Skip to main content
SpringerLink
Log in

The impact of body mass index on quantitative 24-h urine chemistries in stone forming patients: a systematic review and meta-analysis

  • Original Paper
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

To study the impact of body mass index (BMI) on quantitative 24-h urine chemistries in stone forming patients and to explore how overweight and obesity contribute to urolithiasis. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed in July 2017 and updated in October 2017 to detect relevant studies. After that, we screened all the relevant articles in accordance with the predetermined inclusion and exclusion criteria. Data of eligible studies were extracted, and then, a meta-analysis was conducted via RevMan 5.3 software. Nine studies, involving 5965 stone forming patients who underwent 24-h urine collection for chemistry analysis, were included in our analysis. BMI was used to clarify the body size. BMI ≥ 25 kg/m2 group, including overweight and obesity patients, erected more calcium (WMD 34.44 mg; 95% CI 11.33–57.55; p = 0.003), oxalate (WMD 3.44 mg; 95% CI 1.40–5.49; p = 0.001), urate (WMD 97.71 mg; 95% CI 63.05–132.38; p < 0.00001), and sodium (WMD 26.64 mg; 95% CI 18.23–35.05; p < 0.00001) in 24 h than BMI < 25 kg/m2 group. However, the BMI < 25 kg/m2 group showed higher pH of urine (WMD 0.12; 95% CI 0.04–0.20; p = 0.004). There was no significant difference in 24-h urine volume (WMD − 29.30 ml; 95% CI − 122.03 to − 63.42; p = 0.54), citrate (WMD − 34.03 mg; 95% CI − 72.88 to 4.82; p = 0.09), magnesium (WMD − 4.50 mg; 95% CI − 10.48 to 1.48; p = 0.14), phosphate (WMD − 89.38 mg; 95% CI − 219.23 to 40.47; p = 0.18), and creatinine (WMD − 191.98 mg; 95% CI − 395.35 to 11.38; p = 0.06) between the two groups. All the results kept the same tendency when gender was taken in consideration. Sensitivity analysis generated similar results. The current evidence suggested that patients with BMI ≥ 25 kg/m2 erected more promotions but not inhibitors of urolithiasis than those with BMI < 25 kg/m2, which increased the risk of urolithiasis in overweight and obesity individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Zeng G, Mai Z, Xia S, Wang Z, Zhang K, Wang L et al (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120:109–116

    Article  PubMed  Google Scholar 

  2. Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823

    Article  PubMed  Google Scholar 

  3. Scales CD, Smith AC, Hanley JM, Saigal CS (2012) Prevalence of kidney stones in the united states. Eur Urol 62:160–165

    Article  PubMed  Google Scholar 

  4. Raheem OA, Khandwala YS, Sur RL, Ghani KR, Denstedt JD (2017) Burden of urolithiasis: trends in prevalence, treatments, and costs. Eur Urol Focus 3:18–26

    Article  PubMed  Google Scholar 

  5. Antonelli JA, Maalouf NM, Pearle MS, Lotan Y (2014) Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030. Eur Urol 66:724–729

    Article  PubMed  Google Scholar 

  6. Uribarri J, Oh MS, Carroll HJ (1989) The first kidney stone. Ann Intern Med 111:1006–1009

    Article  CAS  PubMed  Google Scholar 

  7. Ramaswamy K, Shah O (2014) Metabolic syndrome and nephrolithiasis. Transl Androl Urol 3:285

    PubMed Central  PubMed  Google Scholar 

  8. Sakhaee K (2008) Nephrolithiasis as a systemic disorder. Curr Opin Nephrol Hypertens 17:304–309

    Article  PubMed  Google Scholar 

  9. Trinchieri A, Croppi E, Montanari E (2017) Obesity and urolithiasis: evidence of regional influences. Urolithiasis 45:271–278

    Article  PubMed  Google Scholar 

  10. Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293:455–462

    Article  CAS  PubMed  Google Scholar 

  11. Yoshimura E, Sawada SS, Lee IM, Gando Y, Kamada M, Matsushita M et al (2016) Body mass index and kidney stones: a cohort study of Japanese men. J Epidemiol 26:131–136

    Article  PubMed  Google Scholar 

  12. Semins MJ, Shore AD, Makary MA, Magnuson T, Johns R, Matlaga BR (2010) The association of increasing body mass index and kidney stone disease. J Urol 183:571–575

    Article  PubMed  Google Scholar 

  13. Lee SC, Kim YJ, Kim TH, Yun SJ, Lee NK, Kim WJ (2008) Impact of obesity in patients with urolithiasis and its prognostic usefulness in stone recurrence. J Urol 179:570–574

    Article  PubMed  Google Scholar 

  14. Siener R, Glatz S, Nicolay C, Hesse A (2014) The role of overweight and obesity in calcium oxalate stone formation. Obes Res 12:106–113

    Article  Google Scholar 

  15. Sarıca K, Altay B, Erturhan S (2008) Effect of being overweight on stone-forming risk factors. Urology 71:771–774

    Article  PubMed  Google Scholar 

  16. Shavit L, Ferraro PM, Johri N, Robertson W, Walsh SB, Moochhala S et al (2015) Effect of being overweight on urinary metabolic risk factors for kidney stone formation. Nephrol Dial Transpl 30:607–613

    Article  CAS  Google Scholar 

  17. Negri AL, Spivacow FR, Del Valle EE, Forrester M, Rosende G, Pinduli I (2008) Role of overweight and obesity on the urinary excretion of promoters and inhibitors of stone formation in stone formers. Urol Res 36:303–307

    Article  CAS  PubMed  Google Scholar 

  18. Najeeb Q, Masood I, Bhaskar N, Kaur H, Singh J, Pandey R et al (2013) Effect of BMI and urinary pH on urolithiasis and its composition. Saudi J Kidney Dis Transpl 24:61–66

    Article  Google Scholar 

  19. Wrobel BM, Schubert G, Hörmann M, Strohmaier WL (2012) Overweight and obesity: risk factors in calcium oxalate stone disease? Adv Urol 2012:1–4

    Article  Google Scholar 

  20. Fram EB, Agalliu I, DiVito J, Hoenig DM, Stern JM (2015) The visceral fat compartment is independently associated with changes in urine constituent excretion in a stone forming population. Urolithiasis 43:213–220

    Article  PubMed  Google Scholar 

  21. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  Google Scholar 

  22. Phillips B, Ball C, Sackett D (2011) Oxford Centre for evidence-based medicine 2011 levels of evidence. http://www.cebm.net/ocebm-levels-of-evidence/. Accessed 24 Nov 2017

  23. Wells G, Shea B, O’connell D, Peterson J, Welch V (2012) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/nosgen.pdf. Accessed 24 Nov 2017

  24. Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration

  25. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A et al (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377:13–27

    Article  PubMed  Google Scholar 

  26. Hartman C, Friedlander JI, Moreira DM, Elsamra SE, Smith AD, Okeke Z (2015) Differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus. BJU Int 115:619–624

    Article  CAS  PubMed  Google Scholar 

  27. Hartman C, Friedlander JI, Moreira DM, Leavitt DA, Hoenig DM, Smith AD et al (2015) Does hypertension impact 24-hour urine parameters in patients with nephrolithiasis? Urology 85:539–543

    Article  PubMed  Google Scholar 

  28. Wollin DA, Skolarikos A, Preminger GM (2017) Obesity and metabolic stone disease. Curr Opin Urol 27:422–427

    Article  PubMed  Google Scholar 

  29. Powell CR, Stoller ML, Schwartz BF, Kane C, Gentle DL, Bruce JE et al (2000) Impact of body weight on urinary electrolytes in urinary stone formers. Urology 55:825–830

    Article  CAS  PubMed  Google Scholar 

  30. Taylor EN, Fung TT, Curhan GC (2009) DASH-style diet associates with reduced risk for kidney stones. J Am Soc Nephro 20:2253–2259

    Article  CAS  Google Scholar 

  31. Prezioso D, Strazzullo P, Lotti T, Bianchi G, Borghi L, Caione P et al (2015) Dietary treatment of urinary risk factors for renal stone formation. A review of CLU working group. Arch Ital Urol Androl 87:105–120

    Article  Google Scholar 

  32. Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR et al (2014) Medical management of kidney stones: AUA Guideline. J Urol 192:316–324

    Article  PubMed  Google Scholar 

  33. Klisic J, Hu MC, Nief V, Reyes L, Fuster D, Moe OW et al (2002) Insulin activates Na(+)/H(+) exchanger 3: biphasic response and glucocorticoid dependence. Am J Physiol Renal Physiol 283:F532-F539

    Article  Google Scholar 

  34. Xu L, Adams-Huet B, Poindexter JR, Maalouf NM, Moe OW, Sakhaee K (2017) Temporal changes in kidney stone composition and in risk factors predisposing to stone formation. J Urol 197:1465–1471

    Article  CAS  PubMed  Google Scholar 

  35. Ryall RL, Harnett RM, Marshall VR (1986) The effect of monosodium urate on the capacity of urine, chondroitine sulphate and heparin to inhibit calcium oxalate crystal growth and aggregation. J Urol 135:174–177

    Article  CAS  PubMed  Google Scholar 

  36. Deng T, Mai Z, Cai C, Duan X, Zhu W, Zhang T et al (2017) Influence of weight status on 24-hour urine composition in adults without urolithiasis: a nationwide study based on a Chinese Han population. Plos one 12:e184655

    Google Scholar 

Download references

Author information

Author notes

  1. Qing Wang and Weijie Hu have contributed equally to this paper.

Authors and Affiliations

  1. Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China

    Qing Wang, Weijie Hu, Yuchao Lu, Henglong Hu, Jiaqiao Zhang & Shaogang Wang

Authors
  1. Qing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Weijie Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuchao Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henglong Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jiaqiao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shaogang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shaogang Wang.

Ethics declarations

Conflict of interest

Qing Wang declares that he has no conflict of interest. Weijie Hu declares that he has no conflict of interest. Yuchao Lu declares that he has no conflict of interest. Henglong Hu declares that he has no conflict of interest. Jiaqiao Zhang declares that he has no conflict of interest. Shaogang Wang declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 592 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Q., Hu, W., Lu, Y. et al. The impact of body mass index on quantitative 24-h urine chemistries in stone forming patients: a systematic review and meta-analysis. Urolithiasis 46, 523–533 (2018). https://doi.org/10.1007/s00240-018-1044-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-018-1044-z

Keywords

Search

Navigation