The spectrum and pathogenesis of hypercalciuria

Hypercalciuria is the most common metabolic abnormality found in patients with nephrolithiasis, being encountered in 50 to 70% of patients. Because of the presumption that this disturbance is pathogenetically important in stone formation, a major effort has been directed toward the elucidation of the cause and management of hypercalciuria. This effort has led to the recognition that hypercalciuria is multifactorial in etiology, and that it may be corrected by several treatment modalities possessing different modes of action. In this chapter, the authors will review: (1) evidence supporting the premise that hypercalciuria contributes to stone formation; (2) the physiological basis for different causes of hypercalciuria; and (3) the mode of action and indications for therapeutic modalities currently available for hypercalciuria.