Urinary metabolic profile and stone composition in kidney stone formers with and without heart disease.

Autor: Bargagli M; U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy., Moochhala S; Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK., Robertson WG; Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK.; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK., Gambaro G; Renal Unit, Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy., Lombardi G; Renal Unit, Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy., Unwin RJ; Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK., Ferraro PM; U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. pietromanuel.ferraro@unicatt.it.; Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy. pietromanuel.ferraro@unicatt.it.
Jazyk: angličtina
Zdroj: Journal of nephrology [J Nephrol] 2022 Apr; Vol. 35 (3), pp. 851-857. Date of Electronic Publication: 2021 Jun 21.
DOI: 10.1007/s40620-021-01096-w
Abstrakt: Objective: Kidney stone disease seems to be associated with an increased risk of incident cardiovascular outcomes; the aim of this study is to identify differences in 24-h urine excretory profiles and stone composition among stone formers with and without cardiovascular disease (CVD).
Methods: Data from patients attending the Department of Renal Medicine's metabolic stone clinic from 1995 to 2012 were reviewed. The sample was divided according to the presence or absence of CVD (myocardial infarction, angina, coronary revascularization, or surgery for calcified heart valves). Univariable and multivariable regression models, adjusted for age, sex, BMI, hypertension, diabetes, eGFR, plasma bicarbonate and potential renal acid load of foods were used to investigate differences across groups.
Results: 1826 patients had available data for 24-h urine analysis. Among these, 108 (5.9%) had a history of CVD. Those with CVD were older, have higher prevalence of hypertension and diabetes and lower eGFR. Univariable analysis showed that patients with CVD had significantly lower 24-h urinary excretions for citrate (2.4 vs 2.6 mmol/24 h, p = 0.04), magnesium (3.9 vs 4.2 mmol/24 h, p = 0.03) and urinary pH (6.1 vs 6.2, p = 0.02). After adjustment for confounders, differences in urinary citrate and magnesium excretions remained significant. No differences in the probability of stone formation or stone compositions were found.
Conclusions: Stone formers with CVD have lower renal alkali excretion, possibly suggesting higher acid retention in stone formers with cardiovascular comorbidities. Randomized clinical trials including medications and a controlled diet design are needed to confirm the results presented here.
(© 2021. The Author(s).)
Databáze: MEDLINE
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