Metabolic factors for urolithiasis in acromegalic patients.

1. Acromegaly is associated with metabolic disturbances of calcium and phosphorus which can also contribute to renal lithogenesis. 2. In order to characterize these disturbances more precisely, an oral calcium load test was performed on 14 active acromegalic patients. Serum and urinary levels of calcium, phosphorus, uric acid, creatinine and urinary cyclic AMP were determined. 3. Of the 14 patients, 5 (36%) presented hypercalciuria, 5 (36%) presented intestinal calcium hyperabsorption, and 6 (43%) had uric acid hyperexcretion. Two patients (14%) presented nephrolithiasis. 4. The medical records of 32 additional acromegalic patients with or without active disease were reviewed for a history of previous stones, which was observed in three cases (9.5%). 5. The present data suggest that nephrolithiasis occurs more frequently among acromegalic patients because of the underlying metabolic disturbances of calcium presented by this population.