Dependence of urine composition on the age and sex of healthy subjects

Hesse, Albrecht; Classen, Alexander; Knöll, Martin; Timmermann, Friedhelm; Vahlensieck, W.

doi:10.1016/0009-8981(86)90126-9

Cited by 60 publications

(39 citation statements)

References 8 publications

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“…Here also, insulin resistance may be a contributing factor. Indeed, older individuals have been shown to exhibit a reduced ammoniagenesis, resulting in low urine pH (39,40). This alteration in tubular function is likely to result from the age-associated decline in mitochondrial function, which induces insulin resistance (41).…”

Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes Increases the Risk for Uric Acid Stones

Daudon¹,

Traxer²,

Conort³

et al. 2006

Journal of the American Society of Nephrology

267

174

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An increased prevalence of nephrolithiasis has been reported in patients with diabetes. Because insulin resistance, characteristic of the metabolic syndrome and type 2 diabetes, results in lower urine pH through impaired kidney ammoniagenesis and because a low urine pH is the main factor of uric acid (UA) stone formation, it was hypothesized that type 2 diabetes should favor the formation of UA stones. Therefore, the distribution of the main stone components was analyzed in a series of 2464 calculi from 272 (11%) patients with type 2 diabetes and 2192 without type 2 diabetes. The proportion of UA stones was 35.7% in patients with type 2 diabetes and 11.3% in patients without type 2 diabetes (P < 0.0001). Reciprocally, the proportion of patients with type 2 diabetes was significantly higher among UA than among calcium stone formers (27.8 versus 6.9%; P < 0.0001). Stepwise regression analysis identified type 2 diabetes as the strongest factor that was independently associated with the risk for UA stones (odds ratio 6.9; 95% confidence interval 5.5 to 8.8). The proper influence of type 2 diabetes was the most apparent in women and in patients in the lowest age and body mass index classes. In conclusion, in view of the strong association between type 2 diabetes and UA stone formation, it is proposed that UA nephrolithiasis may be added to the conditions that potentially are associated with insulin resistance. Accordingly, it is suggested that patients with UA stones, especially if overweight, should be screened for the presence of type 2 diabetes or components of the metabolic syndrome. 17: 202617: -203317: , 200617: . doi: 10.1681 I ncidence of urinary stone disease rose considerably in recent decades in all industrialized countries (1,2), as did the incidence of obesity, the metabolic syndrome, and type 2 diabetes (3-6). These epidemiologic changes took place in parallel with marked modifications in dietary habits and lifestyle that occurred in all Western and westernized populations, characterized by a high calorie intake coupled with reduced physical activity (7-9). This temporal parallelism suggested that an association might exist among diabetes, obesity, and urinary stone disease. Two recent studies revealed an increased prevalence of nephrolithiasis in patients with diabetes as compared with patients without diabetes (10,11), but in these studies, the chemical type of nephrolithiasis was not identified. Therefore, it was not defined whether calcium (Ca) or uric acid (UA) stones or both contributed to the increased prevalence of urinary stone disease in patients with diabetes, as alterations in urine biochemistry associated with obesity and type 2 diabetes may favor the formation of UA as well as of Ca stones (12-15). J Am Soc NephrolInsulin resistance, which constitutes the fundamental metabolic disorder that is associated with the metabolic syndrome and type 2 diabetes (16,17), results in defective renal ammoniagenesis and low urine pH (18,19) and therefore may be expected to favor the production of UA ...

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Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes Increases the Risk for Uric Acid Stones

Daudon¹,

Traxer²,

Conort³

et al. 2006

Journal of the American Society of Nephrology

267

174

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“…In this proof-of-concept study, detection of bacterial growth was monitored in filtered sterilized urine from a healthy donor. However, further clinical application of microcalorimetry in UTI diagnosis requires a standardized procedure as urine composition could vary between individuals and also fluctuates in time within the same person [8,9]. Pathologic conditions also might strongly modify urine composition, respectively [10].…”

Section: Introductionmentioning

confidence: 99%

Standardization of isothermal microcalorimetry in urinary tract infection detection by using artificial urine

et al. 2012

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“…The data reported here demonstrates that young men exhibit a higher excretion of lithogenic promoters (calcium, phosphate) and a lower excretion of the lithogenic inhibitor (citrate) than young women, an observation which may explain why young men are more at risk for calculous disease than young women. Hesse et al (1986) from Germany have previously reported that urinary calcium and phosphate were higher while citrate was lower in men compared to women.20 Reduced citrate excretion in men in comparison to women has been reported from elsewhere.z'-zz…”

Section: Discussionmentioning

confidence: 85%

Influence of Sex and Age in the Risk of Urolithiasis—A Biochemical Evaluation in Indian Subjects

Sarada

Satyanarayana

1991

Ann Clin Biochem

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SUMMARY. Urinary lithogenic promoters and inhibitors were estimated in normal Indian men and women of young and old ages to understand the sex difference in the risk of stone disease. Young men displayed increased phosphate excretion and a higher mean calcium (both lithogenic promoters) and lower excretion of citrate (lithogenic inhibitor) compared to women of the same age indicating that young men are more at risk for calculous disease than women. In the older postmenopausal women, there was increased excretion of calcium and magnesium and a lower mean citrate than in the younger women suggesting that oestrogenic activity during reproductive years appears to offer protection against calculogenesis. This study indicates that sex differences exist in the excretion of lithogenic promoters and inhibitors which partly explain the difference in the incidence of urolithiasis between men and women. Additional key phrases: urinanalysis; Iithogenic promoters and inhibitorsEpidemiological studies indicate that many factors like age, sex, industrialization, and socio-economic status influence urolithiasis.' The biochemical basis of the urinary stone disease, however, is not clearly understood. We have reported from this laboratory the incidence of urolithiasis in relation to age and sex: chemical analysis of urinary c a l c~l i~-~ and the relationship between the age of patients with stones and calculus c o m p~s i t i o n .~ The incidence of urolithiasis is much higher in men compared to Further, our findings indicate that the stone disease is higher in men compared to women at each age group and for each category of stones.2 The present study incorporates the data on certain urinary lithogenic promoters and inhibitors in young and old groups of men and women to evaluate biochemically the role of sex and age in the risk of urolithiasis. MATERIALS AND METHODSNormal and healthy young subjects (men n = 33, women n-28; mean age 26 years) and older Correspondence: Dr U Satyanarayana. subjects (men n=24, women n=24; mean ages 60 and 62 years, respectively) were selected for this study. All the older women were postmenopausal and untreated. All subjects were allowed to continue with their regular diet with normal activities. Twenty-four hour urine samples were collected from all subjects. There was no significant difference in the daily urine volumes among the four groups. Urine from each subject was distributed into two vials, one with hydrochloric acid (10 mmol) as preservative and samples were stored at -20 " C until analysed. Except for uric acid, which was estimated in urine samples free of preservative, the other substances were analysed in acid containing samples. Calcium was determined by the ortho-cresolphthalein method as described in Varleyl" and oxalate by Hodgkinson's procedure" while phosphate was estimated by the method described in Wootton and Freeman.12 Uric acid was estimated by the phosphotungstate method.13 Citrate was determined by a colorimetric p r~c e d u r e , '~ magnesium by the titan yellow method15 an...

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Dependence of urine composition on the age and sex of healthy subjects

Cited by 60 publications

References 8 publications

Type 2 Diabetes Increases the Risk for Uric Acid Stones

Type 2 Diabetes Increases the Risk for Uric Acid Stones

Standardization of isothermal microcalorimetry in urinary tract infection detection by using artificial urine

Influence of Sex and Age in the Risk of Urolithiasis—A Biochemical Evaluation in Indian Subjects

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