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Etiological Role of Estrogen Status in Renal Stone Formation

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(05)64264-4

1527-3792

Howard J. Heller, Khashayar Sakhaee, Orson W. Moe, Charles Y.C. Pak,

Ureteral procedures and complications

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2002Etiological Role of Estrogen Status in Renal Stone Formation HOWARD J. HELLER, KHASHAYAR SAKHAEE, ORSON W. MOE, and CHARLES Y.C. PAK HOWARD J. HELLERHOWARD J. HELLER , KHASHAYAR SAKHAEEKHASHAYAR SAKHAEE , ORSON W. MOEORSON W. MOE , and CHARLES Y.C. PAKCHARLES Y.C. PAK View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64264-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Estrogen may protect against kidney stone formation since nephrolithiasis is more common in men than in women. Moreover, the incidence of stones rises after menopause in women. We examined the contribution of estrogen to kidney stone risk by comparing outpatient evaluations in the 2 genders, and in estrogen treated and untreated postmenopausal women. Materials and Methods: We reviewed the results of the initial evaluation of 1,454 adult calcium oxalate stone formers, including 1,050 men and 404 women. Of the postmenopausal women 39 and 50 were estrogen treated and untreated, respectively. Samples of urine and blood were collected 1 week after the imposition of a diet restricted moderately in sodium and calcium, and modestly in oxalate and animal protein. Results: Compared with men the daily excretion of urinary calcium, oxalate and uric acid was lower in women. Women had lower saturations of calcium oxalate and brushite as well as lower excretion of undissociated uric acid. Compared with men urinary calcium was lower in women until age 50 years, when it equaled that of men. Citrate was equal in the genders until the age 60 years, when it tended to decrease in women. Compared with nontreated postmenopausal women those treated with estrogen had lower mean 24-hour calcium plus or minus SD (155 ± 62 versus 193 ± 90 mg. per day, p <0.02), mean 2-hour fasting urine calcium (0.08 ± 0.05 versus 0.12 ± 0.09 mg./mg. creatinine, p <0.01) and mean calcium oxalate saturation (5.07 ± 2.27 versus 6.48 ± 3.44, p <0.05). Conclusions: The lower risk of stone formation in women may be due to the lower urinary saturation of stone forming salts. Estrogen treatment may decrease the risk of stone recurrence in postmenopausal women by lowering urinary calcium and calcium oxalate saturation. References 1 : The natural history of renal and ureteric calculi. Br J Urol1975; 47: 117. Crossref, Medline, Google Scholar 2 : Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int1979; 16: 624. Crossref, Medline, Google Scholar 3 : Demographic and geographic variability of kidney stones in the Untied States. Kidney Int1994; 46: 893. 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Nijenhuis T, Hoenderop J, Nilius B and Bindels R (2003) (Patho)physiological implications of the novel epithelial Ca2+ channels TRPV5 and TRPV6Pflügers Archiv - European Journal of Physiology, 10.1007/s00424-003-1038-7, VOL. 446, NO. 4, (401-409), Online publication date: 1-Jul-2003. Volume 168Issue 5November 2002Page: 1923-1927 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordskidney calculisexkidneymenopauseestrogensMetricsAuthor Information HOWARD J. HELLER More articles by this author KHASHAYAR SAKHAEE More articles by this author ORSON W. MOE More articles by this author CHARLES Y.C. PAK More articles by this author Expand All Advertisement PDF downloadLoading ...