Top

World Journal of Urology

Published in:

01-02-2015 | Topic Paper

Metabolic disorders: stones as first clinical manifestation of significant diseases

Author: Jean-Philippe Haymann

Published in: World Journal of Urology | Issue 2/2015

Abstract

Introduction

Metabolic syndrome, type 2 diabetes, and primary hyperparathyroidism are metabolic disorders that should deserve a special focus in renal stone patients as a pathogenic link is established with some stone components. Indeed, an acidic urinary pH due to a decreased ammonium bioavailability explains the high prevalence of uric acid stones in patients with metabolic syndrome or diabetes and, primary hyperparathyroidism induced hypercalciuria increases the risk of calcium phosphate stones.

Materials and methods

We report here four clinical cases of renal stone patients with metabolic disorders encountered in a daily practice. Clinical and metabolic findings altogether with stone analysis components presented here, illustrate relevant pathophysiological links.

Conclusion

24 hours urine evaluation and stone analysis which includes both morphological typing and infrared spectroscopy, are key diagnostic steps for early recognition of metabolic disorders. Metabolic screening allows diet related stone identification, points out stone risk factors and identifies patients’comorbidity. The occurrence of nephrocalcinosis with or without chronic renal failure should require a more detailed metabolic evaluation in order to identify uncommon etiologies such as renal tubular acidosis.

Cochat P, Hulton SA, Acquaviva C, Danpure CJ, Daudon M, De Marchi M, Fargue S, Groothoff J, Harambat J, Hoppe B, Jamieson NV, Kemper MJ, Mandrile G, Marangella M, Picca S, Rumsby G, Salido E, Straub M, van Woerden CS (2012) OxalEurope. Primary hyperoxaluria Type 1: indications for screening and guidance for diagnosis and treatment. Nephrol Dial Transplant 27(5):1729–1736PubMedCrossRef

Chillarón J, Font-Llitjós M, Fort J, Zorzano A, Goldfarb DS, Nunes V, Palacín M (2010) Pathophysiology and treatment of cystinuria. Nat Rev Nephrol 6(7):424–434PubMedCrossRef

Bollée G, Dollinger C, Boutaud L, Guillemot D, Bensman A, Harambat J, Deteix P, Daudon M, Knebelmann B, Ceballos-Picot I (2010) Phenotype and genotype characterization of adenine phosphoribosyltransferase deficiency. J Am Soc Nephrol 21(4):679–688PubMedCentralPubMedCrossRef

Daudon M (2005) Epidemiology of nephrolithiasis in France. Ann Urol (Paris) 39(6):209–231CrossRef

Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, Monga M, Penniston KL, Preminger GM, Turk TM, White JR (2014) Medical Management of Kidney Stones: AUA Guideline. J Urol, S0022: 5347

Tiselius HG (2003) Epidemiology and medical management of stone disease. BJU Int 91(8):758–767PubMedCrossRef

Daudon M, Bader CA (1993) Jungers P Urinary calculi: review of classification methods and correlations with etiology. Scanning Microsc 7(3):1081–1104PubMed

Ramphal L, Zhang J, Suzuki S (2014) Ethnic disparities in the prevalence of the metabolic syndrome in American adults: data from the Examination of National Health and Nutrition Examination Survey 1999–2010. Proc Bayl Univ Med Cent 27(2):92–95PubMedCentralPubMed

von Frankenberg AD, doNascimento FV, Gatelli LE, Nedel BL, Garcia SP, de Oliveira CS, Saddi-Rosa P, Reis AF, Canani LH, Gerchman F (2014) Major components of metabolicsyndrome and adiponectin levels: a cross-sectional study. Diabetol Metab Syndr 6(1):26CrossRef

10.

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645PubMedCrossRef

11.

Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolicsyndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65(2):386–392PubMedCrossRef

12.

Kohjimoto Y, Sasaki Y, Iguchi M, Matsumura N, Inagaki T, Hara I (2013) Association of metabolic syndrome traits and severity of kidney stones: results from a nationwide survey on urolithiasis in Japan. Am J Kidney Dis 61(6):923–929PubMedCrossRef

13.

Cho ST, Jung SI, Myung SC, Kim TH (2013) Correlation of metabolic syndrome with urinary stone composition. Int J Urol 20(2):208–213PubMedCrossRef

14.

Maalouf NM, Cameron MA, Moe OW, Adams-Huet B, Sakhaee K (2007) Low urine pH: a novel feature of the metabolic syndrome. Clin J Am Soc Nephrol 2:883–888PubMedCrossRef

15.

Sakhaee K, Maalouf NM (2008) Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol 28(2):174–180PubMedCrossRef

16.

Daudon M, Jungers P (2007) Diabetes and nephrolithiasis. Curr Diab Rep 7(6):443–448PubMedCrossRef

17.

Cameron M, Maalouf NM, Poindexter J, Adams-Huet B, Sakhaee K, Moe OW (2012) The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. Kidney Int 81(11):1123–1130PubMedCentralPubMedCrossRef

18.

Li C, Hsieh MC, Chang SJ (2013) Metabolic syndrome, diabetes, and hyperuricemia. Curr Opin Rheumatol 25(2):210–216PubMedCrossRef

19.

Fraile JM, Puig JG, Torres RJ, de Miguel E, Martínez P, Vázquez JJ (2010) Uric acid metabolism in patients with primary gout and the metabolic syndrome. Nucleosides Nucleotides Nucleic Acids 29(4–6):330–334PubMedCrossRef

20.

Daudon M, Traxer O, Conort P, Lacour B, Jungers P (2006) Type 2 diabetes increases the risk for uric acidstones. J Am Soc Nephrol 17(7):2026–2033PubMedCrossRef

21.

Lieske JC, de la Vega LS, Gettman MT, Slezak JM, Bergstralh EJ, Melton LJ III, Leibson CL (2006) Diabetes mellitus and the risk of urinary tract stones: a population-based case-control study. Am J Kidney Dis 48(6):897–904PubMedCrossRef

22.

Pak CY, 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(3):523–527PubMedCrossRef

23.

Rejnmark L, Vestergaard P, Mosekilde L (2011) Nephrolithiasis and renal calcifications in primary hyperparathyroidism. J Clin Endocrinol Metab 96(8):2377–2385PubMedCrossRef

24.

Suh JM, Cronan JJ, Monchik JM (2008) Primary hyperparathyroidism: is there an increased prevalence of renal stone disease? Am J Roentgenol 191(3):908–911CrossRef

25.

Daudon M, Bouzidi H, Bazin D (2010) Composition and morphology of phosphate stones and their relation with etiology. Urol Res 38(6):459–467PubMedCrossRef

26.

Krambeck AE, Handa SE, Evan AP, Lingeman JE (2010) Brushite stone disease as a consequence of lithotripsy? Urol Res 38(4):293–299PubMedCentralPubMedCrossRef

27.

DeLellis RA, Mazzaglia P, Mangray S (2008) Primary hyperparathyroidism: a current perspective. Arch Pathol Lab Med 8:1251–1262

28.

Nakaoka D, Sugimoto T, Kobayashi T, Yamaguchi T, Kobayashi A, Chihara K (2000) Prediction of bone mass change after parathyroidectomy in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 85(5):1901–1907PubMed

29.

Bruce LJ, Cope DL, Jones GK, Schofield AE, Burley M, Povey S, Unwin RJ, Wrong O, Tanner MJ (1997) Familial distal renal tubular acidosis is associated with mutations in the red cell anion exchanger (Band 3, AE1) gene. J Clin Invest 100(7):1693–1707PubMedCentralPubMedCrossRef

30.

Melton LJ III, Crowson CS, Khosla S, Wilson DM, O’Fallon WM (1998) Fracture risk among patients with urolithiasis: a population-based cohort study. Kidney Int 53(2):459–464PubMedCrossRef

Title: Metabolic disorders: stones as first clinical manifestation of significant diseases
Author: Jean-Philippe Haymann
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 2/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1391-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Metabolic disorders: stones as first clinical manifestation of significant diseases

Abstract

Introduction

Materials and methods

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2015

Diet: from food to stone

Acute management of stones: When to treat or not to treat?

CXCR4 is highly expressed at the tumor front but not in the center of prostate cancers

Lessons learned from the CROES percutaneous nephrolithotomy global study

Urinary bladder mucosal responses to ischemia

WJU special edition: surgical and medical management of stones