Role of core body temperature in nephrolithiasis

Abstract

To assess the role of core body temperature in urinary stone formation using a large clinical dataset. Patients and Methods We retrospectively collected 14 519 039 individual temperature measurements from 580 416 patients with medical history, laboratory values and medication history between 2013 and 2018 at a single institution. After exclusions and matching 2:1 (controls:cases) to account for confounding variables, 7104 patients with a history of urinary stones were identified. Results Patients with a history of urinary stones (cases) had an elevated mean (SD) oral temperature compared to matched controls, at 36.666 (0.17) vs 36.659 (0.20)°C (P = 0.012). Logistic regression of matched samples showed that higher core body temperature was predictive of a history of nephrolithiasis (odds ratio 1.21, 95% confidence interval 1.04-1.4; P = 0.015). Conclusion Core body temperature was significantly higher in patients with a history of urinary stones compared to matched controls, contrary to the anticipated thermodynamic considerations leading to crystal aggregation. Given that the core body temperature is elevated, rather than decreased, thermodynamic process driving stone formation is unlikely.

Pathophysiology and Main Molecular Mechanisms of Urinary Stone Formation and Recurrence

“…The research by Srirangapatanam et al put core body temperature among the factors that could influence stone formation. In particular, they highlighted an unexpected theory against the Ostwald ripening phenomenon [ 68 ].…”

“…Ostwald ripening is a phenomenon that is inversely dependent on temperature, in which supersaturated molecules in a solution will condense so that smaller particles merge into larger particles and has been well described in human nephrolithiasis [ 68 , 69 ]. According to this, it was expected that patients with nephrolithiasis would tend to have a lower core body temperature [ 68 ].…”

“…Ostwald ripening is a phenomenon that is inversely dependent on temperature, in which supersaturated molecules in a solution will condense so that smaller particles merge into larger particles and has been well described in human nephrolithiasis [ 68 , 69 ]. According to this, it was expected that patients with nephrolithiasis would tend to have a lower core body temperature [ 68 ]. It was seen that ambient temperature and local climate appear to play a role in stone formation, as geographical areas with warmer climates tend to have a higher incidence of stone disease, and presentations to the ER tend to increase after particularly hot days [ 70 , 71 , 72 , 73 ].…”

“…It was seen that ambient temperature and local climate appear to play a role in stone formation, as geographical areas with warmer climates tend to have a higher incidence of stone disease, and presentations to the ER tend to increase after particularly hot days [ 70 , 71 , 72 , 73 ]. Srirangapatanam et al, in a retrospective matched case–control study, analyzed the role of core body temperature in the pathophysiological process of stone formation [ 68 ]. This study highlighted that patients with a history of kidney stones were noted to have a slightly higher mean oral temperature when compared to matched controls [ 68 ].…”

“…Srirangapatanam et al, in a retrospective matched case–control study, analyzed the role of core body temperature in the pathophysiological process of stone formation [ 68 ]. This study highlighted that patients with a history of kidney stones were noted to have a slightly higher mean oral temperature when compared to matched controls [ 68 ]. In particular, each 1 °C increase in core body temperature predicts an average 21% increase in the history of kidney stone formation [ 68 ].…”