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Lack of increased urinary calcium-oxalate supersaturation in long-term kidney transplant recipients.
Kidney Int 1997; 51(3):804-10KI

Abstract

Nephrolithiasis is uncommon after kidney transplantation. However, calcium (Ca) supplementation, which has been proposed as a treatment of post-transplant osteopenia, might increase calciuria and bolster Ca stone formation. Therefore, in 24-hour urine of 82 normocalcemic long-term renal transplant recipients (RT) and in 82 healthy subjects (HS), we assessed some Ca nephrolithiasis risk factors and the Ca-salt saturation estimated by the ion-activity product index (AP) and relative supersaturation (RS). In RT, calciuria was lower (mean +/- SD, 3.20 +/- 2.25 vs. 4.61 +/- 1.71 mmol/day; P < 0.001), urinary volume higher (2.41 +/- 0.83 vs. 1.39 +/- 0.53 liter/day; P < 0.001), oxaluria higher (419 +/- 191 vs. 311 +/- 79 mumol/day; P < 0.001) and citraturia lower (1.40 +/- 1.36 vs. 3.77 +/- 1.36 mmol/day; P < 0.001) than in HS. As a result, Ca-oxalate supersaturation was lower in RT than HS (AP, 1.07 +/- 0.69 vs. 2.07 +/- 1.13, P < 0.001; and RS, 0.62 +/- 0.26 vs. 0.94 +/- 0.21, P < 0.001), and was similar in subgroups of RT (N = 37) and HS (N = 37) matched for urinary volume, demonstrating that even without any larger urinary volume, Ca-oxalate saturation was not higher in RT than HS, and suggesting that opposite changes in Ca and oxalate in RT likely canceled their effects on lithogenic risk. In RT which had similar urinary pH and phosphate (P) than HS, Ca-P supersaturation was lower than in HS for brushite (AP, 3.25 +/- 6.67 vs. 6.01 +/- 4.85, P < 0.001; RS, -0.33 +/- 0.76 vs. 0.48 +/- 0.53, P < 0.001) and octacalcium phosphate (RS, -0.95 +/- 0.72 vs. 0.21 +/- 0.85, P < 0.001), and similar for apatite. Finally, fasting calciuria and calciuric response to a single oral Ca load were similar in RT (N = 19) and HS (N = 8). Together, these results argue strongly against a higher risk of Ca stone formation in RT than HS, even in case of Ca supplementation.

Authors+Show Affiliations

Explorations Fonctionnelles Rénales Métaboliques, Centre Hospitalier Universitaire, Besançon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9067914

Citation

Dumoulin, G, et al. "Lack of Increased Urinary Calcium-oxalate Supersaturation in Long-term Kidney Transplant Recipients." Kidney International, vol. 51, no. 3, 1997, pp. 804-10.
Dumoulin G, Hory B, Nguyen NU, et al. Lack of increased urinary calcium-oxalate supersaturation in long-term kidney transplant recipients. Kidney Int. 1997;51(3):804-10.
Dumoulin, G., Hory, B., Nguyen, N. U., Henriet, M. T., Bresson, C., Bittard, H., ... Regnard, J. (1997). Lack of increased urinary calcium-oxalate supersaturation in long-term kidney transplant recipients. Kidney International, 51(3), pp. 804-10.
Dumoulin G, et al. Lack of Increased Urinary Calcium-oxalate Supersaturation in Long-term Kidney Transplant Recipients. Kidney Int. 1997;51(3):804-10. PubMed PMID: 9067914.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lack of increased urinary calcium-oxalate supersaturation in long-term kidney transplant recipients. AU - Dumoulin,G, AU - Hory,B, AU - Nguyen,N U, AU - Henriet,M T, AU - Bresson,C, AU - Bittard,H, AU - Saint-Hillier,Y, AU - Regnard,J, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 804 EP - 10 JF - Kidney international JO - Kidney Int. VL - 51 IS - 3 N2 - Nephrolithiasis is uncommon after kidney transplantation. However, calcium (Ca) supplementation, which has been proposed as a treatment of post-transplant osteopenia, might increase calciuria and bolster Ca stone formation. Therefore, in 24-hour urine of 82 normocalcemic long-term renal transplant recipients (RT) and in 82 healthy subjects (HS), we assessed some Ca nephrolithiasis risk factors and the Ca-salt saturation estimated by the ion-activity product index (AP) and relative supersaturation (RS). In RT, calciuria was lower (mean +/- SD, 3.20 +/- 2.25 vs. 4.61 +/- 1.71 mmol/day; P < 0.001), urinary volume higher (2.41 +/- 0.83 vs. 1.39 +/- 0.53 liter/day; P < 0.001), oxaluria higher (419 +/- 191 vs. 311 +/- 79 mumol/day; P < 0.001) and citraturia lower (1.40 +/- 1.36 vs. 3.77 +/- 1.36 mmol/day; P < 0.001) than in HS. As a result, Ca-oxalate supersaturation was lower in RT than HS (AP, 1.07 +/- 0.69 vs. 2.07 +/- 1.13, P < 0.001; and RS, 0.62 +/- 0.26 vs. 0.94 +/- 0.21, P < 0.001), and was similar in subgroups of RT (N = 37) and HS (N = 37) matched for urinary volume, demonstrating that even without any larger urinary volume, Ca-oxalate saturation was not higher in RT than HS, and suggesting that opposite changes in Ca and oxalate in RT likely canceled their effects on lithogenic risk. In RT which had similar urinary pH and phosphate (P) than HS, Ca-P supersaturation was lower than in HS for brushite (AP, 3.25 +/- 6.67 vs. 6.01 +/- 4.85, P < 0.001; RS, -0.33 +/- 0.76 vs. 0.48 +/- 0.53, P < 0.001) and octacalcium phosphate (RS, -0.95 +/- 0.72 vs. 0.21 +/- 0.85, P < 0.001), and similar for apatite. Finally, fasting calciuria and calciuric response to a single oral Ca load were similar in RT (N = 19) and HS (N = 8). Together, these results argue strongly against a higher risk of Ca stone formation in RT than HS, even in case of Ca supplementation. SN - 0085-2538 UR - https://www.unboundmedicine.com/medline/citation/9067914/Lack_of_increased_urinary_calcium_oxalate_supersaturation_in_long_term_kidney_transplant_recipients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)59942-0 DB - PRIME DP - Unbound Medicine ER -