Essential arterial hypertension and stone disease

Borghi, Loris; Meschi, Tiziana; Guerra, Angela; Briganti, Angelo; Schianchi, Tania; Allegri, Franca; Novarini, A

doi:10.1046/j.1523-1755.1999.00483.x

Cited by 165 publications

(113 citation statements)

References 78 publications

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“…Human epidemiologic studies have demonstrated an association between hypertension and kidney stones (42)(43)(44). Moreover hypercalciuria, a common risk factor for nephrolithiasis, has also been associated with high BP in humans (45)(46)(47), implicating altered calcium metabolism as a common feature.…”

Section: Discussionmentioning

confidence: 99%

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Lieske

Turner

Edeh

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Kidney stones and their risk factors aggregate in families, yet few studies have systematically estimated heritabilities and genetic correlations of the numerous urinary traits associated with risk of kidney stones.Design, setting, participants, & measurements Twenty-four-hour urine samples were collected from the Genetic Epidemiology Network of Arteriopathy cohort of families in Rochester, Minnesota, to measure urinary determinants of supersaturation. Diet was assessed using the Viocare food frequency questionnaire. Heritabilities and genetic correlations among the urinary traits were estimated using variance components methods.Results Samples were available from 811 individuals (344 men, 467 women; mean age 6669 years). Age, sex, and weight were significantly correlated with the majority of urinary traits. Many urine excretions (calcium, magnesium, citrate excretion) had strong evidence for heritability (P,0.01) both before and after adjusting for the identified covariates. Among significantly heritable urinary traits, genetic factors explained 20%-36% of interindividual variation after adjustment for covariates. Urinary calcium excretion was significantly genetically correlated with urinary magnesium and with urinary citrate excretion (P,0.05). Although eGFR influenced many urinary traits, controlling for eGFR did not greatly affect estimated heritabilities.Conclusions Evidence from this cohort suggests a strong heritable component to many urinary nephrolithiasis risk factors. Further study of genetic influences on urinary traits relevant for kidney stone pathogenesis is warranted.Clin J Am Soc Nephrol 9: 943-950, 2014.

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Section: Discussionmentioning

confidence: 99%

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Lieske

Turner

Edeh

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Several previous studies showed that hypertensive patients, particularly those who are salt sensitive, excrete a greater amount of Ca 2ϩ compared with control subjects (1,2,28,29) and that normotensive offspring of hypertensive patients show disturbances in Ca 2ϩ metabolism (9,10). Our findings extend these earlier observations by directly linking hypertension to Ca 2ϩ excretion in families.…”

Section: Discussionmentioning

confidence: 99%

“…isturbances in calcium (Ca 2ϩ ) metabolism have been reported in hypertension (1,2), obesity (1,3), and kidney stone disease (KSD) (4,5), and there are strong associations among these conditions (6 -8). Normotensive offspring of hypertensive patients also have disturbed Ca 2ϩ metabolism, suggesting a possible genetic basis for these abnormalities (9,10).…”

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confidence: 99%

High Urinary Calcium Excretion and Genetic Susceptibility to Hypertension and Kidney Stone Disease

Mente¹,

Honey²,

Bull³

et al. 2006

Journal of the American Society of Nephrology

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Increased urinary calcium excretion commonly is found in patients with hypertension and kidney stone disease (KSD). This study investigated the aggregation of hypertension and KSD in families of patients with KSD and hypercalciuria and explored whether obesity, excessive weight gain, and diabetes, commonly related conditions, also aggregate in these families. Consecutive patients with KSD, aged 18 to 50 yr, were recruited from a population-based Kidney Stone Center, and a 24-h urine sample was collected. The first-degree relatives of eligible patients (n ‫؍‬ 333) and their spouse were interviewed by telephone to collect demographic and health information. Familial aggregation was assessed using generalized estimating equations. Multivariate-adjusted odds ratios (OR) revealed significant associations between hypercalciuria in patients and hypertension (OR 2.9; 95% confidence interval 1.4 to 6.2) and KSD (OR 1.9; 95% confidence interval 1.03 to 3.5) in first-degree relatives, specifically in siblings. No significant associations were found in parents or spouses or in patients with hyperuricosuria. Similarly, no aggregation with other conditions was observed. In an independent study of siblings of hypercalciuric patients with KSD, the adjusted mean fasting urinary calcium/creatinine ratio was significantly higher in the hypertensive siblings compared with normotensive siblings (0.60 ؎ 0.32 versus 0.46 ؎ 0.28 mmol/mmol; P < 0.05), and both sibling groups had significantly higher values than the unselected study participants (P < 0.001). Urinary sodium/creatinine and uric acid/ creatinine ratios were not different among the groups. Although an environmental effect cannot be excluded fully, our findings suggest that the disturbance in calcium metabolism in hypertension and KSD has a genetic basis.

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“…However, whether an NAE-adjusted 24-h urinary pH does actually correlate with adiposity can only be proved if biochemically analyzed NAE is used instead of excretion parameters as sulfate because a high protein intake and consequently high sulfate excretion does not automatically result in a high NAE (Sebastian et al, 2002;. In principle, an independent role of obesity in influencing the 24h-UpH may be of pathophysiological importance as the increased prevalence of kidney stones in obese subjects (Curhan et al, 1998;Borghi et al, 1999;Siener et al, 2004;Taylor et al, 2005b) could have been caused at least partly by an obesityrelated urine pH decrease (Maalouf et al, 2004). Kidney stones, especially idiopathic uric acid nephrolithiasis (Maalouf et al, 2004;Alvarez-Nemegyei et al, 2005), are usually associated with low urine pHs.…”

Section: Introductionmentioning

confidence: 99%

“…Kidney stones, especially idiopathic uric acid nephrolithiasis (Maalouf et al, 2004;Alvarez-Nemegyei et al, 2005), are usually associated with low urine pHs. However, research on linkages between urinary pH and anthropometrics has so far been mainly conducted in patients with nephrolithiasis (Borghi et al, 1999;Maalouf et al, 2004;Siener et al, 2004). Such a possible linkage between the urinary pH and obesity needs further investigation.…”

Section: Introductionmentioning

confidence: 99%

Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

Berkemeyer

Rylander

Vormann³

2006

Eur J Clin Nutr

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Objective: In patients with nephrolithiasis, an inverse relationship between 24-h urinary pH (24h-UpH) and body weight has been reported. Whether body composition indices and 24h-UpH are similarly associated in healthy subjects needs investigation. Design: Cross-sectional, retrospective analysis. Setting: Dortmund, Germany and Gothenburg, Sweden. Subjects: Healthy young adults (18-23 years; n ¼ 117) and elderly (55-75years; n ¼ 85) having a mean body mass index (BMI) of 22.8073.4 and 25.373.9 kg/m 2 , respectively. Methods: Anthropometric data, 24h-UpH, and 24-h urinary excretion rates of net acid (NAE), creatinine, and urea were determined. After adjusting for urea (reflecting protein intake), renal creatinine output was used as a biochemical marker for muscularity. The BMI served as a marker of adiposity. Results: NAE, body weight, and BMI were significantly (Po0.05) higher, and height and creatinine significantly lower in the elderly, whereas body-surface area (BSA) was not different.Step-wise multiple regression analysis using BSA-corrected urinary variables revealed NAE as the primary predictor of 24h-UpH (with R 2 values of 0.64 and 0.68 in young adults and elderly, respectively, Po0.0001), followed by urea (Po0.0001), creatinine (Po0.05), and BMI (Po0.05 for the young adults and P ¼ 0.12 for the elderly). These associations were negative for NAE and BMI, and positive for urea and creatinine. Conclusions: Muscularity (i.e. creatinine adjusted for urea) and particularly in the group of young adults, adiposity (i.e. BMI) proved to be modest, but significant predictors of 24h-UpH. Future research should focus on more obese subjects in whom insulin resistance and particular kidney functions should also be examined to further substantiate the role of obesity in low-urine pH-associated conditions, for example, nephrolithiasis.

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Essential arterial hypertension and stone disease

Cited by 165 publications

References 78 publications

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Heritability of Urinary Traits That Contribute to Nephrolithiasis

High Urinary Calcium Excretion and Genetic Susceptibility to Hypertension and Kidney Stone Disease

Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly

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