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Biomedical subjects

P J Heyburn

Publications and source records attributed to P J Heyburn.

10 recordsLinked to original sources
PubMed1979

The effect of high animal protein intake on the risk of calcium stone-formation in the urinary tract.

1. Studies were carried out on six normal male subjects to determine the short-term effect of increasing the dietary consumption of animal protein on the urinary risk factors for stone-formation, namely, volume, pH, calcium oxalate, uric acid and glycosaminoglycans. 2. An increase of 34 g/day of animal protein in the diet significantly increased urinary calcium (23%) and oxalate (24%). Total urinary nitrogen increased by an average of 368 mmol/day. The accompanying increase in dietary purine (11 mmol of purine nitrogen/day) caused a 48% increase in the excretion of uric acid. 3. The overall relative probability of forming stones, calculated from a combination of the risk factors, was markedly increased (250%) throughout the period of high animal protein ingestion.

Adult↗
PubMed1979

Should recurrent calcium oxalate stone formers become vegetarians?

The hypothesis that the incidence of calcium stone disease is related to the consumption of animal protein has been examined. Within the male population, recurrent idiopathic stone formers consumed more animal protein than did normal subjects. Single stone formers had animal protein intakes intermediate between those of normal men and those of recurrent stone formers. A high animal protein intake caused a significant increase in the urinary excretion of calcium, oxalate and uric acid, 3 of the 6 main urinary risk factors for calcium stone formation. The overall relative probability of forming stones, calculated from the combination of the 6 main urinary risk factors, was markedly increased by a high animal protein diet. Conversely, a low animal protein intake, such as taken by vegetarians, was associated with a low excretion of calcium, oxalate and uric acid and a low relative probability of forming stones.

Calcium↗
PubMed1979

Urinary tract stone disease.

Patients suffering from urinary stone are traditionally referred to a surgeon. Most are investigated only as far as establishing the site of the stone and its effect on renal function. Although a number of patients may require surgery, the majority pass the stone spontaneously and are discharged within a few days. If the patient has a recurrence, as most eventually have, it is not routine practice to establish the type of stone, screen for underlying disease, identify the urinary abnormalities or to institute preventive medical treatment. Although it was considered that surgery itself had something to offer in reducing the recurrence rate this is no longer generally held except in infected stone disease. Nevertheless it is still uncommon to involve a physician, and in particular a nephrologist, in the investigation and management of urinary stone-formers. Urinary stone disease still remains, to a large extent, outside the field of nephrology.

Bacterial Infections↗
PubMed1978

Risk factors in calcium stone disease of the urinary tract.

The concept that calcium stone formation may be explained on the basis of a number of risk factors is developed. The main risk factors involved are shown to be calcium, oxalate, pH, acid mucopolysaccharides and uric acid. A method is described for calculating and combining the individual risk factors into a measure of the "relative probability" of forming stones (PSF). PSF values are generally lower in normal subjects than in stone-formers. Amongst the normals, PSF values are lower in children and women than in men. Recurrent stone-formers have the highest PSF values and these correlate well with the severity of the diseases as defined by the stone episode rate of the patient. Single stone-formers have PSF values intermediate between those of normal men and those of recurrent stone-formers.

Adult↗
PubMed1977

The management of hypoparathyroidism with 1alpha-hydroxyvitamin D3.

A retrospective study of the comparative effects of vitamin D, dihydrotachysterol and 1alpha-hydroxyvitamin D3 was undertaken in twenty-eight patients with hypoparathyroidism. The vitamin D compounds restored plasma calcium to the normal range in most patients with comparable actions on the gut, bone and kidney. Although the vitamin D compounds had a direct action on kidney and bone in the absence of PTH, the major action in maintaining plasma calcium was on the gut. Plasma phosphate fell due to a reduction in renal tubular reabsorption. Dihydrotachysterol and 1alpha-hydroxyvitamin D3 had significant practical advantages over vitamin D in their rapid onset of action and their relatively short biological half-life.

Adolescent↗
PubMed1977

Vitamin D resistant hypophosphataemic osteomalacia: treatment with 1alpha-hydroxyvitamin D3.

Ten patients with vitamin D resistant hypophosphataemic osteomalacia are described. They had hypophosphataemia with a decreased tubular reabsorption of phosphate, malabsorption of calcium and phosphorus, proximal myopathy and extensive osteomalacic changes on iliac crest bone biopsy. The plasma alkaline phosphatase and urine hydroxyproline, however, were raised in only some of the patients. Treatment with 1alpha-hydroxyvitamin D3 in high doses rapidly cured the myopathy, increased calcium and phosphorus absorption and retention and healed the osteomalacia. Phosphorus supplements were not required.

Adolescent↗