The Effect of Obesity on Metabolic Risk Factors in Children with Urinary Stones

Sevgin Taner; Kamina Panahlı; Asena Ünal; Gunay Ekberli; Orkun Tolunay

Araştırma Makalesi

The Effect of Obesity on Metabolic Risk Factors in Children with Urinary Stones

Yıl 2023, Cilt: 11 Sayı: 3, 101 - 106, 15.10.2023

Sevgin Taner Kamina Panahlı Asena Ünal Gunay Ekberli Orkun Tolunay

Öz

Background: Hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia have accepted as metabolic risk factors causing urolithiasis. There are many studies reporting that obesity increases the risk of stone formation by metabolic risk factors. The aim of this study is to evaluate the frequency of metabolic risk factors and the effect of body mass index (BMI) on them.
Methods: Children with urolithiasis >3 mm included in the study. Demographic information and biochemistry analyses including urine metabolic screening were recorded.
Results: Of the 155 patients (94 male/61 female) included in the study, with a mean age of 71±57 months, 98 (63%) have a family history of stones. There was at least one metabolic risk factor in 38.7% of the patients, and the most common ones were hyperoxaluria (16.8%) and hypocitraturia (16.8%), respectively. The presence of metabolic risk factors was significantly higher in patients with stone size ≥5 mm and with multiple stones, respectively (p=0.015, p=0.028). Patients with underweight and normal weight were grouped as Group 1 (n=99 patients), and those with overweight and obese as Group 2 (n=56 patients). The frequencies of hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia and cystinuria were similar between groups.
Conclusion: Family history is common in children with urinary system stones. Since the probability of metabolic risk factors is higher in patients with stone size >5 mm and multiple stones, evaluation in this regard would be appropriate, especially in these patients. There was no evidence in this study that obesity increases metabolic risk factors.

Anahtar Kelimeler

urolithiasis, obesity, body mass index, hyperoxaluria, hypocitraturia

Kaynakça

1. Stamatelou KK, Francis ME, Jones CA. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003; 63(5):1817–23. https://doi.org/10.1046/j.1523-1755.2003.00917.x
2. Spivacow, F. R., Del Valle, E. E., Boailchuk, J. A., Sandoval Díaz, G., Rodríguez Ugarte, V., & Arreaga Álvarez, Z. Metabolic risk factors in children with kidney stone disease: an update. Pediatr Nephrol 2020;35(11):2107-12. https://doi.org/10.1007/s00467-020-04660-x
3. Ece A, Ozdemir E, Gurkan F, Dokucu AI, Akdeniz O. Characteristics of pediatric urolithiasis in south-east Anatolia. Int J Urol 2000;7:330-334. https://doi.org/10.1046/j.1442-2042.2000.00207.x
4. Elder JS. Urinary Lithiasis. Kliegman RM St.Geme JW (ed) Nelson textbook of pediatrics, 21st edn. Elsevier 2020; pp 1822-1826
5. Martins SA, Gomes C, Correia AJ. Paediatric nephrolithiasis and nephrocalcinosis: a 20 year retrospective analysis. Port Nephrol Hypert 2007;21(2): 77-82
6. Bundak R, Furman A, Gunoz H, Darendeliler F, Baş F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95(2):194-8. https://doi.org/10.1080/08035250500334738
7. Edvardsson V, Sas DJ. Urinary Stone Disease and Nephrocalcinosis. In: Emma F, Goldstein SL, Bagga A, Bates CM, Shroff R, editors. Pediatric nephrology Eighth Ed. Springer Switzerland; 2022. p. 1301-1302.
8. Shahta HA, Usama NR. Etiological and clinical patterns of childhood urolithiasis in Iraq. Pediatr Nephrol 2005; 20(10): 1453-1457. https://doi.org/10.1007/s00467-005-1971-0
9. Sas DJ, Becton LJ, Tutman J, Lindsay LA, Wahlquist AH. Clinical, demographic, and laboratory characteristics of children with nephrolithiasis. Urolithiasis 2016; 44(3):241-6. https://doi.org/10.1007/s00240-015-0827-8
10. Karabacak OR, Ipek B, Ozturk U, Demirel F, Saltas H, Altug U. Metabolic evaluation in stone disease metabolic differences between the pediatric and adult patients with stone disease. Urology 2010;76(1):238-241. https://doi.org/10.1016/j.urology.2010.01.036
11. Fang AM, Gibson E, Oster RA, Dangle PP. Effect of age, BMI, and gender on urinary risk factors in pediatric idiopathic stone formers. J Pediatr Urol 2021;17(4):477.e1-477.e9 https://doi.org/10.1016/j.jpurol.2021.05.024
12. Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D et al. M. Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol 2008;40(1):3-9. https://doi.org/10.1007/s11255-007-9234-6
13. Edvardsson V, Elidottir H, Indridason OS, Palsson R. High incidence of kidney stones in Icelandic children. Pediatr Nephrol 2005;20:940–944. https://doi.org/10.1007/s00467-005-1861-5
14. Erbagci A, Erbagci AB, Yilmaz M, Yagci F, Tarakcioglu M, Yurtseven C, et al. Pediatric urolithiasis--evaluation of risk factors in 95 children. Scand J Urol Nephrol 2003;37:129-33. https://doi.org/10.1080/00365590310008866
15. Policastro LJ, Saggi JS, Goldfarb DS, Weiss PJ. Personalized intervention in monogenic stone formers. J Urol 2018;199: 623-32. https://doi.org/10.1016/j.juro.2017.09.143
16. Hoppe B, Martin-Higueras C. Inherited conditions resulting in nephrolithiasis. Curr Opin Pediatr 2020;32: 273-83. https://doi.org/10.1097/MOP.0000000000000848
17. Siener R, Glatz S, Nicolay C, Hesse A. The role of overweight and obesity in calcium oxalate stone formation. Obes Res 2004;12:106–113. https://doi.org/10.1038/oby.2004.14
18. Sarica K. Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res 2006;24:1-6. https://doi.org/10.1007/s00240-005-0018-0
19. Coward RJ, Peters CJ, Duffy PG, Corry D, Kellett MJ, Choong S, et al. Epidemiology of pediatric renal stone disease in the UK. Arch Dis Child 2003;88:962–965. https://doi.org/10.1136/adc.88.11.962
20. Escribano J, Balaguer A, Martin R, Feliu A, Espax R. Childhood idiopathic hypercalciuria clinical significance of renal calyceal microlithiasis and risk of calcium nephrolithiasis. Scand J Urol Nephrol 2004;38(5):422-426. https://doi.org/10.1080/00365590410033434
21. Milliner DS, Murphy ME. Urolithiasis in pediatric patients. Mayo Clin Proc 1993;68: 241-8. https://doi.org/10.1016/s0025-6196(12)60043-3
22. Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, et al. Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 2003;70: 273-7. https://doi.org/10.1159/000070134
23. Alpay H, Özen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol 2009;24(11): 2203-2209. https://doi.org/10.1007/s00467-009-1231-9
24. Eisner BH, Eisenberg ML, Stoller ML. Relationship between body mass index and quantitative 24-hour urine chemistries in patients with nephrolithiasis. Urology 2010; 75(6):1289–1293. https://doi.org/10.1016/j.urology.2009.09.024
25. Ekeruo WO, Tan YH, Young MD, Dahm P, Maloney ME, Mathias BJ, et al. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 2004;172(1):159–163. https://doi.org/10.1097/01.ju.0000128574.50588.97
26. Daudon M, Lacour B, Jungers P. Influence of body size on urinary stone composition in men and women. Urol Res 2006;34(3):193–9. https://doi.org/10.1007/s00240-006-0042-8
27. Roddy JT, Ghousheh AI, Christensen MA, Durkee CT. Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population. J Urol 2014;191:771-776. https://doi.org/10.1016/j.juro.2013.09.064
28. Bandari J, Dangle PP, Lyon TD, Lee A, Schneck FX, Cannon GM, et al. 24-Hour Urinary Parameters in Overweight and Obese Children with Urolithiasis J Urol 2016;196(2):526-530. https://doi.org/10.1016/j.juro.2016.03.012
29. Cambareri GM, Giel DW, Bayne AP, Corbett S, Schurtz E, Kovacevic L, et al. Do Overweight and Obese Pediatric Stone Formers Have Differences in Metabolic Abnormalities Compared With Normal-weight Stone Formers? Urology 2017;101:26-30. https://doi.org/10.1016/j.urology.2016.09.011
30. Carbone A, Al Salhi Y, Tasca A, Palleschi G, Fuschi A, De Nunzio C, et al. Obesity and kidney stone disease: a systematic review. Minerva Urol Nefrol 2018;70(4):393-400

Üriner Sistem Taşı Olan Çocuklarda Obezitenin Metabolik Risk Faktörlerine Etkisi

Yıl 2023, Cilt: 11 Sayı: 3, 101 - 106, 15.10.2023

Sevgin Taner Kamina Panahlı Asena Ünal Gunay Ekberli Orkun Tolunay

Öz

Amaç: Hiperkalsiüri, hiperoksalüri, hiperürikozüri, hipositratüri üriner sistem taş hastalığına neden olan metabolik risk faktörleri olarak kabul edilmiştir. Obezitenin metabolik risk faktörlerine bağlı olarak taş oluşum riskini artırdığını bildiren birçok çalışma bulunmaktadır. Bu çalışmanın amacı metabolik risk faktörlerinin sıklığını ve vücut kitle indeksinin (VKİ) ile ilişkisini değerlendirmektir.
Yöntem: 3 mm’nin üzerinde ürolitiazisi olan çocuklar çalışmaya dahil edildi. Demografik bilgiler ve idrar metabolik taramasını da içeren ve biyokimya analizleri kaydedildi.
Bulgular: Ortalama yaşları 71±57 ay olan 155 hastanın (94 erkek/61 kadın) 98'inin (%63) ailesinde taş öyküsü vardı. Hastaların %38,7'sinde en az bir metabolik risk faktörü vardı ve en yaygın olanlar sırasıyla hiperoksalüri (%16,8) ve hipositratüriydi (%16,8). Taş boyutu ≥5 mm olan ve multipl taşı olan hastalarda metabolik risk faktörlerine daha sık rastlanmaktaydı (p=0,015, p=0,028). Hastalar, zayıf ve normal kilolu hastalar Grup 1 (n=99 hasta), fazla kilolu ve obez olanlar Grup 2 (n=56 hasta) olmak üzere gruplandırıldı. Hiperkalsiüri, hiperürikozüri, hiperoksalüri, hipositratüri ve sistinüri sıklıkları gruplar arasında benzer bulundu.
Sonuç: Aile öyküsü üriner sistem taş hastalığında önemli bir uyarıcıdır. Taş boyutu >5 mm ve birden fazla taşı olan hastalarda metabolik risk faktörlerinin görülme olasılığı daha yüksek olduğundan, özellikle bu hastalarda bu açıdan değerlendirme yapılması uygun olacaktır. Bu çalışmada obezitenin metabolik risk faktörlerini arttırdığına dair bir bulguya rastlanmadı.

Anahtar Kelimeler

ürolitiazis, obezite, vücut kitle indeksi, hiperoksalüri, hipositratüri

Kaynakça

1. Stamatelou KK, Francis ME, Jones CA. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003; 63(5):1817–23. https://doi.org/10.1046/j.1523-1755.2003.00917.x
2. Spivacow, F. R., Del Valle, E. E., Boailchuk, J. A., Sandoval Díaz, G., Rodríguez Ugarte, V., & Arreaga Álvarez, Z. Metabolic risk factors in children with kidney stone disease: an update. Pediatr Nephrol 2020;35(11):2107-12. https://doi.org/10.1007/s00467-020-04660-x
3. Ece A, Ozdemir E, Gurkan F, Dokucu AI, Akdeniz O. Characteristics of pediatric urolithiasis in south-east Anatolia. Int J Urol 2000;7:330-334. https://doi.org/10.1046/j.1442-2042.2000.00207.x
4. Elder JS. Urinary Lithiasis. Kliegman RM St.Geme JW (ed) Nelson textbook of pediatrics, 21st edn. Elsevier 2020; pp 1822-1826
5. Martins SA, Gomes C, Correia AJ. Paediatric nephrolithiasis and nephrocalcinosis: a 20 year retrospective analysis. Port Nephrol Hypert 2007;21(2): 77-82
6. Bundak R, Furman A, Gunoz H, Darendeliler F, Baş F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95(2):194-8. https://doi.org/10.1080/08035250500334738
7. Edvardsson V, Sas DJ. Urinary Stone Disease and Nephrocalcinosis. In: Emma F, Goldstein SL, Bagga A, Bates CM, Shroff R, editors. Pediatric nephrology Eighth Ed. Springer Switzerland; 2022. p. 1301-1302.
8. Shahta HA, Usama NR. Etiological and clinical patterns of childhood urolithiasis in Iraq. Pediatr Nephrol 2005; 20(10): 1453-1457. https://doi.org/10.1007/s00467-005-1971-0
9. Sas DJ, Becton LJ, Tutman J, Lindsay LA, Wahlquist AH. Clinical, demographic, and laboratory characteristics of children with nephrolithiasis. Urolithiasis 2016; 44(3):241-6. https://doi.org/10.1007/s00240-015-0827-8
10. Karabacak OR, Ipek B, Ozturk U, Demirel F, Saltas H, Altug U. Metabolic evaluation in stone disease metabolic differences between the pediatric and adult patients with stone disease. Urology 2010;76(1):238-241. https://doi.org/10.1016/j.urology.2010.01.036
11. Fang AM, Gibson E, Oster RA, Dangle PP. Effect of age, BMI, and gender on urinary risk factors in pediatric idiopathic stone formers. J Pediatr Urol 2021;17(4):477.e1-477.e9 https://doi.org/10.1016/j.jpurol.2021.05.024
12. Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D et al. M. Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol 2008;40(1):3-9. https://doi.org/10.1007/s11255-007-9234-6
13. Edvardsson V, Elidottir H, Indridason OS, Palsson R. High incidence of kidney stones in Icelandic children. Pediatr Nephrol 2005;20:940–944. https://doi.org/10.1007/s00467-005-1861-5
14. Erbagci A, Erbagci AB, Yilmaz M, Yagci F, Tarakcioglu M, Yurtseven C, et al. Pediatric urolithiasis--evaluation of risk factors in 95 children. Scand J Urol Nephrol 2003;37:129-33. https://doi.org/10.1080/00365590310008866
15. Policastro LJ, Saggi JS, Goldfarb DS, Weiss PJ. Personalized intervention in monogenic stone formers. J Urol 2018;199: 623-32. https://doi.org/10.1016/j.juro.2017.09.143
16. Hoppe B, Martin-Higueras C. Inherited conditions resulting in nephrolithiasis. Curr Opin Pediatr 2020;32: 273-83. https://doi.org/10.1097/MOP.0000000000000848
17. Siener R, Glatz S, Nicolay C, Hesse A. The role of overweight and obesity in calcium oxalate stone formation. Obes Res 2004;12:106–113. https://doi.org/10.1038/oby.2004.14
18. Sarica K. Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res 2006;24:1-6. https://doi.org/10.1007/s00240-005-0018-0
19. Coward RJ, Peters CJ, Duffy PG, Corry D, Kellett MJ, Choong S, et al. Epidemiology of pediatric renal stone disease in the UK. Arch Dis Child 2003;88:962–965. https://doi.org/10.1136/adc.88.11.962
20. Escribano J, Balaguer A, Martin R, Feliu A, Espax R. Childhood idiopathic hypercalciuria clinical significance of renal calyceal microlithiasis and risk of calcium nephrolithiasis. Scand J Urol Nephrol 2004;38(5):422-426. https://doi.org/10.1080/00365590410033434
21. Milliner DS, Murphy ME. Urolithiasis in pediatric patients. Mayo Clin Proc 1993;68: 241-8. https://doi.org/10.1016/s0025-6196(12)60043-3
22. Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, et al. Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 2003;70: 273-7. https://doi.org/10.1159/000070134
23. Alpay H, Özen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol 2009;24(11): 2203-2209. https://doi.org/10.1007/s00467-009-1231-9
24. Eisner BH, Eisenberg ML, Stoller ML. Relationship between body mass index and quantitative 24-hour urine chemistries in patients with nephrolithiasis. Urology 2010; 75(6):1289–1293. https://doi.org/10.1016/j.urology.2009.09.024
25. Ekeruo WO, Tan YH, Young MD, Dahm P, Maloney ME, Mathias BJ, et al. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 2004;172(1):159–163. https://doi.org/10.1097/01.ju.0000128574.50588.97
26. Daudon M, Lacour B, Jungers P. Influence of body size on urinary stone composition in men and women. Urol Res 2006;34(3):193–9. https://doi.org/10.1007/s00240-006-0042-8
27. Roddy JT, Ghousheh AI, Christensen MA, Durkee CT. Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population. J Urol 2014;191:771-776. https://doi.org/10.1016/j.juro.2013.09.064
28. Bandari J, Dangle PP, Lyon TD, Lee A, Schneck FX, Cannon GM, et al. 24-Hour Urinary Parameters in Overweight and Obese Children with Urolithiasis J Urol 2016;196(2):526-530. https://doi.org/10.1016/j.juro.2016.03.012
29. Cambareri GM, Giel DW, Bayne AP, Corbett S, Schurtz E, Kovacevic L, et al. Do Overweight and Obese Pediatric Stone Formers Have Differences in Metabolic Abnormalities Compared With Normal-weight Stone Formers? Urology 2017;101:26-30. https://doi.org/10.1016/j.urology.2016.09.011
30. Carbone A, Al Salhi Y, Tasca A, Palleschi G, Fuschi A, De Nunzio C, et al. Obesity and kidney stone disease: a systematic review. Minerva Urol Nefrol 2018;70(4):393-400

Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Çocuk Cerrahisi, Çocuk Nefrolojisi, Çocuk Ürolojisi
Bölüm	Orjinal Araştırma Makaleleri
Yazarlar	Sevgin Taner 0000-0003-1578-789X Kamina Panahlı 0000-0002-8090-4207 Asena Ünal 0000-0003-2233-0513 Gunay Ekberli 0000-0002-0021-5998 Orkun Tolunay 0000-0003-0714-6734
Yayımlanma Tarihi	15 Ekim 2023
Kabul Tarihi	8 Eylül 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 11 Sayı: 3

Kaynak Göster

Vancouver	Taner S, Panahlı K, Ünal A, Ekberli G, Tolunay O. The Effect of Obesity on Metabolic Risk Factors in Children with Urinary Stones. pediatr pract res. 2023;11(3):101-6.

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