Korean J Urol.  2004 Aug;45(8):764-767.

Biochemical Evaluation of Lithogenic Factors in 24-hour Urine of the Long-term Hospitalized Patients with Immobilization

Affiliations
  • 1Department of Urology, Chonnam National University Medical School, Korea. sbryu@chonnam.ac.kr
  • 2Department of Urology, Veterans Hospital, Gwangju, Korea.

Abstract

Purpose
To answer the questions of ambulation dependency for risk of urolithiasis, the urinary lithogenic factors in normal controls were compared with long hospital stay immobilized patients.
Materials and Methods
Fifty immobilized patients and twenty normal controls, on usual constant regular diet, were evaluated with 24-hour urine for the excretion rate differences of lithogenic and inhibitory constituents, such as volume, pH, calcium, phosphorus, uric acid, oxalate, citrate, magnesium, sodium, potassium, chloride and creatinine. The incidence of metabolic abnormalities in the immobilized patients was also evaluated.
Results
The immobilized patients showed significantly increased excretions of uric acid, oxalate, sodium, potassium, urine volume, but decreased excretions of citrate and magnesium (p<0.05). No differences were found between the two groups with regard to urinary excretions of calcium, phosphate, creatinine and chloride or in the pH of excretions. The frequent metabolic abnormalities in the immobilized patients were hypomagnesuria (92%), hypocitraturia (86%), hyperoxalaturia (82%), hypernatriuria (44%), hyperuricosuria (16%) and hypercalciuria (12%).
Conclusions
These results reveal that hypomagnesuria, hypocitraturia and hyperoxalaturia were the most important risk factors for urolithiasis in the immobilized patients. However, a further controlled prospective study will be needed with regard to the influence of ambulation.

Keyword

Urinary calculi; Immobilization
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