An evaluation of the physicochemical risk for renal stone disease during pregnancy.
Seventeen subjects were studied during the third trimester of pregnancy (PG) and post partum (NPG) to evaluate the effect of pregnancy on the physicochemical risk of renal stone disease. Levels of urinary saturation for calcium oxalate (CaOx), brushite (Br), uric acid (UA), and monosodium urate (NaU) were determined as well as urinary excretions of stone-forming elements. In addition to urinary calcium excretion, assessment of calcium metabolism included serum calcium and parathyroid hormone. Urinary calcium excretion was 251 +/- 127 mg/day during pregnancy and 121 +/- 67 mg/day post partum (p < 0.001). This was associated with a higher intake of dietary calcium and altered renal handling of calcium with an increase in the filtered load and a decrease in renal tubular reabsorption. The increase in urinary calcium resulted in a higher level of saturation of the urine for calcium oxalate (NPG 2.1 +/- 1.0 vs PG 3.0 +/- 1.1, p < 0.02) and brushite (NPG 1.2 +/- 0.9 vs PG 1.9 +/- 1.1, p < 0.05) compatible with an increased risk of stone formation.
Smith
C L
CL
Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA. smith156@tc.umn.edu
Kristensen
C
C
Davis
M
M
Abraham
P A
PA
D000328:Adult; D002118:Calcium / Q000097:blood / Q000652:urine; D002129:Calcium Oxalate / Q000652:urine; D002130:Calcium Phosphates / Q000652:urine; D002136:Calcium, Dietary / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000652:urine*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000652:urine*; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D014527:Uric Acid / Q000652:urine
D002130:Calcium Phosphates; D002136:Calcium, Dietary; D002129:Calcium Oxalate; D014527:Uric Acid; C494366:calcium phosphate, dibasic, dihydrate; D002118:Calcium