scholarly journals Simple dietary advice targeting five urinary parameters reduces urinary supersaturation in idiopathic calcium oxalate stone formers

Urolithiasis ◽  
2020 ◽  
Vol 48 (5) ◽  
pp. 425-433 ◽  
Author(s):  
Juri Sromicki ◽  
Bernhard Hess
Keyword(s):  
Calcium Oxalate ◽  
Urine Volume ◽  
Dietary Advice ◽  
Oxalate Absorption ◽  
Adherence Score ◽  
Crystallization Inhibition ◽  
Stone Formers ◽  
Urinary Parameters ◽  
Urinary Citrate ◽  
Induced Changes

Abstract Among 208 kidney stone patients referred within 2 years, 75 patients (66 men, nine women) with truly idiopathic calcium oxalate stones (ICSF) were recruited. Dietary advice (DA) aimed at (1) urine dilution, (2) reduced crystallization promotion (lowering oxalate), and (3) increased crystallization inhibition (increasing citrate). We recommended higher intakes of fluid and calcium with meals/snacks (reducing intestinal oxalate absorption) as well as increased alkali and reduced meat protein (acid) for increasing urinary citrate. The intended effects of DA were elevations in urine volume, calcium (U-Ca) and citrate (U-Cit) as well as reductions in oxalate (U-Ox) and uric acid (U-UA). We retrospectively calculated an adherence score (AS), awarding + 1 point for parameters altered in the intended direction and − 1 point for opposite changes. Calcium oxalate supersaturation (CaOx-SS) was calculated using Tiselius’ AP(CaOx) index EQ. DA induced changes (all p < 0.0001) in urine volume (2057 ± 79 vs. 2573 ± 71 ml/day) and U-Ca (5.49 ± 0.24 vs. 7.98 ± 0.38 mmol/day) as well as in U-Ox (0.34 ± 0.01 vs. 0.26 ± 0.01 mmol/day) and U-UA (3.48 ± 0.12 vs. 3.13 ± 0.10 mmol/day). U-Cit only tendentially increased (3.07 ± 0.17 vs. 3.36 ± 0.23 mmol/day, p = 0.06). DA induced a 21.5% drop in AP(CaOx) index, from 0.93 ± 0.05 to 0.73 ± 0.05 (p = 0.0005). Decreases in CaOx-SS correlated with AS (R = 0.448, p < 0.0005), and highest AS (+ 5) always indicated lowering of CaOx-SS. Thus, simple DA can reduce CaOx-SS which may be monitored by AS.

Oxalate absorption and endogenous oxalate synthesis from ascorbate in calcium oxalate stone formers and non-stone formers

2004 ◽  
Vol 44 (6) ◽  
pp. 1060-1069 ◽  
Author(s):  
Weiwen Chai ◽  
Michael Liebman ◽  
Susan Kynast-Gales ◽  
Linda Massey
Keyword(s):  
Calcium Oxalate ◽  
Calcium Oxalate Stone ◽  
Oxalate Absorption ◽  
Stone Formers ◽  
Oxalate Synthesis

Nephrolithiasis

2018 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

Nephrolithiasis

2017 ◽  
Author(s):  
José Luiz Nishiura ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Dietary Habits ◽  
Stone Formation ◽  
Urine Volume ◽  
First Episode ◽  
Dietary Advice ◽  
Dietary Recommendations ◽  
Genetic Traits ◽  
Oxalate Precipitation

Nephrolithiasis is a highly prevalent condition, but its incidence varies depending on race, gender, and geographic location. Approximately half of patients form at least one recurrent stone within 10 years of the first episode. Renal stones are usually composed of calcium salts (calcium oxalate monohydrate or dihydrate, calcium phosphate), uric acid, or, less frequently, cystine and struvite (magnesium, ammonium, and phosphate). Calcium oxalate stones, the most commonly encountered ones, may result from urinary calcium oxalate precipitation on the Randall plaque, which is a hydroxyapatite deposit in the interstitium of the kidney medulla. Uric acid nephrolithiasis, which is common among patients with metabolic syndrome or diabetes mellitus, is caused by an excessively acidic urinary pH as a renal manifestation of insulin resistance. The medical evaluation of the kidney stone patient must be focused on identifying anatomic abnormalities of the urinary tract, associated systemic diseases, use of lithogenic drugs or supplements, and, mostly, urinary risk factors such as low urine volume, hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, and abnormalities in urine pH that can be affected by dietary habits, environmental factors, and genetic traits. Metabolic evaluation requires a urinalysis, stone analysis (if available), serum chemistry, and urinary parameters, preferably obtained by two nonconsecutive 24-hour urine collections under a random diet. Targeted medication and dietary advice are effective to reduce the risk of recurrence. Clinical, radiologic, and laboratory follow-ups are needed to prevent stone growth and new stone formation, to assess treatment adherence or effectiveness to dietary recommendations, and to allow adjustment of pharmacologic treatment. This review contains 5 highly rendered figure, 3 tables, and 105 references.

scholarly journals Association of urinary sex steroid hormones with urinary calcium, oxalate and citrate excretion in kidney stone formers

2020 ◽  
Author(s):  
Daniel G Fuster ◽  
Gaétan A Morard ◽  
Lisa Schneider ◽  
Cedric Mattmann ◽  
David Lüthi ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Kidney Stone ◽  
Urinary Calcium ◽  
Sex Hormone ◽  
Urinary Oxalate ◽  
Oxalate Excretion ◽  
Stone Formers ◽  
17Β Estradiol ◽  
Urinary Citrate ◽  
Urinary Oxalate Excretion

Abstract Background Sex-specific differences in nephrolithiasis with respect to both distribution of prevalence and stone composition are widely described and may be influenced by sex hormones. Methods We conducted a cross-sectional analysis of the relationship between 24-hour urinary sex hormone metabolites measured by gas chromatography–mass spectrometry with urinary calcium, oxalate and citrate excretion in a cohort of 628 kidney stone formers from a tertiary care hospital in Switzerland, taking demographic characteristics, kidney function and dietary factors into account. Results We observed a positive association of urinary calcium with urinary testosterone and 17β-estradiol. Positive associations of urinary calcium with dehydroepiandrosterone, 5α-DH-testosterone, etiocholanolone, androsterone, and estriol were modified by net gastrointestinal alkali absorption or urinary sulfate excretion. As the only sex hormone, dehydroepiandrosterone was inversely associated with urinary oxalate excretion in adjusted analyses. Urinary citrate correlated positively with urinary testosterone. Associations of urinary citrate with urinary androsterone, 17β-estradiol and estriol were modified by urinary sulfate or sodium, or by sex. Conclusions Urinary androgens and estrogens are significantly associated with urinary calcium and citrate excretion, and associations are in part modified by diet. Our data furthermore reveal dehydroepiandrosterone as a novel factor associated with urinary oxalate excretion in humans.

Circadian Rhythmicity in Urinary Citrate Excretion in Healthy Men and Male Calcium-Oxalate Stone Formers

Urolithiasis ◽  
1989 ◽  
pp. 507-507
Author(s):  
D. Wangoo ◽  
H. Sidhu ◽  
S. Vaidyanathan ◽  
S. K. Thind ◽  
R. Nath ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Circadian Rhythmicity ◽  
Calcium Oxalate Stone ◽  
Healthy Men ◽  
Stone Formers ◽  
Urinary Citrate

scholarly journals Weekend versus Weekday Urine Collections in Assessment of Stone-Formers

1996 ◽  
Vol 89 (10) ◽  
pp. 561-562 ◽  
Author(s):  
Richard W Norman
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Urine Volume ◽  
Acid Excretion ◽  
Metabolic Evaluation ◽  
Uric Acid Excretion ◽  
Stone Formers ◽  
Increased Risk ◽  
Working Day

Twenty-four-hour urine collections are an important part of the metabolic evaluation of stone-formers, but are difficult for patients at work. At weekends the results might be different. Forty-five stone-formers who worked at day jobs from Monday to Friday collected urine for 24 h on a normal working day and also on a Saturday or Sunday and the differences were evaluated. Average 24 h urine volume was higher on weekdays than at weekends. Calcium, oxalate, and uric acid excretion did not differ. These results imply an increased risk of crystalluria at the weekend. Therefore weekend collections are most likely to show abnormalities and should be acceptable to clinicians.

Seasonal Variations in the Composition of Urine in Relation to Calcium Stone-Formation

1975 ◽  
Vol 49 (6) ◽  
pp. 597-602 ◽  
Author(s):  
W. G. Robertson ◽  
M. Peacock ◽  
R. W. Marshall ◽  
R. Speed ◽  
B. E. C. Nordin
Keyword(s):  
Seasonal Variation ◽  
Calcium Oxalate ◽  
Seasonal Variations ◽  
Stone Formation ◽  
Urine Volume ◽  
Cross Sectional ◽  
Seasonal Incidence ◽  
Calcium Stone ◽  
Stone Formers ◽  
Significant Seasonal Variation

1. A retrospective cross-sectional study was carried out on data derived from single 24 h urine collections from 246 male idiopathic calcium stone-formers. 2. The daily urine volume and pH and the excretions of calcium, oxalate, phosphate, creatinine and magnesium were related to the time of year when the urine was collected, and the saturation of urine with calcium oxalate and octocalcium phosphate calculated for each month. 3. There were significant seasonal variations in the urinary excretion of calcium and oxalate, each showing a maximum during the summer months and a minimum in the winter. There was no significant seasonal variation in urinary pH, volume, creatinine, phosphate or magnesium. 4. There was a significant increase in the saturation of urine with calcium oxalate and a trend towards higher saturation levels of octo-calcium phosphate in the summer. These changes were dependent only on the seasonal variation in urinary calcium and oxalate and not on urine volume. 5. A retrospective study of the seasonal incidence of stone episodes among these 246 stone-formers showed that the rate of stone passage per month was 50% higher in the summer than in the winter. There was no significant seasonal variation in the incidence of stones removed surgically.

Quantified water intake in laboratory cats from still, free-falling and circulating water bowls, and its effects on selected urinary parameters

2018 ◽  
Vol 21 (8) ◽  
pp. 682-690
Author(s):  
Michael T Robbins ◽  
Martha G Cline ◽  
Joseph W Bartges ◽  
Erin Felty ◽  
Korinn E Saker ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Water Intake ◽  
Urine Volume ◽  
Urine Osmolality ◽  
Alternative Methods ◽  
Urine Specific Gravity ◽  
Appreciable Effect ◽  
Daily Water ◽  
Urinary Parameters ◽  
Free Falling

ObjectivesThe study objectives were to determine if the method of water presentation (still [S], circulating [C] or free-falling [FF] bowl systems) influences daily water consumption in cats in a controlled environment, and whether differences in water intake affect urine relative super saturation (RSS) for calcium oxalate and struvite, urine specific gravity (USG), urine osmolality (Uosmol) and urine volume.MethodsSixteen healthy laboratory cats fed a dry diet were individually housed with urine collection systems. Each cat underwent a randomized 2 week crossover period with all bowl systems, allowing a 1 week acclimation period between each crossover. Water intake was measured daily by bowl weight, accounting for spillage and evaporation. USG and urine volume were measured daily, whereas other urinary parameters were measured at various time points throughout each 14 day crossover period.ResultsFourteen cats completed the study. Average daily water intake (ml/kg/day), urine volume, USG and urine RSS for struvite and calcium oxalate were not significantly different between water bowls. Uosmol was significantly higher in C compared with S and FF bowl systems ( P = 0.009 for both). Three individual cats demonstrated a significant water bowl preference (Cat 4: C >S, P = 0.039; Cat 10: FF >C, P = 0.005; Cat 11: S >C, P = 0.037).Conclusions and relevanceOverall, water bowl type had no appreciable effect on water intake. Uosmol was the only urinary parameter found to be significantly different, and was higher for the C bowl. The implication of this is unknown, considering water intake did not differ significantly between bowls. Alternative methods to increase water intake should be implemented beyond providing unique water bowls in patients where augmented water intake would be beneficial for disease management.

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