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Calcium urolithiasis, blood pressure and salt intake.
Blood Press 2003; 12(2):122-7BP

Abstract

OBJECTIVES

To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups.

PATIENTS AND METHODS

Thirty-six patients [mean (+/-standard deviation, SD) = 49.0 +/- 11.7 years; range 27-70 years] with kidney or ureteric stones and 108 controls (mean age of 49.6 +/- 6.8 years; range 39-61 years), matched for gender, ethnic origin and age group were studied. Patients and controls underwent physical measurements, a venous blood sample and they were asked to collect a 24-h urine sample for sodium, potassium, calcium and creatinine.

RESULTS

Stone-formers were significantly heavier and had higher BP than age-, sex- and ethnic-matched population controls. Whilst the difference in systolic BP was independent of the difference in body mass index [16.8 mmHg (7.2-26.4 mmHg), p = 0.001), the difference in diastolic BP was attenuated after adjustment for body mass [1.8 (-3.4 to 7.1), p = 0.49]. Stone-formers passed less urine than controls [-438 ml/day (95% CI -852 to -25), p = 0.038]. They had higher urinary calcium than controls [+3.7 mmol/day (2.8-4.6 mmol/day), p < 0.001], even when expressed as ratio to creatinine [+0.20 (0.11-0.29), p < 0.001]. Sodium excretion was positively associated with urinary calcium in both stone-formers and in controls. The slopes were comparable (0.92 vs 0.98 mmol Ca/100 mmol Na) so that for any level of sodium excretion (or salt intake), stone-formers had a higher calcium excretion than controls.

CONCLUSIONS

In stone-formers, the BP is higher than in controls. Stone-formers excrete more calcium than controls do. In stone-formers and controls, the relationship between urinary sodium and calcium is similar. Since this relationship results from an effect of sodium on calcium, a reduction in salt intake may be a useful method of reducing urinary calcium excretion in stone-formers. However, the "relative" hypercalciuria seen in stone-formers is independent of salt intake and may well reflect an underlying genetic predisposition.

Authors+Show Affiliations

Department of Community Health Sciences, St George's Hospital Medical School, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

12797632

Citation

Timio, Francesca, et al. "Calcium Urolithiasis, Blood Pressure and Salt Intake." Blood Pressure, vol. 12, no. 2, 2003, pp. 122-7.
Timio F, Kerry SM, Anson KM, et al. Calcium urolithiasis, blood pressure and salt intake. Blood Press. 2003;12(2):122-7.
Timio, F., Kerry, S. M., Anson, K. M., Eastwood, J. B., & Cappuccio, F. P. (2003). Calcium urolithiasis, blood pressure and salt intake. Blood Pressure, 12(2), pp. 122-7.
Timio F, et al. Calcium Urolithiasis, Blood Pressure and Salt Intake. Blood Press. 2003;12(2):122-7. PubMed PMID: 12797632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcium urolithiasis, blood pressure and salt intake. AU - Timio,Francesca, AU - Kerry,Sally M, AU - Anson,Ken M, AU - Eastwood,John B, AU - Cappuccio,Francesco P, PY - 2003/6/12/pubmed PY - 2004/1/13/medline PY - 2003/6/12/entrez SP - 122 EP - 7 JF - Blood pressure JO - Blood Press. VL - 12 IS - 2 N2 - OBJECTIVES: To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups. PATIENTS AND METHODS: Thirty-six patients [mean (+/-standard deviation, SD) = 49.0 +/- 11.7 years; range 27-70 years] with kidney or ureteric stones and 108 controls (mean age of 49.6 +/- 6.8 years; range 39-61 years), matched for gender, ethnic origin and age group were studied. Patients and controls underwent physical measurements, a venous blood sample and they were asked to collect a 24-h urine sample for sodium, potassium, calcium and creatinine. RESULTS: Stone-formers were significantly heavier and had higher BP than age-, sex- and ethnic-matched population controls. Whilst the difference in systolic BP was independent of the difference in body mass index [16.8 mmHg (7.2-26.4 mmHg), p = 0.001), the difference in diastolic BP was attenuated after adjustment for body mass [1.8 (-3.4 to 7.1), p = 0.49]. Stone-formers passed less urine than controls [-438 ml/day (95% CI -852 to -25), p = 0.038]. They had higher urinary calcium than controls [+3.7 mmol/day (2.8-4.6 mmol/day), p < 0.001], even when expressed as ratio to creatinine [+0.20 (0.11-0.29), p < 0.001]. Sodium excretion was positively associated with urinary calcium in both stone-formers and in controls. The slopes were comparable (0.92 vs 0.98 mmol Ca/100 mmol Na) so that for any level of sodium excretion (or salt intake), stone-formers had a higher calcium excretion than controls. CONCLUSIONS: In stone-formers, the BP is higher than in controls. Stone-formers excrete more calcium than controls do. In stone-formers and controls, the relationship between urinary sodium and calcium is similar. Since this relationship results from an effect of sodium on calcium, a reduction in salt intake may be a useful method of reducing urinary calcium excretion in stone-formers. However, the "relative" hypercalciuria seen in stone-formers is independent of salt intake and may well reflect an underlying genetic predisposition. SN - 0803-7051 UR - https://www.unboundmedicine.com/medline/citation/12797632/Calcium_urolithiasis_blood_pressure_and_salt_intake_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=12797632.ui DB - PRIME DP - Unbound Medicine ER -