Successful Treatment of Recurrent Nephrolithiasis (Calcium Stones) with Cellulose Phosphate

Sixteen patients with absorptive hypercalciuria and nephrolithiasis ate a low-calcium diet and were given cellulose phosphate (5 g twice to three times per day orally). In all 16 cases urinary calcium decreased, usually to values below 200 mg per day, and in 13 cases, the state of saturation of urine with respect to brushite (the nidus of calcium stones) also decreased, often from supersaturation to undersaturation. Clinically, renal-stone formation virtually ceased. The treatment was well tolerated, and no serious side effects have been observed. Serum concentration of parathyroid hormone and bone density by 125I-photon absorption did not change significantly or remained within the normal range. Thus, in these patients with an enhanced intestinal absorption of calcium, hypercalciuria may be corrected, and stone formation prevented, by a low-calcium diet and inhibition of calcium absorption with cellulose phosphate. (N Engl J Med 290:175–180, 1974)