Faculty Collaboration Database

Urine stone risk factors in nephrolithiasis patients with and without bowel disease. Kidney Int 2003 Jan;63(1):255-65

Date

12/11/2002

Pubmed ID

12472791

DOI

10.1046/j.1523-1755.2003.00725.x

Scopus ID

2-s2.0-0037213060 (requires institutional sign-in at Scopus site)   98 Citations

Abstract

BACKGROUND: The prevalence of nephrolithiasis among patients with bowel disease is higher than in the general population. We examined urine stone risk factors and clinical characteristics of these patients, contrasted with a large group of stone forming patients without systemic disease.

METHODS: A total of 180 patients with bowel disease were compared with a group of 2048 nephrolithiasis patients with calcium or uric acid stones and without systemic diseases. Bowel diseases included inflammatory bowel disease with and without bowel resections, bowel resections from cancer or trauma, and bypass procedures for obesity or hypercholesterolemia. Urine stone risk factors, stone rates, stone compositions, and creatinine clearance were measured.

RESULTS: Compared to ordinary stone forming patients, bowel patients formed stones higher in rate of recurrence and in uric acid content. Uric acid content was highest when colon surgery had occurred. Urine volumes were low among all bowel patients except those with a bypass. Average creatinine clearance values were low among all bowel patients. Urine oxalate excretion was modestly elevated after small bowel resection, but very high with bypass. Supersaturations were increased mainly by low urine volume and-for uric acid-low pH. Patients with no surgery were indistinguishable from routine stone formers.

CONCLUSIONS: Low urine volume and pH are the main stone-forming abnormalities in bowel disease patients. Hyperoxaluria is extreme after bypass, but only modest after small bowel surgery. In the absence of surgery, bowel disease patients with stones cannot be distinguished from common stone formers by comprehensive stone risk measurements.

Author List

Parks JH, Worcester EM, O'Connor RC, Coe FL

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Calcium Oxalate
Calcium Phosphates
Citric Acid
Female
Humans
Hydrogen-Ion Concentration
Inflammatory Bowel Diseases
Kidney
Magnesium
Male
Nutritional Physiological Phenomena
Risk Factors
Sex Distribution
Uric Acid
Urinary Calculi
Urine