Recurrent stone formers-metabolic evaluation: a must investigation

Abstract

The lifetime prevalence of kidney stone disease is estimated at 1% to 15% with the probability of having a stone varying according to age, gender, race and geographic location. 1 Kidney stone formation is three times more common in men and although rare before 20 years of age, the frequency increased rapidly and peaks in the age group 40 to 59 years. The mean rate of recurrence of stone is estimated to be up to 30% at 5 years, 50% at 10 years and 80% at 20 years. 2 Once recurrent, the subsequent relapse risk is raised and the interval between recurrences is shortened. The various types of urinary stones are calcium oxalate stones (60%), phosphate stones (30%), uric acid and urate stones (5-10%), cystine stones (1-3%), xanthene/ silicate/ matrix stones. 5 the various risk factors responsible for stone formation are namely: Non-dietary Family history The risk of becoming a stone former is more than 2.5 times greater in patients with a family history of stone disease. 3 Systemic disorders  Primary hyperparathyroidism  Renal tubular acidosis  Crohn's disease  Increasing body mass index (BMI)

Stone residual fragments: A thorny problem

“…52,56 The current literature is however expanding the concept to offer metabolic evaluation also in first-time stone formers. 57,58 Eisner et al 59 compared the frequency of metabolic abnormalities between first time and recurrent stone formers, showing no difference between the two groups. Extensive diagnostic evaluation further requires complete 24-h urine specimen.…”

Metabolic evaluation of patients with recurrent, multiple or bilateral renal stones in Jaffna

“…Hyperoxaluria increases the saturation of calcium oxalate resulting in crystal formation [14]. Reported prevalence of this condition varies from 3.6% to 64.5% around the globe [15,7,16,17]. Hyperoxaluria was found in 9 (30%) patients in our study group.…”

“…Hypomagnesuria reduces this inhibitory effect on nucleation and growth of calcium oxalate crystals [12]. Prevalence of this condition varies from 0% to 30% [15,7,16,17]. 9 patients in our study group had hypomagnesuria (30%), with 4 showing it as a single metabolic abnormality and the rest in combination with hyperuricosuria (1 patient), hypocitraturia (3 patients), hypocalciuria (5 patients) and hypophosphaturia (4 patients).…”

“…Studies carried out in South Asian and other countries revealed many metabolic abnormalities in patients with recurrent, multiple or bilateral renal stones [7,13,15]. In comparison, publications that originated from European…”