Nephrology Dialysis Transplantation, Vol 13, Issue 3 617-622, Copyright © 1998 by Oxford University Press
F Leonetti, B Dussol, P Berthezene, X Thirion and Y Berland
Background: The high social-economic cost of
nephrolithiasis wholly justifies the attempts to understand its mechanism
and avoid recurrences. The influence of dietary habits and urinary risk
factors has been evaluated, but the results were discrepant, probably
because of differences in the methodologies used to compare patients and
controls. Methods: The aim was to assess dietary and
urinary risk factors for urinary stones by comparison between 108 calcium
stone formers (SF) and 210 healthy subjects(HS). All subjects were
recruited during the same 1 year period. Personal characteristics, dietary
habits (evaluated through a food frequency questionnaire) and urinary
biochemical parameters were collected. The high predominance of men in the
SF group led us to focus on the 79 SF and the 96 HS men.
Results: A familial history of stones was reported
more frequently in SF than in HS, 42.9% vs 17.6%,
P<0.005. Body weight was higher in SF, 76.8±12.2 kg
vs 72.8±9.6 kg, P=0.02; and calcium intake
was lower in SF, 794.8±294.1 mg vs
943.6±345.4 mg, P<0.01. For urinary parameters, calcium
and oxalate output were significantly higher in SF. Urinary urea, as a
reflection of daily protein intake, and uric acid were also higher in SF.
Urinary citrate excretion related to body weight was lower in SF. Calciuria
was significantly correlated with urinary urea in both SF, and HS, but the
correlation was stronger for SF. Calciuria correlated significantly with
natriuria only in HS. Conclusions: The main
differences between SF and HS were that SF had a family history of stones,
a higher body weight, a lower daily intake of calcium, and a higher urinary
output of calcium and oxalate. These results underlie the combined role of
genetic and nutritional factors in the pathogenesis of urinary stone
formation. Key words: calcium intake; calcium stone
formers; dietary habits; hypercalciuria; hypocitraturia; hyperoxaluria
ORIGINAL ARTICLES
Dietary and urinary risk factors for stones in idiopathic calcium stone formers compared with healthy subjects
Service de Nephrologie, Hospital Sainte Marguerite, 270, Boulevard de Sainte Marguerite, F-13009 Marseille, France; Unite de Recherche de Physiologie et Pathologie digestives-INSERM Unite 315, Marseille, France; Departement d'Informatique Medicale, France; Corresponding author
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