PURPOSE: To study the impact of dyslipidemia on 24-hour urine analysis and stone composition.
PATIENTS AND METHODS: We retrospectively identified patients with nephrolithiasis who had a 24-hour urine analysis and lipid profile evaluation within 3 months of each other. Patients were divided in groups based on their total cholesterol (TC), HDL, non-HDL, and triglycerides (TG) levels. Groups were compared based on their demographic data, diabetes, hypertension, each component of the 24-hour urine analysis, and stone composition. A multivariate analysis and linear regression were performed to control for potential confounders including age, gender, body-mass index, diabetes, and hypertension.
RESULTS: 2442 patients were included with mean age of 51.1 years. On multivariate analysis, patients with high TC had significant higher urinary potassium and calcium; patients with low HDL or high TG had significant higher urinary sodium, oxalate and uric acid, and lower pH; and patients with high non-HDL had higher urinary sodium and uric acid. Regarding the stone composition, high TC and TG levels were significantly associated with a higher uric acid stone rate (p=0.006 and p< 0.001, respectively). Linear regression showed a significant association between non-HDL level and a higher urinary sodium (p=0.011) and uric acid levels (p< 0.001) as well as TG level 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 the metabolic syndrome (diabetes, obesity). Specific alterations in patients' lipid profiles may portend unique aberrations in urine physicochemistry and stone risk.
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Written by:
Torricelli FC, De S, Gebreselassie S, Li I, Sarkissian C, Monga M. Are you the author?
Research Fellow at Cleveland Clinic.
Reference: J Urol. 2013 Sep 17. pii: S0022-5347(13)05454-2.
doi: 10.1016/j.juro.2013.09.022
PubMed Abstract
PMID: 24055417
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