Biochemical profile of idiopathic uric acid nephrolithiasis

Pak, Charles Y.C.; Sakhaee, Khashayar; Peterson, Roy D.; Poindexter, John R.; Frawley, William H.

doi:10.1046/j.1523-1755.2001.060002757.x

Cited by 152 publications

(100 citation statements)

References 10 publications

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“…A limitation of this report was the small number of UASF included. However, the biochemical characteristics of UASF from this study are consistent with findings from previous reports (7,8,11).…”

Section: Discussionsupporting

confidence: 92%

“…This acidic urinary environment promotes the precipitation of poorly soluble uric acid, leading to stone formation. The two other risk factors that predispose to uric acid nephrolithiasis are low urine volume and hyperuricosuria, although the latter is an uncommon finding in idiopathic UASF (7). The urine volume and uric acid excretion in patients with type 2 diabetes did not differ from NV, but urine pH was markedly lower.…”

Section: Discussionmentioning

confidence: 89%

“…study to examine urinary biochemical characteristics in nonstone-forming patients with type 2 diabetes. The primary risk factor identified in patients with type 2 diabetes was a low urine pH, a typical finding in uric acid nephrolithiasis (7). This feature seems to be shared between UASF and some patients with type 2 diabetes, suggesting a common underlying pathophysiologic abnormality.…”

Section: Discussionmentioning

confidence: 89%

“…A low urine pH is the predominant metabolic abnormality in uric acid stone disease (7,8). At a urine pH Ͻ5.5, uric acid is sparingly soluble and will precipitate at concentrations Ͼ200 mg/L (9).…”

mentioning

confidence: 99%

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Urine Composition in Type 2 Diabetes

Cameron¹,

Maalouf²,

Adams‐Huet³

et al. 2006

Journal of the American Society of Nephrology

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202

162

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Type 2 diabetes is a risk factor for nephrolithiasis in general and has been associated with uric acid stones in particular. The purpose of this study was to identify the metabolic features that place patients with type 2 diabetes at increased risk for uric acid nephrolithiasis. Three groups of individuals were recruited for this outpatient study: Patients who have type 2 diabetes and are not stone formers (n ‫؍‬ 24), patients who do not have diabetes and are uric acid stone formers (UASF; n ‫؍‬ 8), and normal volunteers (NV; n ‫؍‬ 59). Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Twenty-four-hour urine volume and total uric acid did not differ among the three groups. Patients with type 2 diabetes and UASF had lower 24-h urine pH than NV. Urine pH inversely correlated with both body weight and 24-h urine sulfate in all groups. Urine pH remained significantly lower in patients with type 2 diabetes and UASF than NV after adjustment for weight and urine sulfate (P < 0.01). For a given urine sulfate, urine net acid excretion tended to be higher in patients with type 2 diabetes versus NV. With increasing urine sulfate, NV and patients with type 2 diabetes had a similar rise in urine ammonium, whereas in UASF, ammonium excretion remained unchanged. The main risk factor for uric acid nephrolithiasis in patients with type 2 diabetes is a low urine pH. Higher body mass and increased acid intake can contribute to but cannot entirely account for the lower urine pH in patients with type 2 diabetes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 99%

See 2 more Smart Citations

Urine Composition in Type 2 Diabetes

Cameron¹,

Maalouf²,

Adams‐Huet³

et al. 2006

Journal of the American Society of Nephrology

Self Cite

202

162

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“…As urine pH exceeds this value, an increasing proportion of uric acid exists in the form of its base, urate, which is relatively soluble. Therefore, urine pH is the principal determinant of uric acid precipitation, and, in fact, an overly acidic urine is the primary pathogenic finding in uric acid stone formers (24). Our findings suggest that the presence of increasing number of MS features augments the propensity for uric acid stone formation.…”

Section: Discussionmentioning

confidence: 65%

Low Urine pH

Maalouf

Cameron

Moe

et al. 2007

Clinical Journal of the American Society of Nephrology

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252

180

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Background and Objectives: The metabolic syndrome is associated with alterations in renal function. An overly acidic urine has been described as a renal manifestation of the metabolic syndrome in patients with kidney stone disease. This study examined the association between the metabolic syndrome and urine pH in individuals without a history of nephrolithiasis.Design, Setting, Participants, & Measurements: A total of 148 adults who were free of kidney stones were evaluated in this outpatient cross-sectional study. Height, weight, BP, fasting blood, and 24-h urine chemistries were obtained. Urine pH was measured by pH electrode. The following features of the metabolic syndrome were evaluated: BP; body mass index; and serum triglyceride, glucose, and HDL cholesterol concentrations. The degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance.Results: Participants with the metabolic syndrome had a significantly lower 24-h urine pH compared with participants without the metabolic syndrome. Mean 24-h urine pH, adjusted for age, gender, creatinine clearance, and 24-h urine sulfate, decreased from 6.15, 6.10, 5.99, 5.85, to 5.69 with increasing number of metabolic syndrome abnormalities. An association was observed between 24-h urine pH and each metabolic feature. After adjustment for age, gender, creatinine clearance, urine sulfate, and body mass index, a significant inverse relationship was noted between 24-h urine pH and the degree of insulin resistance.Conclusions: An unduly acidic urine is a feature of the metabolic syndrome and is associated with the degree of insulin resistance.

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Uric Acid Stones

Maalouf¹

2014

Urinary Stones

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Biochemical profile of idiopathic uric acid nephrolithiasis

Cited by 152 publications

References 10 publications

Urine Composition in Type 2 Diabetes

Urine Composition in Type 2 Diabetes

Low Urine pH

Uric Acid Stones

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