Skip to main content
SpringerLink
Log in

Urinary factors of kidney stone formation in patients with Crohn's disease

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

An increased frequency of kidney stone formation is reported in patients with inflammatory bowel disease. In order to investigate its pathogenesis, the concentrations of factors known to enhance calcium oxalate stone formation (oxalate, calcium, uric acid) as well as of inhibitory factors for nephrolithiasis (magnesium, citrate) were determined in the urine of 86 patients with Crohn's disease and compared with those of 53 metabolically healthy controls. Six patients with Crohn's disease already had experienced calcium oxalate nephrolithiasis. Patients with Crohn's disease had significantly higher urinary oxalate and lower magnesium and citrate concentrations. Among all patients magnesium and citrate were significantly lower in those with a positive history of kidney stones. Our results demonstrate that the increased propensity for renal stone formation in patients with Crohn's disease is a result not only of increased urinary oxalate, but also of decreased urinary magnesium and citrate concentrations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CDAI:

Crohn's disease activity index

References

  1. Andersson H, Bosaeus I, Fasth S, Hellberg R, Hulten L (1987) Cholelithiasis and urolithiasis in Crohn's disease. Scand J Gastroenterol 22:253–256

    PubMed  Google Scholar 

  2. Best WR, Becktel JM, Singleton JW, Kern F (1976) Development of a Crohn's disease activity index. Gastroenterology 70:439–444

    PubMed  Google Scholar 

  3. Clayman RV, Buchwald H, Varco RL, DeWolf WC, Williams RD (1978) Urolithiasis in patients with jejunoileal bypass. Surg Gynecol Obstet 147:225–230

    PubMed  Google Scholar 

  4. Earnest DL, Johnson G, Williams HE (1974) Hyperoxaluria in patients with ileal resection: an abnormality in dietary oxalate absorption. Gastroenterology 66:1114–1122

    PubMed  Google Scholar 

  5. Fried R, Fried LW (1970) Xanthin. Methoden der enzymatischen Analyse. In: Bergmeyer H (ed) Verlag Chemie, Weinheim, S 1879

    Google Scholar 

  6. Gelzayd EA, Breuer RI, Kirsner JB (1968) Nephrolithiasis in inflammatory bowel disease. Am J Dig Dis 13:1027–1034

    PubMed  Google Scholar 

  7. Hammarsten G (1936) Eine experimentelle Studie über Calciumoxalat als Steinbildner in den Harnwegen: Speziell mit Rücksicht auf die Bedeutung des Magnesiums. Harasowitz, Leipzig, S 1–155

    Google Scholar 

  8. Kalistratos G (1974) Die Bedeutung des Aussalzeffektes für die Harnsteinentstehung,-prophylaxe und -therapie. Fortschr Urol Nephrol 4:56–59

    Google Scholar 

  9. King JS, O'Connor FJ, Smith MJ, Crouse L (1968) The urinary calcium/magnesium ratio in calciferous stone formers. Invest Urol 6:60–66

    PubMed  Google Scholar 

  10. Kyle J (1980) Urinary complications of Crohn's disease. World J Surg 4:153–160

    PubMed  Google Scholar 

  11. Lescovar R, Hartung R, Kratzer M (1980) Bedeutung von Kristallisationsinhibitoren bei der Kalziumlithiasis. Krankenhausarzt 53:875–879

    Google Scholar 

  12. Mandell J, Kraus E, Millian JC (1980) Oxalate induced acute renal failure in Crohn's disease. Am J Med 69:628–632

    PubMed  Google Scholar 

  13. Marangella M, Maddalena D, Futtero B, Bruno M, Malfi B, Linari F (1979) Hiperossaluria nella calcolosi renale e nel morbo di Crohn. Minerva Nefrologica 26:543–548

    PubMed  Google Scholar 

  14. Marshall RW, Robertson WG (1976) Nomogram for the estimation of saturation of urine with calciumoxalate, calciumphosphate, magnesium ammoniumphosphate, uric acid, sodium acid urate, ammonium acid urate and cystine. Clin Chim Acta 72:253–260

    PubMed  Google Scholar 

  15. Meyer JL (1974) Formation constants for interaction of citrate with calcium and magnesium ions. Anal Biochem 62:295–300

    PubMed  Google Scholar 

  16. Möllering H, Gruber W (1966) Determination of citrate with citrate lyase. Anal Biochem 17:369–376

    PubMed  Google Scholar 

  17. Nyhlin H, Dyckner T, Ek B, Westner PO (1982) Magnesium in Crohn's disease. Acta Med Scand [Suppl] 661:21–25

    Google Scholar 

  18. Oreopoulos DG, Soyannwo M, McGeown M (1968) Magnesium/calcium ratio in urine of patients with renal stones. Lancet II:410–412

    Google Scholar 

  19. Rudman D, Dedonis JL, Fountain MT, Chandler JB, Gerron G (1980) Hypocitraturia in patients with gastrointestinal malabsorption. N Engl J Med 303:657–661

    PubMed  Google Scholar 

  20. Saegesser F (1980) Urinary complications of Crohn's disease: invited commentary. World J Surg 4:159

    Google Scholar 

  21. Schmidt K, Hagmaier V, Bruchelt G, Rutishauser G (1980) Analytical isotachophoresis: a rapid and sensitive method for determination of urinary oxalate. Urological Res 8:177–180

    Google Scholar 

  22. Schofield PF, Staff WG, Moore T (1968) Uretral involvement in regional ileitis (Crohn's disease). J Urol 99:412–415

    PubMed  Google Scholar 

  23. Smith LH, Fromm H, Hofmann AF (1972) Acquired hyperoxaluria, nephrolithiasis and intestinal disease, description of a syndrome. N Engl J Med 286:1371–1375

    PubMed  Google Scholar 

  24. Terhost B, Melchior H (1972) Die medikamentöse Behandlung des Harnsteinleidens. II. Periorale Litholyse und Prophylaxe. Uro Int 27:230–236

    Google Scholar 

  25. Thiele H, Lampe HJ, Trede M, Ludwig G (1980) Urologische Komplikationen bei Morbus Crohn. Chirurg 51:150–154

    PubMed  Google Scholar 

  26. Valensieck W, Hesse A, Bach D (1981) Inzidenz and Prävalenz und Morbidität des Harnsteinleidens in der BRD. Fortschr Urol Nephrol 17:1–5

    Google Scholar 

  27. Welshman SG, McGeown MG (1976) Urinary citrate excretion in stone-formers and normal controls. Br J Urol 48:7–11

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung Pädiatrie der Universität Erlangen, Germany

    H. Böhles, O. J. Beifuss, U. Brandl & Z. Akçetin

  2. Abteilung Innere Medizin der Universität Erlangen, Germany

    J. Pichl & L. Demling

Authors
  1. H. Böhles
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. J. Beifuss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. Brandl
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Pichl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Akçetin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Demling
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Professor Dr. N. Zöllner on the occasion of his 65th birthday

Rights and permissions

Reprints and permissions

About this article

Cite this article

Böhles, H., Beifuss, O.J., Brandl, U. et al. Urinary factors of kidney stone formation in patients with Crohn's disease. Klin Wochenschr 66, 87–91 (1988). https://doi.org/10.1007/BF01774220

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01774220

Key words

Search

Navigation