Calcium stone disease in the urinary tract is due to the formation of excessively large crystals and aggregates of calcium salts in urine. This phenomenon, in turn, is due to the combination of abnormalities in a number of potential urinary risk factors for the disorder. These include supersaturation-determining factors such as hypercalciuria, mild and severe hyperoxaluria, a persistently alkaline urine and a low urine volume; a reduced excretion of certain polyanionic inhibitors of crystallization of calcium oxalate, in particular glycosaminoglycans, RNA, and Tamm-Horsfall mucoprotein; and an increased excretion of certain promoters of crystallization such as urate and, perhaps, polymerized uromucoid. In turn, abnormalities in these urinary risk factors may be aggravated by or attributed to a number of epidemiological factors such as the age and sex of the individual, climate, season, stress, level of affluence, dietary and fluid intake and various metabolic and genetic disorders such as primary hyperparathyroidism, renal tubular acidosis and hereditary and enteric hyperoxaluria.
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