Commenting on the study, Brian R. Matlaga, MD, MPH, of Johns Hopkins Medical Institutions, Baltimore and a member of the Urology Times Editorial Council, said the relationship between nephrolithiasis and gout has been reported prior to this study. But the new research provides additional data supporting the relationship between nephrolithiasis and diabetes mellitus, as well as obesity.
That’s important, said Dr. Matlaga, who was not involved with the study.
“Weight loss is associated with a myriad of health benefits, and this study emphasizes that a reduced risk of nephrolithiasis is one of them,” Dr. Matlaga said.
Dr. Matlaga said the finding that loop diuretics were associated with a decreased risk of nephrolithiasis is puzzling.
“Given the pharmacology of these medications, one would expect nephrolithiasis to increase, as the medications will promote hypercalciuria. As the study was not designed to test this relationship, it is difficult to assign a more meaningful conclusion to this finding,” he said.
The study’s observational design also makes it difficult to draw a firm conclusion about the association between losartan and nephrolithiasis, according to Dr. Matlaga.
Dr. Matlaga said he’s cautious about the findings that none of the other commonly used drugs for cardiovascular disease and hypertension increased nephrolithiasis risk in those with gout and there was no protective effect from allopurinol, given in low doses.
“The study was observational, and not a priori designed to test these relationships,” he said.
But the findings that male gender, diabetes mellitus, and obesity were shown to increase risk of the condition are consistent with the current understanding of lithogenic risk factors, he said.
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