Obesity and metabolic evaluation of 24 hour urinary analysis of adult stone formers, a case control study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20163804Keywords:
24 hour urinary analysis, Saleem SM, Stone formers, Urolithiasis and obesityAbstract
Background: Urinary tract stone (Urolithiasis) is a common problem nowadays. Frequencies of urolithiasis vary from region to region: 1-5% in Asia, 5-9% in Europe, 13% in North America. Urolithiasis is believed to be due to imbalance & crystallisation of minerals inside urine, which act as the focus for more sedimentation and finally the formation of a stone within the urinary tract. The comorbidities associated with urinary stones includes: renal colic, urinary tract infection, hydronephrosis, obstruction of the collecting system, renal parenchymal damage which ultimately leads to renal failure and even death. The aim of this study was to assess the relationship between obesity and the metabolic evaluation of 24 hour urinary analysis of stone formers.
Methods: A case-control study was carried out on 70 patients aged ≥20 years with urolithiasis that were without any comorbidities treated between January 2014 to January 2015. We performed 24 hour urinary analysis on urolithiasis patients and classified them as being of low weight (body mass index; BMI: <18.5, 8 men, 5 women), normal weight (BMI: 18.5-24.9, 19 men, 7 women), overweight (BMI: 25-29.9, 30 men, 12 women) or obese (BMI≥30, 12 men, 7 women).140 healthy normal weight sex and age-matched controls were also included in the study in the ratio of 1:2.
Results: There was a statistically significant difference in the prevalence of obesity between the urolithiasis group and the control group (p<0.05).The correlation analysis revealed a significant positive relationship between BMI and the serum calcium, uric acid, urinary calcium, uric acid and citrate, and there was an inverse relationship between BMI and urinary pH (p<0.05). The frequency of urinary stone risk factors was increased with BMI (p<0.05).
Conclusions: The positive relationship between Obesity and the risk factors for urolithiasis was evident from this study. To understand the mechanism of urolithiasis in obese patient’s further research is required.
References
Saleem SM, Raina AF, Khan MSS, Jan SS. Epidemological characteristics of urolithiasis in Kashmir division and relation to source of water. Int J Cur Res. 2015;7(12):24450-3.
Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT. Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int. 1979;16:624-31.
Curhan GC. Epidemiology of stone disease. Urol Clin North Am. 2007;34:287-93.
Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int. 2003;63:1817- 23.
Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. 1993;328:833-8.
Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 1996;155:839-43.
Robertson WG, Peacock M, Hodgkinson A. Dietary changes and the incidence of urinary calculi in the U.K. between 1958 and 1976. J Chronic Dis 1979;32:469-76.
Atan L, Andreoni C, Ortiz V, Silva EK, Pitta R, Atan F, et al. High kidney stone risk in men working in steel industry at hot temperatures. Urology. 2005;65:858-61.
Curhan GC, Willett WC, Rimm EB, Stampfer MJ. Family history and risk of kidney stones. J Am Soc Nephrol. 1997;8:1568-73.
Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT. Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int. 1979;16:624-31.
Hiatt RA, Dales LG, Friedman GD, Hunkeler EM. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol. 1982;115:255-65.
Curhan GC. Epidemiology of stone disease. Urol Clin North Am. 2007;34:287-93.
Kumar R, Kapoor R, Mittal B, Kumar A, Mittal RD. Evaluation ofurinary abnormalities in urolithiasis patients: A study from north India. Ind J Clin Biochem. 2003;18(2):209-15.
Mittal RD, Kumar R, Mitall B, Prasad R, Bhandari M. Stone composition,metabolic profile and presence of the gut-inhabiting bacterium oxalobacterformigenes as risk factors for renal stone formation. Med PrincPract. 2003;12:208-13.
Curhan GC, Willett C, Speizer FE, Stampler MJ. Twenty-four-hour urinechemistries and the risk of kidney stones among women and men. Kidney int. 2001;59(6)2290-8.
Curhan GC, Taylor EN. 24-h uric acid excretion and the risk of kidney stones. Kidney Int. 2008;73(4):489-96.
Alconcher LF, Castro C, Quintana D, Abt N, Moran L, Gonzalez L, et al. Urinary calcium excretion in healthy school children. Pediatr Nephrol. 1997;11:186-8.
Pak CY, Britton F, Peterson R, Ward D, Northcutt C, Breslau NA, et al. Ambulatory evaluation of nephrolithiasis. Classification, clinical presentation and diagnostic criteria. Am J Med. 1980;69:19-30.
Esen T, Akinci M, Tellaloglu S, Kocak T. Role of inhibitor deficiency onurolithiasis. EurUrol. 1991;19:244-8.
Semins MJ, Shore AD, Makary MA, Magnuson T, Johns R, Matlaga BR. The association of increasing bodymass index and kidney stone disease. J Urol. 2010;183:571-5.
Chou YH, Su CM, Li CC, Liu CC, LiuME, Wu WJ, et al. Difference in urinary stone components between obese and nonobese patients. Urol Res. 2011;39:283-7.
Negri AL, Spivacow FR, Del Valle EE, Forrester M, Rosende G, Pinduli I. Role of overweight and obesity on the urinary excretion of promoters and inhibitors of stone formation in stone formers. Urol Res. 2008;36:303-7.
Powell CR, Stoller ML, Schwartz BF, Kane C, Gentle DL, Bruce JE, et al. Impact of body weight on urinary electrolytes in urinary stone formers. Urology. 2000;55:825-30.
Taylor EN, Curhan GC. Body size and 24-hour urine composition. Am J Kidney Dis. 2006;48:905-15.
