Skip to main content
Top
Published in: Urolithiasis 3/2006

01-06-2006 | Original Paper

Influence of body size on urinary stone composition in men and women

Authors: Michel Daudon, Bernard Lacour, Paul Jungers

Published in: Urolithiasis | Issue 3/2006

Login to get access

Abstract

A larger body size has been shown to be associated with increased excretion of urinary lithogenic solutes, and an increased risk of nephrolithiasis has been reported in overweight patients. However, the type of stones produced in these subjects has not been ascertained. Based on a large series of calculi, we examined the relationship between body size and the composition of stones, in order to assess which type of stone is predominantly favoured by overweight. Among 18,845 consecutive calculi referred to our laboratory, 2,100 came from adults with recorded body height and weight. Excluding calculi from patients with diabetes mellitus, as well as struvite and cystine stones, the study material consisted of 1,931 calcium or uric acid calculi. All calculi were analysed by infrared spectroscopy and categorized according to their main component. Body mass index (BMI) values were stratified as normal BMI (<25 kg/m2), overweight (BMI 25–29.9) or obese (BMI≥30). Overall, 27.1% of male and 19.6% of female stone formers were overweight, and 8.4 and 13.5% were obese, respectively. In males, the proportion of calcium stones was lower in overweight and obese groups than in normal BMI group, whereas the proportion of uric acid stones gradually increased with BMI, from 7.1% in normal BMI to 28.7% in obese subjects (P<0.0001). The same was true in females, with a proportion of uric acid stones rising from 6.1% in normal BMI to 17.1% in obese patients (P=0.003). In addition, the proportion of uric acid stones markedly rose with age in both genders (P<0.0001). The average BMI value was significantly higher in uric acid stone formers aged <60 years than in all other groups, whereas it did not differ from other groups in those aged ≥60 years. Stepwise regression analysis identified BMI and age as significant, independent covariates associated with the risk of uric acid stones. Our data provide evidence that overweight is associated with a high proportion of uric acid stones in patients less than 60 years of age, whereas beyond this limit, advancing age is the main risk factor.
Literature
2.
go back to reference Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary tract stones during the last ten years. Eur Urol 37:23PubMedCrossRef Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary tract stones during the last ten years. Eur Urol 37:23PubMedCrossRef
3.
go back to reference Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817PubMedCrossRef Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817PubMedCrossRef
4.
go back to reference Robertson WG (1987) Diet and calcium stones. Miner Electrolyte Metab 13:228PubMed Robertson WG (1987) Diet and calcium stones. Miner Electrolyte Metab 13:228PubMed
5.
go back to reference Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723PubMedCrossRef Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723PubMedCrossRef
6.
go back to reference Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356PubMedCrossRef Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356PubMedCrossRef
7.
8.
go back to reference Curhan GC, Willett WC, Rimm EB, Speizer FE, Stampfer MJ (1998) Body size and risk of kidney stones. J Am Soc Nephrol 9:1645PubMed Curhan GC, Willett WC, Rimm EB, Speizer FE, Stampfer MJ (1998) Body size and risk of kidney stones. J Am Soc Nephrol 9:1645PubMed
9.
go back to reference Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293:455PubMedCrossRef Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293:455PubMedCrossRef
10.
go back to reference Lemann J Jr, Pleuss JA, Worcester EM, Hornick L, Schrab D, Hoffmann RG (1996) Urinary oxalate excretion increases with body size and decreases with increasing dietary calcium intake among healthy adults. Kidney Int 49:200PubMedCrossRef Lemann J Jr, Pleuss JA, Worcester EM, Hornick L, Schrab D, Hoffmann RG (1996) Urinary oxalate excretion increases with body size and decreases with increasing dietary calcium intake among healthy adults. Kidney Int 49:200PubMedCrossRef
11.
go back to reference Powell CR, Stoller ML, Schwartz BF, Kane C, Gentle DL, Bruce JE, Leslie SW (2000) Impact of body weight on urinary electrolytes in urinary stone formers. Urology 55:825PubMedCrossRef Powell CR, Stoller ML, Schwartz BF, Kane C, Gentle DL, Bruce JE, Leslie SW (2000) Impact of body weight on urinary electrolytes in urinary stone formers. Urology 55:825PubMedCrossRef
12.
go back to reference Siener R, Ebert D, Nicolay C, Hesse A (2003) Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 63:1037PubMedCrossRef Siener R, Ebert D, Nicolay C, Hesse A (2003) Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 63:1037PubMedCrossRef
13.
go back to reference Siener R, Glatz S, Nicolay C, Hesse A (2004) The role of overweight and obesity in calcium oxalate stone formation. Obes Res 12:106PubMed Siener R, Glatz S, Nicolay C, Hesse A (2004) The role of overweight and obesity in calcium oxalate stone formation. Obes Res 12:106PubMed
14.
go back to reference Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CYC (2004) Association of urinary pH with body weight in nephrolithiasis. Kidney Int 65:1422PubMedCrossRef Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CYC (2004) Association of urinary pH with body weight in nephrolithiasis. Kidney Int 65:1422PubMedCrossRef
15.
go back to reference Pak CYC, Sakhaee K, Peterson RD, Poindexter JR, Frawley WH (2001) Biochemical profile of idiopathic uric acid nephrolithiasis. Kidney Int 60:757PubMedCrossRef Pak CYC, Sakhaee K, Peterson RD, Poindexter JR, Frawley WH (2001) Biochemical profile of idiopathic uric acid nephrolithiasis. Kidney Int 60:757PubMedCrossRef
16.
go back to reference Ekeruo WO, Tan YH, Young MD, Dahm P, Maloney ME, Mathias BJ, Albala DM, Preminger GM (2004) Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 172:159PubMedCrossRef Ekeruo WO, Tan YH, Young MD, Dahm P, Maloney ME, Mathias BJ, Albala DM, Preminger GM (2004) Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 172:159PubMedCrossRef
17.
go back to reference Khatchadourian J, Preminger GM, Whitson PA, Adams-Huet B, Pak CYC (1995) Clinical and biochemical presentation of gouty diathesis: comparison of uric acid versus pure calcium stone formation. J Urol 154:1665PubMedCrossRef Khatchadourian J, Preminger GM, Whitson PA, Adams-Huet B, Pak CYC (1995) Clinical and biochemical presentation of gouty diathesis: comparison of uric acid versus pure calcium stone formation. J Urol 154:1665PubMedCrossRef
18.
go back to reference Sakhaee K, Adams-Huet B, Moe OW, Pak CYC (2002) Pathophysiologic basis for normouricosuric uric acid nephrolithiasis. Kidney Int 62:971PubMedCrossRef Sakhaee K, Adams-Huet B, Moe OW, Pak CYC (2002) Pathophysiologic basis for normouricosuric uric acid nephrolithiasis. Kidney Int 62:971PubMedCrossRef
19.
go back to reference Daudon M, Dore JC, Jungers P, Lacour B (2004) Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urol Res 32:241PubMedCrossRef Daudon M, Dore JC, Jungers P, Lacour B (2004) Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urol Res 32:241PubMedCrossRef
20.
go back to reference Pak CYC, Sakhaee K, Moe O, Preminger GM, Poindexter JR, Peterson RD, Pietrow P, Ekeruo W (2003) Biochemical profile of stone-forming patients with diabetes mellitus. Urology 61:523PubMedCrossRef Pak CYC, Sakhaee K, Moe O, Preminger GM, Poindexter JR, Peterson RD, Pietrow P, Ekeruo W (2003) Biochemical profile of stone-forming patients with diabetes mellitus. Urology 61:523PubMedCrossRef
21.
go back to reference Daudon M, Lacour B, Jungers P (2005) High prevalence of uric acid calculi in diabetic stone formers. Nephrol Dial Transplant 20:468PubMedCrossRef Daudon M, Lacour B, Jungers P (2005) High prevalence of uric acid calculi in diabetic stone formers. Nephrol Dial Transplant 20:468PubMedCrossRef
22.
go back to reference Daudon M, Bader CA, Jungers P (1993) Urinary calculi: review of classification methods and correlations with etiology. Scanning Microsc 7:1081–1104; discussion 1104 Daudon M, Bader CA, Jungers P (1993) Urinary calculi: review of classification methods and correlations with etiology. Scanning Microsc 7:1081–1104; discussion 1104
23.
go back to reference Daudon M, Jungers P (2004) Clinical value of crystalluria and quantitative morphoconstitutional analysis of urinary calculi. Nephron Physiol 98:31CrossRef Daudon M, Jungers P (2004) Clinical value of crystalluria and quantitative morphoconstitutional analysis of urinary calculi. Nephron Physiol 98:31CrossRef
24.
go back to reference Charles MA, Basdevant A, Eschwege E (2002) Prévalence de l’obésité de l’adulte en France: la situation en 2000 à partir des résultats des études OBEPI. Ann Endocrinol (Paris) 63:154 Charles MA, Basdevant A, Eschwege E (2002) Prévalence de l’obésité de l’adulte en France: la situation en 2000 à partir des résultats des études OBEPI. Ann Endocrinol (Paris) 63:154
25.
go back to reference Nishio S, Yokoyama M, Iwata H, Takeuchi M, Kamei O, Sugamoto T, Seike Y, Ochi K, Kin M, Aoki K, Nabeshima S, Takeda H, Takei S (1998) Obesity as one of the risk factors for urolithiasis. Nippon Hinyokika Gakkai Zasshi 89:573PubMed Nishio S, Yokoyama M, Iwata H, Takeuchi M, Kamei O, Sugamoto T, Seike Y, Ochi K, Kin M, Aoki K, Nabeshima S, Takeda H, Takei S (1998) Obesity as one of the risk factors for urolithiasis. Nippon Hinyokika Gakkai Zasshi 89:573PubMed
27.
go back to reference Hall WD, Pettinger M, Oberman A, Watts NB, Johnson KC, Paskett ED, Limacher MC, Hays J (2001) Risk factors for kidney stones in older women in the southern United States. Am J Med Sci 322:12PubMedCrossRef Hall WD, Pettinger M, Oberman A, Watts NB, Johnson KC, Paskett ED, Limacher MC, Hays J (2001) Risk factors for kidney stones in older women in the southern United States. Am J Med Sci 322:12PubMedCrossRef
28.
go back to reference Curhan GC, Willett WC, Speizer FE, Stampfer MJ (2001) Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 59:2290PubMed Curhan GC, Willett WC, Speizer FE, Stampfer MJ (2001) Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 59:2290PubMed
29.
30.
go back to reference Yu T, Gutman AB (1967) Uric acid nephrolithiasis in gout. Predisposing factors. Ann Intern Med 67:1133PubMed Yu T, Gutman AB (1967) Uric acid nephrolithiasis in gout. Predisposing factors. Ann Intern Med 67:1133PubMed
31.
go back to reference Shekarriz B, Stoller ML (2002) Uric acid nephrolithiasis: current concepts and controversies. J Urol 168:1307PubMedCrossRef Shekarriz B, Stoller ML (2002) Uric acid nephrolithiasis: current concepts and controversies. J Urol 168:1307PubMedCrossRef
32.
go back to reference Pak CYC, Poindexter JR, Peterson RD, Koska J, Sakhaee K (2002) Biochemical distinction between hyperuricosuric calcium urolithiasis and gouty diathesis. Urology 60:789PubMedCrossRef Pak CYC, Poindexter JR, Peterson RD, Koska J, Sakhaee K (2002) Biochemical distinction between hyperuricosuric calcium urolithiasis and gouty diathesis. Urology 60:789PubMedCrossRef
33.
go back to reference Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65:386PubMedCrossRef Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65:386PubMedCrossRef
35.
go back to reference Hesse A, Classen A, Knoll M, Timmermann F, Vahlensieck W (1986) Dependence of urine composition on the age and sex of healthy subjects. Clin Chim Acta 160:79PubMedCrossRef Hesse A, Classen A, Knoll M, Timmermann F, Vahlensieck W (1986) Dependence of urine composition on the age and sex of healthy subjects. Clin Chim Acta 160:79PubMedCrossRef
36.
go back to reference Petersen KF, Befroy D, Dufour S, Dziura J, Ariyan C, Rothman DL, DiPietro L, Cline GW, Shulman GI (2003) Mitochondrial dysfunction in the elderly: possible role in insulin resistance. Science 300:1140PubMedCrossRef Petersen KF, Befroy D, Dufour S, Dziura J, Ariyan C, Rothman DL, DiPietro L, Cline GW, Shulman GI (2003) Mitochondrial dysfunction in the elderly: possible role in insulin resistance. Science 300:1140PubMedCrossRef
37.
go back to reference Grundy SM, Hansen B, Smith SC Jr, Cleeman JI, Kahn RA (2004) Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 109:551PubMedCrossRef Grundy SM, Hansen B, Smith SC Jr, Cleeman JI, Kahn RA (2004) Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 109:551PubMedCrossRef
Metadata
Title
Influence of body size on urinary stone composition in men and women
Authors
Michel Daudon
Bernard Lacour
Paul Jungers
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
Urolithiasis / Issue 3/2006
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-006-0042-8

Other articles of this Issue 3/2006

Urolithiasis 3/2006 Go to the issue