Metabolic diagnosis in stone formers in relation to body mass index.

It is known that several metabolic abnormalities that favor stone formation have a strong dependence on environmental and nutritional factors. The incidence and prevalence of kidney stone is increasing while there has been a parallel growth in the overweight/obesity rate, and epidemiologic studies have shown a significant association between overweight/obesity and increased nephrolithiasis risk. The aim of this study was to assess if metabolic abnormalities observed in stone patients differ in relation to their BMI. We evaluated 817 renal stone formers (459 men and 358 woman) in an outpatient setting. They were all studied with a standard protocol (two 24 h urine collections and serum parameters) and classified according to their BMI in normal, overweight and obese and according to age in <50 or >50 year old. In the whole population we found that 58.7% were either overweight or obese: 39.4% (n = 322) were OW and 19.3% (n = 158) were OB. The proportion of overweight was significantly higher among men than women. In women of all ages regardless of BMI, hypercalciuria was the most prevalent diagnosis. Hyperuricosuria increased its prevalence significantly only in overweight and obese women <50 years of age (p < 0.01). Hypercalciuria was the predominant diagnosis in normal weight men of both age groups. Hyperuricosuria was the most frequent abnormality in overweight and obese men followed by gouty diathesis and both increased their prevalence significantly from normal weight to obesity and in both age groups (p < 0.05 and <0.01). We conclude that the only abnormalities that increased their prevalence significantly with increasing BMI were hyperuricosuria and gouty diathesis, the first one in men of all ages and women under 50 years of age, while the second one only in men.

Role of overweight and obesity on the urinary excretion of promoters and inhibitors of stone formation in stone formers.

In recent decades there has been an increasing prevalence of urolitithiasis in many western countries and at the same time there has been an increasing progression of obesity that has reached epidemic proportions. The aim of the present study was to assess the influence of overweight/obesity on the metabolic risk factors for renal stone formation. We studied 799 renal stone formers (462 men and 337 women) who came to the clinic for metabolic risk factors evaluation. They were all studied with a standard protocol (two 24-h urine collections and serum parameters). They were divided according to their BMI in normal (BMI < 25) overweight (BMI 25-29.9) and obese (BMI > 30). Low-weight individuals were excluded. Overall, 487 of 799 (60.9%) patients had a BMI > 25, including 40.6% overweight and 20.3% obese. Among women 55.2% had normal weight, 25.5 were overweight, and 19.3% were Obese; among men 27.3% had normal weight, 51.7 were overweight, and 21% were obese. Age increased significantly with increasing BMI both in men and women. In women there was a significant increase in the excretion of oxalate, uric acid, phosphorus, creatinine, and sodium with increasing BMI, but no change was observed in calcium, magnesium, citrate, and urine pH. In men there was a significant increase in the excretion of oxalate, uric acid, creatinine, phosphorus, sodium, magnesium, and citrate with increasing BMI, no change in urinary calcium and significant progressive decrease in urinary pH. In this population of stone formers there was a high prevalence of overweight/obesity (60.9%). Both in men and women we found a significant increase in the urinary excretion of two promoters of stone formation, oxalate, and uric acid but no change in urinary calcium. There was either no change or increase in magnesium and citrate, inhibitors of crystallization, and a significant decrease in urine pH only in men.

Trastornos de la fertilidad en el hombre con diabetes tipo 1 y 2 / Fertility alterations in men wiht type 1 and 2

La diabetes mellitus (DM) es una de las mayores amenazas para la Salud Publica en las sociedades modernas. Si bien durante varios años se sugirió que la DM no tenía efecto significativo en la función reproductiva masculina, esta visión fue cambiando. La creciente incidencia de la DM a nivel mundial afectara a cada vez más hombres y de menor edad, y por lo tanto podría afectar su potencial reproductivo.

Nefropatía por Ig A: Un caso que ilustra sus controversias / Ig A Nephropathy: A case that illustrates its controversies

La nefropatía por IgA (N IgA)es una glomerulonefritis que se caracteriza por evidenciar depósitos mesangiales difusos de IgA. Fue por primera vez descripta en 1968 por el patólogo francés Jean Berger, coincidiendo su aparición con la introducción de técnicas de inmunofluorescencia (IF) en las biopsias renales. De ahí el hecho de que esta patología sea conocida también como Enfermedad de Berger.La nefropatía por IgA es la única glomerulopatía que se define por la presencia de un tipo de depósito en la IF, más allá del patrón morfológico descripto en la biopsia. Los hallazgos en la microscopía óptica son tan variables que no permiten la elaboración de un score universal y a la vez determinar la correlación de la histopatología con la clínica.Durante muchos años la N IgA fue considerada una patología benigna. Hoy se sabe sin embargo que muchos casos evolucionan hacia la insuficiencia renal (hasta un 50%)...

IgA nephropaty (IgAN) is a mesangial proliferative glomerulonephritis characterized by diffuse mesangial deposition of IgA. IgAN is unique among glomerular diseases in being defined by the presence of an inmune reactant rather than by another morphologic feature found in renal biopsy. Light microscopic changes are so variable that there is no universal score and it is not possible to correlate pathology with clinical manifestations...

Nefropatía por Ig A: Un caso que ilustra sus controversias / Ig A Nephropathy: A case that illustrates its controversies

La nefropatía por IgA (N IgA)es una glomerulonefritis que se caracteriza por evidenciar depósitos mesangiales difusos de IgA. Fue por primera vez descripta en 1968 por el patólogo francés Jean Berger, coincidiendo su aparición con la introducción de técnicas de inmunofluorescencia (IF) en las biopsias renales. De ahí el hecho de que esta patología sea conocida también como Enfermedad de Berger.La nefropatía por IgA es la única glomerulopatía que se define por la presencia de un tipo de depósito en la IF, más allá del patrón morfológico descripto en la biopsia. Los hallazgos en la microscopía óptica son tan variables que no permiten la elaboración de un score universal y a la vez determinar la correlación de la histopatología con la clínica.Durante muchos años la N IgA fue considerada una patología benigna. Hoy se sabe sin embargo que muchos casos evolucionan hacia la insuficiencia renal (hasta un 50%)... (AU)

IgA nephropaty (IgAN) is a mesangial proliferative glomerulonephritis characterized by diffuse mesangial deposition of IgA. IgAN is unique among glomerular diseases in being defined by the presence of an inmune reactant rather than by another morphologic feature found in renal biopsy. Light microscopic changes are so variable that there is no universal score and it is not possible to correlate pathology with clinical manifestations... (AU)