Metabolic diagnosis in stone formers in relation to body mass index

Abstract

It is known that several metabolic abnormalities that favor stone formation have a strong dependence on environmental and nutritional factors. The incidence and prevalence of kidney stone is increasing while there has been a parallel growth in the overweight/obesity rate, and epidemiologic studies have shown a significant association between overweight/obesity and increased nephrolithiasis risk. The aim of this study was to assess if metabolic abnormalities observed in stone patients differ in relation to their BMI. We evaluated 817 renal stone formers (459 men and 358 woman) in an outpatient setting. They were all studied with a standard protocol (two 24 h urine collections and serum parameters) and classified according to their BMI in normal, overweight and obese and according to age in <50 or >50 year old. In the whole population we found that 58.7% were either overweight or obese: 39.4% (n = 322) were OW and 19.3% (n = 158) were OB. The proportion of overweight was significantly higher among men than women. In women of all ages regardless of BMI, hypercalciuria was the most prevalent diagnosis. Hyperuricosuria increased its prevalence significantly only in overweight and obese women <50 years of age (p < 0.01). Hypercalciuria was the predominant diagnosis in normal weight men of both age groups. Hyperuricosuria was the most frequent abnormality in overweight and obese men followed by gouty diathesis and both increased their prevalence significantly from normal weight to obesity and in both age groups (p < 0.05 and <0.01). We conclude that the only abnormalities that increased their prevalence significantly with increasing BMI were hyperuricosuria and gouty diathesis, the first one in men of all ages and women under 50 years of age, while the second one only in men.

Visceral obesity: A new risk factor for stone disease

“…Del Vella and colleagues found significantly higher obesity rates in men than in women with urolithiasis. 17 Similar conclusions were found by Daudonet and colleauges. 18 As a result, higher BMI in men means that an increased incidence of kidney stones will also increase in men.…”

Short-Term Changes in Algometry, Inclinometry, Stabilometry, and Urinary pH Analysis After a Thoracolumbar Junction Manipulation in Patients with Kidney Stones

“…41 Not surprisingly, the mean scores of BMI were above 25 and therefore can be classified as overweight or obese grade I. 4,42 Spinal manipulation increased trunk flexion at T12-L1 levels in the EG. The mechanical force introduced into the spine during SMT may alter the segmental biomechanics through the release of adhesions, the trapped meniscus or reducing the distortion of the annulus fibrosus.…”

“…Recurrence rates of 50% after 10 years and 75% after 20 years have been reported. 2 The etiological factors of kidney stone formation are complex and diverse and involve genetic, metabolic and environmental risk factors, 3 some of which may be adjustable; 4,5 so that the stone formation usually results from an imbalance between factors that promote urinary crystallization, and those that inhibit crystal formation and growth. 6 The most important data appear to be related to the links between genetic variability and urine calcium excretion and pH, so these risk factors seem to be at the very center of the problem of kidney stone disease.…”

New Insights Into the Pathogenesis of Renal Calculi

“…Using a BMI cutoff of 30, the RRs were 1.33, 1.90, and 2.09, respectively. Similarly, in a study of more than 800 renal stone formers, Del Valle and colleagues 41 showed that most patients (nearly 60%) were either overweight or obese. In 2006, Taylor and Curhan 42 investigated the relationship of BMI as a continuous variable to stone formation, and noted that even in nonobese patients (BMI <30), an increasing BMI lent itself to a higher risk of urolithiasis.…”