Body Size and 24-Hour Urine Composition

Taylor, Eric N.; Curhan, Gary C.

doi:10.1053/j.ajkd.2006.09.004

Cited by 286 publications

(207 citation statements)

References 26 publications

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“…Previous reports have shown an inverse correlation between body weight and urine pH in kidney stone-forming (21) and nonstone-forming individuals (14). Similarly, a recent report found an inverse relation between BMI and urine pH among stone formers and non-stone formers (22). Our study confirms these finding because a higher BMI, a surrogate of abdominal obesity, was associated with more acidic urine.…”

Section: Discussionsupporting

confidence: 82%

Low Urine pH

Maalouf

Cameron

Moe

et al. 2007

Clinical Journal of the American Society of Nephrology

253

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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Section: Discussionsupporting

confidence: 82%

Low Urine pH

Maalouf

Cameron

Moe

et al. 2007

Clinical Journal of the American Society of Nephrology

253

180

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“…Maalouf et al have reported a linear decrease in urine pH with an increasing weight in stone formers (12). Taylor has also reported an inverse relationship between BMI and urine pH (13). These facts seem to be in direct conflict with the better dissolution rates seen in patients with lower weight in our study.…”

Section: Discussioncontrasting

confidence: 57%

Results of urinary dissolution therapy for radiolucent calculi

Sinha¹,

Prabhu²,

Venkatesh³

et al. 2013

Int. braz j urol.

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Purpose: In this paper we present our experience with dissolution therapy of radiolucent calculi. Materials and Methods:This was a retrospective analysis of patients who were offered urinary dissolution therapy between January 2010 and June 2011. Patients were treated with tablets containing potassium citrate and magnesium oxide. Partial dissolution was defined as at least a 50% reduction in stone size. Patients with complete or partial dissolution were classified in the successful dissolution group. Patients with no change, inadequate reduction, increase in stone size and those unable to tolerate alkali therapy were classified as failures. Patient sex, stenting before alkalinization, stone size, urine pH at presentation and serum uric acid levels were analyzed using Fisher t-test for an association with successful dissolution. Results: Out of 67, 48 patients reported for follow up. 10 (15%) had complete dissolution and 13 (19%) had partial dissolution. Alkalinization was unsuccessful in achieving dissolution in 25 (37%). Stenting before alkalinization, patient weight (< 60 vs. > 75kg) and serum uric acid levels (≤ 6 vs. > 6) were the only factors to significantly affected dissolution rates (p = 0.039, p 0.035, p 0.01 respectively). Conclusions: A policy of offering dissolution therapy to patients with radiolucent calculi had a successful outcome in 34% of patients.

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“…1. About sodium intake, it is well known that diets high in sodium expose renal stone patients, especially if overweight and hypercalciuric, to an increase in urinary calcium excretion (Taylor 2006 prospective study, evidence L) (16) which may increase the lithogenic risk and the risk to develop hypertension and bone demineralization. However, it should be considered that the elderly patient is particularly sensitive to sodium intake from a hemodynamic point of view.…”

Section: Dietmentioning

confidence: 99%

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group

Prezioso

Strazzullo

Lotti

et al. 2015

Arch Ital Urol Androl

158

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Objective: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease. Materials and Methods: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori. Studies were screened by titles and abstracts for eligibility. Data were extracted using a standardized form and the quality of evidence was assessed. Results: Evidence from the selected studies were used to form evidencebased guideline statements. In the absence of sufficient evidence, additional statements were developed as expert opinions. Conclusions: General measures: Each patient with nephrolithiasis should undertake appropriate evaluation according to the knowledge of the calculus composition. Regardless of the underlying cause of the stone disease, a mainstay of conservative management is the forced increase in fluid intake to achieve a daily urine output of 2 liters. Hypercalciuria: Dietary calcium restriction is not recommended for stone formers with nephrolithiasis. Diets with a calcium content ≥ 1 g/day (and low protein-low sodium) could be protective against the risk of stone formation in hypercalciuric stone forming adults. Moderate dietary salt restriction is useful in limiting urinary calcium excretion and thus may be helpful for primary and secondary prevention of nephrolithiasis. A low-normal protein intake decrease calciuria and could be useful in stone prevention and preservation of bone mass. Omega-3 fatty acids and bran of different origin decreases calciuria, but their impact on the urinary stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. Hyperoxaluria: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults) reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. Hyperuricosuria: In patients with renal calcium stones SummaryNo conflict of interest declared. DOI: 10.4081/aiua.2015.2.105the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not cle...

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Body Size and 24-Hour Urine Composition

Cited by 286 publications

References 26 publications

Low Urine pH

Low Urine pH

Results of urinary dissolution therapy for radiolucent calculi

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group

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