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Kim, Ha, Kim, Yun, Lee, and Kim: Comparison of Clinico-Metabolic Characteristics between Calcium Oxalate and Uric Acid Stone Formers
Original Article
Endourology/Urolithiasis
Korean Journal of Urology

Korean Journal of Urology 2009; 50(9): 897-901.

Published online: 18 September 2009

DOI: https://doi.org/10.4111/kju.2009.50.9.897

Comparison of Clinico-Metabolic Characteristics between Calcium Oxalate and Uric Acid Stone Formers

Young-Won Kim, Yun-Sok Ha, Yong-June Kim, Seok-Joong Yun, Sang-Cheol Lee, Wun-Jae Kim

Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.

Correspondence to: Yong-June Kim. Department of Urology, Chungbuk National University Hospital, 62, Gaesin-dong, Heungdeok-gu, Cheungju 361-711, Korea. TEL: 043-269-6134, FAX: 043-269-6129, urokyj@cbnu.ac.kr

Received 10 April 2009       Accepted 17 August 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

Although both intrinsic and environmental factors contribute to urinary stone formation, recent epidemiologic studies have suggested the importance of lifestyle and dietary habit in urolithiasis. The aim of this study was to compare clinical and metabolic characteristics between calcium oxalate (CaOx) and uric acid (UA) stone formers (SF).

Materials and Methods

A database of patient histories and serum and urine chemistries was analyzed for 172 consecutive stone formers [124 pure CaOx SF, 25 mixed (CaOx-UA) SF, and 23 pure UA SF]. We compared the clinical profiles and urinary metabolites among these groups. Urinary CaOx supersaturation was assessed by using the Okawa index.

Results

Compared with pure CaOx SF, SF with an increased UA component were older (p=0.01) and had a higher body mass index (BMI) (p=0.02). However, there were no significant differences in gender, stone episodes, family history, or serum chemistry among the three groups (p>0.05). In the SF with a greater calcium component, urinary excretion of calcium and CaOx supersaturation were significantly elevated (p<0.01, respectively). On the contrary, SF with an increased UA component had significantly decreased urine pH (p=0.03).

Conclusions

This study revealed that CaOx stone formation was associated with a young age, hypercalciuria, and high CaOx supersaturation, whereas UA stone formation was associated with high BMI and low urine pH. This study suggests that modification of risk factors in urolithiasis may contribute to preventing stone formation and stone recurrence.

Keywords: Urolithiasis, Calcium oxalate, Uric acid, Recurrence

Figures and Tables

Table 1
Baseline characteristics of the patients
kju-50-897-i001

CaOx: calcium oxalate stone, CaOx-UA: calcium oxalate-uric acid (mixed) stone, UA: uric acid stone, BMI: body mass index, a: Mean±SD, b: ANOVA, c: chi-square test

Table 2
Comparison of urinary metabolites in patients with calcium oxalate stones, mixed stones, and uric acid stones
kju-50-897-i002

CaOx: calcium oxalate stone, CaOx-UA: calcium oxalate-uric acid (mixed) stone, UA: uric acid stone, Okawa index: ion activity product of calcium oxalate (APCaOx), All variants: Mean±SD, a: chi-square test, b: ANOVA, c: value was expressed by pKCaOx, pKCaOx=-log10 (APCaOx)

Table 3
Prevalence of metabolic risk factors
kju-50-897-i003

CaOx: calcium oxalate stone, CaOx-UA: calcium oxalate-uric acid (mixed) stone, UA: uric acid stone, a: chi-square test

Notes

This work was supported by the research grant of the Chungbuk National University in 2008.

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