24 Hour Urinary Metabolic Profile After Percutaneous Nephrolithotomy
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 2
Abstract
Introduction: Renal stone disease is a common problem and prevalence ranges about 1% to 15%. Recurrence is seen in up to 50% in the next 10 years after first stone episode. Identifying and correcting the metabolic abnormality helps to reduce recurrence. For this, we evaluated metabolic profile of renal stone formers from their 24 hour urinary sample. Methods: In this cross sectional study, we estimated the levels of 24 hour urinary citrate, calcium, sodium, potassium, creatinine, phosphorus, magnesium, chloride, uric acid, oxalate, volume, and urinary Ph in 77 consecutive renal stone formers. All patients were on normal diet with no special instruction. Results: The prevalence of metabolic abnormalities were in the order hypernatriuria>hypercalciuria>hypophosphaturia>hypocitraturia=hypomagnesuria>hyperoxalura> hyperuricosuria. 72/77(93.5%) had at least two abnormality, 57/77 (74.02%) had three, 29/77(37.66%) had four and 8/77 (10.38%) had five abnormalities. Significant correlation was observed between urine calcium and urine sodium(r=0.497, p<0.0001), urine calcium and urine uric acid(r=0.425,p<0.0001), urine uric acid and urine sodium(r=0.362,p<0.001). Metabolic profile in 24hr urinary samples was statistically similar among males and females, unilateral and bilateral disease and vegetarian and mixed diet. Conclusion: The prevalence of metabolic abnormalities were in the order hypernatriuria>hypercalciuria>hypophosphaturia>hypocitraturia=hypomagnesuria>hyperoxalura> hyperuricosuria. Urine calcium levels significantly correlated with urine sodium and uric acid levels. So we suggest that dietary restriction of sodium as an important factor in reducing urinary calcium and uric acid along with potassium citrate supplementation to prevent stone recurrence.
Authors and Affiliations
Sreedhar Dayapule, Suryaprakash Vaddi, Vijaya Bhaskar G, Rammohan Pathapati
Keywords
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