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Patients with nephrolithiasis and blood hypertension have higher calciuria than those with isolated nephrolithiasis or hypertension?

AIM
The aim of this study was to determine urinary excretion of calcium, uric acid and sodium and to evaluate insulin resistance in patients with nephrolithiasis and blood hypertension, isolated and in association, and in healthy controls, in absence of obesity and diabetes.


METHODS
The study included 83 non-obese or diabetic patients: 17 with nephrolithiasis and hypertension (group D); 25 with nephrolithiasis (group C); 17 with hypertension (group B) and 24 healthy controls (group A). Urinary analysis was done in 24-hour urine collection and insulin resistance was evaluated through the HOMA-IR index.


RESULTS
Calciuria was higher in group D in relation to groups A (P<0.01), B (P<0.01) and C (P=0.01). There was no significant difference between groups A and B (P=0.32), A and C (P=0.10) and B and C (P=0.68). Correlation analysis between urinary calcium detected strong correlation with uric acid in group A, regular in groups B and C and, strong with sodium in groups B and C. No differences were detected in uric acid and sodium excretion or insulin resistance among groups.


CONCLUSIONS
Patients with blood hypertension and nephrolithiasis present higher calciuria than healthy people, with hypertension or with lithiasis and do not have the positive correlation observed in these latter groups with renal excretion of uric acid and sodium. These results suggest that impaired renal calcium reabsorption in non-obese or diabetic individuals is involved in the association between hypertension and urolithiasis.