Hypertension is associated with increased urinary calcium excretion in patients with nephrolithiasis.
OBJECTIVE
The epidemiological relationship between nephrolithiasis and hypertension is well-known. Patients with hypertension are at increased risk for nephrolithiasis and those with nephrolithiasis are at risk for hypertension. Urine calcium or urine citrate may be related to hypertension status. We examined the relationship between hypertension and 24-hour urine composition in patients with nephrolithiasis.


METHODS
We retrospectively reviewed the database on 462 stone forming patients to examine the relationship between hypertension and 24-hour urine composition. Multivariate linear regression models were adjusted for age, race, gender, body mass index, diabetes mellitus and 24-hour urine constituents. Nominal logistic regression was also done to examine the hypertension prevalence by quintile of calcium and citrate excretion.


RESULTS
On adjusted multivariate analysis compared with normotensive stone formers those with hypertension excreted 25.6 mg per day more urine calcium, corresponding to a 12% increase in urinary calcium excretion. The relative risk of hypertension was significantly associated with quintile of calcium excretion but not with quintile of citrate excretion (1.29, 95% CI 1.02 to 1.61 vs 0.94, 95% CI 0.78 to 1.14).


CONCLUSIONS
In stone formers hypertension was associated only with significantly increased urine calcium. This association is important when treating patients with nephrolithiasis since those with hypertension may require unique dietary and medical therapy.
Eisner
Brian H
BH
Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. beisner@partners.org
Porten
Sima P
SP
Bechis
Seth K
SK
Stoller
Marshall L
ML
D002118:Calcium / Q000652:urine*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000150:complications* / Q000652:urine*; D012189:Retrospective Studies
D002118:Calcium