Stress und Urolithiasis

Abstract

Stress is a response state of the body which may be evoked by various stimuli. The effect of such stress factors on the quantitative composition of 24-hour urine in young male Wistar rats is examined using short, repetitive, weak electric impulses. Changes in body development and, in particular, of the absolute and relative increases in size and weight of the adrenal glands compared with control groups are used as evidence of the endured stress procedure. Three 24-hour urine groups can be clearly distinguished. While concentrations of calcium and sodium remain unaltered by the adaptation syndrome of the body, the concentrations of potassium and magnesium are clearly reduced during the first days of the stress period compared with the control group. Inorganic phosphorus and uric acid concentrations, however, are markedly increased during the experimental period. The combination of increased uric acid and inorganic phosphorus concentrations and reduced potassium and magnesium levels favors a disposition to urolithiasis since uric acid and inorganic phosphorus are recognized promoters, and potassium and magnesium are known inhibitors, of stone formation.

Stressful life events and risk of symptomatic kidney stones

“…If stress does indeed promote symptomatic kidney stones, there are some biologically plausible mechanisms. 4,5,9,13,14 Our results are impressive enough to warrant additional investigations. Stress has been implicated as an important factor in coronary heart disease and a variety of other illnesses.…”

“…This case-control study provided no support for the belief that the risk of symptomatic kidney stones is higher among a more affluent socioeconomic group or people with higher consumption of meat and/or calcium from dietary sources or with lower consumption of alcohol. 1,4,[6][7][8]12 On the contrary, the annual family income of the cases was significantly (P Ͻ 0.006) lower than controls. Our findings contrast with what might be expected in that kidney stones are more common in industrial countries where there is greater consumption of protein and dietary calcium.…”

“…13 Human studies of 24-hour urine specimens showed that lithogenic urinary constituents (calcium, oxalate and uric acid) have peak concentrations within a 24-hour period after an individual is subjected to stress. 4,5,13 In stressful conditions the neurologically triggered 'fight-or-flight' response stimulates neurosecretory cells in the supraoptic and paraventricular nuclei of the hypothalamus resulting in secretion of several hormones, including vasopressin, that cause hypertonic urine and a decrease in urine volume. 5 Adrenocorticotropic hormone (ACTH) is secreted by the anterior hypophysis in response to stress.…”

“…5 Stressful lifestyles have been shown to increase lithogenic urinary constituents (calcium, oxalate and uric acid), with peak concentrations occurring within a 24-hour period after an individual is subject to stress. 4,5 Based on these reports, we undertook this exploratory study to test the hypothesis that there is an association between stressful life events(s) and symptomatic kidney stones. To our knowledge such a study has not been reported in the medical literature.…”

Clinical Significance of Stone Analysis

“…2); this is due to the increasing liberation of the social situation of women. Next to nutrition the regular stress situations that come with a working life are one of the main reasons for the formation of uri nary stones [10]. Specific metaphylaxis therefore should be practiced, especially since it is well known that stone analysis and laboratory examinations of se rum and 24-hour urine allow a distinct improvement of the recurrence rate.…”