{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:02:56Z","timestamp":1784206976040,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Nephrol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Prospective evaluation of the\u00a0prevalence of incomplete distal renal tubular acidosis (idRTA) in idiopathic calcium stone formers (ICSF)\u00a0diagnosed by half-dose ammonium chloride loading (NH\n                      <jats:sub>4<\/jats:sub>\n                      Cl, 0.05\u00a0g\/kg body weight\/day) and impact of alkali treatment of idRTA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Evaluation of 386 consecutive idiopathic calcium stone formers (ICSF) (280 males, 106 females) for idRTA. If screening fasting urine pH was\u2009&gt;\u20095.80, 1-day NH\n                      <jats:sub>4<\/jats:sub>\n                      Cl loading was performed without severe adverse effects. Normally, urine pH falls below 5.45.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-four idiopathic calcium stone formers\u00a0exhibited idRTA, one complete dRTA. Prevalence was higher in women (25.4%) than in men (13.6%). Thus, for more equilibrated comparisons, we formed pairs of 62 idiopathic calcium stone formers (ICSF) with and 62 without idRTA, matched for gender, age, BMI and serum creatinine. Idiopathic calcium stone formers\u00a0with idRTA more often had hypercalciuria (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.025) and urine citrate\u2009&lt;\u20092\u00a0mmol\/d (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), formed calcium phosphate stones\u00a0more frequently, exhibited higher numbers of stones\/year (1.4\u2009\u00b1\u20091.5 vs. 0.9\u2009\u00b1\u20090.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034) and 2.5 times more intrarenal calcifications (4.6\u2009\u00b1\u20095.9 vs. 1.8\u2009\u00b1\u20093.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). All idiopathic calcium stone formers\u00a0with idRTA were recommended chronic alkali therapy. After 4\u201315\u00a0years of follow-up, stone events \/years follow-up (stone passage or urologic intervention) were higher in patients\u00a0non-adherent to alkali therapy\u00a0(0.61\u2009\u00b1\u20090.92) than in patients\u00a0adherent to treatment\u00a0(0.11\u2009\u00b1\u20090.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incomplete distal renal tubular acidosis\u00a0is 1.8-fold more prevalent among female\u00a0idiopathic calcium stone formers, predicts more stone recurrences, predisposes to calcium phosphate stones and\u00a0is associated with 2.5 times more intrarenal calcifications vs. non-idRTA patients. Chronic alkali treatment reduces clinical stone recurrences by 5.5 times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-021-01207-7","type":"journal-article","created":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T02:16:29Z","timestamp":1641003389000},"page":"1619-1626","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prospective long-term evaluation of incomplete distal renal tubular acidosis in idiopathic calcium nephrolithiasis diagnosed by low-dose NH4CL loading \u2013 gender prevalences and impact of alkali treatment"],"prefix":"10.1093","volume":"35","author":[{"given":"Juri","family":"Sromicki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Kacl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"F\u00f6hl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8942-8465","authenticated-orcid":false,"given":"Bernhard","family":"Hess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,1]]},"reference":[{"key":"1207_CR1","first-page":"F32","volume":"284","author":"M Maurer","year":"2003","unstructured":"Maurer M, Riesen W, Muser J, Hulter HN, Krapf R (2003) Neutralization of western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. Am J Physiol 284:F32\u2013F40","journal-title":"Am J Physiol"},{"key":"1207_CR2","first-page":"492","volume":"36","author":"PJ Osther","year":"1989","unstructured":"Osther PJ, Hansen AB, R\u00f6hl HF (1989) Distal renal tubular acidosis in recurrent renal stone formers. Dan Med Bull 36:492\u2013493","journal-title":"Dan Med Bull"},{"key":"1207_CR3","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/S0140-6736(98)03087-6","volume":"352","author":"SL Gluck","year":"1998","unstructured":"Gluck SL (1998) Acid\u2013base. Lancet 352:474\u2013479","journal-title":"Lancet"},{"key":"1207_CR4","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1007\/s00240-005-0026-0","volume":"34","author":"B Hess","year":"2006","unstructured":"Hess B (2006) Acid\u2013base metabolism: implications for kidney stone formation. Urol Res 34:134\u2013138","journal-title":"Urol Res"},{"key":"1207_CR5","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.2215\/CJN.01320217","volume":"12","author":"NA Dhayat","year":"2017","unstructured":"Dhayat NA, Gradwell MW, Pathare G, Anderegg M, Schneider L, Luethi D, Mattmann C, Moe OW, Vogt B, Fuster DG (2017) Furosemide\/Fludrocortisone test and clinical parameters to diagnose incomplete distal renal tubular acidosis in kidney stone formers. Clin J Am Soc Nephrol 12:1507\u20131517","journal-title":"Clin J Am Soc Nephrol"},{"key":"1207_CR6","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1097\/01.ASN.0000023430.92674.E5","volume":"13","author":"J Rodr\u00edguez Soriano","year":"2002","unstructured":"Rodr\u00edguez Soriano J (2002) Renal tubular acidosis: the clinical entity. J Am Soc Nephrol 13:2160\u20132170","journal-title":"J Am Soc Nephrol"},{"key":"1207_CR7","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1046\/j.1523-1755.2001.0590031086.x","volume":"59","author":"S Domrongkitchaiporn","year":"2001","unstructured":"Domrongkitchaiporn S, Pongsakul C, Stitchantrakul W et al (2001) Bone mineral density and histology in distal renal tubular acidosis. Kidney Int 59:1068\u20131093","journal-title":"Kidney Int"},{"key":"1207_CR8","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00240-016-0906-5","volume":"45","author":"J Sromicki","year":"2017","unstructured":"Sromicki J, Hess B (2017) Abnormal distal renal tubular acidification in patients with low bone mass: prevalence and impact of alkali treatment. Urolithiasis 45:263\u2013269","journal-title":"Urolithiasis"},{"key":"1207_CR9","first-page":"259","volume":"28","author":"O Wrong","year":"1959","unstructured":"Wrong O, Davies HEF (1959) The excretion of acid in renal disease. Quart J Med 28:259\u2013313","journal-title":"Quart J Med"},{"key":"1207_CR10","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1038\/sj.ki.5002220","volume":"71","author":"SB Walsh","year":"2007","unstructured":"Walsh SB, Shorley DG, Wrong OM, Unwin RJ (2007) Urinary acidification assessed by simultaneous furosemide and fludrocortisone treatment: an alternative to ammonium chloride. Kidney Int 71:1310\u20131316","journal-title":"Kidney Int"},{"key":"1207_CR11","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1093\/ndt\/9.6.642","volume":"9","author":"B Hess","year":"1994","unstructured":"Hess B, Michel R, Takkinen R, Ackermann D, Jaeger Ph (1994) Risk factors of low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list. Nephrol Dial Transplant 9:642\u2013649","journal-title":"Nephrol Dial Transplant"},{"key":"1207_CR12","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s00240-011-0397-3","volume":"40","author":"S Arampatzis","year":"2012","unstructured":"Arampatzis S, R\u00f6pke-Rieben B, Lippuner K, Hess B (2012) Prevalence and densitometric characteristics of incomplete distal renal tubular acidosis in men with recurrent calcium nephrolithiasis. Urol Res 40:53\u201359","journal-title":"Urol Res"},{"key":"1207_CR13","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1159\/000516389","volume":"46","author":"V D\u2019Ambrosio","year":"2021","unstructured":"D\u2019Ambrosio V, Azzara A, Sangiorgi E et al (2021) Results of a gene panel approach in a cohort of patients with incomplete distal renal tubular acidosis and nephrolithiasis. Kidney Blood Press Res 46:469\u2013474","journal-title":"Kidney Blood Press Res"},{"key":"1207_CR14","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1093\/ndt\/12.7.1362","volume":"12","author":"B Hess","year":"1997","unstructured":"Hess B, Hasler-Strub U, Ackermann D, Jaeger Ph (1997) Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasis. Nephrol Dial Transplant 12:1362\u20131368","journal-title":"Nephrol Dial Transplant"},{"key":"1207_CR15","doi-asserted-by":"crossref","unstructured":"Israni AK, Kasiske BL (2012) In: Taal ML et al (eds) Brenner and Rector\u2019s the kidney, 9th edn. Elsevier Saunders, pp 868\u2013896","DOI":"10.1016\/B978-1-4160-6193-9.10025-9"},{"key":"1207_CR16","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1097\/00041552-199511000-00009","volume":"4","author":"RD Toto","year":"1995","unstructured":"Toto RD (1995) Conventional measurement of renal function utilizing serum creatinine, creatinine clearance, inulin and para-aminohippuric acid clearance. Curr Opin Nephrol Hypertens 4:505\u2013509","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"1207_CR17","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s00240-015-0849-2","volume":"44","author":"WG Robertson","year":"2016","unstructured":"Robertson WG (2016) Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease. Urolithiasis 44:9\u201326","journal-title":"Urolithiasis"},{"key":"1207_CR18","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1093\/ndt\/13.4.1033","volume":"13","author":"B Hess","year":"1998","unstructured":"Hess B (1998) \u2018Bad dietary habits\u2019 and recurrent calcium oxalate nephrolithiasis. Nephrol Dial Transplant 13:1033\u20131038","journal-title":"Nephrol Dial Transplant"},{"key":"1207_CR19","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1159\/000282232","volume":"47","author":"H-G Tiselius","year":"1991","unstructured":"Tiselius H-G (1991) Aspects of estimation of the risk of calcium oxalate crystallization in urine. Urol Int 47:255\u2013259","journal-title":"Urol Int"},{"key":"1207_CR20","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s00240-020-01194-7","volume":"48","author":"J Sromicki","year":"2020","unstructured":"Sromicki J, Hess B (2020) Simple dietary advice targeting five urinary parameters reduces urinary supersaturation in idiopathic calcium oxalate stone formers. Urolithiasis 48:425\u2013433","journal-title":"Urolithiasis"},{"key":"1207_CR21","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1056\/NEJM197909063011008","volume":"301","author":"J Lemann","year":"1979","unstructured":"Lemann J, Adams ND, Gray RW (1979) Urinary calcium excretion in human beings. N Engl J Med 301:535\u2013541","journal-title":"N Engl J Med"},{"key":"1207_CR22","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1159\/000282457","volume":"50","author":"H Ito","year":"1993","unstructured":"Ito H, Kotake T, Suzuki F (1993) Incidence and clinical features of renal tubular acidosis-1 in urolithiasis. Urol Int 50:82\u201385","journal-title":"Urol Int"},{"key":"1207_CR23","first-page":"49","volume":"35","author":"U Backman","year":"1976","unstructured":"Backman U, Danielson BG, Sohtell M (1976) Urine acidification capacity in renal stone formers. Scand J Urol Nephrol Suppl 35:49\u201361","journal-title":"Scand J Urol Nephrol Suppl"},{"key":"1207_CR24","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1093\/ndt\/gfv423","volume":"31","author":"L Shavit","year":"2016","unstructured":"Shavit L, Chen L, Ahmed F, Ferraro PM, Moochhala S, Walsh SB, Unwin R (2016) Selective screening for distal renal tubular acidosis in recurrent stone formers: initial experience and comparison of the simultaneous furosemide and fludrocortisone test with the short ammonium chloride test. Nephrol Dial Transplant 31:1870\u20131876","journal-title":"Nephrol Dial Transplant"},{"key":"1207_CR25","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1159\/000181761","volume":"25","author":"U Backman","year":"1980","unstructured":"Backman U, Danielson BG, Johansson G, Ljunghall S, Wikstr\u00f6m B (1980) Incidence and clinical importance of renal tubular defects in recurrent renal stone formers. Nephron 25:96\u20131010","journal-title":"Nephron"},{"key":"1207_CR26","doi-asserted-by":"publisher","first-page":"3512","DOI":"10.1681\/ASN.2016030305","volume":"27","author":"RT Alexander","year":"2016","unstructured":"Alexander RT, Cordat E, Chambrey R, Dimke H, Eladary D (2016) Acidosis and urinary calcium excretion: insights from genetic disorders. J Am Soc Nephrol 27:3512\u20133520","journal-title":"J Am Soc Nephrol"},{"key":"1207_CR27","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.2215\/CJN.17541120","volume":"16","author":"DE Wesson","year":"2021","unstructured":"Wesson DE (2021) The continuum of acid stress. Clin J Am Soc Nephrol 16:1292\u20131299","journal-title":"Clin J Am Soc Nephrol"},{"key":"1207_CR28","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1053\/j.ackd.2018.05.007","volume":"25","author":"DG Fuster","year":"2018","unstructured":"Fuster DG, Moe OW (2018) Incomplete renal tubular acidosis and kidney stones. Adv Chronic Kidney Dis 25:366\u2013374","journal-title":"Adv Chronic Kidney Dis"},{"key":"1207_CR29","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1056\/NEJM198207223070403","volume":"307","author":"RJ Brenner","year":"1982","unstructured":"Brenner RJ, Spring DB, Sebastian A, McSherry EM, Genant HK, Palubinskas AJ, Morris RC (1982) Incidence of radiographically evident bone disease, nephrocalcinosis, and nephrolithiasis in various types of renal tubular acidosis. N Engl J Med 307:217\u2013221","journal-title":"N Engl J Med"},{"key":"1207_CR30","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/S0022-5347(17)46963-1","volume":"134","author":"GM Preminger","year":"1985","unstructured":"Preminger GM, Sakhaee K, Skurla C, Pak CYC (1985) Prevention of recurrent calcium stone formation with potassium citrate in patients with distal renal tubular acidosis. J Urol 134:20\u201323","journal-title":"J Urol"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-021-01207-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-021-01207-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-021-01207-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:54:32Z","timestamp":1777564472000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/35\/6\/1619\/8325643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,1]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["1207"],"URL":"https:\/\/doi.org\/10.1007\/s40620-021-01207-7","relation":{},"ISSN":["1724-6059"],"issn-type":[{"value":"1724-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,1]]},"assertion":[{"value":"17 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval was obtained from the ethics committee of the University of Zurich. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}