Nephrolithiasis as a Complication of Ulcerative Colitis and Regional Enteritis

Abstract

The case histories of 583 patients with ulcerative colitis and regional enteritis were reviewed. Twenty-eight (4.8%) patients with nephrolithiasis were found and the clinical and laboratory features of this group are presented. Uric acid stones occurred in 13 subjects, calcium stones in 9, and in 6 the composition of the stones could not be determined. Renal lithiasis occurred with greater frequency in those patients subjected to an ileostomy or other types of short-circuiting surgery of the gastrointestinal tract. Pyelonephritis was found in more than half of the patients. The metabolic derangements responsible for the formation of renal calculi are reviewed. The most conspicuous alteration in this series was the relative oliguria with persistently acid urine. The diminished urine output played a prominent role in the formation of calcium oxalate stones and contributed to the formation of all other stones. The persistently acid reaction of the urine appeared to account for the high incidence of uric acid stones. Preventive measures include maintenance of an adequate urinary output, correction of electrolyte depletion and treatment of urinary tract infections. In appropriate cases, modification of the urine pH is indicated.