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Contributory metabolic factors in the development of nephrolithiasis in patients with medullary sponge kidney.
Am J Kidney Dis. 2001 Jun; 37(6):1140-3.AJ

Abstract

Whether specific metabolic abnormalities are related to nephrolithiasis in patients with medullary sponge kidney (MSK) remains a debated issue. The purpose of this study is to determine metabolic disorders in patients with MSK and nephrolithiasis compared with idiopathic calcium-stone-forming patients. One hundred eighty-four patients with recurrent calcium-stone formations were investigated with regard to metabolic abnormalities. Of these, 22 patients (11.9%; 13 men, 9 women) showed MSK by radiological examination. MSK was defined as a kidney that presented at least three linear or round papillary opacities in the affected papilla on urography. Multiple stones (more than five) existed in both kidneys in all patients with MSK. The remaining 162 patients (109 men, 53 women) were idiopathic calcium-stone formers. Frequencies of low urine volume (urine < 1,500 mL/24 h) and hyperoxaluria (oxalate > 40 mg/24 h) were similar between the groups. Hypercalciuria (men, calcium > 300 mg/24 h; women, calcium of 250 mg/24 h) was found less frequently in the MSK group. The frequency of hypocitraturia (citrate < 300 mg/24 h) was significantly greater in the MSK group than the idiopathic group (77.3% versus 33.9%, respectively). Mean 24-hour urinary excretions of calcium, citrate, uric acid, and magnesium were significantly less in the MSK group. No differences were found in serum calcium, phosphate, and parathyroid hormone levels between the groups. Low urinary excretions of citrate and magnesium are the most typical metabolic disorders that distinguish MSK stone patients from idiopathic calcium-stone-forming patients. In addition to such anatomic abnormalities as ectatic collecting ducts, low levels of urinary inhibitors of stones seem to contribute to the pathogenesis of nephrolithiasis in patients with MSK.

Authors+Show Affiliations

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. t-yagisawa@mvb.biglobe.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11382681

Citation

Yagisawa, T, et al. "Contributory Metabolic Factors in the Development of Nephrolithiasis in Patients With Medullary Sponge Kidney." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 37, no. 6, 2001, pp. 1140-3.
Yagisawa T, Kobayashi C, Hayashi T, et al. Contributory metabolic factors in the development of nephrolithiasis in patients with medullary sponge kidney. Am J Kidney Dis. 2001;37(6):1140-3.
Yagisawa, T., Kobayashi, C., Hayashi, T., Yoshida, A., & Toma, H. (2001). Contributory metabolic factors in the development of nephrolithiasis in patients with medullary sponge kidney. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 37(6), 1140-3.
Yagisawa T, et al. Contributory Metabolic Factors in the Development of Nephrolithiasis in Patients With Medullary Sponge Kidney. Am J Kidney Dis. 2001;37(6):1140-3. PubMed PMID: 11382681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contributory metabolic factors in the development of nephrolithiasis in patients with medullary sponge kidney. AU - Yagisawa,T, AU - Kobayashi,C, AU - Hayashi,T, AU - Yoshida,A, AU - Toma,H, PY - 2001/5/31/pubmed PY - 2001/6/29/medline PY - 2001/5/31/entrez SP - 1140 EP - 3 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 37 IS - 6 N2 - Whether specific metabolic abnormalities are related to nephrolithiasis in patients with medullary sponge kidney (MSK) remains a debated issue. The purpose of this study is to determine metabolic disorders in patients with MSK and nephrolithiasis compared with idiopathic calcium-stone-forming patients. One hundred eighty-four patients with recurrent calcium-stone formations were investigated with regard to metabolic abnormalities. Of these, 22 patients (11.9%; 13 men, 9 women) showed MSK by radiological examination. MSK was defined as a kidney that presented at least three linear or round papillary opacities in the affected papilla on urography. Multiple stones (more than five) existed in both kidneys in all patients with MSK. The remaining 162 patients (109 men, 53 women) were idiopathic calcium-stone formers. Frequencies of low urine volume (urine < 1,500 mL/24 h) and hyperoxaluria (oxalate > 40 mg/24 h) were similar between the groups. Hypercalciuria (men, calcium > 300 mg/24 h; women, calcium of 250 mg/24 h) was found less frequently in the MSK group. The frequency of hypocitraturia (citrate < 300 mg/24 h) was significantly greater in the MSK group than the idiopathic group (77.3% versus 33.9%, respectively). Mean 24-hour urinary excretions of calcium, citrate, uric acid, and magnesium were significantly less in the MSK group. No differences were found in serum calcium, phosphate, and parathyroid hormone levels between the groups. Low urinary excretions of citrate and magnesium are the most typical metabolic disorders that distinguish MSK stone patients from idiopathic calcium-stone-forming patients. In addition to such anatomic abnormalities as ectatic collecting ducts, low levels of urinary inhibitors of stones seem to contribute to the pathogenesis of nephrolithiasis in patients with MSK. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/11382681/Contributory_metabolic_factors_in_the_development_of_nephrolithiasis_in_patients_with_medullary_sponge_kidney_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(01)14502-6 DB - PRIME DP - Unbound Medicine ER -