Verapamilが尿中諸物質とくに蓚酸排泄量に及ぼす影響について

Abstract

120mg/dayを上部尿路結石症16例に投与した。1)尿中Ca排泄量はverapamil服用前後で差はなかった。過Ca尿症患者(250mg/day以上)で服用前後のCa排泄量を比較しても減少効果はみられなかった。2)尿中蓚酸排泄量は全症例でみると服用前後で差はみられなかったが, 過蓚酸尿症患者(50mg/day以上)でみると著明に減少した。3)尿中クエン酸, マグネシウム排泄量はverapamil服用前後で差はみられなかった。4)蓚酸CaのRisk Indexは全症例でみると服用前後で差はなかったが, 過Ca尿症でしかも過蓚酸尿症のある4例ではverapamil服用によって有意に低下した

The effect of the calcium antagonist verapamil on urinary calcium and oxalate excretion was examined and compared with that of trichlormethiazide to evaluate whether verapamil is useful in the prevention of calcium oxalate renal stones. Twenty-four-hour urine of 16 renal stone formers was measured at the outpatient clinic before and after administration of 120 mg/day verapamil for a mean duration of 2.7 months (range, 2 weeks to 6 months). The 24-hour urine was analyzed for creatinine, calcium, oxalic acid, magnesium and citric acid and the results compared with those in 20 renal stone formers who were administered trichlormethiazide. Verapamil was found to significantly reduce the urinary oxalate excretion of the 5 hyperoxaluric (> or = 50 mg/day) patients but no significant effect on urinary calcium, magnesium or citric acid was observed. Conversely, trichlormethiazide significantly decreased urinary calcium excretion in the hypercalciuric (> or = 250 mg/day) patients. Calcium oxalate risk index of hypercalciuric and hyperoxaluric patients was significantly reduced after the administration of verapamil. These findings suggest that verapamil is effective in reducing urinary oxalate excretion in the hyperoxaluric patients.