Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus

Leonardo Spatola, Pietro Manuel Ferraro, Giovanni Gambaro, Salvatore Badalamenti, Marco Dauriz

Research output: Contribution to journalReview article

Abstract

Uric acid nephrolithiasis (UAN) is an increasingly common disease in ethnically diverse populations and constitutes about 10% of all kidney stones. Metabolic syndrome and diabetes mellitus are accounted among the major risk factors for UAN, together with environmental exposure, individual lifestyle habits and genetic predisposition. The development and overt manifestation of UAN appears to stem on the background of insulin resistance, which acts at the kidney level by reducing urinary pH, thus hampering the ability of the kidney to generate renal ammonium in response to an acid load. Unduly acidic urinary pH and overt UAN are both considered renal manifestations of insulin resistance. The mechanisms underlying increased endogenous acid production and/or defective ammonium excretion are yet to be completely understood. Although the development of UAN and, more in general, of kidney stones largely recognizes modifiable individual determining factors, the rising prevalence of diabetes, obesity and accompanying metabolic disorders calls for the identification of novel therapeutic approaches and intervention targets. This review aims at providing an updated picture of existing evidence on the relationship between insulin resistance and UAN in the context of metabolic syndrome and in light of the most recent advancements in our understanding of its genetic signature.

Original languageEnglish
Pages (from-to)225-233
Number of pages9
JournalMetabolism: Clinical and Experimental
Volume83
DOIs
Publication statusPublished - Jun 1 2018

Keywords

  • Diabetes mellitus
  • Insulin resistance
  • Metabolic syndrome
  • Uric acid nephrolithiasis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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