title: Increased risk of urinary stone disease by physical exercise.
abstract: Constituents of 6-hour (0900-1500 hours) urine collected during rest and exercise have been compared among 3 groups of male volunteers. Groups 1 and 2 (GI, GII) were normal controls residing in an urban area (n = 10) and rural villages (n = 9), respectively, and group 3 (GIII) consisted of 10 renal stone formers from the same location as GII. Exercise was performed by cycling on an electronic bicycle with three 150-watt loads and the duration of each load was 20 minutes. Collected usine was analyzed for volume, pH, PI (permissible increment) in oxalate, creatinine, calcium, sodium, potassium, phosphorus, oxalate, uric acid and citrate. The results showed that most urinary excretions during both rest and exercise periods were similar among the 3 groups. Only the following values were significantly different, ie in the rest period, calcium of GIII < GII (p < .01) and potassium of GII < GI (p < .05); in the exercise period, potassium of GIII < GI (p < .02) and phosphorus of GIII < GII (p < .03). In comparison between the rest and exercise periods within each group, the decreased total excretions during exercise were creatinine of GI (p < .05) and GIII (p < .05), calcium of GII (p < .05) and phosphorus of GIII (p < .05); only calcium of GIII (p < .05) was increased. However, when the concentration of each constituent was taken into consideration, most constituents increased in concentration during the exercise period due to the fall in urinary volume. Furthermore, during exercise both pH and PI in oxalate of urine decreased significantly. Thus the results of our study suggested that though most total urinary excretion patterns were similar between the rest and exercise periods, the risk of stone formation in the urinary tract during exercise could be enhanced. The enhanced risk is likely due to 3 main factors, ie (1) decrease in urinary volume, (2) increased propensity for crystallization of calcium oxalate (PI in oxalate decreased) and (3) decrease in urinary pH which will directly cause an increase in saturation level of uric acid. This increased risk of stone formation was consistently observed in all three groups of subjects.
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Sriboonlue
authors.forename: V
authors.initials: V
authors.lastname: Prasongwatana
authors.forename: P
authors.initials: P
authors.lastname: Tosukhowong
authors.forename: K
authors.initials: K
authors.lastname: Tungsanga
authors.forename: S
authors.initials: S
authors.lastname: Bovornpadoongkitti
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D002118:Calcium / Q000652:urine; D002129:Calcium Oxalate / Q000652:urine; D003404:Creatinine / Q000652:urine; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006801:Humans; D007669:Kidney Calculi / Q000209:etiology* / Q000652:urine; D008297:Male; D011188:Potassium / Q000652:urine; D012306:Risk; D014563:Urodynamics / Q000502:physiology
chemical_list: D002129:Calcium Oxalate; D003404:Creatinine; D011188:Potassium; D002118:Calcium