Does hypertension impact 24-hour urine parameters in patients with nephrolithiasis?
OBJECTIVE
To examine the differences in 24-hour urine parameters and stone composition between patients with and without systemic hypertension (HTN) in a large cohort of stone formers.


METHODS
We performed a retrospective review over a 10-year period of patients with stone, who had completed a 24-hour urinalysis (Litholink) and for whom demographic information was available, including the presence of HTN. Univariate and multivariate analyses were performed, comparing the 24-hour urinalysis profiles of patients with HTN with that of normotensive patients.


RESULTS
Of the 1115 patients eligible for inclusion, 442 patients (40%) had HTN and 673 (60%) did not. Patients with HTN were significantly older, had a higher body mass index, and had a greater number of comorbid conditions than normotensive patients. Univariate analysis revealed significantly lower urine pH, calcium, supersaturation (SS) of calcium oxalate (CaOx) and SS calcium phosphate (all P <.05) in patients with HTN. Multivariate analysis showed significantly lower calcium, citrate, and SS CaOx in patients with HTN (all P <.05).


CONCLUSIONS
Our results demonstrate lower levels of calcium and SS CaOx on univariate and multivariate analysis, as well as lower levels of citrate on multivariate analysis in patients with HTN. These results suggest that lower levels of citrate may contribute to stone formation to a greater degree in patients with HTN than abnormalities in calcium metabolism.
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY. Electronic address: CHartmanMD@gmail.com.
Christopher
C
Hartman
Department of Urology, Fox Chase/Einstein Urologic Institute, Philadelphia, PA.
Justin I
JI
Friedlander
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY.
Daniel M
DM
Moreira
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY.
David A
DA
Leavitt
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY.
David M
DM
Hoenig
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY.
Arthur D
AD
Smith
Department of Urology, Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY.
Zeph
Z
Okeke
D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000652:urine*; D007669:Kidney Calculi / Q000737:chemistry / Q000150:complications* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053040:Nephrolithiasis / Q000150:complications / Q000652:urine; D012189:Retrospective Studies