Toxicity of Perirenal Fat in Overweight or Obese Subjects: A Pathophysiological Link Between Uric Acid Stones and Renal Ammonium Formation

NCT02561858 | Completed

• 1 other identifier: 15-AOI-07
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Patients who are overweight or obese, diabetic or not, share with those who are suffering from uric stones the same way to remove abnormal acidity of the body in urine, ie a kidney ammoniogenesis default. This results in an overly acidic urine pH which is directly pathogenic in people predisposed to develop uric stones because the precipitation of urate soluble uric acid is accelerated in acid medium. Excess visceral fat, particularly perirenal, this defect may promote formation of renal ammonium. Indeed, the perirenal fat is adjacent to the renal cortex and shares with it a common arterial supply via the plexus Turner. Adipokines and fatty acids of the perirenal fat are predisposed to gain the renal cortex, seat of the ammoniogenesis. In humans the pathogenic role of the perirenal fat is demonstrated in chronic kidney disease and essential hypertension. However, the amount of fat and perirenal that of intra-abdominal fat are positively correlated. Investigators hypothesis is that the perirenal fat also exert a pathogenic role in uric because of anatomical links between kidney stones and greasy environment and because excess fatty acids reaching the renal cortex decreases ammoniogenesis in an animal model metabolic syndrome. For the test, the investigators will compare the amount of fat and perirenal renal ability to form ammonium in patients with uric or calcium lithiasis taking into account the amount of intra-abdominal fat.

Conditions

Uric Acid Stones

Keywords

Renal Ammonium ;uric acid

Outcome Measures

Primary Outcomes (1)

• the perirenal fat thickness (left)

  This is the perirenal fat thickness measured between the left posterior wall of the kidney and the posterior wall of the abdominal cavity on a TDM section in the plane of the left renal vein.

  baseline

Secondary Outcomes (3)

• the perirenal fat thickness (right)

  baseline

• NH4 + / NAE

  at day 7 of a standard diet

• net acid urinary flow

  at day 7 of a standard diet and when urine pH became <5.5

Study Arms (1)

acid load test

EXPERIMENTAL

Other: acid load test

Interventions

acid load test OTHER

acid load test

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Urolithiasis Uric defined by more than 90% of uric acid anhydrous and / or dihydrate or calcium lithiasis defined by more than 90% mono calcium oxalate and / or dihydrate, and / or carbapatite and / or brushite;
• Overweight and obesity defined by 25 \<BMI \<35 kg / m2

You may not qualify if:

• staghorn lithiasis, stones struvite or cystine;
• Primary hyperparathyroidism;
• Hyperthyroidism;
• Any form of calcium or uric lithiasis secondary;
• Abnormal kidney structure (cysts, cortical thinning, kidney tumor);

Sponsors & Collaborators

• Centre Hospitalier Universitaire de Nice: lead

Study Sites (1)

CHU de Nice

Nice, 06000, France

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 22, 2015
• First Posted: September 28, 2015
• Study Start: October 14, 2015
• Primary Completion: June 24, 2016
• Study Completion: September 29, 2016
• Last Updated: March 12, 2018

Record last verified: 2018-03

Locations

FR (1)