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Metabolic disorders: stones as first clinical manifestation of significant diseases

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Abstract

Introduction

Metabolic syndrome, type 2 diabetes, and primary hyperparathyroidism are metabolic disorders that should deserve a special focus in renal stone patients as a pathogenic link is established with some stone components. Indeed, an acidic urinary pH due to a decreased ammonium bioavailability explains the high prevalence of uric acid stones in patients with metabolic syndrome or diabetes and, primary hyperparathyroidism induced hypercalciuria increases the risk of calcium phosphate stones.

Materials and methods

We report here four clinical cases of renal stone patients with metabolic disorders encountered in a daily practice. Clinical and metabolic findings altogether with stone analysis components presented here, illustrate relevant pathophysiological links.

Conclusion

24 hours urine evaluation and stone analysis which includes both morphological typing and infrared spectroscopy, are key diagnostic steps for early recognition of metabolic disorders. Metabolic screening allows diet related stone identification, points out stone risk factors and identifies patients’comorbidity. The occurrence of nephrocalcinosis with or without chronic renal failure should require a more detailed metabolic evaluation in order to identify uncommon etiologies such as renal tubular acidosis.

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Acknowledgments

We do thank Dr. Michel Daudon for helpful comments and critical review of the manuscript.

Conflict of interest

None.

Ethical standard

The patients described in the case reports of this manuscript gave an informed consent.

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Authors and Affiliations

  1. Service d’Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la chine, 75020, Paris, France

    Jean-Philippe Haymann

  2. UMR_S1155, Institut National de la Santé et de la Recherche Médicale, Paris, France

    Jean-Philippe Haymann

  3. Sorbonne Universités, UPMC Univ Paris 06, DHUI2B, Paris, France

    Jean-Philippe Haymann

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  1. Jean-Philippe Haymann
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Correspondence to Jean-Philippe Haymann.

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Haymann, JP. Metabolic disorders: stones as first clinical manifestation of significant diseases. World J Urol 33, 187–192 (2015). https://doi.org/10.1007/s00345-014-1391-5

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  • DOI: https://doi.org/10.1007/s00345-014-1391-5

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