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Does obesity or hyperuricemia influence lithogenic risk profile in children with urolithiasis?
Elżbieta Kuroczycka-Saniutycz1, Tadeusz Porowski, Piotr T Protas
1Department of Pediatrics and Nephrology, Medical University of Białystok, ul. Waszyngtona 17, 15-274, Białystok, Poland, e.kuroczycka@wp.pl.
Insights
Hyperuricemia in children with urolithiasis is linked to lower excretion of urinary crystallization inhibitors. Obesity did not directly impact the lithogenic risk profile in this pediatric cohort.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Obesity and hyperuricemia are suspected factors in urinary stone formation.
- Understanding their impact on pediatric urolithiasis is crucial.
Purpose of the Study:
- To investigate the effect of obesity and hyperuricemia on the urinary lithogenic risk profile in children with urolithiasis.
Main Methods:
- Compared lithogenic profiles in pediatric urolithiasis patients with and without hyperuricemia.
- Analyzed effects of overweight/obesity versus normal weight on lithogenic parameters.
- Utilized a cohort of 478 children with urolithiasis and 517 healthy controls.
Main Results:
- Hyperuricemia in pediatric urolithiasis patients correlated with significantly lower urinary excretion of crystallization inhibitors (citrates, magnesium).
- Negative correlations were observed between serum uric acid levels and urine citrate/creatinine and magnesium/creatinine ratios.
- No significant differences in urinary stone risk parameters were found between overweight/obese and normal-weight pediatric urolithiasis patients.
Conclusions:
- Hyperuricemia is associated with reduced urinary excretion of crystallization inhibitors in pediatric stone formers.
- Obesity did not show a direct influence on the lithogenic risk profile in this pediatric cohort.
- Further research is needed to confirm the clinical relevance of these findings and explore potential links between elevated serum uric acid, renal function, and lithogenic parameters.
Background:
There are indications that obesity and hyperuricemia may influence the formation and composition of urinary stones. The aim of our study was to determine the effect of obesity and hyperuricemia on the urinary lithogenic risk profile in a large cohort of pediatric patients.
Methods:
The study population comprised 478 children with urolithiasis and 517 healthy children (reference group). We studied the effects of obesity on the lithogenic profile by dividing the patients with urolithiasis into two groups based on body mass index Z-score (patients who were overweight/obese vs. those with normal weight for age) and comparing the two groups. To study the effect of hyperuricemia on the lithogenic profile, we divided the patients with urolithiasis into two groups based on the presence or not of hyperuricemia (110 patients with urolithiasis accompanied by hyperuricemia vs. 368 patients with urolithiasis and normal serum uric acid levels) and compared the groups.
Results:
Among the children and adolescents with urolithiasis and hyperuricemia, there was a significantly lower excretion of crystallization inhibitors (citrates, magnesium). We also found significantly negative correlations between serum uric acid levels and the urine citrate/creatinine ratio (citrate/cr.; r = -0.30, p < 0.01), as well as the magnesium/cr. ratio (Mg/cr.; r = -0.33, p < 0.01). There was no statistically significant differences in the urinary excretion of oxalates, citrates, calcium, phosphorus, magnesium and uric acid between children with urolithiasis who were either overweight or obese and children with urolithiasis who had a normal body weight.
Conclusions:
In our pediatric patient cohort, hyperuricemia was associated with a decrease in the excretion of crystallization inhibitors in the urine, but the clinical relevance of this observation needs to be confirmed in future studies. Obesity and overweight had no direct influence on the lithogenic risk profile in the urinary stone formers in our study, but there was an indication that higher serum uric acid may be associated with impairment in renal function, which in turn could influence the excretion of lithogenic parameters.
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