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    Korean J Urol. 2007 Jul;48(7):718-723. Korean.
    Published online Jul 31, 2007.
    https://doi.org/10.4111/kju.2007.48.7.718
    Copyright © 2007 The Korean Urological Association
    Original Article

    Metabolic Abnormalities and the Risk for Recurrence in Obese Patients with Urolithiasis

    In-Chang Cho, Yong-June Kim and Sang-Cheol Lee
      • Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.
    • Corresponding author (Email: lscuro@chungbuk.ac.kr )
    Received April 11, 2007; Accepted May 14, 2007.

    Abstract

    Purpose

    Recent studies have suggested an increased prevalence of urolithiasis with obesity. This study aimed to assess the influence of obesity on urinary metabolic abnormalities and the recurrence of stone.

    Materials and Methods

    We analyzed 802 consecutive stone formers (SF: first-time SF=501, recurrent SF=291) who underwent a comprehensive metabolic evaluation that included blood chemistry tests and a 24-hour urinary examination, as well as determining the body mass index (BMI). The BMI was categorized into the non-obese (BMI<25kg/m2) and obese (BMI≥25kg/m2) according to the re-defined Western Pacific Region WHO criteria on obesity (WPRO). All possible risk factors such as age, gender, BMI, the clinical characteristics and the metabolic parameters were compared between both groups. Among them, 184 (22.9%) patients had been followed up for more than 24 months or they recurred during the follow up (mean: 56.0, median: 58.5, range: 7.0-140.0) and they were examined for the risk of stone recurrence by performing multivariate Cox regression analysis.

    Results

    Obesity was significantly associated with the increased urinary excretion of sodium, calcium and oxalate (p<0.05, respectively). The urinary pH value showed inverse correlation with obesity (p=0.012). Urinary metabolic abnormalities were more common in the obese SF patients than the non-obese SF patients (p=0.003). Obesity was significantly associated with the stone recurrence rate (p=0.009). Cox regression analysis revealed that obesity was a strong predictor for recurrent stone formation (adjusted HR=2.384 95% CI: 1.372-4.143, p=0.002).

    Conclusions

    Our results reveal that obesity is highly associated with metabolic alterations and urinary stone recurrence. Therefore, weight control might be considered as one of the preventive measures against recurrent stone formation.

    Keywords
    Urolithiasis; Obesity; Recurrence

    Figures

    Fig. 1
    Stone analysis with obesity (n=150). *COD: calcium oxalate dihydrate, †UA: uric acid, ‡CAP: calcium phosphate, §COM: calcium oxalate monohydrate.

    Fig. 2
    Rate of being stone recurrence free according to obesity (follow-up duration ≥2 years) (n=184).

    Tables

    Table 1
    Baseline clinical characteristics

    Table 2
    Differences of the 24 hour urine metabolites according to the body mass index

    Table 3
    Comparison of the 24 hour urine analysis abnormalities

    Table 4
    Comparison of the metabolic risk sum*

    Table 5
    Univariate and multivariate analyses of the time to recurrence (follow up duration ≥2 years) (n=184)

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    MeSH Terms
    Calcium
    Chemistry
    Humans
    Hydrogen-Ion Concentration
    Obesity
    Prevalence
    Recurrence*
    Risk Factors
    Sodium
    Urinary Calculi
    Urolithiasis*
    Metrics
    Share
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