Clinical Investigation

Kidney International (1989) 36, 108–113; doi:10.1038/ki.1989.168

Gestational hypercalciuria causes pathological urine calcium oxalate supersaturations

Patsy Maikranz1,1, Jean L Holley1,2, Joan H Parks1, Marshall D Lindheimer1, Yasushi Nakagawa1 and Fredric L Coe1

1Nephrology Program, University of Chicago, Chicago, Illinois, USA

Correspondence: Fredric Coe, Nephrology Section, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, Box 28, Chicago, Illinois, 60637 USA.

1Present address: Dallas Nephrology Associates, Dallas, Texas, USA.

2Present address: Nephrology Section, Univ. of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Received 5 October 1988; Revised 1 February 1989; Accepted 13 February 1989.

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Abstract

Gestational hypercalciuria causes pathological urine calcium oxalate supersaturations. Although normal pregnant women are more hypercal-ciuric than women with calcium oxalate nephrolithiasis (243 plusminus 23 mg/day vs. 194 plusminus 5 mg/day), pregnancy is not an established stone-forming state and pregnant women do not exhibit pathological crystalluria. One hypothesis to explain their lack of overt stone formation and pathological crystalluria is that pregnancy does not raise urine supersaturation with respect to stone forming salts such as calcium oxalate or calcium monohydrogen phosphate (brushite) to levels as high as in stone forming women. To test this hypothesis, we studied eleven normal women during each trimester of pregnancy, and between six and eight weeks post-partum. During pregnancy, hypercalciuria occurs with unchanged urine volume, citrate and magnesium excretions do not increase proportionally with calcium excretion, and urine pH increases. Supersaturations with respect to calcium oxalate (CaOx) and brushite (Br) are as high as those of women with calcium nephrolithiasis. The lack of pathological crystalluria and stones during pregnancy is not due to a failure of supersaturations to increase; urinary potential for crystallization is as high as in patients with established stone disease.

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References

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