Tags

Type your tag names separated by a space and hit enter

Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers.

Abstract

INTRODUCTION AND OBJECTIVE

Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevention counseling.

METHODS

We performed a retrospective study of 392 consecutive patients from 2007 to 2014 with ≥2 lifetime stone episodes, >70% calcium oxalate by mineral analysis, and ≥1 24-hour urine collection. We compared mean 24-hour urine values by age in decades. We used logistic regression and receiver operating characteristic (ROC) curve analysis to assess the predictive ability of age, gender, body mass index (BMI), and comorbidities to detect abnormal 24-hour urine parameters.

RESULTS

The mean age of the cohort was 51 ± 16 years. Older age was associated with greater urinary oxalate (p-trend <0.001), lower urinary uric acid (UA) (p-trend = 0.007), and lower urinary pH (p-trend <0.001). A nonlinear association was noted between age and urinary calcium or citrate (calcium peaked at 40-49 years, p = 0.03; citrate nadired at 18-29 years, p = 0.001). ROC analysis of age, gender, and BMI to predict 24-hour urine abnormalities performed the best for hyperuricosuria (area under the curve [AUC] 0.816), hyperoxaluria (AUC 0.737), and hypocitraturia (AUC 0.740). Including diabetes mellitus or hypertension did not improve AUC significantly.

CONCLUSIONS

In our recurrent calcium oxalate cohort, age significantly impacted urinary calcium, oxalate, citrate, and pH. Along with gender and BMI, age can be used to predict key 24-hour urine stone risk results. These data lay the foundation for a risk prediction tool, which could be a surrogate for 24-hour urine results in recurrent stone formers, who are unwilling or unable to complete metabolic testing. Further validation of these findings is needed in other stone populations.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    1 Department of Urology, University of Florida College of Medicine , Gainesville, Florida.

    ,

    1 Department of Urology, University of Florida College of Medicine , Gainesville, Florida. 2 Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida College of Medicine , Gainesville, Florida.

    ,

    1 Department of Urology, University of Florida College of Medicine , Gainesville, Florida.

    ,

    2 Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida College of Medicine , Gainesville, Florida.

    ,

    1 Department of Urology, University of Florida College of Medicine , Gainesville, Florida.

    1 Department of Urology, University of Florida College of Medicine , Gainesville, Florida.

    Source

    Journal of endourology 31:12 2017 Dec pg 1335-1341

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Body Mass Index
    Calcium
    Calcium Oxalate
    Calcium Phosphates
    Citrates
    Citric Acid
    Comorbidity
    Diabetes Mellitus
    Female
    Humans
    Hypercalciuria
    Hyperoxaluria
    Hypertension
    Kidney Calculi
    Male
    Middle Aged
    Nephrolithiasis
    Obesity
    Oxalates
    Recurrence
    Regression Analysis
    Retrospective Studies
    Sex Factors
    Uric Acid
    Urinalysis
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29084490

    Citation

    Otto, Brandon J., et al. "Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers." Journal of Endourology, vol. 31, no. 12, 2017, pp. 1335-1341.
    Otto BJ, Bozorgmehri S, Kuo J, et al. Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers. J Endourol. 2017;31(12):1335-1341.
    Otto, B. J., Bozorgmehri, S., Kuo, J., Canales, M., Bird, V. G., & Canales, B. (2017). Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers. Journal of Endourology, 31(12), pp. 1335-1341. doi:10.1089/end.2017.0352.
    Otto BJ, et al. Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers. J Endourol. 2017;31(12):1335-1341. PubMed PMID: 29084490.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers. AU - Otto,Brandon J, AU - Bozorgmehri,Shahab, AU - Kuo,Jennifer, AU - Canales,Muna, AU - Bird,Vincent G, AU - Canales,Benjamin, PY - 2017/11/1/pubmed PY - 2018/7/4/medline PY - 2017/11/1/entrez KW - calcium oxalate stone disease KW - metabolic testing KW - nephrolithiasis SP - 1335 EP - 1341 JF - Journal of endourology JO - J. Endourol. VL - 31 IS - 12 N2 - INTRODUCTION AND OBJECTIVE: Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevention counseling. METHODS: We performed a retrospective study of 392 consecutive patients from 2007 to 2014 with ≥2 lifetime stone episodes, >70% calcium oxalate by mineral analysis, and ≥1 24-hour urine collection. We compared mean 24-hour urine values by age in decades. We used logistic regression and receiver operating characteristic (ROC) curve analysis to assess the predictive ability of age, gender, body mass index (BMI), and comorbidities to detect abnormal 24-hour urine parameters. RESULTS: The mean age of the cohort was 51 ± 16 years. Older age was associated with greater urinary oxalate (p-trend <0.001), lower urinary uric acid (UA) (p-trend = 0.007), and lower urinary pH (p-trend <0.001). A nonlinear association was noted between age and urinary calcium or citrate (calcium peaked at 40-49 years, p = 0.03; citrate nadired at 18-29 years, p = 0.001). ROC analysis of age, gender, and BMI to predict 24-hour urine abnormalities performed the best for hyperuricosuria (area under the curve [AUC] 0.816), hyperoxaluria (AUC 0.737), and hypocitraturia (AUC 0.740). Including diabetes mellitus or hypertension did not improve AUC significantly. CONCLUSIONS: In our recurrent calcium oxalate cohort, age significantly impacted urinary calcium, oxalate, citrate, and pH. Along with gender and BMI, age can be used to predict key 24-hour urine stone risk results. These data lay the foundation for a risk prediction tool, which could be a surrogate for 24-hour urine results in recurrent stone formers, who are unwilling or unable to complete metabolic testing. Further validation of these findings is needed in other stone populations. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/29084490/Age_Body_Mass_Index_and_Gender_Predict_24_Hour_Urine_Parameters_in_Recurrent_Idiopathic_Calcium_Oxalate_Stone_Formers_ L2 - https://www.liebertpub.com/doi/full/10.1089/end.2017.0352?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -