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Novel evaluation of nephrolithiasis as a complication of gout: a cross-sectional study using helical computerized

Toru Shimizu1, Hitoshi Kitada, Masanori Umeyama

  • 1Gout Clinic, Midorigaoka Hospital, Osaka, Japan. shimizut@gold.ocn.ne.jp

The Journal of Urology
|November 20, 2012
PubMed

Insights

Many gout patients with kidney stones (stone carriers) do not report a history of stones (stone formers). Stone carriers show worse kidney function, highlighting the importance of studying stone carriers for gout and urolithiasis research.

Area of Science:

  • Nephrology
  • Urology
  • Gout Management

Background:

  • Urolithiasis is a common complication in gout patients.
  • Previous studies often relied on patient-reported history of stones (stone formers), potentially underestimating prevalence.
  • The clinical profiles of stone formers may not accurately represent all patients with renal stones (stone carriers).

Purpose of the Study:

  • To compare the clinical characteristics of patients with a history of urolithiasis (stone formers) versus those with current renal stones (stone carriers).
  • To determine if relying on urolithiasis history underestimates the prevalence of kidney stones in gout patients.
  • To investigate the association between stone burden and renal function in gout patients.

Main Methods:

  • Evaluated 463 gout patients using helical computerized tomography (CT) and clinical parameters.
  • Assessed urolithiasis history and identified current renal stones (stone carriers) via CT.
  • Compared laboratory findings (serum urate, creatinine, estimated glomerular filtration rate, urinary pH) between stone carriers and non-stone carriers, and between stone formers and non-stone formers.

Main Results:

  • Nephrolithiasis was detected in 34% of patients by CT, but only 16% reported a history of stones.
  • Of the 157 stone carriers, 68% had no prior urolithiasis history.
  • Stone carriers exhibited higher serum urate and creatinine, and lower estimated glomerular filtration rate and urinary pH compared to non-stone carriers.

Conclusions:

  • The definition of 'stone formers' may lead to underestimation of urolithiasis prevalence in gout.
  • A higher stone burden in stone carriers is linked to greater renal impairment.
  • Studying 'stone carriers' is more advantageous for accurately clarifying the relationship between gout and urolithiasis.
Abstract

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