TY - JOUR
T1 - 24-h urine metabolic profile
T2 - is it necessary in all kidney stone formers?
AU - Abu-Ghanem, Yasmin
AU - Shvero, Asaf
AU - Kleinmann, Nir
AU - Winkler, Harry Z.
AU - Zilberman, Dorit E.
N1 - Publisher Copyright:
© 2018, Springer Nature B.V.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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.
AB - 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.
KW - 24-h urine metabolic profile
KW - Comorbidities
KW - Low urine volume
KW - Nephrolithiasis
KW - Stone recurrence
UR - http://www.scopus.com/inward/record.url?scp=85048030742&partnerID=8YFLogxK
U2 - 10.1007/s11255-018-1902-1
DO - 10.1007/s11255-018-1902-1
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C2 - 29876775
AN - SCOPUS:85048030742
SN - 0301-1623
VL - 50
SP - 1243
EP - 1247
JO - International Urology and Nephrology
JF - International Urology and Nephrology
IS - 7
ER -