DOI: http://dx.doi.org/10.18203/2349-3933.ijam20174307

24-hour urinary constituents in stone formers: a study from Kashmir

Adnan Firdous Raina, Mohd Ashraf Bhat, Imtiyaz Wani, Majid Kawaja, Mosin Saleem, Syed Mudasir, Sheikh Mohd Saleem

Abstract


Background: Urolithiasis is a common disorder. Studies have shown that metabolic causes of urolithiasis include hypercalciuria, hypocitraturia, high or low pH of urine, hyperuricosuria, hyperoxaluria and hypomagnesuria. We intended to conduct this study with the aim to provide historical data regarding the 24-hour urinary analysis in this part of India with a distinct and different geographical and cultural background.

Methods: A total of 186 patients having urinary stone disease attending the departments of Nephrology and Urology in Sher-I- Kashmir institute of medical sciences were included. 26 healthy members of hospital staff were taken as controls. Demographic and clinico-pathological characteristics of each patient were recorded in a questionnaire. Urine was collected for 24-hours from 186 patients and 26 controls. 10ml sample of this urine collection was stored at 20c0 before processing for urinary parameters.

Results: The mean concentration of calcium salts, Magnesium, Oxalate and Uric acid in the 24-hour urinary analysis of urolithiasis patients is higher than that of the normal healthy controls and the relation was statistically significant. On comparing the 24-hour urinary constituents among urolithiasis patients and health controls, the concentration of phosphate was almost equal in both cases and controls while the concentration of oxalate was much higher in cases than controls.

Conclusions: In present study hypercalciuria is main cause of renal calculi along with hypocitraturia, hypomagnesuria and hyperphosphaturia in our valley. Measurement of 24-hour urine constituents is still gold standard for evaluation of stone formers.

 


Keywords


24-hour urinary constituents, Hypercalciuria, Kashmir renal diseases, Urolithiasis

Full Text:

PDF

References


Tekin A, Tekgul S, Atsu N, Bakkaloglu, Kendi S. Oral potassium citrate treatment for idiopathic hypocitruria in children with calcium urolithiasis. J Urol. 2002;2572-74.

Schwille PO, Scholz D, Paulus M, Engelhardt W, Sigel A. Citrate in daily and fasting urine: results of controls, patients with recurrent idiopathic calcium urolithiasis, and primary hyperparathyroidism. Invest Urol. 1979;16:457-62.

Jawalekar S, Surve VT, Bhutey AK. Twenty-four hours urine and serum biochemical parameters in patients with urolithiasis. Nepal Med Coll J. 2010;12(1):5-7.

Gupta M, Bhayana S, Sikka SK. Role of urinary inhibitors andPromoters in calcium oxalate crystallisation. IJRPC. 2011:1.

Hussein NS, Sadiq SM, Kamaliah MD. Twenty-four-hour urine constituents in stone formers: a study from the Northeast Part of Peninsular Malaysia. Saudi J Kidney Dis Transpl. 2013;24(3):630-7.

Shokouhi B, Gasemi K, Norizadeh E. Chemical composition and epidemiological risk factors of urolithiasis in Ardabil Iran. Res J Biol Sci. 2008;3(6):620-6.

Rayhan ZH, Ogavwa Y, Hokama S, Morozumi M, Hatano T. Urolithiasis in Okinawa, Japan: A relatively high prevalence of uric acid stones. Int J Urol. 2003;10:411.

Nazir M, Bajwa AI, Anees M, Islam S, Khan HJ, Ahmad Z. Medical management of uric acid renal calculi. J Fatima Jinnah Med Coll Lahore. 2007;1:44-6.

López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatric Nephrol (Berlin, Germany). 2010;25(1):49-59.

Yagisawa S, Chandhoke PS, Fan J. Metabolic risk factors in patients with first time and recurrent stone formation as determined by comprehensive metabolic evaluation. Urol. 1998;52:750-5.

Mittal RD, Kumar R, Mitall B, Prasad R, Bhandari M. Stone composition, metabolic profile and presence of the gut-inhabiting bacterium oxalobacter form igenes as risk factors for renal stone formation. Med Princ Pract. 2003;12:208-13.

Kumar R, Kapoor R, Mittal B. Evaluation of urinary abnormalities in urolithiasis patients: A study from north India. Indian J Clin Biochem. 2003;18(2)209-15.

Orakzai N, Hanbury DC, Farrington K. Screening for biochemical abnormalities in urolithiasis patients. J Ayub Med College Abottabad. 2004;16(2):60-3.

Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Ankinci. Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int. 2003;70(4):273-7.

Babiv-Ivancic V, Avdagic SC, seric V, Kontrec J, Tucak A, Markovic M, et al. Metabolic evaluation of urolithiasis patients from eastern Croatia. Coll Antopol. 2004;28(2):655-66.

Sriboonlue P, Prasongwatana V, Tungsanga K. Blood and urine aggregatorand inhibitor composition and renal: patients from Northeastern Thailand Nephron. 1991;59:591-6.

Sarić M, Piasek M. Effects of sodium chloride on bone health. Arh Hig Rada Toksikol. 2005;56(1):39-44.

Esen T, Akinci M, Tellaloglu S, Kocak T. Role of inhibitor deficiency on urolithiasis. Eur Urol. 1991;19:244-8.

Abdel-Goad EH, Bereczky ZB. Metabolic risk factors in patients with renal stones in Kwazulu Natal: An inter racial study (Asian and whites). Br J Urol. 2004;93(1):120.

Zuckerman JM, Assimos DG. Hypocitraturia: pathophysiology and medical management. Rev Urol. 2009;11(3):134-44.

Basavaraj DR, Biyani CS, Browning AJ. The role of urinary kidney stone inhibitors and promoters in the pathogenesis of calcium containing renal stones. EAU-EBU update series 5. 2007:126-36.

Iqbal MW, Akhter S, Khawaja MA. Urinary metabolic abnormalities in idiopathic calcium oxalate stone formers: a single center study Canadian J Pure Appl Sci. 2008;2:139-42.

Hess A, Brandle E, Wilbert D, Kohrmann KU, Alken P. Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979vs 2000. Eur Urol. 2003;44:709-13.

El-Rashaid K, Mughal H, Kapoor M. Epidemiological profile, mineral metabolic pattern and crystallography analysis of urolithiasis in Kuwait. Eur J Epidemiol. 1997;13:229-34.

Levy FL, Adams-Huet B, Pak CYC. Ambulatory evaluation of nephrolithiasis: An update of a 1980 protocol. Am J Med. 1995;98:50-9.