Most Read Articles
4 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 4 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
5 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.

Characterizing elevated urinary ammonium in nephrolithiasis

27 Jun 2020

While uncommon, elevated urinary ammonium in kidney stone patients is associated with higher rates of comorbid metabolic conditions, urinary tract infections, and bowel surgery, according to a study.

The retrospective study involved 3,625 adult kidney stone disease patients (49.9 percent female) who completed 24-hour urine studies, among whom 259 (7.1 percent) showed high ammonium. Researchers selected 121 patients with elevated urinary ammonium (case) and 121 matched controls for the final analysis.

The overall cohort had an average age of 51.5 years. Mean urinary ammonium (NH24) levels were 79.1 mmol/d in the case group vs 34.7 mmol/d in the control group (p<0.01). The median time between 24-H urine and stone analysis was 100 days.

Compared with controls, patients with elevated urinary ammonium had higher urine volume, oxalate, calcium, uric acid, sodium, chloride, and sulfate. They were also more likely to have higher body mass index and a history of recurrent urinary tract infections, diabetes, gout, bowel resection, and urinary reconstruction history.

Struvite stones were more frequently identified in the case than in the control group, although the difference was not statistically significant (7 vs 1; p=0.07).

The current study is the first to describe the clinical characteristics of kidney stone formers with elevated urinary ammonium and demonstrates the clinical utility of measuring urinary ammonium, especially in identifying patients likely to be infected/colonized with urease-producing bacteria, according to the researchers. Anecdotal experience has shown that antibiotic treatment in these patients leads to short-term decreases in urinary ammonia, consistent with an infectious aetiology.

Editor's Recommendations
Most Read Articles
4 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 4 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
5 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.