Diabetes mellitus and the risk of nephrolithiasis

Taylor, Eric N.; Stampfer, Meir J.; Curhan, Gary C.

doi:10.1111/j.1523-1755.2005.00516.x

Cited by 472 publications

(321 citation statements)

References 31 publications

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“…However, also for patients, a more specific insight into the potential influence of body composition on urinary pH is required, especially concerning the contribution of increasing insulin resistance which is closely associated with the severity of obesity (Garca-Estevez et al, 2004;Taylor et al, 2005a). Overall, the findings in patients with nephrolithiasis and our findings in healthy young adults and elderly underline that increased adiposity may be involved in urine pH decrease.…”

Section: Discussionmentioning

confidence: 59%

“…A corresponding inverse relationship between adiposity indices (BMI or weight) and urinary pH has been suggested for patients especially with kidney stones (Maalouf et al, 2004;Siener et al, 2004), but not yet for healthy subjects. Whether lower urinary pH values in more obese subjects represent one mechanism explaining their increased risk for urolithiasis (Curhan et al, 1998;Siener et al, 2004;Taylor et al, 2005b) and whether insulin resistance is involved (Taylor et al, 2005a), is currently under discussion and needs further research. Protein intake is a known confounder of urinary creatinine excretion (Gibson, 1990;Neubert and Remer, 1998) and therefore has to be controlled for, if creatinine's specific muscularity contribution is to be investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Both obesity itself and diabetes mellitus type 2 are associated with increased kidney stones (Taylor et al, 2005a, b). Although the underlying pathophysiological mechanisms are not still clear (Taylor et al, 2005a) evidence increases for an inverse relationship between urinary pH and adiposity in patients with kidney stones (Maalouf et al, 2004;Siener et al, 2004). Whether this relationship is also seen in health needs research.…”

Section: Introductionmentioning

confidence: 99%

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Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

Berkemeyer

Rylander

Vormann³

2006

Eur J Clin Nutr

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Objective: In patients with nephrolithiasis, an inverse relationship between 24-h urinary pH (24h-UpH) and body weight has been reported. Whether body composition indices and 24h-UpH are similarly associated in healthy subjects needs investigation. Design: Cross-sectional, retrospective analysis. Setting: Dortmund, Germany and Gothenburg, Sweden. Subjects: Healthy young adults (18-23 years; n ¼ 117) and elderly (55-75years; n ¼ 85) having a mean body mass index (BMI) of 22.8073.4 and 25.373.9 kg/m 2 , respectively. Methods: Anthropometric data, 24h-UpH, and 24-h urinary excretion rates of net acid (NAE), creatinine, and urea were determined. After adjusting for urea (reflecting protein intake), renal creatinine output was used as a biochemical marker for muscularity. The BMI served as a marker of adiposity. Results: NAE, body weight, and BMI were significantly (Po0.05) higher, and height and creatinine significantly lower in the elderly, whereas body-surface area (BSA) was not different.Step-wise multiple regression analysis using BSA-corrected urinary variables revealed NAE as the primary predictor of 24h-UpH (with R 2 values of 0.64 and 0.68 in young adults and elderly, respectively, Po0.0001), followed by urea (Po0.0001), creatinine (Po0.05), and BMI (Po0.05 for the young adults and P ¼ 0.12 for the elderly). These associations were negative for NAE and BMI, and positive for urea and creatinine. Conclusions: Muscularity (i.e. creatinine adjusted for urea) and particularly in the group of young adults, adiposity (i.e. BMI) proved to be modest, but significant predictors of 24h-UpH. Future research should focus on more obese subjects in whom insulin resistance and particular kidney functions should also be examined to further substantiate the role of obesity in low-urine pH-associated conditions, for example, nephrolithiasis.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

Berkemeyer

Rylander

Vormann³

2006

Eur J Clin Nutr

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“…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%

Metabolic Basis for Low Urine pH in Type 2 Diabetes

Maalouf

Cameron

Moe³

et al. 2010

Clinical Journal of the American Society of Nephrology

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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“…Diets richer in protein and sodium may lead to a more acidic urine and decrease in urinary citrate, also contributing to kidney stone risk. The insulin resistance characteristic of obesity may also predispose to nephrolithiasis [51] through its impact on tubular Na-H exchanger [52] and ammoniagenesis [53], and the promotion of an acidic milieu [54]. Complicating the picture is the fact that some weight loss therapies result in a worsening, rather than an improvement in the risk for kidney stone formation; e.g.…”

Section: Mechanisms Of Action Underlying the Renal Effects Of Obesitymentioning

confidence: 99%

Obesity and kidney disease: hidden consequences of the epidemic

2017

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Diabetes mellitus and the risk of nephrolithiasis

Abstract: DM is a risk factor for the development of kidney stones. Additional studies are needed to determine if the increased risk of DM in stone formers is due to subclinical insulin resistance.

Cited by 472 publications

References 31 publications

Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

Metabolic Basis for Low Urine pH in Type 2 Diabetes

Obesity and kidney disease: hidden consequences of the epidemic

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