The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis: a systematic review and dose-response meta-analysis

Fatemah Taheri, Kurosh Djafarian, Cain Clark, Maryam Taheri, Farhang Djafari, Elaheh Honarkar-Shafie, Mohadeseh Aghasi, Sakineh Shab-Bidar

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    Objective The aim of the present study was to evaluate the impact of body mass index (BMI) on urinary excretion of different metabolites in patients with nephrolithiasis. Methods A systematic search of PubMed and Scopus was performed up to July 2019. The eligible studies based on inclusion/exclusion criteria were screened and their data were extracted. Finally, 91 articles were included for dose response analysis, of which, 14 articles were included. Patients were dichotomized according to their BMI, i.e. normal weight patients with BMI˂25 and overweight/obese patients with BMI≥25 kg/m². Results Our results indicated that normal weight stone forming patients excreted less calcium (p<0.001), uric acid (p<0.001), oxalate (p<0.001), sodium p<0.001), citrate (p<0.001) and magnesium (p<0.001), however, these patients also had a higher urinary pH (p<0.001). There was a linear dose-response relationship between BMI and 24-h excretion of oxalate (p linearity˂0.001), uric acid (p linearity ˂ 0.001), sodium (p linearity= 0.002), phosphate (p linearity = 0.006), citrate (p linearity = 0.003) and creatinine (p linearity=0.0006), respectively. Conclusion The findings from the present study highlight overweight and obesity increase the urinary excretion of both stone promoters (calcium, sodium, oxalate and uric acid) and inhibitors (citrate and magnesium) urinary pH and prevalence of kidney stones is still higher in overweight/obese patients. Overall, overweight and obese people have more chance to form the kidney stones.
    Original languageEnglish
    Article number100262
    Number of pages8
    JournalObesity Medicine
    Early online date9 Aug 2020
    Publication statusPublished - Dec 2020

    Bibliographical note

    NOTICE: this is the author’s version of a work that was accepted for publication in Obesity Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Obesity Medicine, 20, (2020) DOI: 10.1016/j.obmed.2020.100262

    © 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International


    • Acid uric
    • Body mass index
    • Obesity
    • Urinary calcium
    • Urolithiasis

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Public Health, Environmental and Occupational Health


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