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Biochemical diagnosis in 3040 kidney stone formers in Argentina

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Abstract

Nephrolithiasis is a frequent condition in urology that has an important recurrence and high impact in health economy. Knowing the biochemical abnormalities implicated in its pathogenesis is mandatory to establish therapeutic aims. Our objectives are to present the results in 3040 kidney stone formers in Argentina. All patients were selected after completing an ambulatory metabolic protocol with diagnostic purposes. There were 1717 men, (56.48 %), with a mean age of 45 ± 12 years, and 1323 women, (43.52 %), mean age 44 ± 12 years. 2781 patients had biochemical abnormalities, (91.49 %), and were arbitrarily divided in two groups: those who had only one (single) biochemical abnormality (n = 2156) and those who had associated abnormalities (n = 625). No biochemical abnormalities were found in 259 patients (8.51 %). The abnormalities present, single and associated, in order of frequency, were idiopathic hypercalciuria, (56.88 %), hyperuricosuria (21.08 %), unduly acidic urine (10.95 %), hypocitraturia (10.55 %), hypomagnesuria (7.9 %), primary hyperparathyroidism (3.01 %), hyperoxaluria (2.6 %), and cystinuria (0.32 %). We performed in 484 patient’s stone composition and found calcium oxalate stones related to idiopathic hypercalciuria predominantly while uric acid stones to unduly acidic urine. In conclusion, the biochemical abnormalities described are similar to those found in a previous series of our own and to those reported in the literature. Its diagnosis is important to therapeutic purposes to avoid eventual recurrence.

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References

  1. Fwu CW, Eggers PW, Kimmel PL, Kusek JW, Kirkali Z (2013) Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States. Kidney Int 83(3):479–486

    Article  PubMed Central  PubMed  Google Scholar 

  2. Romero V, Akpinar H, Assimos DG (2010) Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 12:e86–e96

    PubMed Central  PubMed  Google Scholar 

  3. Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary track stones during the last 10 years. Eur Urol 37:23–25

    Article  CAS  PubMed  Google Scholar 

  4. Stamatelou KK, Francis ME, Jones CA, Nyberg LM Jr, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823

    Article  PubMed  Google Scholar 

  5. Parks JH, Coe F (1996) The financial effects of kidney stone prevention. Kidney Int 50:1706–1712

    Article  CAS  PubMed  Google Scholar 

  6. Sakhaee K (2008) Nephrolithiasis as a systemic disorder. Curr Opin Nephrol Hypertens 17:304–309

    Article  PubMed  Google Scholar 

  7. Melton LJ III, Crowson CS, Khosla S, Wilson DM, O’Fallon WM (1998) Fracture risk among patients with urolithiasis: a population-based cohort study. Kidney Int 53:459–464

    Article  PubMed  Google Scholar 

  8. Sakhaee K (2009) Recent advances in the pathophysiology of nephrolithiasis. Kidney Int 75:585–595

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Chandhoke PS (2007) Evaluation of the Recurrent Stone Former. Urol Clin North Am 34:315–322

    Article  PubMed  Google Scholar 

  10. del Valle EE, Spivacow R, Zanchetta JR (1999) Alteraciones Metabólicas en 2612 pacientes con Litiasis Renal. Medicina 59:417–422

    PubMed  Google Scholar 

  11. Walton RJ, Bijvoet OL (1975) Nomogram for derivation of renal threshold phosphate concentration. Lancet 2:309–310

    Article  CAS  PubMed  Google Scholar 

  12. Pinduli I, Spivacow R, del Valle EE, Vidal S, Negri AL, Previgliano H et al (2006) Prevalence of Urolithiasis in the autonomous city of Buenos Aires. Argentina Urol Res 34:8–11

    Article  PubMed  Google Scholar 

  13. Robertson WG, Peacock M, Hodgkinson A (1979) Dietary changes and the incidence of urinary calculi in the U.K. between 1958 and 1976. J Chronic Dis 32:468–476

    Article  Google Scholar 

  14. Andersen DA (1969) Historical and geographical differences in the pattern of incidence of urinary stones considered in relation to possible aetiological factors. In: Hodgkinson A, Nordin BEC (eds) Proccedings Renal Stone Research Symposium, Leeds. Churchill, London, 7–31

  15. Andersen DA (1972) Enviromental factors in the etiology of urolithiasis. In: Cifuentes Delatte L, Rapado A, Hodgkinson A (eds) Urinary calculi. Kargel, Basel, pp 130–5

  16. Daudon M, Lacour B, Jungers P (2006) Influence of body size on urinary stone composition in men and women. Urol Res 34(3):193–199

    Article  PubMed  Google Scholar 

  17. Henneman PH, Wallach S, Dempsey E (1962) The metabolic defect responsible for uric acid stone formation. J Clin Invest 41:537–542

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Yki-Jarvinen H, Taskinen MR (1988) Interrelationship among insulin’s antilipolytic and glucoregulatory effects and plasma triglycerides in nondiabetics and diabetic patients with endogenous hypertriglyceridemia. Diabetes 37:1271–1278

    Article  CAS  PubMed  Google Scholar 

  19. Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65:386–392

    Article  CAS  PubMed  Google Scholar 

  20. Pyrah LN (1979) Epidemiology of urolithiasis. In: Renal calculus. Springer, Berlin, pp 3–17

  21. del Valle EE, Spivacow FR, Zanchetta JR (1995) Evaluación metabólica ante el primer episodio de litiasis renal. Medicina (Buenos Aires) 55:69–74

    Google Scholar 

  22. Amaro CR, Goldberg J, Amaro JL, Padovani CR (2005) Metabolic assessment in patients with urinary lithiasis. Int Braz J Urol 31:29–33

    Article  PubMed  Google Scholar 

  23. Weisinger JR, Bellorín-Font E (1995) Experiencia Latino-Americana em Litíase Renal. Venezuela. En: Calculose Renal. Fisiopatologia, Diagnóstico. Tratamiento. N Schor, I Pfeferman Heilberg (eds), Sao Paulo; Sarvier, 354–359

  24. Scales CD Jr, Curtis LH, Norris RD, Springhart WP, Sur RL, Schulman KA, Preminger GM (2007) Changing gender prevalence of stone disease. J Urol 177(3):979–982

    Article  PubMed  Google Scholar 

  25. Fazil Marickar YM, Vijay A (2009) Female stone disease: the changing trend. Urol Res 37:337–340

    Article  CAS  Google Scholar 

  26. Levy FL, Adams-Huet B, Pak CYC (1995) Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med 98:50–59

    Article  CAS  PubMed  Google Scholar 

  27. Pak CY, Britton F, Peterson R, Ward D, NortIHutt C, Breslau NA, McGuire J, Sakhaee K et al (1980) Ambulatory evaluation of nephrolithiasis. Classification, clinical presentation and diagnostic criteria. Am J Med 9:19–30

    Article  Google Scholar 

  28. Coe FL, Parks JH, Moore ES (1979) Familial idiopathic hypercalciuria. N Engl J Med 300:337–340

    Article  CAS  PubMed  Google Scholar 

  29. Atan L, Andreoni C, Ortiz V, Silva EK, Pitta R, Atan F et al (2005) High kidney stone risk in men working in steel industry at hot temperatures. Urology 65(5):858–861

    Article  PubMed  Google Scholar 

  30. Breslau NA, Brinkley L, Hill KD, Pak CYC (1988) Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metab 66:140–146

    Article  CAS  PubMed  Google Scholar 

  31. Taylor EN, Curhan GC (2009) Demographic, dietary, and urinary factors and 24-h urinary calcium excretion. Clin J Am Soc Nephrol 4:1980–1987

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Liebman SE, Taylor JG, Bushinsky DA (2006) Idiopathic Hypercalciuria. Curr Rheumatol Rep 8:70–75

    Article  PubMed  Google Scholar 

  33. Worcester EM, Coe FL (2008) New insights into the pathogenesis of idiopathic hypercalciuria. Semin Nephrol 28:120–132

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Negri AL, Spivacow FR, del Valle EE, Pinduli I, Marino A, Fradinger E, Zanchetta JR (2007) Clinical and biochemical profile of patients with “pure” uric acid nephrolithiasis compared with “pure” calcium oxalate stone formers. Urol Res 35:247–251

    Article  CAS  PubMed  Google Scholar 

  35. Curhan GC, Taylor EN (2008) 24-h uric acid excretion and the risk of kidney stones. Kidney Int 73:489–496

    Article  CAS  PubMed  Google Scholar 

  36. Preminger GM (1992) Renal calculi: pathogenesis, diagnosis, and medical therapy. Semin Nephrol 12:200–216

    CAS  PubMed  Google Scholar 

  37. Worcester EM, Coe FL (2008) Nephrolithiasis. Prim Care 35(2):369–391

    Article  PubMed Central  PubMed  Google Scholar 

  38. Pak CYC, Poindexter JR, Peterson RD, Koska J, Sakhaee K (2002) Biochemical distinction between hyperuricosuric calcium urolithiasis and gouty diathesis. Urology 60(5):789–794

    Article  PubMed  Google Scholar 

  39. Maalouf NM, Cameron MA, Moe OW, Sakhhaee K (2004) Novel insights into the pathogenesis of uric acid nephrolithiasis. Curr Opin Nephrol Hypertens 13:181–189

    Article  PubMed  Google Scholar 

  40. Sakhaee K, Adams-Huet B, Moe OW, Pak CYC (2002) Pathophysiologic basis for normouricosuric uric acid nephrolithiasis. Kidney Int 62:971–979

    Article  CAS  PubMed  Google Scholar 

  41. Robinson MR, Leitao VA, Haleblian GE, Scales CD Jr, Chandrashekar A, Pierre SA, Preminger GM (2009) Impact of long-term potassium citrate therapy on urinary profiles and recurrent stone formation. J Urol 181:1145–1150

    Article  PubMed  Google Scholar 

  42. Pak CYC (1994) Citrate and renal calculi: an update. Miner Electrolyte Metab 20:371–377

    CAS  PubMed  Google Scholar 

  43. Goodman HO, Holmes RP, Assimos DG (1995) Genetic factors in calcium oxalate stone disease. J Urol 153(2):301–307

    Article  CAS  PubMed  Google Scholar 

  44. Levy FL, Adams-Huet B, Pak CY (1995) Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med 98(1):50–59

    Article  CAS  PubMed  Google Scholar 

  45. Amaro CR, Goldberg J, Amaro JL, Padovani CR (2005) Metabolic assessment in patients with urinary lithiasis. Int Braz J Urol 31:29–33

    Article  PubMed  Google Scholar 

  46. Curhan GC, Willett WC, Rimm EB, Stampfer MJ (1993) A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 328(12):833–838

    Article  CAS  PubMed  Google Scholar 

  47. Liebman M, Chai W (1997) Effect of dietary calcium on urinary oxalate excretion after oxalate loads. Am J Clin Nutr 65(5):1453–1459

    CAS  PubMed  Google Scholar 

  48. Palacin M, Borsani G, Sebastio G (2001) The molecular bases of cystinuria and lysinuric protein intolerance. Curr Opin Genet Dev 11:328–335

    Article  CAS  PubMed  Google Scholar 

  49. Spivacow FR, Negri AL, del Valle EE, Calviño I, Fradinger E, Zanchetta JR (2008) Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol 23:1129–1133

    Article  PubMed  Google Scholar 

  50. Leusmann DB, Blaschke R, Schmandt W (1990) Results of 5035 stone analyses: a contribution to epidemiology of urinary stone disease. Scand J Urol Nephrol 24:205–210

    Article  CAS  PubMed  Google Scholar 

  51. Pahira JJ (1987) Management of the patient with cystinuria. Urol Clin North Am 14(2):339–346

    CAS  PubMed  Google Scholar 

  52. Mintz DH, Canary JJ, Carreon G, Kyle LH (1961) Hyperuricemia in hyperparathyroidism. N Engl J Med 265:112–115

    Article  CAS  PubMed  Google Scholar 

  53. Broulik PD, Stepan JJ, Pacovsky V (1987) Primary hyperparathyroidism and hyperuricaemia are associated but not correlated with indicators of bone turnover. Clin Chim Acta 170(2–3):195–200

    Article  CAS  PubMed  Google Scholar 

  54. Kuroczycka-Saniutycz E, Porowski T, Protas PT, Pszczółkowska M, Porowska H, Kirejczyk JK, Wasilewska A (2014) Does obesity or hyperuricemia influence lithogenic risk profile in children with urolithiasis? Pediatr Nephrol  Nov 8. [Epub ahead of print]

  55. Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65:386–392

    Article  CAS  PubMed  Google Scholar 

  56. Mene P, Punzo G (2008) Uric acid: bystander or culprit in hypertension and progressive renal disease? J Hypertens 26:2085–2092

    Article  CAS  PubMed  Google Scholar 

  57. Prié D, Ravery V, Boccon-Gibod L, Friedlander G (2001) Frequency of renal phosphate leak among patients with calcium nephrolithiasis. Kidney Int 60:272–276

    Article  PubMed  Google Scholar 

  58. Williams CP, Child DP, Hudson PR et al (1995) Inappropriate phosphate excretion in idiopathic hypercalciuria: the key to a common cause and future treatments. J Clin Pathol 49:881

    Article  Google Scholar 

  59. Negri AL, Spivacow R, del Valle E, Fradinger E, Marino A, Zanchetta JR (2003) Renal phosphate leak in patients with idiopathic hypercalciuria and calcium nephrolithiasis. Urol Res 31:378–381

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Instituto de Investigaciones Metabólicas (IDIM), Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador (USAL), Libertad 836, 1012, Buenos Aires, Argentina

    Francisco Rodolfo Spivacow, Elisa Elena del Valle, Armando Luis Negri, Erich Fradinger, Anabella Abib & Paula Rey

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  1. Francisco Rodolfo Spivacow
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  2. Elisa Elena del Valle
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  3. Armando Luis Negri
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  6. Paula Rey
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Correspondence to Francisco Rodolfo Spivacow.

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Spivacow, F.R., del Valle, E.E., Negri, A.L. et al. Biochemical diagnosis in 3040 kidney stone formers in Argentina. Urolithiasis 43, 323–330 (2015). https://doi.org/10.1007/s00240-015-0778-0

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