 26) Kitamura, T., Hirano, Y., Ueda, D. and Niijima, T.: Possibility of elevated parathyroid function in patients with calcium-containing nephrolithiasis as compared with normal controls. Eur. Urol. in press. – reference: 15) Robertson, W. G. and Morgan, D. B.: The distribution of urinary calcium excretions in normal persons and stone-formers. Clin. Chim. Acta, 37, 503-508, 1972. – reference: 1) Flocks, R. H.: Calcium and phosphate excretion in the urine of patients with renal or ureteral calculi. J. Am. Med. Ass., 114, 1466-1471, 1939. – reference: 21) Smith, L. H., Werness, P. G. and Wilson, D. M.: Metabolic and clinical disturbances in patients with calcium urolithiasis. Scand. J. Urol. Nephrol., 53 (Suppl), 213-220, 1980. – reference: 6) Hodgkinson, A. and Pyrah, L. N.: The urinary excretion of calcium and inorganic phosphate in 344 patients with calcium stone of renal origin. Brit. J. Surg., 46, 10-18, 1958. – reference: 17) 高橋悦司: 尿路結石の再発 ―尿石患者700例735結石の分析を基礎として―. 日泌尿会誌, 65, 423-436, 1974. – reference: 5) 北村唯一: 上部尿路結石と原発性副甲状腺機能亢進症. 腎と透析, 4, 509-516, 1978. – reference: 20) Evans, R. A., Hills, E., Wong, S. Y. P., Wyndham, L. E., Eade, Y. and Dunstan, C. R.: The pathogenesis of idiopathic hypercalciuria: Evidence for parathyroid hyperfunction. Quart. J. Med., 53 (New Series), 41-53, 1984. – reference: 4) Kaplan, R. A., Haussler, M. R., Deftos, L. J., Bone, H. and Pak, C. Y. C.: The role of 1 α, 25-dihydroxyvitamin D in the mediation of intestinal hyperabsorption of calcium in primary hyperparathyroidism and absorptive hypercalciuria. J. Clin. Invest., 59, 756-760, 1977. |
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| Snippet | 日本人における特発性高カルシウム尿症 (IH) の境界値を設定する目的で, カルシウム (Ca) 含有上部尿路結石患者 (SF) 113例と正常対照者 (Normal) 10名に対して, 普通食... 日本人における特発性高カルシウム尿症(IH)の境界値を設定する目的で,カルシウム(Ca)含有上部尿路結石患者(SF)113例と正常対照者(Normal)10名に対して,普通食下およびCa制... |
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| Subtitle | 日本人における特発性高カルシウム尿症の境界値設定の試み |
| Title | カルシウム含有上部尿路結石患者の尿中カルシウム排泄量に関して |
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| ispartofPNX | 日本泌尿器科學會雑誌, 1986/11/20, Vol.77(11), pp.1831-1839 |
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