Demography and biochemistry of 2800 patients from a renal stones clinic.

Abstract

BACKGROUND:

Because the causes of stones are uncertain, interventions to prevent recurrence have an insecure foundation. Progress depends on careful evaluation of stone formers.

METHODS:

A descriptive retrospective database study of 1983 men and 816 women from the Southampton stones clinic from 1990 to March 2007. Anonymized data from the first attendance were analysed using non-parametric statistical tests.

RESULTS:

Sex ratio (2.43:1), age (median 49 y, 2.5th-97.5th percentiles, 23-77 y men, 20-79 y women), recurrent stone formers (30%) and type of stone were similar to other centres. Women more often had a positive family history (24% versus 19% men), previous urinary infection (31% versus 5%) and structural urinary tract abnormality (14% versus 7%); more men had gout (5% versus 1%) and bladder outlet obstruction (3% versus <1%). Calcium, oxalate and uric acid excretion were increased in 43%, 17% and 22% respectively of men and 31%, 7% and 10% of women. Urinary calcium, oxalate and uric acid correlated significantly, r ranging from 0.149 to 0.311 for 24 h excretion and 0.510 to 0.695 for concentrations per litre. Twenty-two percent of men and 8% of women with normal parathyroid hormone had phosphaturia (excretion of phosphate corrected for glomerular filtration rate (TmPO4/GFR) < 0.70 mmol/L); 6% men and 1.6% women also had low plasma phosphate. Many variables correlated significantly but often weakly with age. Creatinine clearance, pH and (men) TmPO4/GFR decreased from 50 y, urine creatinine, calcium and citrate from 60 y.

CONCLUSIONS:

Risk factors for stones differ between men and women, change with ageing and in some may have a genetic basis. The role of phosphaturia merits further exploration.

• Authors: Valerie Walker, Elizabeth M Stansbridge, Damian G Griffin
• Journal: Annals of clinical biochemistry (Ann Clin Biochem) Vol. 50 Issue Pt 2 Pg. 127-39 (Mar 2013) ISSN: 1758-1001 [Electronic] England
• PMID: 23431484 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aging (blood, metabolism, urine)
• Ambulatory Care Facilities
• Demography
• Female
• Humans
• Hypophosphatemia, Familial (complications)
• Kidney Calculi (blood, epidemiology, metabolism, urine)
• Male
• Middle Aged
• Risk Factors
• Sex Characteristics
• Young Adult