Postmenopausal status increases the risk of uric acid stones

Abstract

Objective

This study investigated the impact of menopause on stone composition in women with urolithiasis.

Study design

A cross-sectional study was conducted from March 2013 to March 2018. Women with urolithiasis patients were divided into two groups according to their menopause status.

Main outcome measures

The clinical demographic characteristics, stone removal, stone composition, and urine chemistry were investigated. Univariate and multivariate survival analyses were performed to identify risk factors for the risk of uric acid stones.

Results

Our study enrolled 1221 female patients with stone diseases, 783 (64.1 %) of whom were postmenopausal (66 patients surgically menopause and 717 patients naturally menopause). Postmenopausal women had higher rates of diabetes and hyperuricemia, a higher serum uric acid level, a higher urinary specific gravity, and a lower estimated glomerular filtration rate. Stone analysis revealed calcium oxalate stones in 66.2 % of the patients, apatite stones in 19.4 %, calcium oxalate and calcium phosphate stones in 7.7 %, uric acid stones in 4.4 %, struvite stones in 2.0 %, and brushite stones in 0.2 %. Postmenopausal women had a higher rate of uric acid stones. Multivariate analysis confirmed that postmenopausal status and hyperuricemia were independent risk factors of uric acid stones. Postmenopausal women required more invasive procedures to remove the stones, and they had lower self-voiding rates.

Conclusions

Postmenopausal women had higher rates of stone episodes, specifically related to uric acid stones. Given the prevalence and impact of chronic kidney diseases, factors that impede optimal renal function management in women must be identified to provide tailored treatment recommendations.