Obesity and kidney stone disease: a systematic review

作者：Antonio Carbone, Yazan Al Salhi, Andrea Tasca, Giovanni Palleschi, Andrea Fuschi, Cosimo De Nunzio, Giorgio Bozzini, Sandro Mazzaferro, Antonio Luigi Pastore · 发表于：Minerva Urologica e Nefrologica · 年份：2018 · DOI：10.23736/s0393-2249.18.03113-2 · 被引用次数：174 · 研究领域：Kidney Stones and Urolithiasis Treatments、Chronic Kidney Disease and Diabetes、Parathyroid Disorders and Treatments

INTRODUCTION: Currently, abdominal obesity has reached an epidemic stage and obesity represents an important challenge for worldwide health authorities. Epidemiologic studies have demonstrated that the stone risk incidence increases with Body Mass Index, through multiple pathways. Metabolic syndrome and diabetes are associated with an increased renal stones disease incidence. The aim of this systematic review was to investigate the prevalence, morbidity, risk factors involved in the association between obesity and urolithiasis. EVIDENCE ACQUISITION: The search involved finding relevant studies from MEDLINE, EMBASE, Ovid, the Cochrane Central Register of Controlled Trials, CINAHL, Google Scholar, and individual urological journals between January 2001 and May 2017. The inclusion criteria were for studies written in the English language, reporting on the association between obesity and urinary stones. EVIDENCE SYNTHESIS: The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are observed frequently in these patients. Insulin resistance is thought to alter the renal acid-base metabolism, resulting in a lower urine pH, and increasing the risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances and with an increase in urinary tract infection incidence. Recent studies hi...