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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Uric acid nephrolithiasis is typically found in individuals with a low urine pH and a normal concentration of urinary uric acid. Patients with a history of gout are at greater risk of forming uric acid stones, as are patients with obesity, diabetes, or the complete metabolic syndrome. The unifying renal tubular abnormality of these disorders appears to be the excretion of abnormally acidic urine. This article focuses on the relationship of these disorders to the development of uric acid stones. The diagnosis of uric acid stones can be elusive, because pure uric acid stones are radiolucent on plain radiographs. Ultrasound, or preferably noncontrast helical CT scanning, is required for their detection. The treatment of uric acid stones should focus on alkalinization of the urine with citrate or bicarbonate salts. Additional interventions such as increase in fluid intake and decrease in animal protein ingestion are often beneficial. Patients with documented hyperuricemia often require specific therapy to lower serum uric acid concentration and subsequent excretion.
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PMID:Uric acid nephrolithiasis. 1753 Nov 80

Uric acid nephrolithiasis is frequent accounting for 10% of urinary stones in industrialized countries. Its frequency will increase in the next decades because of the ageing and the increasing prevalence of obesity and type 2 diabetes mellitus. The pathophysiologic defect is an excessively acidic urine pH rather than hyperuricosuria. Undissociated uric acid is poorly soluble in acidic urines (pH < 5.5) but solubility increases when sodium urate forms at higher pH. Insulin resistance may contribute to the development of acidic urine because of higher net acid excretion. Because uric acid kidney stones are radiolucent, diagnosis is based on echography and tomodensitometry. Medical management strategies focus primarily on alkali treatment and/or decreasing hyper-uricosuria.
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PMID:[Uric acid nephrolithiasis]. 2156 21

Uric acid nephrolithiasis (UAN) is an increasingly common disease in ethnically diverse populations and constitutes about 10% of all kidney stones. Metabolic syndrome and diabetes mellitus are accounted among the major risk factors for UAN, together with environmental exposure, individual lifestyle habits and genetic predisposition. The development and overt manifestation of UAN appears to stem on the background of insulin resistance, which acts at the kidney level by reducing urinary pH, thus hampering the ability of the kidney to generate renal ammonium in response to an acid load. Unduly acidic urinary pH and overt UAN are both considered renal manifestations of insulin resistance. The mechanisms underlying increased endogenous acid production and/or defective ammonium excretion are yet to be completely understood. Although the development of UAN and, more in general, of kidney stones largely recognizes modifiable individual determining factors, the rising prevalence of diabetes, obesity and accompanying metabolic disorders calls for the identification of novel therapeutic approaches and intervention targets. This review aims at providing an updated picture of existing evidence on the relationship between insulin resistance and UAN in the context of metabolic syndrome and in light of the most recent advancements in our understanding of its genetic signature.
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PMID:Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus. 2951 Jan 80