Adults with high calcium, oxalate urinary levels may have increased kidney stone risk
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Key takeaways:
- Urinary factors and kidney stone formation were mostly linear for calcium.
- Urine pH was the only factor not significantly tied to the risk of developing kidney stones.
Adults with high calcium and oxalate urinary levels may have a greater risk for developing kidney stones, according to data from a published study.
“Kidney stones are a common ailment in Western countries, with a high prevalence and tendency to recur,” Pietro Manuel Ferraro, MD, MSc, PhD, of the section of nephrology, department of medicine at Università degli Studi di Verona in Italy, and colleagues wrote. “In particular, because the minerals that make up the most common types of stones are calcium oxalate and calcium phosphate (and mixtures thereof), urinary excretions of calcium, oxalate and phosphorus as well as urine volume are expected to directly affect urinary supersaturations for those salts; other urinary constituents such as citrate, uric acid, magnesium, potassium, and sodium as well as urine pH might play a more indirect role.”
Researchers conducted the prospective study to evaluate independent associations between urine chemistries and kidney stone formation. They analyzed 9,045 24-hour urine collections from 6,217 participants in the Health Professionals Follow-Up Study and Nurses’ Health Studies I and II. They focused on urine volume and pH, and concentrations of calcium, citrate, oxalate, potassium, magnesium, uric acid, phosphorus and sodium. The main outcome was symptomatic kidney stones.
Each urinary factor, except for urine pH, was significantly associated to the risk of kidney stone development, according to the results. Researchers noted higher levels of calcium, oxalate, phosphorus and sodium in the urine were linked to a greater risk of kidney stones, while higher urine volume, uric acid, citrate, potassium and magnesium were related to lower risk. Urine acidity was not related to the risk of kidney stones.
Researchers also found that while relationships between urinary factors and stone formation were mostly linear for calcium, uric acid and sodium, the relationships were slightly attenuated at higher levels for oxalate, citrate, volume, phosphorus, potassium and magnesium.
“The results of our analysis could be implemented in clinical practice for the management of patients with kidney stones,” according to the researchers. “Dietary and pharmacological approaches to increase urine volume, reduce the urinary excretion of calcium, and increase that of citrate could potentially be prioritized, such as increased intake of fluid and alkali-rich foods, reduced intake of sodium and animal protein, and use of thiazide diuretics and supplemental alkali.”
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