Correlation of Parathormone and the Serum Values of Acidum Uricum with Calcium Nephrolithiasis Examined by Three Different Methods of Diagnostics

Abstract

Introduction.Urolithiasis is a multifactorial disease. Changes in social and economic living conditions have generated changes in chemical composition of urolith too. Although calcium is a predominant crystalline constituent of kidney stones in 80% of cases, metabolic disorders are not the main reason for their formation. Hyperparathyroidism may be a cause of occurrence of calcium lithiasis, however, the biggest number of its occurrence is not a consequence of elevated values of parathormone. Acid uric has a pervasive presence in all body fluids. The serum level of acid uric is determined by its rate of synthesis, rate of excretion by kidney and gastrointestinal tract, and metabolism.Goal.The goal of our study is to determine a correlation of calcium lithiasis of the upper part of the urinary tract with the parathormone values and the concomitant values of acidum uricum.Material and methods.The study was prospective and included 120 patients with calcium lithiasis of the upper part of urinary tract, divided in three age categories, 20-40 years, 40-60 years and older than 60 years. The diagnosis of calcium lithiasis of the upper part of the urinary tract was made on the basis of urinary tract ultrasonography, and kidney-ureter-bladder radiography (KUB) /intravenous urography (IVU), urine culture and chemical analysis of stone with patients who had a spontaneous emission of stone or following some of the methods for active removal of stone; with some patients non-contrast (NCCT) was carried out too. All patients were subjected to the laboratory analysis of the serum level of acidum uricum and parathormone.Results.With observed 120 patients suffering from calcium urolithiasis, who belonged to adult population, no patient had an elevated value of parathormone, while three patients (2.5%) had the values of acidum uricum higher than the reference values. The average value (for both parameters) was the lowest with the youngest patients and vice versa, and only in the group of 40 to 60 years of age there were patients whose values of the acidum uricum parameter was outside the interval of reference values; the other age groups did not have such values. Based on the analysis of the variance, as a statistical method, it was determined that the average values of acidum uricum in different age groups were statistically significantly different, which is not the case for the parameter parathormone. (p>0,05).Conclusion.The biggest number of nephrolithiasis is not a consequence of elevated values of parathormone. Hyperuricosemia may be present with calcium urolithiasis, without participation in forming kidney stones, most probably as an indirect sign of the existence of the initial insulin resistance and metabolic disease.

Prevalence of osteoporosis in patients with nephrolithiasis and vice versa: a cumulative analysis

“…A parathyroid-independent pathologic process may cause bone Ca efflux. Excess PTH levels induce additional loss of calcium in the sufferers, which leads to the formation of calcium stones ( 50 , 51 ). In individuals with hyperparathyroidism, urinary tract stones, and vertebral fractures occur frequently ( 52 ).…”

Correlation of Osteoporosis and Calcium Urolithiasis in Adult Population

“…In particular, rapid bone loss occurs in the elderly, especially women in menopause and an additional problem in this group is a negative balance of calcium, which is doubled during the period of menopause ( 2 ). Excess hormones such as parathyroid hormone and estrogen levels, can result in additional loss of calcium in the elderly population which results in formation of calcium stones in patients ( 3 - 7 ). However, the pathogenic mechanisms and factors that are associated with loss of bone mineral mass and osteoporosis in patients with calcium urolithiasis are not completely understood and are in the clinical testing phase ( 8 - 10 ).…”