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The impact of metabolic syndrome components on urinary parameters and risk of stone formation

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Abstract

Purpose

To investigate the relationship between metabolic syndrome (MS) and urinary abnormalities in stone-forming patients. Additionally, to delineate whether severity of urinary derangements is impacted by the number of co-occurring MS components.

Methods

Stone-forming patients who underwent initial metabolic workup prior to medical intervention at a comprehensive stone clinic were retrospectively reviewed and included in the study. Patients were given a six point (0–5) Metabolic Syndrome Severity Score (MSSS) based on the number of co-occurring MS components and split into six respective groups. Baseline clinical characteristics and metabolic profiles were compared between groups.

Results

Four-hundred-ninety-five patients were included in the study. Median age and median BMI was 58 years and 27.26 kg/m2, respectively. Several significant metabolic differences were noted, most notably a downward trend in median urinary pH (p < 0.001) and an upward trend in median urinary supersaturation uric acid (p < 0.001) across groups as MSSS increased. Multivariate analysis demonstrated an independent association between higher MSSS and increasing number of urinary abnormalities. A second multivariate analysis revealed that all MS components except hyperlipidemia were independently associated with low urinary pH. Additionally, obesity was independently associated with the greatest number of urinary abnormalities and had the strongest association with hyperuricosuria.

Conclusions

Prior research has attributed the strong association of nephrolithiasis and MS to high prevalence of UA nephrolithiasis and low urinary pH. Our findings indicate that all MS components with the exception of hyperlipidemia were independently associated with low urinary pH suggesting a mechanism independent from insulin resistance.

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Abbreviations

MSSS:

Metabolic Syndrome Severity Score

MS:

Metabolic syndrome

DM:

Diabetes mellitus

HLD:

Hyperlipidemia

HTN:

Hypertension

HTG:

Hypertriglyceridemia

IDF:

International diabetes federation

AHA/NHLBI:

American Heart Association/National Heart, Lung, and Blood Institute

BMI:

Body mass index

HbA1c:

Glycated hemoglobin

SSCaP:

Supersaturation calcium phosphate

Ca24:

24-Hour urinary calcium

Ox24:

24-Hour urinary oxalate

Cit24:

24-Hour urinary citrate

SSCaOx:

Supersaturation calcium oxalate

SSUA:

Supersaturation uric acid

UA24:

24-Hour urinary uric acid

Na24:

24-Hour urinary sodium

NH424:

24-Hour urinary ammonium

CaOx:

Calcium oxalate

UA:

Uric acid

OR:

Odds ratio

AUA:

American Urologic Association

References

  1. Liu Y-T, Yang P-Y, Yang Y-W, Sun H-Y, Lin IC (2017) The association of nephrolithiasis with metabolic syndrome and its components: a cross-sectional analysis. Ther Clin Risk Manag 13:41–48

    Article  CAS  Google Scholar 

  2. Eckel RH, Alberti KG, Grundy SM, Zimmet PZ (2010) The metabolic syndrome. Lancet (London, England) 375(9710):181–183

    Article  Google Scholar 

  3. Wong Y, Cook P, Roderick P, Somani BK (2016) Metabolic syndrome and kidney stone disease: a systematic review of literature. J Endourol 30(3):246–253

    Article  Google Scholar 

  4. Sakhaee K (2014) Epidemiology and clinical pathophysiology of uric acid kidney stones. J Nephrol 27(3):241–245

    Article  CAS  Google Scholar 

  5. Abate N, Chandalia M, Cabo-Chan AV, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65(2):386–392

    Article  CAS  Google Scholar 

  6. Taylor EN, Curhan GC (2006) Body size and 24-hour urine composition. Am J Kidney Dis 48(6):905–915

    Article  CAS  Google Scholar 

  7. Hsi RS, Sanford T, Goldfarb DS, Stoller ML (2017) The role of the 24-hour urine collection in the prevention of kidney stone recurrence. J Urol 197(4):1084–1089

    Article  Google Scholar 

  8. Milose JC, Kaufman SR, Hollenbeck BK, Wolf JS Jr, Hollingsworth JM (2014) Prevalence of 24-hour urine collection in high risk stone formers. J Urol 191(2):376–380

    Article  Google Scholar 

  9. Samson SL, Garber AJ (2014) Metabolic syndrome. Endocrinol Metab Clin North Am 43(1):1–23

    Article  Google Scholar 

  10. Pearle MS, Goldfarb DS, Assimos DG et al (2014) Medical management of kidney stones: AUA guideline. J Urol 192(2):316–324

    Article  Google Scholar 

  11. Ekeruo WO, Tan YH, Young MD et al (2004) Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 172(1):159–163

    Article  Google Scholar 

  12. Ferraro PM, Bargagli M, Trinchieri A, Gambaro G (2020) Risk of kidney stones: influence of dietary factors, dietary patterns, and vegetarian-vegan diets. Nutrients 12(3):779

    Article  CAS  Google Scholar 

  13. Bobulescu IA, Park SK, Xu LHR et al (2019) Net acid excretion and urinary organic anions in idiopathic uric acid nephrolithiasis. Clin J Am Soc Nephrol 14(3):411–420

    Article  CAS  Google Scholar 

  14. Kadlec AO, Greco K, Fridirici ZC, Hart ST, Vellos T, Turk TM (2012) Metabolic syndrome and urinary stone composition: what factors matter most? Urology 80(4):805–810

    Article  Google Scholar 

  15. Castro-Barquero S, Ruiz-León AM, Sierra-Pérez M, Estruch R, Casas R (2020) Dietary strategies for metabolic syndrome: a comprehensive review. Nutrients. https://doi.org/10.3390/nu12102983

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

All authors report no funding, financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jacob N. Bamberger, Daniel C. Rosen, Johnathan A. Khusid, Elie Kaplan-Marans, Blair Gallante, Arjun Kapoor, Ishan Paranjpe, Danie J. Atashsokhan, William M. Atallah & Mantu Gupta

  2. SUNY Downstate College of Medicine, Brooklyn, NY, USA

    Jacob N. Bamberger

Authors
  1. Jacob N. Bamberger
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  2. Daniel C. Rosen
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  3. Johnathan A. Khusid
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  4. Elie Kaplan-Marans
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  5. Blair Gallante
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  6. Arjun Kapoor
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  7. Ishan Paranjpe
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  8. Danie J. Atashsokhan
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  9. William M. Atallah
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  10. Mantu Gupta
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Contributions

BJN protocol/project development; data collection or management; data analysis; manuscript writing/editing, RDC protocol/project development; data collection or management; manuscript writing/editing, KJA protocol/project development; manuscript writing/editing, K-ME protocol/project development; data collection or management; data analysis; manuscript writing/editing, GB protocol/project development; data collection or management; manuscript writing/editing, KA protocol/project development; data collection or management; manuscript writing/editing, PI protocol/project development; data collection or management; data analysis; manuscript writing/editing, ADJ data collection or management; manuscript writing/editing, AWM manuscript writing/editing, GM manuscript writing/editing.

Corresponding author

Correspondence to Jacob N. Bamberger.

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Ethical approval

The study was approved by the Institutional Review Board and necessary informed consent was collected from all participants.

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Bamberger, J.N., Rosen, D.C., Khusid, J.A. et al. The impact of metabolic syndrome components on urinary parameters and risk of stone formation. World J Urol 39, 4483–4490 (2021). https://doi.org/10.1007/s00345-021-03790-7

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  • DOI: https://doi.org/10.1007/s00345-021-03790-7

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