Korean J Urol.  2006 Sep;47(9):928-932. 10.4111/kju.2006.47.9.928.

The Stone Risk Factors for Stone Patients with Hypertension

• Lim JH
• Kim MK
• Kim YG

• KMID: 2294086
• DOI: http://doi.org/10.4111/kju.2006.47.9.928

Abstract

Purpose
In order to identify the stone risk factors for stone patients with hypertension, we analyzed the stone metabolic studies of stone patients with hypertension and stone patients without hypertension.
Materials and Methods
Between January 1998 and December 2005, we analyzed 92 urinary calculi patients with hypertension, and we also 210 urinary calculi patients who had no history of hypertension as a control group. Hypertension was defined as systolic blood pressure >140 mmHg or a diastolic pressure >90mmHg or both, or those patients who were on drug therapy for hypertension. We evaluated such metabolic risk factors as calcium, sodium, potassium, chloride, uric acid, oxalate, phosphorus, the total urine volume and urine citrate level of the 24-hour urine collection, and the uric acid, calcium, phosphorus, cholesterol, triglyceride from the serum.
Results
The mean age was 53.2+/-11.2 in the hypertensive group and 48.4+/-14.0 in the normotensive group. There were significant differences between the hypertensive group and the normotensive group for the body mass index (BMI) (28.7+/-0.9kg/m2 vs 25.1+/-1.1kg/m2, respectively), weight (73.2+/-3.2kg vs 67.4+/-2.1kg respectively) and urine calcium (262.4+/-21.7 mg/day vs 205.2+/-22.3mg/day respectively), uric acid (662.7+/-184.3mg/ day vs 578.3+/-179.2 mg/day respectively). Moreover, there were significant differences between the two groups for total cholesterol (198.5+/-47.4mg/dl vs 167.1+/-42.5 mg/dl respectively) and triglyceride (207.5+/-109.5mg/dl vs 160.8+/-107.1 mg/dl respectively).
Conclusions
Our results suggest that higher urinary calcium excretion and higher uric acid excretion appear to be the characteristic risk factors in the hypertensive group. Hypercholesterolemia, hypertriglyceridemia and an excessive BMI are also related to stone patients with hypertension.

Keyword

Urinary calculi; Hypertension; Calcium; Uric acid; Cholesterol

MeSH Terms

Blood Pressure
Body Mass Index
Calcium
Cholesterol
Citric Acid
Drug Therapy
Humans
Hypercholesterolemia
Hypertension*
Hypertriglyceridemia
Phosphorus
Potassium
Risk Factors*
Sodium
Triglycerides
Uric Acid
Urinary Calculi
Urine Specimen Collection
Calcium
Cholesterol
Citric Acid
Phosphorus
Potassium
Sodium
Uric Acid

Reference

1. Leusmann DB, Blaschke R, Schmandt W. Results of 5,035 stone analyses: a contribution to epidermiology of urinary stone disease. Scand J Urol Nephrol. 1990. 24:205–210.

2. Drash GW. Walsh PC, Retik AB, Stamey TA, Vaughan ED, editors. Urinary lithiasis. Campbell's urology. 1992. 6th ed. Philadelphia: Saunders;2085–2156.

3. Seftel A, Resnick MI. Metabolic evaluation of urolithiasis. Urol Clin North Am. 1990. 17:159–169.

4. Westbury EJ. Some observations on the quantitative analysis of over 1000 urinary calculi. Br J Urol. 1974. 46:215–227.

5. Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, et al. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002. 346:77–84.

6. Cappuccio FP, Siani A, Barba G, Mellone MC, Russo L, Farinaro E, et al. A prospective study of hypertension and the incidence of kidney stones in men. J Hypertens. 1999. 17:1017–1022.

7. Madore F, Stampfer MJ, Rimm EB, Curhan GC. Nephrolithiasis and risk of hypertension. Am J Hypertens. 1998. 11:46–53.

8. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996. 155:839–843.

9. Cupisti A, Morelli E, Lupetti S, Meola M, Barsotti G. Low urine citrate excretion as main risk factor for recurrent calcium oxalate nephrolithiasis in males. Nephron. 1992. 61:73–76.

10. Coe FL, Parks JH, Asplin JR. The pathogenesis and treatment of kidney stones. N Engl J Med. 1992. 327:1141–1152.

11. Smith LH. The pathophysiology and medical treatment of urolithiasis. Semin Nephrol. 1990. 10:31–52.

12. Tibblin G. High blood pressure in men aged 50--a population study of men born in 1913. Acta Med Scand. 1967. 470:Suppl. 1–84.

13. Tisler A, Pierratos A, Honey JD, Bull SB, Rosivall L, Logan AG. High urinary excretion of uric acid combined with high excretion of calcium links kidney stone disease to familial hypertension. Nephrol Dial Transplant. 2002. 17:253–259.

14. Breslau NA. Pathogenesis and management of hypercalciuric nephrolithiasis. Miner Electrolyte Metab. 1994. 20:328–339.

15. Menon M, Krishman CS. Evaluation and medical management of the patient with calcium stone disease. Urol Clin North Am. 1983. 10:595–615.

16. Strazzullo P, Mancini M. Hypertension, calcium metabolism, and nephrolithiasis. Am J Med Sci. 1994. 307:Suppl 1. S102–S106.

17. Levy FL, Adams-Huet B, Pak CY. Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med. 1995. 98:50–59.

18. Iguchi M, Takamura C, Umekawa T, Kurita T, Kohri K. Inhibitory effects of female sex hormones on urinary stone formation in rats. Kidney Int. 1999. 56:479–485.

19. Julius S, Jamerson K, Meija A, Krause L, Schork N, Jones K. The association of borderline hypertension with target organ changes and higher coronary risk. Tecumseh Blood Pressure study. JAMA. 1990. 264:354–358.

20. Henry PD. Hyperlipidemic arterial dysfunction. Circulation. 1990. 81:697–699.

21. Kanbay M, Yildirir A, Bozbas H, Ulus T, Bilgi M, Muderrisoglu H, et al. Statin therapy helps to control blood pressure levels in hypertensive dislipidemic patients. Ren Fail. 2005. 27:297–303.

22. Bichler KH, Strohmaier WL, Schanz F, Nelde HJ, Gaiser I, Shulze E, et al. Effects of calcium antagonists (nifedipine) on nephrocalcinosis and calcium excretion in the rat. Urol Int. 1985. 40:13–21.

23. Kajikawa H. The influence of dietary lipids on nephrolithiasis in rats. Nippon Hinyokika Gakkai Zasshi. 1998. 89:931–938.

24. Kim SC, Moon YT, Hong YP, Hwang TK, Choi SH, Kim KJ, et al. Prevalence and risk factors of urinary stones in Koreans. J Korean Med Sci. 1998. 13:138–146.

25. Iguchi M, Umekawa T, Ishikawa Y, Katayama Y, Kodama M, Takada M, et al. Dietary intake and habits of Japanese renal stone patients. J Urol. 1990. 143:1093–1095.

26. Powell CR, Stoller ML, Schwartz BF, Kane C, Gentle DL, Bruce JE, et al. Impact of body weight on urinary electrolytes in urinary stone formers. Urology. 2000. 55:825–830.