Urinary stone risk factors in the descendants of patients with kidney stone disease
Evidence has indicated that immediate family members of nephrolithiasis patients had high opportunity to develop stones. However, they are usually not regarded to be at risk, since it is unclear if there are any lithogenic abnormalities found in non-stone-forming nephrolithiasis relatives. Our aim was to investigate urinary metabolic abnormalities in the children of nephrolithiasis patients, compared with the general population.
The 24-h urinary metabolic profile was studied for 28 calcium oxalate nephrolithiasis patients (NL) and 46 of their descendants (ND), as well as 40 non-stone-forming volunteers (V) and 34 of their descendants (VD).
There was no difference between age, gender, and serum creatinine between NL vs. V (parental groups) and ND vs. VD (descendant groups). High urinary oxalate in nephrolithiasis and urinary calcium in their descendants was detected. In addition, an elevated urinary excretion rate of calcium, phosphate, protein, and albumin, along with low citrate excretion and high urinary supersaturation was observed in both the nephrolithiasis patients and their descendants. Approximate 17.8–24.4% of the nephrolithiasis descendants had a urinary supersaturation higher than the nephrolithiasis level, but none was found in VD group. The level of urinary supersaturation index was correlated with urinary protein and albumin excretion in nephrolithiasis family.
It was demonstrated that nephrolithiasis offspring carried several urinary metabolic risks predisposing to stone formation which are similar to their parents, and about one in every five nephrolithiasis children had nephrolithiasis level urinary supersaturation.
KeywordsNephrolithiasis Family Urinary supersaturation Hypercalciuria Hypocitraturia Heritability
We would like to thank Assistant Professor Dr. Thavorn Supaprom and Assistant Professor Dr. Kaew Udomsirichakorn from the Department of Science, Ubon Ratchathani University, and Mrs. Darunee Boonthong and Mrs. Tasanee Klinhom, nurses from the Division of Urology, Department of Surgery, Sunpasitthiprasong Hospital, as well as Yang Bowei, a graduate student from the Department of Biochemistry, Faculty of Medicine, Chulalongkorn University for assisting in subject enrollment, follow-up and sample delivery. We have deep gratitude for all the subjects in this study for their participation, as well as Assistant Professor Dr. Phisit Prapunwattana, Head of the Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, the staff from our Department and the Research Affair of the Faculty of Chulalongkorn University for their assistance. Finally, we would like to thank Professor Yoshihide Ogawa for his kind recommendation about the investigation of urinary supersaturation.
Financial support for this study was granted by The Thailand Research Fund and the 90th anniversary of Chulalongkorn University fund (Ratchadaphiseksomphot Endowment Fund).
Compliance with ethical standards
All procedures performed in the present study involving human participation were approved by the Ethics Committee for Research in Human Subjects in the Fields of Thai Traditional and Alternative Medicine, and by Ethics committee of Sunpasitthiprasong Hospital. Written consent or assent was obtained from all participants after a detailed explanation of the procedures involved. In addition, parental approval was obtained at the same time for all descendant subjects.
Conflict of interest
The authors declare that they have no competing interests.
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