Metabolic abnormalities were investigated in 44 stone patients with first time (group 1) and 56 with 2 times stone formation (group 2), and in 25 normal individuals. 24hr urine was analysed spectrophotometrically for oxalate, calcium, magnesium, citrate, uric acid, phosphate and creatinine. Hypocitraturia and hyperoxaluria were the common abnormalities in the stone formers. Stone patients had significantly higher urinary oxalate, calcium and uric acid and lower phosphate than normal individuals. Citrate/calcium and magnesium/calcium ratio were significantly high in normal individuals than stone formers. Patients in group 2 excreted significantly higher urinary calcium and lower citrate that patients in group 1. Citrate/calcium ratio was higher in group 1 than group 2. Hypocitraturia, hyperoxaluria, hypercalciuria and increased citrate/calcium and magnesium/calcium ratio seem to be an essential risk factor for stone formation. Patients with recurrent stone formation could be distinguished from patients with first time stone formation on the basis of urinary calcium and citrate.
Keywords: Recurrent stone formation; hypercalciuria; hyperoxaluria; hypocitraturia; metabolic abnormality.