Circadian variations in the risk of urinary calcium oxalte stone formation

Robert, M; Roux, J-P.; Bourelly, F.; Boularan, Anne-Marie; Guiter, J; Monnier, L.

doi:10.1111/j.1464-410x.1994.tb16613.x

Cited by 32 publications

(12 citation statements)

References 14 publications

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“…This rhythm means that urine is hyperconcentrated during night time, which entails a risk of nephrolithiasis and infections. The lithogenic risk for calcium oxalate stones is highest at the end of the night or during the early morning, when urinary output is minimal 3. Studies on healthy people and people who have had kidney stones showed a higher risk of calcium oxalate crystallisation in the morning 4.…”

Section: Commentmentioning

confidence: 99%

Circadian pattern in occurrence of renal colic in an emergency department: analysis of patients' notes

Manfredini

2002

BMJ

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Section: Commentmentioning

confidence: 99%

Circadian pattern in occurrence of renal colic in an emergency department: analysis of patients' notes

Manfredini

2002

BMJ

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“…Most, if not all, renal functions (e.g., glomerular filtration, urine production, and renal solute excretion) exhibit temporal changes that lead to increased nighttime urine concentration that could act as a predisposing factor for the morning occurrence of renal colic attacks. In addition, the rates of urine production and renal solute excretion reach minimum levels during the night [24]. For this reason, our study showed the highest peak during the morning.…”

Section: Discussionmentioning

confidence: 53%

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers

Kim

Hwang

Park

et al. 2018

Urogenit Tract Infect

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Purpose: Acute abdominal pain accounts for 7-10% of all emergency department visits. The purpose of this study is to investigate the epidemiology and outcome of acute flank pain at regional emergency medical centers (EMC) and to investigate the necessity of urologists. Materials and Methods:We retrospectively reviewed all records of EMC visits for flank pain between 1 July 2015 and 30 June 2017. The renal colic was defined according to the code allocation of the Korean standard classification of disease-6 code N132, N200-N203, and N210-N211. The results of this study were retrospectively analyzed and the characteristics of the patients. Results: The total number of visits to the EMC was 67,792, and the number of visits for acute abdominal pain was 9,641. The number of visits for acute flank pain was 1,133 and the number of patients was 1,018. The departments included emergency medicine (n=235), urology (n=711), internal medicine (n=132), general surgery (n=19), gynecology (n=10), and others (n=26). The causes of urological flank pain were urolithiasis in 628 cases, infection in 41 cases, and other diseases in 42 cases. Among these, 244 cases were admitted, and 193 cases of them were urolithiasis patients, and 171 patients underwent stone removal surgery. Conclusions: According to our study, patients with flank pain accounted for 11.8% of patients with abdominal pain. However, considering hospitalization and frequency of surgery, it is necessary to take the national measurement for the long-term supply of urology. -63-859-1335, Fax: +82-63-842-7379 E-mail: mygentlelove@gmail.com Original Article Keywords: Renal colic; Epidemiology; Hospital emergency service INTRODUCTIONAcute abdominal pain, traditionally defined as a pain of non-traumatic origin with a maximum duration of 5 days [1], is one of the most common symptoms that causes people to visit the emergency center, making up approximately 7-10% of all emergency department (ED) visits [2]. Despite the relatively high incidence, abdominal pain may be a symptom of serious underlying diseases, and the challenging differential diagnosis may lead to medical litigation or undesirable outcomes [3,4].Despite substantial improvements in the diagnostic approach to acute abdominal pain, many diagnostic pitfalls remain due to the extensive use of imaging techniques (especially computed tomography [CT]), which can be associated with a substantial number of misdiagnoses and/or avoidable surgery [5,6]. Acute flank pain is the most common clinical symptom of urinary tract stones and is a common [7]. Furthermore, the lifetime recurrence rate has been estimated to be as high as 50% within 10 years of the initial urolithiasis episode [8]. Several previous studies have shown a worldwide trend toward an increasing prevalence of urolithiasis [9]. Proper assessment by the emergency physician is essential for the management of these patients, since the underlying cause of acute abdominal pain can involve a variety of medical specialties, including gynecology, general surgery, in...

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“…Superimposed upon these considerations are circadian rhythms of calcium, oxalate, and phosphate, which have been shown to aVect saturation and lithogenic risk. [53][54][55] We recommend that these factors should be explored in terms of the eVects of calcium supplementation.…”

Section: Discussionmentioning

confidence: 99%

“…Although urine phosphate appeared to be higher in the summer, there were no significant seasonal differences in 246 male stone formers in observations by Robertson,35 and there were no diVerences in a study of UK doctors, 36 or in 147 institutionalised elderly patients. 37 Urine phosphate was lower in the March to August period of the year in 118 male stone formers on a "free diet" reported by Juuti et al 38 …”

mentioning

confidence: 89%

Why oral calcium supplements may reduce renal stone disease: report of a clinical pilot study

Williams

Child²,

Hudson³

et al. 2001

Journal of Clinical Pathology

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Aims-To investigate whether increasing the daily baseline of gut calcium can cause a gradual downregulation of the active intestinal transport of calcium via reduced parathyroid hormone (PTH) mediated activation of vitamin D, and to discuss why such a mechanism might prevent calcium oxalate rich stones. To demonstrate the importance of seasonal eVects upon the evaluation of such data. Methods-Within an intensive 24 hour urine collection regimen, daily calcium supplementation (500 mg) was given to five stone formers for a 10 week period during a six month crossover study. In a further population of patients on follow up for previous renal stone disease, observations were made on 1066 24 hour urine samples collected over five years in respect of seasonal eVects relevant to the interpretation of the study. Results-In the group of patients on calcium supplements the following results were found. During calcium supplementation, the proportion of urine calcium to oxalate was higher (increased calcium to oxalate molar ratio), the 24 hour urine product of calcium and oxalate did not rise, and urine oxalate was lower during the first six weeks of supplementation. Twenty four hour urine calcium was 10.2% higher than baseline in the final four weeks of the 10 weeks of supplementation. Twenty four hour urine phosphate was 11.4% lower during the first six weeks of supplementation, but then rose while the patients were still on supplementation; renal tubular reabsorption of phosphate (TmP/GFR) mirrored the urine phosphate changes inversely. PTH was higher after stopping supplementation, but 1,25-(OH) 2 -cholecalciferol changes were not detected. In the 1066 urine samples collected over five years the following results were found. Calcium and oxalate excretion correlated positively and not inversely. Urine calcium and phosphate excretion were 5.5% and 2.5% higher, respectively, in "light" months of the year compared with "dark" months. A post summer decline in both urine calcium and urine phosphate was relevant to the interpretation of the study. Conclusions-Regular calcium supplementation does not raise the product of calcium and oxalate in urine and the proportion of oxalate to calcium is reduced.The underlying mechanisms of the changes seen in phosphate, calcium, and PTH and the observations on 1,25-(OH) 2 -cholecalciferol are not clear. Observed changes in phosphate could possibly be part of a calcium regulating feedback loop operating over a period of weeks. In evaluating these mechanisms background seasonal eVects are important. It is possible that "programming" of the gut mucosa in terms of calcium transport is a major determinant of the relation between calcium and oxalate concentrations in urine and their relative abundance. Increased oral calcium, in association with a reduction of the relative proportion absorbed, may be pertinent to the prevention of calcium oxalate rich stones. (J Clin Pathol 2001;54:54-62)

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Circadian variations in the risk of urinary calcium oxalte stone formation

Cited by 32 publications

References 14 publications

Circadian pattern in occurrence of renal colic in an emergency department: analysis of patients' notes

Circadian pattern in occurrence of renal colic in an emergency department: analysis of patients' notes

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers

Why oral calcium supplements may reduce renal stone disease: report of a clinical pilot study

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