, Volume 46, Issue 3, pp 257–264 | Cite as

Lime powder treatment reduces urinary excretion of total protein and transferrin but increases uromodulin excretion in patients with urolithiasis

  • Piyaratana Tosukhowong
  • Pimsuda Kulpradit
  • Sakdithep Chaiyarit
  • Wattanachai Ungjareonwattana
  • Nuttiya Kalpongnukul
  • Supoj Ratchanon
  • Visith Thongboonkerd
Original Paper


Our previous study has shown that lime powder (LP) had an inhibitory effect against calcium oxalate stone formation. However, the precise mechanisms underlying such beneficial effect remained unclear. Our present study thus aimed to address the effect of LP on excretory level and compositions of urinary proteins using a proteomics approach. From a total of 80 calcium oxalate stone formers recruited into our 2-year randomized clinical trial of LP effect, 10 patients with comparable age and clinical parameters were selected for this proteomic study. 24-h urine specimens were collected from all subjects, at baseline (before) and after LP treatment for 6 months, and then subjected to quantitative proteomics analysis and subsequent validation by ELISA. Total urinary protein excretion was significantly decreased by LP treatment, but unaffected by placebo. Nanoflow liquid chromatography coupled to tandem mass spectrometry (nanoLC–MS/MS) followed by quantitative analysis revealed 17 proteins whose levels were significantly altered (16 decreased and 1 increased) exclusively by LP treatment. Among these, the decrease of transferrin and increase of uromodulin were validated by ELISA. Moreover, there was a significant correlation between microalbuminuria and urinary transferrin level by Pearson’s correlation test. In summary, LP treatment caused significant reduction in total urinary protein excretion and changes in urinary protein compositions that could be linked to stone inhibitory effects and might be relevant mechanisms responsible for the beneficial effects of LP to prevent kidney stone formation and recurrence.


Calcium oxalate Kidney stone Proteome Proteomics THP Urinary proteins 


Author contributions

PT, PK, SC, WU, NK, SR and VT designed research; PK, SC, WU, NK and SR performed experiments; PT, PK, SC, WU, NK, SR and VT analyzed data; PT, PK and VT wrote the manuscript; All authors reviewed and approved the manuscript.

Compliance with ethical standards


This study was supported by National Research Council of Thailand, Mahidol University research grant, Office of the Higher Education Commission and Mahidol University under the National Research Universities Initiative, and the Thailand Research Fund (RTA5680004 and IRG5980006). SC and VT are also supported by Faculty of Medicine Siriraj Hospital.

Conflict of interest

All Authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Piyaratana Tosukhowong
    • 1
  • Pimsuda Kulpradit
    • 1
  • Sakdithep Chaiyarit
    • 2
  • Wattanachai Ungjareonwattana
    • 3
  • Nuttiya Kalpongnukul
    • 4
  • Supoj Ratchanon
    • 5
  • Visith Thongboonkerd
    • 2
    • 6
  1. 1.Department of Biochemistry, Faculty of MedicineChulalongkorn UniversityBangkokThailand
  2. 2.Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  3. 3.Division of Urology, Department of SurgerySappasit Prasong HospitalUbon RatchathaniThailand
  4. 4.Division of Biology System, Faculty of MedicineChulalongkorn UniversityBangkokThailand
  5. 5.Division of Urology, Department of Surgery, Faculty of MedicineChulalongkorn UniversityBangkokThailand
  6. 6.Center for Research in Complex Systems ScienceMahidol UniversityBangkokThailand

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