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Risk factors for low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list

Hess, B. ; Michel, R. ; Takkinen, R. ; Ackermann, D. ; Jaeger, Ph

In: Nephrology Dialysis Transplantation, 1994, vol. 9, no. 6, p. 642-649

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    Titre
    • Risk factors for low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list
    Auteur
    • Hess, B.. Policlinic of Medicine University Hospital Berne, Switzerland
    • Michel, R.. Policlinic of Medicine University Hospital Berne, Switzerland
    • Takkinen, R.. Policlinic of Medicine University Hospital Berne, Switzerland
    • Ackermann, D.. Department of Urology, University Hospital Berne, Switzerland
    • Jaeger, Ph. Policlinic of Medicine University Hospital Berne, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Nephrology Dialysis Transplantation, 1994, vol. 9, no. 6, p. 642-649. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:302793
    Summary
    Risk factors for low urinary citrate excretion were assessed in 34 consecutive male recurrent idiopathic calcium stone formers (RCSF) who collected two 24-h urines while on free-choice diet. Overt hypocitraturia (hypo-cit) was defined as UCit×V<1.70 mmol/day, and ‘low' citraturia (low-cit) as UCit×V between 1.70 and 2.11 mmol/day. Twenty-three RCSF had normocitraturia (normo-cit), six low-cit and five hypo-cit. UCit×V positively correlated with urine volume (VOLUME, r=0.44, P=0.009), vegetable fibre intake (fibers, r=0.46, P=0.009) and GI-alkali absorption (alkali, r=0.47, P=0.006), and volume, fibres and alkali tended to be lower among RCSF with low-/hypo-cit. A 3-day NH4Cl loading test (0.95 mEq/kg BW daily in 3 doses) was performed in RCSF as well as in 14 age-matched healthy male controls (C). On a plot of urine pH versus serum bicarbonate, 10 of 11 RCSF with low-/hypo-cit, but only six of 23 with normo-cit (P=0.0004) fell off the normal range, indicating incomplete RTA. Two or more risk factors simultaneously occurred in only four of 23 RCSF with normo-cit, but in eight of 11 with low-/hypo-cit (P= 0.002). In conclusion, incomplete RTA is the most prevalent risk factor for low-/hypo-cit in RCSF, and decreases in vegetable fibres and urine volume emerge as two new risk factors for low urinary CIT