Phosphate Treatment of Calcium Urolithiasis

Abstract

Dietary supplementation with orthophosphate was proposed as an alternative for prophylaxis of renal stone formation many years ago¹. The rationale for this proposal is the documented effect of phosphates on reducing the urinary excretion of calcium, thus decreasing supersaturation of the urine. Phosphate intake has also been shown to increase the urinary excretion of inhibitors of stone formation, e.g. pyrophosphate². A number of reports of prophylactic treatment with phosphate have been published. They have shown varying clinical results³. Since there is a great need for treatment alternatives in renal stone disease we undertook a study of the clinical and biochemical effects of long-term phosphate treatment. Since patients with renal acidification defects tend to have more severe stone disease⁴, a special interest was placed on the clinical outcome in these patients.