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Related Experiment Videos

Risk factors for developing renal stones in inflammatory bowel disease.

N McConnell1, S Campbell, I Gillanders

  • 1Biochemistry Department and Gastroenterology Unit, Stobhill Hospital, Glasgow, UK. niel.mcconnell@northglasgow.scot.nhs.uk

BJU International
|May 16, 2002
PubMed
Summary

Renal calculi in inflammatory bowel disease patients are linked to lower urinary citrate and magnesium levels, not hyperoxaluria. Maintaining adequate citrate and magnesium may help prevent kidney stones.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Biochemistry

Background:

  • Inflammatory bowel disease (IBD) patients have an increased risk of renal calculi (kidney stones).
  • Previous research suggested hyperoxaluria due to fat malabsorption or reduced stone inhibitors contribute to calculi formation in IBD.
  • Understanding the specific biochemical factors is crucial for prevention and treatment strategies.

Purpose of the Study:

  • To correlate renal calculi and clinical factors with urinary biochemical analytes in IBD patients.
  • To determine the relative importance of hyperoxaluria versus reduced stone inhibitors in IBD-related calculi.

Main Methods:

  • Urine samples analyzed for oxalate, citrate, magnesium, and other analytes from 25 Crohn's disease (CD) patients, 15 ulcerative colitis (UC) patients, and 17 controls.

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  • Renal calculi presence confirmed via imaging (plain films, ultrasonography, intravenous urography).
  • Statistical analysis, including analysis of covariance, used to identify associations between urinary analytes and calculi.

    • Main Results:

    • Renal calculi were identified in two CD patients; none were found in UC patients.
    • Hyperoxaluria was present in 36% of CD patients but absent in UC patients.
    • A low urinary citrate/creatinine ratio (P=0.02) and a low CMC index (citrate x magnesium / calcium; P=0.017) were significantly associated with renal stones.

    Conclusions:

    • Reduced urinary magnesium and citrate concentrations, relative to calcium (low CMC index), are more significant in IBD-related lithogenesis than hyperoxaluria.
    • A low CMC index may predict stone formation in IBD patients with a functioning colon.
    • Maintaining adequate urinary levels of magnesium and citrate could aid in preventing and treating renal calculi in IBD.