Biochemical profile of stone-forming patients with diabetes mellitus

Pak, Charles Y.C.; Sakhaee, Khashayar; Moe, Orson W.; Preminger, Glenn M.; Poindexter, John R.; Peterson, Roy D.; Pietrow, Paul K.; Ekeruo, Wesley

doi:10.1016/s0090-4295(02)02421-4

Cited by 183 publications

(107 citation statements)

References 7 publications

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“…Furthermore, the greater NAE in patients with type 2 diabetes is not accounted for by dietary factors or unmeasured anions in urine (Table 3). The lower urine pH in individuals with type 2 diabetes seen in this study was previously demonstrated by our group (3,7) and others (4); however, those studies did not control for various factors that influence urinary pH, such as consumption of acid-rich foods, age, gender, renal function, and BMI. In contrast, this study overcame these limitations by controlling dietary influences and matching for age, gender, and body size.…”

Section: Discussioncontrasting

confidence: 44%

“…Obesity, a common finding in patients with type 2 diabetes, is also associated with lower urine pH (10,11). To date, the role of other confounding factors, such as impaired renal function (12), age (13), ethnicity (14), and dietary factors, that also known to influence urine pH have not been investigated in this population (3,4,7). To understand better the metabolic factors that lead to an unduly acidic urine and thus increase the risk for UA stones in individuals with type 2 diabetes, we conducted a metabolic study under a controlled dietary environment while controlling other variables that are known to influence urinary pH.…”

mentioning

confidence: 94%

“…T ype 2 diabetes is associated with an increased risk for nephrolithiasis (1,2), particularly uric acid (UA) stones (3)(4)(5). Urine pH is a key determinant of UA solubility in urine, and an excessively acidic urine is recognized as a major risk factor for UA precipitation and stone formation (5,6).…”

mentioning

confidence: 99%

“…Urine pH is a key determinant of UA solubility in urine, and an excessively acidic urine is recognized as a major risk factor for UA precipitation and stone formation (5,6). Unduly acidic urine (pH Ͻ5.5) is frequently encountered in patients who have type 2 diabetes both with (3,4) and without UA stones (7).…”

mentioning

confidence: 99%

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Metabolic Basis for Low Urine pH in Type 2 Diabetes

Maalouf

Cameron

Moe³

et al. 2010

Clinical Journal of the American Society of Nephrology

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133

113

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Background and objectives: Type 2 diabetes is associated with excessively low urine pH, which increases the risk for uric acid nephrolithiasis. This study was conducted to assess the metabolic basis responsible for the excessive urinary acidity of individuals with type 2 diabetes.Design, setting, participants, & measurements: Nine non-stone-forming patients who had type 2 diabetes and low urine pH and 16 age-and body mass index-matched non-stone-forming volunteers without type 2 diabetes were maintained on a constant metabolic diet for 7 days, and 24-hour urine was collected on the last 2 days of the diet.Results: Urine dietary markers (potassium, sulfate, phosphorus, and urea nitrogen) were not different between the two groups. Patients with type 2 diabetes exhibited a significantly lower 24-hour urine pH (5.45 ؎ 0.27 versus 5.90 ؎ 0.42; P < 0.01) and higher net acid excretion (NAE; 57 ؎ 12 versus 38 ؎ 18 mEq/d; P < 0.01) compared with control subjects. The proportion of NAE excreted as ammonium (NH 4 ؉ /NAE) was significantly lower in patients with type 2 diabetes than in control subjects

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Section: Discussioncontrasting

confidence: 44%

mentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Metabolic Basis for Low Urine pH in Type 2 Diabetes

Maalouf

Cameron

Moe³

et al. 2010

Clinical Journal of the American Society of Nephrology

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133

113

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“…Our findings suggest that the presence of increasing number of MS features augments the propensity for uric acid stone formation. This notion is supported by cross-sectional studies that show a significantly greater prevalence of uric acid nephrolithiasis among obese stone-forming individuals and in nephrolithiasis patients with type 2 diabetes (25)(26)(27)(28). Insulin resistance is a common feature in obesity (29), type 2 diabetes (30), and the MS (2) and is thought to cause the overly acidic urine in patients with these conditions (14,21).…”

Section: Discussionmentioning

confidence: 90%

Low Urine pH

Maalouf

Cameron

Moe

et al. 2007

Clinical Journal of the American Society of Nephrology

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258

180

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Background and Objectives: The metabolic syndrome is associated with alterations in renal function. An overly acidic urine has been described as a renal manifestation of the metabolic syndrome in patients with kidney stone disease. This study examined the association between the metabolic syndrome and urine pH in individuals without a history of nephrolithiasis.Design, Setting, Participants, & Measurements: A total of 148 adults who were free of kidney stones were evaluated in this outpatient cross-sectional study. Height, weight, BP, fasting blood, and 24-h urine chemistries were obtained. Urine pH was measured by pH electrode. The following features of the metabolic syndrome were evaluated: BP; body mass index; and serum triglyceride, glucose, and HDL cholesterol concentrations. The degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance.Results: Participants with the metabolic syndrome had a significantly lower 24-h urine pH compared with participants without the metabolic syndrome. Mean 24-h urine pH, adjusted for age, gender, creatinine clearance, and 24-h urine sulfate, decreased from 6.15, 6.10, 5.99, 5.85, to 5.69 with increasing number of metabolic syndrome abnormalities. An association was observed between 24-h urine pH and each metabolic feature. After adjustment for age, gender, creatinine clearance, urine sulfate, and body mass index, a significant inverse relationship was noted between 24-h urine pH and the degree of insulin resistance.Conclusions: An unduly acidic urine is a feature of the metabolic syndrome and is associated with the degree of insulin resistance.

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Uric Acid Stones

Maalouf¹

2014

Urinary Stones

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Biochemical profile of stone-forming patients with diabetes mellitus

Cited by 183 publications

References 7 publications

Metabolic Basis for Low Urine pH in Type 2 Diabetes

Metabolic Basis for Low Urine pH in Type 2 Diabetes

Low Urine pH

Uric Acid Stones

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