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Etiological role of estrogen status in renal stone formation.

Abstract

PURPOSE

Estrogen may protect against kidney stone formation since nephrolithiasis is more common in men than in women. Moreover, the incidence of stones rises after menopause in women. We examined the contribution of estrogen to kidney stone risk by comparing outpatient evaluations in the 2 genders, and in estrogen treated and untreated postmenopausal women.

MATERIALS AND METHODS

We reviewed the results of the initial evaluation of 1,454 adult calcium oxalate stone formers, including 1,050 men and 404 women. Of the postmenopausal women 39 and 50 were estrogen treated and untreated, respectively. Samples of urine and blood were collected 1 week after the imposition of a diet restricted moderately in sodium and calcium, and modestly in oxalate and animal protein.

RESULTS

Compared with men the daily excretion of urinary calcium, oxalate and uric acid was lower in women. Women had lower saturations of calcium oxalate and brushite as well as lower excretion of undissociated uric acid. Compared with men urinary calcium was lower in women until age 50 years, when it equaled that of men. Citrate was equal in the genders until the age 60 years, when it tended to decrease in women. Compared with nontreated postmenopausal women those treated with estrogen had lower mean 24-hour calcium plus or minus SD (155 +/- 62 versus 193 +/- 90 mg. per day, p <0.02), mean 2-hour fasting urine calcium (0.08 +/- 0.05 versus 0.12 +/- 0.09 mg./mg. creatinine, p <0.01) and mean calcium oxalate saturation (5.07 +/- 2.27 versus 6.48 +/- 3.44, p <0.05).

CONCLUSIONS

The lower risk of stone formation in women may be due to the lower urinary saturation of stone forming salts. Estrogen treatment may decrease the risk of stone recurrence in postmenopausal women by lowering urinary calcium and calcium oxalate saturation.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Center for Mineral Metabolism and Clinical Research, USA.

    , ,

    Source

    The Journal of urology 168:5 2002 Nov pg 1923-7

    MeSH

    Adult
    Age Factors
    Aged
    Calcium Oxalate
    Calcium Phosphates
    Estrogens
    Female
    Humans
    Kidney Calculi
    Male
    Middle Aged
    Postmenopause
    Risk Factors
    Sex Factors
    Uric Acid

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12394677

    Citation

    Heller, Howard J., et al. "Etiological Role of Estrogen Status in Renal Stone Formation." The Journal of Urology, vol. 168, no. 5, 2002, pp. 1923-7.
    Heller HJ, Sakhaee K, Moe OW, et al. Etiological role of estrogen status in renal stone formation. J Urol. 2002;168(5):1923-7.
    Heller, H. J., Sakhaee, K., Moe, O. W., & Pak, C. Y. (2002). Etiological role of estrogen status in renal stone formation. The Journal of Urology, 168(5), pp. 1923-7.
    Heller HJ, et al. Etiological Role of Estrogen Status in Renal Stone Formation. J Urol. 2002;168(5):1923-7. PubMed PMID: 12394677.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Etiological role of estrogen status in renal stone formation. AU - Heller,Howard J, AU - Sakhaee,Khashayar, AU - Moe,Orson W, AU - Pak,Charles Y C, PY - 2002/10/24/pubmed PY - 2002/11/26/medline PY - 2002/10/24/entrez KW - Non-programmatic SP - 1923 EP - 7 JF - The Journal of urology JO - J. Urol. VL - 168 IS - 5 N2 - PURPOSE: Estrogen may protect against kidney stone formation since nephrolithiasis is more common in men than in women. Moreover, the incidence of stones rises after menopause in women. We examined the contribution of estrogen to kidney stone risk by comparing outpatient evaluations in the 2 genders, and in estrogen treated and untreated postmenopausal women. MATERIALS AND METHODS: We reviewed the results of the initial evaluation of 1,454 adult calcium oxalate stone formers, including 1,050 men and 404 women. Of the postmenopausal women 39 and 50 were estrogen treated and untreated, respectively. Samples of urine and blood were collected 1 week after the imposition of a diet restricted moderately in sodium and calcium, and modestly in oxalate and animal protein. RESULTS: Compared with men the daily excretion of urinary calcium, oxalate and uric acid was lower in women. Women had lower saturations of calcium oxalate and brushite as well as lower excretion of undissociated uric acid. Compared with men urinary calcium was lower in women until age 50 years, when it equaled that of men. Citrate was equal in the genders until the age 60 years, when it tended to decrease in women. Compared with nontreated postmenopausal women those treated with estrogen had lower mean 24-hour calcium plus or minus SD (155 +/- 62 versus 193 +/- 90 mg. per day, p <0.02), mean 2-hour fasting urine calcium (0.08 +/- 0.05 versus 0.12 +/- 0.09 mg./mg. creatinine, p <0.01) and mean calcium oxalate saturation (5.07 +/- 2.27 versus 6.48 +/- 3.44, p <0.05). CONCLUSIONS: The lower risk of stone formation in women may be due to the lower urinary saturation of stone forming salts. Estrogen treatment may decrease the risk of stone recurrence in postmenopausal women by lowering urinary calcium and calcium oxalate saturation. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12394677/Etiological_role_of_estrogen_status_in_renal_stone_formation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)64264-4 DB - PRIME DP - Unbound Medicine ER -