Step I Acetazolamide and Calcium stones

[Mushrooomboy]

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Does anyone know why Acetazolamide precipitates Calcium Oxalate stones? Is it because Acetazolamide causes metabolic acidosis and build up of H+ in the blood displaces Ca2+ from albumin --> excess free Ca2+ gets filtered by glomerulus and precipitates calcium stones?

Thanks for the help!

 

[veganbythefjord]

Bump

 

[virajpatel]

That and maybe it would have to do with metabolic acidosis leading to hypocitraturia.

 

[maieutic]

They primarily increase the risk of Ca phosphate stones with long term treatment. Heres how.

1.Metabolic acidosis -> bone releases Ca and PO4 to buffer the acid -> this increases the amount of Ca and PO4 in the urine
2.Nephron tubular fluid is more alkaline due to decreased reclamation of filtered bicarb
The above two together lead to Ca phosphate stones

For Ca oxalate stones:
1.Increased Ca in the renal tubules (as above)
2.Hypocitraturia (due to acidosis)

 

[veganbythefjord]

Thanks everyone for the input!