scholarly journals Does the Urinary Calcium/Citrate Ratio Add to the Diagnostic Workup of Children at Risk of Kidney Stones? A Cross-Sectional Study

2019 ◽  
Vol 09 (01) ◽  
pp. e1-e6
Author(s):  
Misan Lee ◽  
Carmen Rodriguez Cuellar ◽  
Ravneet Nagra ◽  
Zhan Tao Wang ◽  
Vipin Bhayana ◽  
...  
Keyword(s):  
At Risk ◽  
Kidney Stones ◽  
Clinical Laboratory ◽  
Urinary Calcium ◽  
Urinary Sodium ◽  
Calcium Citrate ◽  
Sodium Potassium ◽  
Positive Correlation ◽  
Stone Formers ◽  
Urinary Citrate

The purpose of the study was to evaluate urinary citrate/creatinine (UCi/UCr) and urinary calcium/citrate (UCa/UCi) ratios for distinguishing stone formers (SF) from non-stone formers (NSF) in an at-risk population. This was a retrospective study that included all pediatric patients who underwent urinary citrate testing from April 2017 to March 2018. The urinary levels of citrate, calcium, sodium, potassium, creatinine, oxalate, urate, pH, and specific gravity (SG) were measured in our clinical laboratory. Diagnosis of kidney stones was obtained through chart review.A total of 97 patients were included (46 NSF and 51 SF). The UCi/UCr ratio was not significantly different between NSF and SF. Median UCa/UCr ratio was higher in SF (0.67) compared with NSF (0.21, p < 0.0001). The median ratio of UCa/UCi was also higher in SF (1.30) than in NSF (0.65, p = 0.001). Oxalate, urate, pH, SG, and urinary sodium/potassium ratio did not differentiate between the SF and NSF. Positive correlation was seen between UCa/UCr and urinary sodium/creatinine UNa/UCr (p < 0.0001), as well as between UCa/UCr and UCi/UCr (p < 0.0001).The study has demonstrated significantly higher UCa/UCi and UCa/UCr in SF compared with NSF, while the use of urinary oxalate, urate, pH, and SG did not differentiate between SF from NSF. We also confirmed a positive correlation between UNa/UCr and UCa/UCr. While the utility of UCa/UCr is well established, our data suggest that UCa/UCi rather than UCi/UCr may be more predictive in the clinical setting when evaluating for nephrolithiasis.

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.

scholarly journals The association of dietary inflammatory index with urinary risk factors of kidney stones formation in men with nephrolithiasis

2020 ◽  
Author(s):  
Niloofarsadat Maddahi ◽  
Habib Yarizadeh ◽  
SeyedMohammad Kazem Aghamir ◽  
Shahab Alizadeh ◽  
MirSaeed Yekaninejad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Stones ◽  
Urinary Calcium ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Leading Role ◽  
Multivariate Adjustment ◽  
Urinary Citrate

Abstract Objective Inflammation plays a leading role in the pathogenesis of nephrolithiasis. The association of the dietary inflammatory index (DII) with urinary lithogenic factors is unclear. This study aimed to evaluate the relation of DII to urinary risk factors of kidney stones formation. Results Of 264 participants, 61.4% (n= 162), 72% (n=190), 74.6% (n=197), 68.6% (n=181), and 80.3% (n=212) had hyperoxaluria, hypercreatininuria, hypercalciuria, hyperuricosuria, hypocitraturia, respectively. There was a significant increasing trajectory in urinary calcium, uric acid, and creatinine as well as a decreasing trend in urinary citrate across tertiles of DII score (all P=≤0.001). After multivariate adjustment for energy intake, age, physical activity and body mass index, high DII scores were associated with elevated odds of having hypercreatininuria (OR=2.80, 95%CI: 1.10-7.12, P trend =0.04), hypercalciuria (OR=7.44, 95%CI: 2.62-21.14, P trend ≤0.001), hyperuricosuria (OR=2.22, 95%CI: 1.001-4.95, P trend =0.05), and hypocitraturia (OR=5.84, 95%CI: 2.14-15.91, P trend ≤0.001). No association was identified between DII and hyperoxaluria.

scholarly journals The association of dietary inflammatory index with urinary risk factors of kidney stones formation in men with nephrolithiasis

2020 ◽  
Author(s):  
Niloofarsadat Maddahi ◽  
Habib Yarizadeh ◽  
SeyedMohammad Kazem Aghamir ◽  
SeyedSaeed Moddaresi ◽  
Shahab Alizadeh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Stones ◽  
Urinary Calcium ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Leading Role ◽  
Multivariate Adjustment ◽  
Urinary Citrate

Abstract Objective: Inflammation plays a leading role in the pathogenesis of nephrolithiasis. The association of the dietary inflammatory index (DII) with urinary lithogenic factors is unclear. This study aimed to evaluate the relation of DII to urinary risk factors of kidney stones formation.Results: Of 264 participants, 61.4% (n= 162), 72% (n=190), 74.6% (n=197), 68.6% (n=181), and 80.3% (n=212) had hyperoxaluria, hypercreatininuria, hypercalciuria, hyperuricosuria, hypocitraturia, respectively. There was a significant increasing trajectory in urinary calcium, uric acid, and creatinine as well as a decreasing trend in urinary citrate across tertiles of DII score (all P=≤0.001). After multivariate adjustment for energy intake, age, physical activity and body mass index, high DII scores were associated with elevated odds of having hypercreatininuria (OR=2.80, 95%CI: 1.10-7.12, Ptrend=0.04), hypercalciuria (OR=7.44, 95%CI: 2.62-21.14, Ptrend≤0.001), hyperuricosuria (OR=2.22, 95%CI: 1.001-4.95, Ptrend=0.05), and hypocitraturia (OR=5.84, 95%CI: 2.14-15.91, Ptrend≤0.001). No association was identified between DII and hyperoxaluria.

scholarly journals Dietary pattern analysis among stone formers: resemblance to a DASH-style diet

2020 ◽  
Vol 42 (3) ◽  
pp. 338-348
Author(s):  
Fernanda Guedes Rodrigues ◽  
Thalita Melo Lima ◽  
Lysien Zambrano ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Dietary Pattern ◽  
Stone Formation ◽  
Epidemiological Studies ◽  
Urinary Calcium ◽  
Urinary Sodium ◽  
Dash Diet ◽  
Low Sodium ◽  
Stone Formers ◽  
Diet Pattern ◽  
Dietary Pattern Analysis

Abstract Recent epidemiological studies have shown that dietary patterns may have a more persistent impact on the risk of stone formation than single nutrients of the diet. Dietary Approaches to Stop Hypertension (DASH), a low-sodium and fruits/vegetables-rich diet, has been associated with a lower risk of nephrolithiasis, due to altered urinary biochemistry. This observational study aimed to investigate whether the dietary pattern of stone formers (SF) resembled a DASH-diet and its influence on urinary lithogenic parameters. Anthropometric data, fasting serum sample, 24-h urine samples, and a 3-day food intake record under an unrestricted diet were obtained from 222 SF and compared with 136 non-SF subjects (controls). The DASH-diet food portions were determined from the food records whereas intakes of sodium chloride (NaCl) and protein (protein equivalent of nitrogen appearance, PNA) were estimated from 24-hr urinary sodium and urea. A dietary profile close to a DASH-diet was not observed in any of the groups. NaCl intake and PNA were significantly higher in SF versus non-SF (12.0 ± 5.2 v.s. 10.1 ± 3.4 g/day, p = 0.01 and 1.8 ± 0.1 v.s. 1.4 ± 0.1 g/kg/day, p = 0.03). SF exhibited a positive correlation of NaCl intake and PNA with urinary calcium, oxalate and uric acid, and of PNA with urinary sodium. SF consumed more vegetables and legumes, but less fruits and low-fat dairy items than non-SF. The present series presented a dietary profile characterized by low calcium and high salt and protein contents, not reflecting an ideal DASH-style diet pattern.

scholarly journals The association of dietary inflammatory index with urinary risk factors of kidney stones formation in men with nephrolithiasis

2020 ◽  
Author(s):  
Niloofarsadat Maddahi ◽  
Habib Yarizadeh ◽  
SeyedMohammad Kazem Aghamir ◽  
Shahab Alizadeh ◽  
MirSaeed Yekaninejad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Stones ◽  
Urinary Calcium ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Leading Role ◽  
Multivariate Adjustment ◽  
Urinary Citrate

Abstract Objective: Inflammation plays a leading role in the pathogenesis of nephrolithiasis. The association of the dietary inflammatory index (DII) with urinary lithogenic factors is unclear. This study aimed to evaluate the relation of DII to urinary risk factors of kidney stones formation.Results: Of 264 participants, 61.4% (n= 162), 72% (n=190), 74.6% (n=197), 68.6% (n=181), and 80.3% (n=212) had hyperoxaluria, hypercreatininuria, hypercalciuria, hyperuricosuria, hypocitraturia, respectively. There was a significant increasing trajectory in urinary calcium, uric acid, and creatinine as well as a decreasing trend in urinary citrate across tertiles of DII score (all P=≤0.001). After multivariate adjustment for energy intake, age, physical activity and body mass index, high DII scores were associated with elevated odds of having hypercreatininuria (OR=2.80, 95%CI: 1.10-7.12, Ptrend=0.04), hypercalciuria (OR=7.44, 95%CI: 2.62-21.14, Ptrend≤0.001), hyperuricosuria (OR=2.22, 95%CI: 1.001-4.95, Ptrend=0.05), and hypocitraturia (OR=5.84, 95%CI: 2.14-15.91, Ptrend≤0.001). No association was identified between DII and hyperoxaluria.

scholarly journals The association of dietary inflammatory index with urinary risk factors of kidney stones formation in men with nephrolithiasis

2020 ◽  
Author(s):  
Niloofarsadat Maddahi ◽  
Habib Yarizadeh ◽  
SeyedMohammad Kazem Aghamir ◽  
Shahab Alizadeh ◽  
MirSaeed Yekaninejad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Stones ◽  
Urinary Calcium ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Leading Role ◽  
Multivariate Adjustment ◽  
Urinary Citrate

Abstract Objective: Inflammation plays a leading role in the pathogenesis of nephrolithiasis. The association of the dietary inflammatory index (DII) with urinary lithogenic factors is unclear. This study aimed to evaluate the relation of DII to urinary risk factors of kidney stones formation.Results: Of 264 participants, 61.4% (n= 162), 72% (n=190), 74.6% (n=197), 68.6% (n=181), and 80.3% (n=212) had hyperoxaluria, hypercreatininuria, hypercalciuria, hyperuricosuria, hypocitraturia, respectively. There was a significant increasing trajectory in urinary calcium, uric acid, and creatinine as well as a decreasing trend in urinary citrate across tertiles of DII score (all P=≤0.001). After multivariate adjustment for energy intake, age, physical activity and body mass index, high DII scores were associated with elevated odds of having hypercreatininuria (OR=2.80, 95%CI: 1.10-7.12, Ptrend=0.04), hypercalciuria (OR=7.44, 95%CI: 2.62-21.14, Ptrend≤0.001), hyperuricosuria (OR=2.22, 95%CI: 1.001-4.95, Ptrend=0.05), and hypocitraturia (OR=5.84, 95%CI: 2.14-15.91, Ptrend≤0.001). No association was identified between DII and hyperoxaluria.

scholarly journals The association of dietary inflammatory index with urinary risk factors of kidney stones formation in men with nephrolithiasis

2020 ◽  
Author(s):  
Niloofarsadat Maddahi ◽  
Habib Yarizadeh ◽  
SeyedMohammad Kazem Aghamir ◽  
Shahab Alizadeh ◽  
MirSaeed Yekaninejad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Stones ◽  
Urinary Calcium ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Leading Role ◽  
Multivariate Adjustment ◽  
Urinary Citrate

Abstract Objective: Inflammation plays a leading role in the pathogenesis of nephrolithiasis. The association of the dietary inflammatory index (DII) with urinary lithogenic factors is unclear. This study aimed to evaluate the relation of DII to urinary risk factors of kidney stones formation.Results: Of 264 participants, 61.4% (n= 162), 72% (n=190), 74.6% (n=197), 68.6% (n=181), and 80.3% (n=212) had hyperoxaluria, hypercreatininuria, hypercalciuria, hyperuricosuria, hypocitraturia, respectively. There was a significant increasing trajectory in urinary calcium, uric acid, and creatinine as well as a decreasing trend in urinary citrate across tertiles of DII score (all P=≤0.001). After multivariate adjustment for energy intake, age, physical activity and body mass index, high DII scores were associated with elevated odds of having hypercreatininuria (OR=2.80, 95%CI: 1.10-7.12, Ptrend=0.04), hypercalciuria (OR=7.44, 95%CI: 2.62-21.14, Ptrend≤0.001), hyperuricosuria (OR=2.22, 95%CI: 1.001-4.95, Ptrend=0.05), and hypocitraturia (OR=5.84, 95%CI: 2.14-15.91, Ptrend≤0.001). No association was identified between DII and hyperoxaluria.

scholarly journals Urinary risk factors for calcium oxalate urolithiasis in children with monosymptomatic enuresis

2021 ◽  
Vol 10 (4) ◽  
pp. e42-e42
Author(s):  
Alicja Liszewska ◽  
Joanna Olga Bagińska ◽  
Jan Krzysztof Kirejczyk ◽  
Tadeusz Porowski ◽  
Agata Korzeniecka-Kozerska
Keyword(s):  
At Risk ◽  
Reference Group ◽  
Stone Formation ◽  
Risk Index ◽  
Urinary Calcium ◽  
Bonn Risk Index ◽  
Monosymptomatic Nocturnal Enuresis ◽  
Urinary Citrate ◽  
Work Up

Introduction: A disturbed calcium-phosphate balance is an important issue for kidney stone formation in nephrolithiasis. Hypercalciuria (HC) has been proposed as an essential etiology of monosymptomatic nocturnal enuresis (MNE). Objectives: We may suspect that patients with MNE may be at risk of stone formation hence the objective of this paper was to assess the risk in MNE children using Bonn Risk Index (BRI). Patients and Methods: The urinary work-up of 204 children (83 with MNE and 121 controls) included urinary calcium (Ca), magnesium (Mg) and sodium (Na) excretion, Ca/creatinine ratio, BRI, ionized calcium (Ca2+), Mg/creatinine and Ca/citrate ratios, urinary citrates and oxalates (Ox). Results: Ca/creatinine and Mg/creat ratios were higher in the MNE group. There were no differences in Mg and Ca amount in urine and Mg/Ca ratio between MNE and the reference group. Both groups differed in Mg and Ca excretion per kg of body mass. MNE children differed from controls regarding BRI, Ox and urinary Ca2+. No differences in urinary citrate excretion nor Ca/citrate ratio between MNE and the controls were found. Correlations between factors important in the crystallization process in MNE children were recorded. Conclusion: MNE patients may be at risk of oxalate nephrolithiasis. Further studies to assess the role of the BRI and Ca/citrate ratio in predicting stone formation in MNE children are needed.

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