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An update on metabolic assessment in patients with urinary lithiasis

World Journal of Urology volume 33, pages 125–129 (2015)Cite this article

Abstract

Purpose

The objective of this study was to evaluate the prevalence of urinary metabolic abnormalities in patients with urolithiasis and their potential risk factors.

Methods

A total of 905 stone patients were evaluated in a prospective trial from February 2000 to January 2012. Inclusion criteria were as follows: history and/or imaging tests confirming at least 2 separate or concurrent stone episodes; creatinine clearance ≥60 mL/min; and negative proteinuria and urine culture. Metabolic study consisted of two 24-h urine collections separated by a period of 3 months for dosing Ca, P, uric acid, Na, K, Mg, oxalate, and citrate. Serum levels of Ca, P, uric acid, Na, K, Cl, Mg, creatinine, and glucose were assessed. Urinary pH and urinary acidification tests were also performed.

Results

A total of 735 patients were included, with a mean age of the 40 ± 1.0 year; 96.8 % of patients presented diagnosis of one or more urinary metabolic abnormalities. The most prevalent metabolic abnormalities were hypercalciuria (50.8 %), hypomagnesuria (50.1 %), hypocitraturia (35.4 %), and hyperuricosuria (30.7 %). Body weight was significantly higher in patients with hyperuricosuria (81.20 ± 15.67 kg vs. 70.17 ± 14.13 kg, respectively, p = 0.001). Urinary sodium was significantly higher in patients with hypercalciuria than without (246.97 ± 103.9 mEq/24 h vs. 200.31 ± 91.6 mEq/24 h, p = 0.001) and hyperuricosuria compared to without (283.24 ± 107.95 mEq/24 h vs. 198.57 ± 85.3 mEq/24 h, p = 0.001).

Conclusion

Urinary metabolic disturbances were diagnosed in 96.8 % of patients in the study. These results warrant metabolic study and follow-up in patients with recurrent lithiasis in order to decrease recurrence rate through specific treatments, modification in alimentary, and behavioral habits.

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References

  1. Turney BW, Reynard JM, Noble JG, Keoghane SR (2012) Trends in urological stone disease. BJU Int 109(7):1082–1087

    PubMed  Article  Google Scholar 

  2. Ferraro PM, Taylor EN, Gambaro G, Curhan GC (2013) Soda and other beverages and the risk of kidney stones. Clin J Am Soc Nephrol 8(8):1389–1395

    PubMed Central  PubMed  Article  Google Scholar 

  3. Nesterova G, Malicdan MC, Yasuda K, Sakaki T, Vilboux T, Ciccone C, Horst R, Huang Y, Golas G, Introne W, Huizing M, Adams D, Boerkoel CF, Collins MT, Gahl WA (2013) 1,25-(OH)2D-24 Hydroxylase (CYP24A1) deficiency as a cause of nephrolithiasis. Clin J Am Soc Nephrol 8(4):649–657

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  4. Saigal CS, Joyce G, Timilsina AR (2005) Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney Int 68(4):1808–1814

    PubMed  Article  Google Scholar 

  5. Worcester EM, Coe FL (2010) Clinical practice. Calcium kidney stones. N Engl J Med 363(10):954–963

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  6. Johri N, Cooper B, Robertson W, Choong S, Rickards D, Unwin D (2010) An update and practical guide to renal stone management. Nephron Clin Pract 116:c159–c171

    PubMed  Article  Google Scholar 

  7. Wasserstein AG (2011) Epidemiology and natural history of nephrolithiasis. Clin Rev Bone Min Metabol 9(3–4):165–180

    Article  Google Scholar 

  8. Amaro CR, Goldberg J, Amaro JL, Padovani CR (2005) Metabolic assessment in patients with urinary lithiasis. Int Braz J Urol 31(1):29–33

    PubMed  Article  Google Scholar 

  9. Menditto VG, Lucci M, Polonara S (2012) The role of hypomagnesuria in urolithiasis and renal colic: results from a prospective study of a metabolic evaluation protocol. Minerva Med 103(5):377–382

    CAS  PubMed  Google Scholar 

  10. Scales CD, Smith AC, Hanley JM, Saigal CS (2012) Prevalence of kidney stones in the United States. Eur Urol 62(1):160–165

    PubMed Central  PubMed  Article  Google Scholar 

  11. Xiong Z, Zhu C, Qian X, Zhu J, Wu Z, Chen L (2013) Serum uric acid is associated with dietary and lifestyle factors in elderly women in suburban Guangzhou in Guangdong province of south China. J Nutr Health Aging 17(1):30–34

    CAS  PubMed  Article  Google Scholar 

  12. Tamba S, Nishizawa H, Funahashi T, Okauchi Y, Ogawa T, Noguchi M et al (2008) Relationship between the serum uric acid level, visceral fat accumulation and serum adiponectin concentration in Japanese men. Intern Med 47(13):1175–1180

    PubMed  Article  Google Scholar 

  13. Kawamoto R, Tabara Y, Kohara K, Kusunoki T, Abe M, Miki T (2013) Synergistic influence of age and serum uric acid on blood pressure among community-dwelling Japanese women. Hypertens Res 36(7):634–638

    CAS  PubMed  Article  Google Scholar 

  14. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155(3):839–843

    CAS  PubMed  Article  Google Scholar 

  15. Laranja S, Heilberg IP, Coelho S, Novoa C, Schor N (1995) Estudo multicêntrico da litíase renal no Brasil (MULTILIT). In: Schor N, Heilberg IP (eds) Calculose renal fisiopatologia, diagnóstico. Tratamento, Sarvier, pp 295–338

    Google Scholar 

  16. Karabacak OR, Ipek B, Ozturk U, Demirel F, Saltas H, Altug U (2010) Metabolic evaluation in stone disease metabolic differences between the pediatric and adult patients with stone disease. Urology 76(1):238–241

    PubMed  Article  Google Scholar 

  17. Abdel Goad EH, Bereczky ZB (2004) Metabolic risk factors in patients with renal stones in KwaZulu Natal: an inter-racial study (Asian and Whites). BJU Int 93(1):120–123

    CAS  PubMed  Article  Google Scholar 

  18. Massey L (2005) Magnesium therapy for nephrolithiasis. Magnes Res 18(2):123–126

    CAS  PubMed  Google Scholar 

  19. Bibilash BS, Vijay A, Fazil Marickar YM (2010) Stone composition and metabolic status. Urol Res 38(3):211–213

    CAS  PubMed  Article  Google Scholar 

  20. Moe OW, Preisig PA (2005) Hypothesizing on the evolutionary origins of salt-induced hypercalciuria. Curr Opin Nephrol Hypertens 14(4):368–372

    CAS  PubMed  Article  Google Scholar 

  21. Heilberg IP, Schor N (2006) Renal stone disease: causes, evaluation and medical treatment. Arq Bras Endocrinol Metabol 50(4):823–831

    PubMed  Article  Google Scholar 

  22. Freitas Junior CH, Mazzucchi E, Danilovic A, Brito AH, Srougi M (2012) Metabolic assessment of elderly men with urolithiasis. Clinics 67(5):457–461

    PubMed  Article  Google Scholar 

  23. Damasio PCG, Amaro CRPR, Cunha NB, Pichutte AC, Goldberg J, Padovani CR, Amaro JL (2011) The role of salt abuse on risk for hypercalciuria. Nutr J 10:1–4

    Article  Google Scholar 

  24. Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CYC (2004) Association of urinary pH with body weight in nephrolithiasis. Kidney Int 65(4):1422–1425

    PubMed  Article  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Affiliations

  1. Urinary Lithiasis Metabolism Service, Medical School of Botucatu - UNESP, Botucatu, SP, 18618-970, Brazil

    Carmen Regina Petean Ruiz Amaro & Patricia Capuzzo Damasio

  2. Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil

    Jose Goldberg, Victor Augusto Leitão & João Luiz Amaro

  3. Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

    Benjamin Turney

  4. Department of Biostatistics, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil

    Carlos Roberto Padovani

Authors
  1. Carmen Regina Petean Ruiz Amaro
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  2. Jose Goldberg
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  3. Patricia Capuzzo Damasio
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  4. Victor Augusto Leitão
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  5. Benjamin Turney
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  6. Carlos Roberto Padovani
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  7. João Luiz Amaro
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Corresponding author

Correspondence to Carmen Regina Petean Ruiz Amaro.

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Amaro, C.R.P.R., Goldberg, J., Damasio, P.C. et al. An update on metabolic assessment in patients with urinary lithiasis. World J Urol 33, 125–129 (2015). https://doi.org/10.1007/s00345-014-1271-z

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  • DOI: https://doi.org/10.1007/s00345-014-1271-z

Keywords

  • Urolithiasis
  • Risk factors
  • Metabolic disease
  • Follow-up studies