Nephrolithiasis is a common disorder, and idiopathic hypercalciuriais the most frequent metabolic disorder associated with nephrolithiasis.1 Several studies have shown that subjects with idiopathic hypercalciuriahave phosphaturia or renal phosphate leak. In fact, a studythat measured the tubular maximal reabsorption of phosphate(TmP, or maximal renal phosphate threshold) normalized for theglomerular filtration rate (GFR) (the TmP/GFR value) in 207subjects with calcium nephrolithiasis reported that 20% of personswith normal parathyroid function in whom stones formed havea decreased TmP/GFR value.2 The associated mild hypophosphatemiaresults in increased 1,25-dihydroxyvitamin D production, whichcauses increased intestinal phosphate and . . . [Full Text of this Article]
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From the Departments of Medicine, Physiology, and Biophysics, University of Colorado, Denver, and Veterans Affairs Medical Center, Denver.
This article (10.1056/NEJMe0805943) was last updated on September 16, 2009, at NEJM.org.
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