Advanced Biomedical Research

Metabolic evaluation in patients with nephrolithiasis: A report from Isfahan, Iran

Authors

1 Medical School; Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Isfahan Kidney Diseases Research Center; Department of Nephrology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Nephrolithiasis is a major public health problem worldwide. In recent years, growing evidence suggest that this disease may originate from underlying metabolic disorders. This is the first study that reports the frequency of different metabolic abnormalities among patients with nephrolithiasis in Isfahan, a large central province of Iran.
Materials and Methods: From the time period between March 2009 and August 2010, 437 nephrolithiasis patients in Isfahan province enrolled in this study. Metabolic evaluation was performed by obtaining a 24-hours urine sample and fasting venous blood draw. We analyzed urine samples for volume, creatinine, calcium, citrate, oxalate, uric acid, sodium, and cystine. Fasting blood samples were assessed for serum calcium, phosphorus, sodium, potassium, uric acid, albumin, creatinine and blood urea nitrogen.
Results: The mean age was 46 ± 13.8 years (rang: 18-87). Nearly 50% were first time stone formers. The most common metabolic abnormalities were hypocitraturia (40.5%) and hypernatriuria (31.8%) that was followed by hyperoxaluria (28.8%). Hypercalciuria was detected only in 9.2% of the cases.
Conclusion: Although, high calcium excretion was the most frequent metabolic derangement in several similar studies, in our province with considerably high prevalence of vitamin D deficiency, it is not frequent among nephrolithiasis patients. Instead, other metabolic risk factors were in higher frequencies.

Keywords

1. Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol2010;12:e86-96.  Back to cited text no. 1
    
2. Worcester EM, Coe FL. Nephrolithiasis. Prim Care 2008;35:369-91.  Back to cited text no. 2
    
3. Moe OW. Kidney stones: pathophysiology and medical management. Lancet 2006;367:333-44.  Back to cited text no. 3
    
4. Pak CY. Medical management of urinary stone disease. Nephron ClinPract 2004;98:c49-53.  Back to cited text no. 4
    
5. Spivacow FR, Negri AL, del Valle EE, Calviño I, Zanchetta JR. Clinical and metabolic risk factor evaluation in young adults with kidney stones. IntUrolNephrol 2010;42:471-5.  Back to cited text no. 5
    
6. Curhan GC, Willett WC, Speizer FE, Stampfer MJ. Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 2001;59:2290-8.  Back to cited text no. 6
    
7. Hosseini MM, Eshraghian A, Dehghanian I, Irani D, Amini M. Metabolic abnormalities in patients with nephrolithiasis: comparison of first-episode with recurrent cases in Southern Iran. IntUrolNephrol 2010;42:127-31.  Back to cited text no. 7
    
8. Nouri-Majalan N, Baghianimoghadam B, Amiri N, Moghaddasi-Moosavi S. Metabolic abnormalities in patients with recurrent stone formation in a hot territory. BratislLekListy 2010;111:79-82.  Back to cited text no. 8
    
9. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.  Back to cited text no. 9
    
10. Zuckerman JM, Assimos DG. Hypocitraturia: pathophysiology and medical management. Rev Urol 2009;11:134-44.  Back to cited text no. 10
    
11. Zacchia M, Preisig P. Low urinary citrate: an overview. J Nephrol 2010;23Suppl 16:s49-56.  Back to cited text no. 11
    
12. Mohammadifard N, Sarrafzadegan N, Nouri F, Sajjadi F, Alikhasi H, Maghroun M, et al. Using factor analysis to identify dietary patterns in Iranian adults: Isfahan healthy heart program. Int J Public Health 2012;57:235-41.  Back to cited text no. 12
    
13. Hovsepian S, Amini M, Aminorroaya A, Amini P, Iraj B. Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran. J Health PopulNutr 2011;29:149-55.  Back to cited text no. 13
    
14. Berlin T, Holmberg I, Björkhem I. High circulating levels of 25-hydroxyvitamin D3 in renal stone formers with hyper absorptivehypercalciuria. Scand J Clin Lab Invest 1986;46:367-74.  Back to cited text no. 14
    
15. Taylor WH. Renal calculi and self-medication with multivitamin preparations containing vitamin D. ClinSci 1972;42:515-22.  Back to cited text no. 15
    
16. Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006;354:669-83.  Back to cited text no. 16
    
Advanced Biomedical Research
Volume 2012, August
August 2012
Pages 1-4