Studies on Phosphate and Calcium Metabolism in Urolithiasis II.Effects of Various Drugs on Phosphate and Calcium Metabolism

摘要

Effects of various drugs closely related to forma t i on or prevention of urinary calculi on phosphate and calcium metabolism have been experimentally and clinically studied. 1) Cortisone and ACTH If a large doses of cortisone and ACTH were injected daily to rabbits in short priod, urinary outputs of phosphate and calcium were transiently decreased, then increased and again decreased, in another words the outputs showed biphasic pattern. This tendency was more prominent in calcium metabolism than that of phosphate. If a large doses of Cortisone and ACTH were injected daily in shorter period, effects of the former were prominent than that of ACTH and the larger the dose injected, the longer was the period of increased urinary outputs of phosphate and calcium. 2) Alumi-gel Oral administration of Alumi-gel to human subjects slightly decreased the level of serum phosphate and markedly decreased urinary output of phosphate. The mechanism of decrease in urinary output of phosphate has been comfirmed by Tracer Test of P32, which indicated the blocking action of Alumi-gel to intestinal phosphate absorption. Theoretically prevention of phosphate calculi by Alumi-gel will be recommended. Since oral administration of large doses of Alumi-gel in longer period, however, may cause hypophosphatemia and disfunction of gastric secretion, treatment with Alumi-gel for urinary phosphate calculi should be limited only to those cases which are relapsing and excreting large amount of phosphate in urine and furthermore regular biochemical test and gastric secretory function test are both essential. 3) Neo-stro n g Minophagen C and Chondroitin Sulfate Prevention of urinary calculi formation by th e se drugs is due to their protective action of urinary colloids and no effect on urinary outputs of phosphate and calcium. Therefore if one expects full effect of these drugs for prevention of urinary calculi formation, it is recommended that urinary outputs of phosphate and calcium are decreased by other durgs. 4) Sulfonamide In a case of anuria due to acute sulfonamide poisoning, the level of serum and urinary phosphate and calcium were measured after the patient started urinating. Immediately after urination has been started, the high level of serum phosphate, phosphaturia, calciuria were encountered. As renal function was improved, serum phosphate and urinary phosphate and calcium were decreased. In acute sulfonamide poisoning, both urinary obstruction due to non-soluble sulfonamide and formations of phosphate and calcium calcuii produce anuria. Administration of Alumi-gel for prevention of phosphaturia and for activation of protective action on urinary colloids is recommended.