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Sodium restriction as initial conservative treatment for urinary stone disease.
J Urol. 2010 Oct; 184(4):1372-6.JU

Abstract

PURPOSE

Sodium restriction is widely recommended to prevent urinary stone recurrence. However, the effect of urinary sodium excretion has not been fully evaluated. We investigated the relationship between urinary sodium, urinary metabolite excretion and the risk of recurrence in urinary stone formers.

MATERIALS AND METHODS

Selected for study were 798 stone formers with no evidence of metabolic disorders as the cause of abnormal urinary solutes. We analyzed the relationship between urinary sodium and other metabolic parameters by gender. Values were adjusted by covariates according to correlation status. Patients were divided into stone formers with hypernatriuresis or normal natriuresis (less than 220 mEq daily) and urinary parameters were compared. Kaplan-Meier analysis was done to determine the cumulative incidence of recurrent stones by urinary sodium. Patients were considered recurrence-free at a minimum followup of 3 years without incidence.

RESULTS

In the 492 men and 306 women mean ± SD age was 40.0 ± 11.4 and 45.4 ± 12.7 years, and mean body mass index was 23.9 ± 3.1 and 23.0 ± 3.0 kg/m(2), respectively. Using covariate adjusted partial correlation coefficients urinary sodium was noted to influence volume, pH, calcium, uric acid, oxalate and citrate in men, and volume, pH, calcium, uric acid and citrate in women (each p <0.05). At a median followup of 56.1 months 46 of 98 stone formers (46.9%) with normal natriuresis experienced stone recurrence vs 60 of 93 (64.5%) with hypernatriuresis. Patients with hypernatriuresis also had significantly decreased time to recurrence than those with normal natriuresis (log rank test p = 0.043).

CONCLUSIONS

Results show that urinary sodium is an important determinant of other stone forming parameters and of the risk of recurrent stones. These findings suggest that a sodium restricted diet should be the initial step when treating stone formers.

Authors+Show Affiliations

Department of Urology, Chungbuk National University, Cheongju, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20723924

Citation

Yun, Seok Joong, et al. "Sodium Restriction as Initial Conservative Treatment for Urinary Stone Disease." The Journal of Urology, vol. 184, no. 4, 2010, pp. 1372-6.
Yun SJ, Ha YS, Kim WT, et al. Sodium restriction as initial conservative treatment for urinary stone disease. J Urol. 2010;184(4):1372-6.
Yun, S. J., Ha, Y. S., Kim, W. T., Kim, Y. J., Lee, S. C., & Kim, W. J. (2010). Sodium restriction as initial conservative treatment for urinary stone disease. The Journal of Urology, 184(4), 1372-6. https://doi.org/10.1016/j.juro.2010.06.019
Yun SJ, et al. Sodium Restriction as Initial Conservative Treatment for Urinary Stone Disease. J Urol. 2010;184(4):1372-6. PubMed PMID: 20723924.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sodium restriction as initial conservative treatment for urinary stone disease. AU - Yun,Seok Joong, AU - Ha,Yun-Sok, AU - Kim,Won Tae, AU - Kim,Yong-June, AU - Lee,Sang-Cheol, AU - Kim,Wun-Jae, Y1 - 2010/08/17/ PY - 2010/02/19/received PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2010/10/5/medline SP - 1372 EP - 6 JF - The Journal of urology JO - J. Urol. VL - 184 IS - 4 N2 - PURPOSE: Sodium restriction is widely recommended to prevent urinary stone recurrence. However, the effect of urinary sodium excretion has not been fully evaluated. We investigated the relationship between urinary sodium, urinary metabolite excretion and the risk of recurrence in urinary stone formers. MATERIALS AND METHODS: Selected for study were 798 stone formers with no evidence of metabolic disorders as the cause of abnormal urinary solutes. We analyzed the relationship between urinary sodium and other metabolic parameters by gender. Values were adjusted by covariates according to correlation status. Patients were divided into stone formers with hypernatriuresis or normal natriuresis (less than 220 mEq daily) and urinary parameters were compared. Kaplan-Meier analysis was done to determine the cumulative incidence of recurrent stones by urinary sodium. Patients were considered recurrence-free at a minimum followup of 3 years without incidence. RESULTS: In the 492 men and 306 women mean ± SD age was 40.0 ± 11.4 and 45.4 ± 12.7 years, and mean body mass index was 23.9 ± 3.1 and 23.0 ± 3.0 kg/m(2), respectively. Using covariate adjusted partial correlation coefficients urinary sodium was noted to influence volume, pH, calcium, uric acid, oxalate and citrate in men, and volume, pH, calcium, uric acid and citrate in women (each p <0.05). At a median followup of 56.1 months 46 of 98 stone formers (46.9%) with normal natriuresis experienced stone recurrence vs 60 of 93 (64.5%) with hypernatriuresis. Patients with hypernatriuresis also had significantly decreased time to recurrence than those with normal natriuresis (log rank test p = 0.043). CONCLUSIONS: Results show that urinary sodium is an important determinant of other stone forming parameters and of the risk of recurrent stones. These findings suggest that a sodium restricted diet should be the initial step when treating stone formers. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/20723924/Sodium_restriction_as_initial_conservative_treatment_for_urinary_stone_disease_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2010.06.019?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -