NDT Advance Access originally published online on August 20, 2008
Nephrology Dialysis Transplantation 2009 24(1):137-141; doi:10.1093/ndt/gfn468
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Increased acid excretion in kidney stone formers with essential hypertension
1 Struttura Complessa Nefrologia e Dialisi 2 Struttura Complessa Anatomia Patologica, Ospedale Santa Maria della Misericordia 3 Clinica Urologia ed Andrologica, Università degli studi di Perugia, Perugia, Italy
Attilio Losito, via Dei Mille 5, San Mariano, 06070 Perugia, Italy. Tel: +39-075-5782609; Fax: +39-075-5782566; E-mail: alosito3{at}gmail.com
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Abstract |
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Background. Although several studies have reported that kidney stone disease and hypertension are associated, the link between the two conditions has not been identified. This study investigated urinary excretion of different solutes, particularly citrate and acids, in kidney stone formers and examined their association with high blood pressure.
Methods. The retrospective study included 234 consecutive subjects, aged 47.0 ± 15.6, attending our metabolic clinic after episodes of kidney stones. Essential hypertension was present in 82 patients (35.0%). A difference in the urinary excretion of some of the investigated components was found between subjects with normal blood pressure and those with hypertension.
Results. The results showed that hypertensive subjects were older and had a higher body mass index (BMI) and serum uric acid. They had a significantly lower urinary pH (5.6 ± 0.4 versus 6.0 ± 0.5) and citrate (2.55 ± 1.36 versus 2.83 ± 1.65 mmol/24 h), higher titratable acid (38.8 ± 19.0 versus 26.8 ± 15.0 mEq/24 h) and ammonium (41.6 ± 17.6 versus 34.2 ±12.4 mmol/24 h). Logistic regression analysis with the presence of hypertension as the dependent variable produced a model with the following predictors: age (P < 0.0001), BMI (P = 0.026), titratable acid (P = 0.025) and low urinary citrate level (P = 0.033). Urinary acid excretion increased with the stage of hypertension. No difference was found in the urinary excretion of other solutes.
Conclusions. These findings suggest that essential hypertension and acid excretion are linked in stone formers.
Keywords: citraturia; hypertension; kidney stones; urinary acid
Received for publication: 12. 5.08
Accepted in revised form: 24. 7.08
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A. Losito Reply Nephrol. Dial. Transplant., June 1, 2009; 24(6): 2004 - 2005. [Full Text] [PDF]
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