Volume 12, Number 4Review ArticlesMetabolic Syndrome and Urologic DiseasesMangement ReviewHaluk AkpinarIlya GorbachinskyMetabolic syndrome (MetS) is a complex entity consisting of multiple interrelated factors including insulin resistance, central adiposity, dyslipidemia, endothelial dysfunction and atherosclerotic disease, low-grade inflammation, and in males, low testosterone levels. MetS has been linked to a number of urologic diseases including nephrolithiasis, benign prostatic hyperplasia and lower urinary tract symptoms, erectile dysfunction, male infertility, female incontinence, and prostate cancer. This article reviews the relationships between MetS and these entities. Urologists need to be cognizant of the impact that MetS has on urologic diseases as well as on overall patient health.[Rev Urol. 2010;12(4):e157-e180 doi: 10.3909/riu0487]© 2010 MedReviews®, LLCObesityMetabolic syndromeBenign prostatic hyperplasiaNephrolithiasisHypogonadismCardiovascular diseaseInsulin resistanceEndothelial dysfunction
Volume 17, Number 3Review ArticlesMetabolic Syndrome and Nephrolithiasis Risk: Should the Medical Management of Nephrolithiasis Include the Treatment of Metabolic Syndrome?Patrick MufarrijJohn Michael DiBiancoTW JarrettThis article reviews the relationship between metabolic syndrome (MetS) and nephrolithiasis, as well as the clinical implications for patients with this dual diagnosis. MetS, estimated to affect 25% of adults in the United States, is associated with a fivefold increase in the risk of developing diabetes, a doubling of the risk of acquiring cardiovascular disease, and an increase in overall mortality. Defined as a syndrome, MetS is recognized clinically by numerous constitutive traits, including abdominal obesity, hypertension, dyslipidemia (elevated triglycerides, low high-density lipoprotein cholesterol), and hyperglycemia. Urologic complications of MetS include a 30% higher risk of nephrolithiasis, with an increased percentage of uric acid nephrolithiasis in the setting of hyperuricemia, hyperuricosuria, low urine pH, and low urinary volume. Current American Urological Association and European Association of Urology guidelines suggest investigating the etiology of nephrolithiasis in affected individuals; however, there is no specific goal of treating MetS as part of the medical management. Weight loss and exercise, the main lifestyle treatments of MetS, counter abdominal obesity and insulin resistance and reduce the incidence of cardiovascular events and the development of diabetes. These recommendations may offer a beneficial adjunctive treatment option for nephrolithiasis complicated by MetS. Although definitive therapeutic recommendations must await further studies, it seems both reasonable and justifiable for the urologist, as part of a multidisciplinary team, to recommend these important lifestyle changes to patients with both conditions. These recommendations should accompany the currently accepted management of nephrolithiasis. [Rev Urol. 2015;17(3):117-128 doi: 10.3909/riu0650] © 2015 MedReviews®, LLCMetabolic syndromeNephrolithiasisUric acid nephrolithiasis
Volume 22, Number 1Review ArticlesObesity and Its Impact on Kidney Stone FormationDisease State ReviewDean G AssimosKyle WoodWilliam PooreCarter J BoydNikhi P SinghBarbara GowerThe prevalence of obesity is rising and places this cohort at risk for developing kidney stones. Some of the pathophysiologic responses that link obesity and kidney stone formation have been identified. Herein, we review the involved mechanisms driving this relationship and the impact of various weight loss strategies on kidney stone risk. [Rev Urol. 2020;22(1):17–23] © 2020 MedReviews®, LLCObesityKidney stonesDiabetesMetabolic syndromeHypertensionWeight managementObese animal models