An update on metabolic assessment in patients with urinary lithiasis

Amaro, Carmen Regina Petean Ruiz; Goldberg, José; Damasio, Patrícia Capuzzo Garcia; Leitão, Victor A.; Turney, Benjamin; Padovani, Carlos Roberto; Amaro, João Luiz

doi:10.1007/s00345-014-1271-z

Cited by 18 publications

(22 citation statements)

References 21 publications

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“…The prevalence of urolithiasis is reported between 2 and 20% globally, with peak incidence in the second and third decade of life. 1,2 The incidence of urolithiasis increased along with the increasing life expectancy. 3 There are several factors that may be related to the development of urinary stones, such as age, gender, race, genetic, climate, dietary intake, and metabolic changes.…”

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“…3 There are several factors that may be related to the development of urinary stones, such as age, gender, race, genetic, climate, dietary intake, and metabolic changes. 1,2 Metabolic abnormalities were found in more than 90% of stone patients. 1 Hypercalciuria and hypocitraturia are the most prevalent condition that cause stone disease, although there are also other causes such as hyperuricosuria, hypokalemia, hyperuricemia, hypophosphatemia, and low urine volume.…”

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“…1,2 Metabolic abnormalities were found in more than 90% of stone patients. 1 Hypercalciuria and hypocitraturia are the most prevalent condition that cause stone disease, although there are also other causes such as hyperuricosuria, hypokalemia, hyperuricemia, hypophosphatemia, and low urine volume. 1,2,4,5 In large epidemiological studies, obesity and type 2 diabetes have been associated with increased risk of nephrolithiasis.…”

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“…1 Hypercalciuria and hypocitraturia are the most prevalent condition that cause stone disease, although there are also other causes such as hyperuricosuria, hypokalemia, hyperuricemia, hypophosphatemia, and low urine volume. 1,2,4,5 In large epidemiological studies, obesity and type 2 diabetes have been associated with increased risk of nephrolithiasis. 6 Insulin resistance reduces the production and transport of ammonia, resulting in alterations of urine acidification and low urine pH.…”

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“…Mechanisms of obesity to affect urolithiasis genesis are still being investigated. A study by Amaro, et al 1 has shown that metabolic syndrome (including obesity and high blood pressure) patients were at risk of certain stone formation (uric acid and calcium oxalate stones). Significant contribution of high BMI to kidney stone formation were through its influence in lowering urine pH.…”

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Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity

2015

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Background: Urolithiasis refers to formation of stone in the kidney, ureter, or bladder. Several studies showed metabolic abnormalities were common in urolithiasis patients. The aim of this study was to describe the association between body-mass-index (BMI), serum uric acid, serum glucose, and blood pressure toward stone opacity in urinary tract stone patients.Methods: This study was done retrospectively by reviewing registry data of urinary tract stone patients that had undergone ESWL on January 2008 – December 2013 in Department of Urology Cipto Mangunkusumo Hospital. Data concerning body mass index, serum uric acid, serum glucose, blood pressure, and urinary tract stone opacity were recorded. Associations between body mass index, serum uric acid, serum glucose and blood pressure with urinary tract stone opacity were analyzed using chi-square test.Results: There were 2,889 patients who underwent ESWL on January 2008 – December 2013. We analyzed 242 subjects with complete data. Mean age was ± 12.78 (48.02 years). Male-to-female ratio was 2.27:1. Mean BMI was ± 3.78 (29.91 kg/m2). High risk BMIs were found in 161 patients (66.52%). The proportion of radioopaque stone was 77.69% (188 patients). Twenty two patients (9.1%) had normal blood pressure. Patients with high serum uric acid were 34.30% (83 patients). We found a significant association between random serum glucose level and stone opacity (p < 0.05).Conclusion: There is an association between random serum glucose level and stone opacity in urolithiasis patients. Hyperglycemia patients tend to have radiolucent stone, whereas normoglycemia patients tend to have radioopaque stone.

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Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity

2015

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Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

et al. 2015

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This study is to evaluate the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) versus retrograde intrarenal surgery (RIRS) for the treatment for renal calculi 1-2 cm. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Database were researched and hand-searched for relevant congress abstracts and journals about RIRS and ESWL for the treatment for 1- to 2-cm renal stones. The retrieval time ended in September 2014. The related trials met the inclusion criteria were included in the meta-analysis. Two reviewers independently assessed the quality of all included studies, and meta-analysis was performed with RevMan 5.2. Seven literatures were retrieved, including 983 patients. The meta-analysis results showed that, compared to RIRS group, the patients in ESWL group had the following features:(1) the stone-free rate [relative risk (RR) 0.86; 95% confidence interval (CI) 0.77-0.95, P = 0.005] was significantly different between two groups; (2) The retreatment rate of RIRS group was lower (RR 8.12; 95% CI 4.77-13.83, P < 0.00); (3) The complications were not significantly different between two groups (Grade I RR 1.06; 95% CI 0.67-1.69, P = 0.80; Grade II RR 0.75; 95% CI 0.29-1.91, P = 0.54; Grade III RR 0.86; 95% CI 0.26-2.86, P = 0.80). Compared to ESWL, our results showed that RIRS provided significantly higher stone-free rate and lower retreatment rate and without increase in the incidence of complications. However, further randomized trials are needed to confirm these findings.

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The potential of at-home prediction of the formation of urolithiasis by simple multi-frequency electrical conductivity of the urine and the comparison of its performance with urine ion-related indices, color and specific gravity

et al. 2015

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It is important to control daily diet, water intake and life style as well as monitor the quality of urine for urolithiasis prevention. For decades, many ion-related indices have been developed for predicting the formation of urinary stones or urolithiasis, such as EQUILs, relative supersaturation (RSS), Tiselius indices (TI), Robertson risk factor algorithms (RRFA) and more recently, the Bonn risk index. However, they mostly demand robust laboratory analysis, are work-intensive, and even require complex computational programs to get the concentration patterns of several urine analytes. A simple and fast platform for measuring multi-frequency electrical conductivity (MFEC) of morning spot urine (random urine) to predict the onset of urolithiasis was implemented in this study. The performance thereof was compared to ion-related indices, urine color and specific gravity. The concentrations of relevant ions, color, specific gravity (SG) and MFEC (MFEC tested at 1, 10, 100, 5001 KHz and 1 MHz) of 80 random urine samples were examined after collection. Then, the urine samples were stored at 4 °C for 24 h to determine whether sedimentation would occur or not. Ion-activity product index of calcium oxalate (AP(CaOx) EQ2) was calculated. The correlation between AP(CaOx) EQ2, urine color, SG and MFEC were analyzed. AP(CaOx) EQ2, urine color and MFEC (at 5 frequencies) all demonstrated good prediction (p = 0.01, 0.01, 0.01, respectively) for stone formation. The positive correlation between AP(CaOx) EQ2 and MFEC is also significant (p = 0.01). MFEC provides a good metric for predicting the onset of urolithiasis, which is comparable to conventional ion-related indices and urine color. This technology can be implemented with much ease for objectively monitoring the quality of urine at points-of-care or at home.

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An update on metabolic assessment in patients with urinary lithiasis

Abstract: 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.

Cited by 18 publications

References 21 publications

Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity

Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity

Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

The potential of at-home prediction of the formation of urolithiasis by simple multi-frequency electrical conductivity of the urine and the comparison of its performance with urine ion-related indices, color and specific gravity

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