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Dyslipidemia and Kidney Stone Risk

医学 血脂异常 内科学 尿检 泌尿系统 肾结石 肾病科 肾结石病 肥胖
作者
Fábio César Miranda Torricelli,Shubha De,Surafel Gebreselassie,Ina Li,Carl Sarkissian,Manoj Monga
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:191 (3): 667-672 被引量:86
标识
DOI:10.1016/j.juro.2013.09.022
摘要

No AccessJournal of UrologyUrological Survey1 Mar 2014Dyslipidemia and Kidney Stone Risk Fabio Cesar Miranda Torricelli, Shubha K. De, Surafel Gebreselassie, Ina Li, Carl Sarkissian, and Manoj Monga Fabio Cesar Miranda TorricelliFabio Cesar Miranda Torricelli Cleveland Clinic, Cleveland, Ohio More articles by this author , Shubha K. DeShubha K. De Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, Ohio More articles by this author , Surafel GebreselassieSurafel Gebreselassie Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio More articles by this author , Ina LiIna Li Cleveland Clinic, Cleveland, Ohio More articles by this author , Carl SarkissianCarl Sarkissian Cleveland Clinic, Cleveland, Ohio More articles by this author , and Manoj MongaManoj Monga Stevan B. Streem Center for Endourology and Stone Disease, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.09.022AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied the impact of dyslipidemia on 24-hour urinalysis and stone composition. Materials and Methods: We retrospectively identified patients with nephrolithiasis who underwent 24-hour urinalysis and lipid profile evaluation within 3 months. Patients were divided into groups based on total cholesterol, high density lipoprotein, nonhigh density lipoprotein and triglycerides. The groups were compared based on demographic data, diabetes, hypertension and each component of 24-hour urinalysis and stone composition. Multivariate analysis and linear regression were performed to control for potential confounders, including age, gender, body mass index, diabetes and hypertension. Results: A total of 2,442 patients with a mean age of 51.1 years were included in study. On multivariate analysis patients with high total cholesterol had significantly higher urinary potassium and calcium, those with low high density lipoprotein or high triglycerides had significantly higher urinary sodium, oxalate and uric acid with lower pH, and those with high nonhigh density lipoprotein had higher urinary sodium and uric acid. Regarding stone composition, high total cholesterol and triglycerides were significantly associated with a higher uric acid stone rate (p = 0.006 and <0.001, respectively). Linear regression showed a significant association of nonhigh density lipoprotein with higher urinary sodium (p = 0.011) and uric acid (p <0.001) as well as triglycerides and higher uric acid (p = 0.017), and lower urinary pH (p = 0.005). Conclusions: There is a link between dyslipidemia and kidney stone risk that is independent of other components of metabolic syndrome such as diabetes and obesity. Specific alterations in the patient lipid profiles may portend unique aberrations in urine physicochemistry and stone risk. References 1 : Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management. J Clin Endocrinol Metab2012; 97: 1847. Google Scholar 2 : Race, ethnicity and urolithiasis: a critical review. Urolithiasis2013; 41: 99. Google Scholar 3 : Kidney stone disease: pathophysiology, investigation and medical treatment. Clin Med2012; 12: 467. Google Scholar 4 : Association between body mass index, lipid profiles, and types of urinary stones. Ren Fail2012; 34: 1140. 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Prev Med2013; 57: 201. Google Scholar 12 : Objectively measured sedentary behavior, physical activity, and plasma lipids in overweight and obese children. Obesity (Silver Spring)2013; 21: 382. Google Scholar 13 : Metabolic syndrome and urinary stone composition: what factors matter most?. Urology2012; 80: 805. Google Scholar 14 : Overweight, insulin resistance and blood pressure (parameters of the metabolic syndrome) in uric acid urolithiasis. Urol Res2012; 40: 171. Google Scholar 15 : Metabolic syndrome and the risk of calcium stones. Nephrol Dial Transplant2012; 27: 3201. Google Scholar 16 : Association of metabolic syndrome traits and severity of kidney stones: results from a nationwide survey on urolithiasis in Japan. Am J Kidney Dis2013; 61: 923. Google Scholar 17 : Metabolic syndrome and urolithiasis. A new concept for the urologist. Prog Urol2008; 18: 828. Google Scholar 18 : Nephrocalcinosis and hyperlipidemia in rats fed a cholesterol- and fat-rich diet: association with hyperoxaluria, altered kidney and bone minerals, and renal tissue phospholipid-calcium interaction. Urol Res2000; 28: 404. Google Scholar 19 : Lifestyle recommendations to reduce the risk of kidney stones. Urol Clin North Am2011; 38: 313. Google Scholar 20 : Physical activity and dietary energy intake are independently associated with incident kidney stones in women: a report from the Women's Health Initiative (WHI). J Urol2013; 189: e28. abstract 67. Abstract, Google Scholar 21 : Dyslipidemia in obesity: mechanisms and potential targets. Nutrients2013; 5: 1218. Google Scholar 22 : Increased risk of urinary stone disease by physical exercise. Southeast Asian J Trop Med Public Health1996; 27: 172. Google Scholar 23 : Divergence between stone composition and urine supersaturation: clinical and laboratory implications. J Urol1999; 161: 1077. Link, Google Scholar 24 : LDL subclass phenotypes and the insulin resistance syndrome in women. Circulation1993; 88: 381. Google Scholar 25 : HDL lipids and insulin resistance. Curr Diab Rep2010; 10: 78. Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTaguchi K, Okada A, Hamamoto S, Iwatsuki S, Naiki T, Ando R, Mizuno K, Tozawa K, Kohri K and Yasui T (2018) Proinflammatory and Metabolic Changes Facilitate Renal Crystal Deposition in an Obese Mouse Model of Metabolic SyndromeJournal of Urology, VOL. 194, NO. 6, (1787-1796), Online publication date: 1-Dec-2015. Volume 191Issue 3March 2014Page: 667-672 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordskidneycholesterolnephrolithiasisdyslipidemiasbody mass indexMetricsAuthor Information Fabio Cesar Miranda Torricelli Cleveland Clinic, Cleveland, Ohio More articles by this author Shubha K. De Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, Ohio More articles by this author Surafel Gebreselassie Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio More articles by this author Ina Li Cleveland Clinic, Cleveland, Ohio More articles by this author Carl Sarkissian Cleveland Clinic, Cleveland, Ohio More articles by this author Manoj Monga Stevan B. Streem Center for Endourology and Stone Disease, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Expand All Advertisement PDF downloadLoading ...
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