scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Influence of Overweight on 24-hour Urine Chemistry Studies and Recurrent Urolithiasis in Children

01 Apr 2012-Korean Journal of Urology (Korean Urological Association)-Vol. 53, Iss: 4, pp 268-274
TL;DR: Unlike in adults, in children, overweight adjusted for gender and age was not associated with 24-hour urine chemistry studies and was not a risk factor for recurrent UL.
Abstract: Results: A total of 125 patients were included. The age of the patients in the NBW group was older than that of patients in the LBW group, but 24-hour urine chemistry studies did not differ significantly between the three groups. Mean urine citrate levels were lower (0.273±0.218 mg/mg/d vs. 0.429±0.299 mg/mg/d, p<0.05) and the incidence of hypocitraturia was higher (81.5% vs. 45.7%, p<0.05)) in the recurrent stone former group. In the univariate analysis, hypocitraturia and acidic urinary pH were risk factors, but in the multivariate analysis, only hypocitraturia was a risk factor for stone recurrence (hazard ratio, 3.647; 95% confidence interval, 1.047 to 12.703). In the Kaplan-Meier curve, the hypocitraturia group showed higher recurrence than did the normocitraturia group (p<0.05). Conclusions: Unlike in adults, in children, overweight adjusted for gender and age was not associated with 24-hour urine chemistry studies and was not a risk factor for recurrent UL. Hypocitraturia was the only risk factor for UL in children.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
TL;DR: Low dose MDCT can be effectively used for the evaluation of urinary tract calculi with significantly decrease radiation dose to the patients compared with standard dose CT due to the improvements in CT technology which allow isotropic resolution with faster scan coverage in a single, short breath-hold, and high diagnostic performance.
Abstract: Objective: This study is designed to assess the diagnostic accuracy of Low-dose unenhanced multi detector computed tomography (MDCT) in patients with suspected urinary tract calculi taking Standard-dose unenhanced MDCT as gold standard Methods: The cross-sectional study was conducted from July to December 2016 among patients with suspected urinary tract calculi The patients underwent unenhanced low-dose MDCT scan with reconstruction slice thickness, 70 mm; pitch= 100; tube potential 120kV; and tube charge per gantry rotation, 25-50 m As, followed by standard-dose computed tomography (CT) scan Diagnostic accuracy of unenhanced low dose multi-detector computed tomography was calculated taking standard dose MDCT as gold standard Results: Out of total 50 adult patients, 32 (64%) were males and 18 (36%) were females The mean age of the patients was 50 ± 11 years The diagnostic accuracy of Low dose CT showed 100% sensitivity when compared with Unenhanced Standard dose CT in diagnosing urinary tract calculi, indirect signs of obstruction and adjacent organs However, a difference was observed in blood vessels within the renal sinus which were seen in 48 kidneys in low dose CT and 49 in standard dose CT (True positive 96%, true negative 100%) Conclusion: Low dose MDCT can be effectively used for the evaluation of urinary tract calculi with significantly decrease radiation dose to the patients compared with standard dose CT This is due to the improvements in CT technology which allow isotropic resolution with faster scan coverage in a single, short breath-hold, and high diagnostic performance
References
More filters
Journal ArticleDOI
26 Jan 2005-JAMA
TL;DR: Obesity and weight gain increase the risk of kidney stone formation, and the magnitude of the increased risk may be greater in women than in men.
Abstract: ContextLarger body size may result in increased urinary excretion of calcium, oxalate, and uric acid, thereby increasing the risk for calcium-containing kidney stones. It is unclear if obesity increases the risk of stone formation, and it is not known if weight gain influences risk.ObjectiveTo determine if weight, weight gain, body mass index (BMI), and waist circumference are associated with kidney stone formation.Design, Setting, and ParticipantsA prospective study of 3 large cohorts: the Health Professionals Follow-up Study (N = 45 988 men; age range at baseline, 40-75 years), the Nurses’ Health Study I (N = 93 758 older women; age range at baseline, 34-59 years), and the Nurses’ Health Study II (N = 101 877 younger women; age range at baseline, 27-44 years).Main Outcome MeasuresIncidence of symptomatic kidney stones.ResultsWe documented 4827 incident kidney stones over a combined 46 years of follow-up. After adjusting for age, dietary factors, fluid intake, and thiazide use, the relative risk (RR) for stone formation in men weighing more than 220 lb (100.0 kg) vs men less than 150 lb (68.2 kg) was 1.44 (95% confidence interval [CI], 1.11-1.86; P = .002 for trend). In older and younger women, RRs for these weight categories were 1.89 (95% CI, 1.52-2.36; P<.001 for trend) and 1.92 (95% CI, 1.59-2.31; P<.001 for trend), respectively. The RR in men who gained more than 35 lb (15.9 kg) since age 21 years vs men whose weight did not change was 1.39 (95% CI, 1.14-1.70; P = .001 for trend). Corresponding RRs for the same categories of weight gain since age 18 years in older and younger women were 1.70 (95% CI, 1.40-2.05; P<.001 for trend) and 1.82 (95% CI, 1.50-2.21; P<.001 for trend). Body mass index was associated with the risk of kidney stone formation: the RR for men with a BMI of 30 or greater vs those with a BMI of 21 to 22.9 was 1.33 (95% CI, 1.08-1.63; P<.001 for trend). Corresponding RRs for the same categories of BMI in older and younger women were 1.90 (95% CI, 1.61-2.25; P<.001 for trend) and 2.09 (95% CI, 1.77-2.48; P<.001 for trend). Waist circumference was also positively associated with risk in men (P = .002 for trend) and in older and younger women (P<.001 for trend for both).ConclusionsObesity and weight gain increase the risk of kidney stone formation. The magnitude of the increased risk may be greater in women than in men.

977 citations


"Influence of Overweight on 24-hour ..." refers background in this paper

  • ...[11] reported a significantly increased risk between increasing body mass and subsequent kidney stones in three large prospective cohorts....

    [...]

Journal ArticleDOI
TL;DR: The incidence of urolithiasis in the pediatric population increased nearly 5-fold at this institution during the last decade, and it is recommended that the primary diagnostic test be a 24-hour urine collection.

309 citations


"Influence of Overweight on 24-hour ..." refers background in this paper

  • ...Recent studies have shown that the annual incidence is increasing in different populations [2]....

    [...]

  • ...[2] also observed that hypocitraturia is the most commonly identified metabolic abnormality, which was present in 52% of the children studied between 2003 and 2005....

    [...]

Journal ArticleDOI
01 Mar 1993
TL;DR: Overall, 166 of 221 children examined at the Mayo Clinic between 1965 and 1987 were found to have factors that predisposed to urolithiasis, and 166 of 166 children (75.1%) were foundTo determine the clinical characteristics, types of stone problems, and outcomes of pediatric patients with urolithsiasis encountered in a referral center, retrospectively assessed 221 patients.
Abstract: Urolithiasis in pediatric patients has been perceived as uncommon, and the appropriate evaluation and management have been controversial. To determine the clinical characteristics, types of stone problems, and outcomes of pediatric patients with urolithiasis encountered in a referral center, we retrospectively assessed 221 patients (113 girls and 108 boys) with urolithiasis examined at the Mayo Clinic between 1965 and 1987. The median age at onset of symptoms was 11 6 / 12 years among the female patients and 10 6 / 12 years among the male patients. Analysis of stone constituents in 122 patients showed the proportion of calcium oxalate (44.7%), calcium phosphate (23.6%), and cystine (8.1%) stones to be similar in all age-groups. Overall, struvite stones were found in 17.1% and uric acid stones in 1.6% of patients. Conditions that predisposed to metabolic urolithiasis were identified in 115 patients (52%). Hypercalciuria was confirmed in 49 of 145 patients (33.8%) and hyperoxaluria in 25 of 124 (20.2%). Eight of 96 patients had hyperuricosuria, and 5 of 54 had hypocitraturia. Forty-one patients (18.6%) had infection-related stones. Of 66 patients with structural anomalies of the genitourinary tract, 24 (36%) had metabolic abnormalities and 26 (39%) had chronic infection. Among patients with chronic infection, 29% had metabolic abnormalities. Of the 221 patients, 148 (67%) had two or more stones during a mean follow-up of 59 months. Among 140 patients with 12 months or more of follow-up, metabolic activity was present in 31 (22.1%) at the time of most recent examination. Overall, 166 of 221 children (75.1%) were found to have factors that predisposed to urolithiasis. Infected, obstructed, or structurally anomalous urinary tracts seem to be factors permissive for formation of stones and do not obviate the need for careful metabolic assessment in all young patients who form renal stones.

288 citations


"Influence of Overweight on 24-hour ..." refers background in this paper

  • ...Most children with urinary UL have underlying metabolic abnormalities, and hypercalciuria is the most prevalent [3]....

    [...]

Journal ArticleDOI
TL;DR: Positive associations between BMI and urinary calcium excretion likely are due to differences in animal protein and sodium intake and may be due to an increase in uric acid nephrolithiasis.

281 citations


"Influence of Overweight on 24-hour ..." refers background in this paper

  • ...Increasing BMI is a risk factor for abnormal 24-hour urine chemistry studies in adult stone formers and healthy controls without a history of UL [8]....

    [...]

Journal ArticleDOI
TL;DR: Overweight and obese men are more prone to stone formation than overweight women, and the risk of stone formation increased significantly with increasing BMI among both men and women with urolithiasis.
Abstract: Objective: The aim of the study was to assess the influence of overweight and obesity on the risk of calcium oxalate stone formation. Research Methods and Procedures: BMI, 24-hour urine, and serum parameters were evaluated in idiopathic calcium oxalate stone formers (363 men and 164 women) without medical or dietetic pretreatment. Results: Overweight and obesity were present in 59.2% of the men and in 43.9% of the women in the study population. Multiple linear regression analysis revealed a significant positive relationship between BMI and urinary uric acid, sodium, ammonium, and phosphate excretion and an inverse correlation between BMI and urinary pH in both men and women, whereas BMI was associated with urinary oxalate excretion only among women and with urinary calcium excretion only among men. Serum uric acid and creatinine concentrations were correlated with BMI in both genders. Because no association was established between BMI and urinary volume, magnesium, and citrate excretion, inhibitors of calcium oxalate stone formation, the risk of stone formation increased significantly with increasing BMI among both men and women with urolithiasis (p = 0.015). The risk of calcium oxalate stone formation, median number of stone episodes, and frequency of diet-related diseases were highest in overweight and obese men. Discussion: Overweight and obesity are strongly associated with an elevated risk of stone formation in both genders due to an increased urinary excretion of promoters but not inhibitors of calcium oxalate stone formation. Overweight and obese men are more prone to stone formation than overweight women.

255 citations


"Influence of Overweight on 24-hour ..." refers background in this paper

  • ...[13] demonstrated a strong association between obesity and an increased risk for stone formation owing to increased urinary excretion of stone-forming risk factors....

    [...]

  • ...[13] noted that increased BMI affects urinary homeostasis by increasing factors that promote stone formation, such as decreased urinary pH, increased urinary calcium, and increased urinary uric acid excretion....

    [...]