PTU - Polskie Towarzystwo Urologiczne
list of articles:

Urinary lithiasis (part I). Non-metabolic factors associated with urolithiasis
Article published in Urologia Polska 2005/58/3.


Bożena Eberdt-Gołąbek
Instytut Matki i Dziecka w Warszawie, Klinika Pediatrii
Dyrektor instytutu: prof. dr hab. Wojciech Woźniak
Kierownik kliniki: prof. dr hab. Andrzej Milanowski


urinary tract, urinary lithiasis, non-metabolic forms of urinary lithiasis


Urinary lithiasis is not always an isolated finding, which is treated by surgical procedures. Frequently, there is a severe inborn metabolic disorder of various etiology responsible for the progressive stone formation. Hence the diagnosis of the different etiological factors makes prophylaxis easier.
The aim of the study.
The aim of this presentation is to demonstrate the pathomechanism of renal stone formation and to discuss the non-metabolic factors which are involved, such as: infectious urinary lithiasis, idiopathic oxalic urinary lithiasis, distal ileal dysfunction, after resection of ileum terminale, in cases of renal pyramid spongiosis and after long-term immobilisation.
Each patient with urolithiasis should undergo investigations in order to establish the etiology. Non-metabolic etiology of urinary lithiasis is not the most common cause of renal stone formation.


  1. Miliner DS: Urolithiasis in pediatric patients. Mayo Clinic. Proceed 1993; 68; 241-248.
  2. Iguchi M et al: Prevalance of urolithiasis in Kaizuka city, Japanan epidemiologic study urinary stones. Int J Urol 1996; 3; 175-179.
  3. Daszkiewicz E, Wyszyńska T: Kamica układu moczowego, w: Choroby układu moczowego u dzieci. T. Wyszyńska (red.), PZWL, 1975, 148-152
  4. Eberdt-Gołąbek B: Badania nad przyczynami metabolicznymi kamicy układu moczowego. Praca doktorska, 1979.
  5. Gołąbek B, Słowik M, Jaros I, Drejewicz H, Makowska U: 25-letnie doświadczenie w zakresie profilaktyki nawrotowej kamicy układu moczowego u dzieci. Urol Pol 2004; 57; 82-89.
  6. Bass HN, Emarel B: Nephrolithiasis in children. J Urol 1966; 95; 749-553.
  7. Malek RS, Kolodis PP: Pediatric nephrolithiasis. J Urol 1975; 118; 897-899.
  8. Fleisch H: Inhibitors and promoteres of stone formation. Kidney Int 1978; 13; 361-371.
  9. Marangella M, Bagnis C: Crystallization inhibitors in the pathophysiology and treatment of nephrolithiasis. Urol Int 2004; 72 Suppl 1; 6-10.
  10. Finlayston MD: Renal lithasis in reviev. Symposium of renal lithiasis. Urol Clin North Am 1974; 1; 181-212.
  11. Pak CYC: Physiochemical basis for the formation of renal stones of calcium phosphate origin: calculation of the degree of saturation of urine with respect to brushite. J Clin Invest 1969; 48; 1914-1922.
  12. Robertson WG, Peacock M: Calcium oxalate cristaluria and urine saturation in recurrent renal stone formers. Clin Sci 1971; 40; 365-374.
  13. Pak CYC, Watres O et al: Mechanism for calcium urolithiasis among patiens with hyperuricosuria: Supersaturation of urine with respect to monosodium urate. J Clin Invest 1977; 59; 426-431.
  14. Walinder O, Ljunghall S, Wibell L et al: Urinary excretion of cyclic AMP in hyperparathyroidism. Scand. J Urol Nephrol 1978; 12; 67-71.
  15. Pak CYC, Holt K: Nucleation and growth of brushite and calcium oxalate in urine of stone formes. Metabolism 1976; 25; 665-673.
  16. Asplin JR, Parks JH, Nakagawa Y, Coe FL: Reduced crystallization inhibition by urine from women with nephrolithiasis. Kidney Int 2002; 61; 1821-1829.
  17. Langley SEM, Fry CH: Differences in the free Ca2+ in undiluted urine from stone formers and normal subjects using a new generation ofionselective electrodes. Br J Urol 1995; 75; 288-295.
  18. Langley SEM, Fry CH: The influence of pH on urinary ionized (Ca2+) differences between urinary tract stone formers and normal subjects. Br J Urol 1997; 79; 8-14.
  19. Coe FL, Lawton RL: Sodium urate accelerates precipitation of calcium oxalate in vitro. Proc Soc Exp Biol Med 1975; 149; 926-929.
  20. Lerolle N, Lantz B, Paillard F et al: Risk factors for nephrolithiasis in patients with familial idiopathic hypercalciuria. Am J Med 2002; 113; 99-103.
  21. Meyer JL, Bergert JH, Smith LH et al: Epitaxial relationships in urolithiasis: the calcium oxalate monohydrate hydroxyapatite system. Clin Sci Mol Med 1975; 49; 369-371.
  22. Muldowney FP: Diagnostic approach to hypercalciuria. Kidney Int 1979; 16; 637-648.
  23. Coe FL, Strauss AL, Tembe V et al: Uric acid saturation in calcium nephrolithiasis. Kidney Int 1980; 17; 661-668.
  24. Barilla DE, Toletino R et al: Selective effects of thiazide on intestinal absorption of calcium in absorptive and renal hypercalciurias. Metabolism 1978; 27; 125-131.
  25. Yendt ER: Renal calculi. Canad Med Assoc J 1970; 102; 479-489.
  26. McCarron DA, Rankin LJ, Bennett WM et al: Urinary calcium excretion of extremes of sodium intake in normal man. Am J Nephrol 1981; 1; 84-90.
  27. Muldowney FP, Freaney R, Moloney MF: Importance of dietary sodium in the hypercalciuria syndrom. Kidney Int 1982; 22; 292-296.
  28. Meschi T, Schianchi T, Ridolo E et al: Body weight, diet and water intake in preventing stone disease. Urol Int 2004; 72 Suppl 1: 29-33.
  29. Ferrari L, Meschi M et al: Etiopathogenesis and clinical aspects of nephrolithiasis-at present. Recenti Prog Med 2003; 94; 136-141.
  30. Moyad MA: Calcium oxalate kidney stones: another reason to encourage moderate calcium intakes and other dietary changes. Urol Nurs 2003; 23; 310-313.
  31. Kaplan RA, Pak CYC: Diagnosis and managment of renal calcul. Tex Med 1974; 70; 88-93.
  32. Melick RA, Henneman PH: Clinical and laboratory studies of 207 consecutive patients in the kidney stone. N Engl J Med 1958; 259; 307-314.
  33. Penido MG, Diniz JS et al: Idiopathic hypercalciuria: presentation of 471 cases. J Pediatr 2001; 77; 101-104.
  34. Massey LK: Effects of ascorbate supplements on urinary oxalate and risk of kidney stones. J Am Diet Assoc 2000; 100; 516-519.
  35. Traxer O, Huet B, Poindexter J et al: Effect of ascorbic acid cosnumtions of pes ofurinary stone risk factors. J Urol 2003; 170; 397-401.
  36. Wandzilak TR, D?Andre SD, Davis PA et al: Effect of high dose vitamin C on urinary oxalate levels. J Urol 1996; 151; 834-837.
  37. Schwille PO, Schmiedl A, Herrmann U et al: Ascorbic acid in idiopathic recurrent calcium urolithiasis in humans-does it have an abettor role in oxalate, and calcium oxalate crystalization? Urol Res 2000; 28; 167-177.
  38. Williams HE, Smith LH: Disorders of oxalate metabolism. Am J Med 1968; 45; 715-735.
  39. O?Connor RC, Worcester EM, Evan AP et al: Nephrolithiasis and nephrocalcinosis in rats with small bowel resection. Urol Res 2005; 33 (2); 105-115
  40. Ghazali S, Barratt TM: Urinary excretion of calcium and magnesium in children. Arch Dis Child 1974; 49; 97-101.
  41. Oreopoulos DG, Sayannwo MA: Magnesium/calcium ratio in urine of patents of renal stone. Lancet 1968; 2; 420-422.
  42. Takasaki E: The magnesium/calcium ratio in the concentrated urines of patients with calcium oxalate calculi. Ivest Urol 1972; 10; 147-150.
  43. Chodwick VS, Madna K et al: Mechanism for hyperoxaluria in patients with ileal dysfunction. N Eng J Med 1973; 289; 172-176.
  44. Trinchieri A, Lizzano R, Castelnuovo et al: Urinary patterns of patients with renal stones associated with chronic inflammatory bowel disease. Arch Ital Urol Androl 2002; 74; 61-64.
  45. Griffith DP, Musher DM: Urease the primary cause of infection induced urinary stones. Invest Urol 1976; 13; 346-350.
  46. Gleeson MJ, Griffith DP: Struvite calculi. Br J Urol 1993; 71; 503-511.


Bożena Eberdt-Gołąbek
Klinika Pediatrii
ul. Kasprzaka 17a
01-211 Warszawa
tel. /fax (022) 32 77 043