Impact Of Obesity In Patients With Urolithiasis And Its Prognostic Usefulness In Stone Recurrence

Main Category: Urology / Nephrology
Also Included In: Obesity / Weight Loss / Fitness;  Clinical Trials / Drug Trials
Article Date: 31 Mar 2008 - 0:00 PDT

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As we continue to investigate the origins of illness, we are learning that most surgical disease, which is invariably localized, is the effect of a multifactorial cause. In urolithiasis, we are now beginning to understand that there is an association, between obesity and urolithiasis (i.e. the metabolic syndrome). The metabolic syndrome also includes hyperlipidemia, type 2 diabetes, and hypertension. In this study from South Korea, among 163 first time stone formers followed for more than 3 years (median 4.5 years), obesity (defined here as a BMI of > 25) alone was the strongest factor predicting stone recurrence. Of note, uric acid was higher and pH was lower in the obese patients; this is attributed to impaired ammonium excretion secondary to insulin resistance and hyperinsulinemia that are characteristic of the type II diabetes associated with the metabolic syndrome. Not surprisingly the obese patients had a much higher incidence of uric acid stones (16%).

Bottom line: "Lose the weight, lose the stone".

Lee SC, Kim YJ, Kim TH, Yun SJ, Lee NK, Kim WJ.

J Urol. 2007 Dec 12 [Epub ahead of print]
doi:10.1016/j.juro.2007.09.040

Reported by UroToday.com Medical Editor Ralph V. Clayman, MD Chair, Department of Urology University of California, Irvine

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