Impact of body weight on urinary electrolytes in urinary stone formers

Powell, Curt R.; Stoller, Marshall L.; Schwartz, Bradley F.; Kane, Christopher J.; Gentle, Donald L.; Bruce, Jeremy E.; Leslie, Stephen

doi:10.1016/s0090-4295(99)00617-2

Cited by 190 publications

(114 citation statements)

References 22 publications

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“…These characteristics are components of the metabolic syndrome, a condition that is attributed to lifestyle factors (39). We also observed an increase in urinary oxalate excretion, and others have shown that both urinary UA and oxalate are positively associated with obesity (4,40,41). These findings in conjunction with the negative familial aggregation results underscore the importance of environmental factors in these individuals, with hyperuricosuria being the common link for hypertension, obesity, diabetes, and possibly hyperoxaluria.…”

Section: Discussionsupporting

confidence: 77%

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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Section: Discussionsupporting

confidence: 77%

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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“…23 Obesity is associated with increased urinary calcium and oxalate excretions leading to calcium oxalate crystallization. 24 In addition, obesity-related insulin resistance can limit renal ammoniagenesis and subsequently cause acidic urine, resulting in higher risk of uric acid stone formation. 25 Bariatric surgery has been shown to be an effective treatment for weight loss.…”

Section: Discussionmentioning

confidence: 99%

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

et al. 2016

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Background With rising prevalence of morbid obesity, the number of bariatric surgeries performed each year has been increasing worldwide. The objective of this meta-analysis was to assess the risk of kidney stones following bariatric surgery. Methods A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through July 2015. Only studies reporting relative risks, odd ratios or hazard ratios (HRs) to compare risk of kidney stones in patients who underwent bariatric surgery versus no surgery were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results Four studies (One randomized controlled trial and three cohort studies) with 11,348 patients were included in analysis to assess the risk of kidney stones following bariatric surgery. The pooled RR of kidney stones in patients undergoing bariatric surgery was 1.22 (95% CI, 0.63-2.35). The type of bariatric surgery subgroup analysis demonstrated an increased risk of kidney stones in patients following Roux-en-Y gastric bypass (RYGB) with the pooled RR of 1.73 (95% CI, 1.30-2.30) and a decreased risk of kidney stones in patients following restrictive procedures including laparoscopic banding or sleeve gastrectomy with the pooled RR of 0.37 (95% CI, 0.16-0.85). Conclusions Our meta-analysis demonstrates an association between RYGB and increased risk of kidney stones. Restrictive bariatric surgery, on the other hand, may decrease kidney stone risk. Future study with long-term follow-up data is needed to confirm this potential benefit of restrictive bariatric surgery.

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“…The parallel growth in prevalence of obesity and morbid obesity over the past decades has increased the management of stone disease in this population (12,13). The association between urolithiasis and obesity is established in the literature and has shown that weight gain increases the urinary excretion of substances such as oxalate and uric acid, leading to stone formation (14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients

et al. 2013

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Purpose: The purpose of this study is to determine if body mass index (BMI) and stone skin distance (SSD) affect stone free rate (SFR) in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm. Materials and Methods: A retrospective chart review was performed of consecutive patients that underwent flexible URS. Inclusion criteria were: proximal ureteral stones and renal stones less than 20 mm in the preoperative computed tomography (CT). SFR were then compared according to SSD and BMI. Results: A total of 153 patients were eligible for this analysis, 49 (32.02%) with SSD < 10 cm and 104 (67.97%) with SSD ≥ 10 cm. The mean stone size was 10.5 ± 6.4 mm. The overall SFR in our study was 82.4%. The SFR for the SSD < 10 and ≥ 10 were 79.6% and 83.7% respectively (p = 0.698) and for BMI < 30, ≥ 30 and < 40 and ≥ 40 were 82.9%, 81.7% and 90.9% respectively. Regression analysis showed no affect between BMI or SSD regarding SFR. Conclusion: Ureteroscopy should be considered as a first-line of treatment for renal/proximal stones in obese and morbid obese patients. URS may be preferable to SWL in obese patients independently of the SSD, BMI or the location of proximal stones. INTRODuCTIONThe ideal treatment for proximal ureteral and renal stones has become controversial, with the noninvasive nature of shock wave lithotripsy (SWL) and the expansion of endoscopic digital technology. The 2007 update of the EAU/AUA ureteral stone guidelines (1) showed that both ureteroscopy (URS) and SWL should be considered first-line therapy for proximal ureteral stones, as opposed to just SWL as previously reported. On the other hand SWL has emerged as the primary treatment of choice for renal calculi less than 1.5-2 cm (2).In that context, the treatment of urolithiasis in obese patients has gained more importance in the last years since obesity rates have increased markedly since 1980 in the United States (3). Data from the national Center for Health Statistics (2009Statistics ( -2010 showed that 35.7% of adults and 17% of children and adolescents in the United States were obese (4). According to the World Health Organization guidelines, a body mass index (BMI) of 18.5 to 25 kg/m 2 is considered normal, overweight is a BMI of 25 to Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients _______________________________________________

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Impact of body weight on urinary electrolytes in urinary stone formers

Cited by 190 publications

References 22 publications

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

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

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients

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