title: The most important metabolic risk factors in recurrent urinary stone formers.
abstract: OBJECTIVE
  To evaluate different urinary factors contributing to idiopathic calcium stone disease for determining appropriate medical treatments.
  
  
  METHODS
  Two 24-hour urine samples were collected from 106 male recurrent idiopathic calcium stone formers and another 109 randomly selected men as the control group matching for age.
  
  
  RESULTS
  Cases had significantly higher mean urine oxalate, calcium, uric acid, and chloride in comparison with the healthy controls (P < .001). After necessary adjustment, only mean urine levels of oxalate and uric acid were higher in stone formers than those in controls. The mean value of supersaturation for calcium oxalate was significantly higher in patients than the controls (P = .001); whereas supersaturation for calcium phosphate and uric acid did not reach statistical significance (P = .675 and P = .675, respectively). Hyperoxaluria and hypercalciuria were among the most frequent abnormalities. After categorizing urine parameter values into four quartiles, the risk of stone formation was found to increase as the urine calcium, oxalate, uric acid, chloride, and citrate rise. In contrast, the risk of stone formation decreased with the increase of urine potassium.
  
  
  CONCLUSIONS
  Oxalate seems to play the most important role as urinary stone risk factor in our population followed by calcium and uric acid. In addition to the risk factors, it seems that supersaturation as the sum of all risk factors probably has a high predictive value.
authors.affiliation: Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Parvin
authors.forename: Nasser
authors.initials: N
authors.lastname: Shakhssalim
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Miladipour
authors.forename: Banafsheh
authors.initials: B
authors.lastname: Golestan
authors.forename: Peyman
authors.initials: P
authors.lastname: Mohammadi Torbati
authors.forename: Mohaddeseh
authors.initials: M
authors.lastname: Azadvari
authors.forename: Sanaz
authors.initials: S
authors.lastname: Eftekhari
mesh_terms: D000328:Adult; D002118:Calcium / Q000652:urine; D002129:Calcium Oxalate / Q000652:urine; D002130:Calcium Phosphates / Q000652:urine; D002712:Chlorides / Q000652:urine; D019343:Citric Acid / Q000652:urine; D003404:Creatinine / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000652:urine; D012008:Recurrence; D012307:Risk Factors; D012964:Sodium / Q000652:urine; D014527:Uric Acid / Q000652:urine; D014545:Urinary Calculi / Q000209:etiology / Q000652:urine*
chemical_list: D002130:Calcium Phosphates; D002712:Chlorides; D002129:Calcium Oxalate; D014527:Uric Acid; D019343:Citric Acid; C020243:calcium phosphate; D012964:Sodium; D003404:Creatinine; D011188:Potassium; D002118:Calcium