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Determinants of brushite stone formation: a case-control study.
Roswitha Siener1, Linda Netzer, Albrecht Hesse
1University Stone Centre, Department of Urology, University of Bonn, Bonn, Germany.
Plos One
|November 23, 2013
Summary
Brushite stone formation is linked to high urinary pH, calcium, and oxalate, with low citrate levels. Distal renal tubular acidosis (dRTA) and diet do not fully explain these urinary changes.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Brushite (calcium phosphate) urolithiasis is increasingly prevalent.
- The specific factors contributing to brushite stone development are not fully understood.
Purpose of the Study:
- To investigate the pathogenic factors associated with brushite stone formation.
- To compare urinary parameters and dietary intake between brushite stone formers and healthy controls.
Main Methods:
- A case-control study involving 28 brushite stone formers and 28 matched healthy controls.
- Assessment included anthropometric data, clinical information, 24-hour urinary parameters, and 7-day weighed food records.
Main Results:
- Brushite stone formers exhibited higher urinary pH and oxalate excretion, and lower urinary citrate compared to controls.
- Despite lower dietary intake, urinary calcium excretion was significantly higher in brushite stone patients.
- Key risk factors identified were urinary pH > 6.50, calcium > 6.40 mmol/24h, and citrate excretion < 2.600 mmol/24h.
Conclusions:
- Hypercalciuria, low urinary citrate, and elevated urinary pH are primary determinants of brushite stone formation.
- Urinary phosphate levels were not associated with brushite urolithiasis.
- Increased urinary oxalate may contribute to mixed calcium oxalate stone formation; dietary factors and distal renal tubular acidosis (dRTA) do not fully explain the observed urinary changes.
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