24-h urine metabolic profile: is it necessary in all kidney stone formers?

Yasmin Abu-Ghanem, Asaf Shvero, Nir Kleinmann, Harry Z. Winkler, Dorit E. Zilberman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: A 24-h urine metabolic profile (24-UMP) is an integral part of nephrolithiasis work-up. We aimed to explore whether it can be waived under certain circumstances. Materials and methods: We reviewed our prospective registry database of patients seen at our outpatient clinic for nephrolithiasis between the years 2010 and 2017. Data included: gender, age at first stone, body mass index (BMI), self-reported comorbidities and family history of nephrolithiasis. A 24-UMP was obtained from each patient under random diet. The following were recorded: urine volume, urinary levels of sodium, calcium, uric acid, oxalate and citrate. Presence of at least one comorbidity (i.e., hypertension/diabetes/hyperlipidemia) was defined as “associated comorbidities” (AC). Their absence was defined as “no comorbidities” (NC). Subjects were divided into two subgroups: first-time and recurrent stone formers, which were further divided into two subgroups: 1st + AC; 1st + NC; recurrent + AC; recurrent + NC. 24-UMPs have been compared between the four groups. Results: Four hundred and fifty-seven patients were included in the study. In the AC groups, patients demonstrated higher BMI levels (p = 0.001), and were statistically significantly obese (BMI > 30, p = 0.001) and older at first stone event (p = 0.001). First formers, either with AC or NC were more likely to have low urine volume (LUV) compared with recurrent formers (72.5 vs. 59.5%, p = 0.005). In the remaining metabolic abnormalities, no such differences were observed. Conclusions: First-time stone formers, either with or without AC are likely to demonstrate LUV as their primary metabolic abnormality in 24-UMP. Therefore, 24-UMP may be postponed until recurrent stone event.

Original languageEnglish
Pages (from-to)1243-1247
Number of pages5
JournalInternational Urology and Nephrology
Volume50
Issue number7
DOIs
StatePublished - 1 Jul 2018

Keywords

  • 24-h urine metabolic profile
  • Comorbidities
  • Low urine volume
  • Nephrolithiasis
  • Stone recurrence

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