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2013 ; 28
(12
): 2535-9
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Kidney stones: a fetal origins hypothesis
#MMPMID23703881
Howles SA
; Edwards MH
; Cooper C
; Thakker RV
J Bone Miner Res
2013[Dec]; 28
(12
): 2535-9
PMID23703881
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Kidney stones are common, with a multifactorial etiology involving dietary,
environmental, and genetic factors. In addition, patients with nephrolithiasis
are at greater risk of hypertension, diabetes mellitus, metabolic syndrome, and
osteoporosis, although the basis for this is not fully understood. All of these
renal stone-associated conditions have also been linked with adverse early-life
events, including low-birth weight, and it has been suggested that this
developmental effect is due to excess exposure to maternal glucocorticoids in
utero. This is proposed to result in long-term increased
hypothalamic-pituitary-axis activation; there are mechanisms through which this
effect could also promote urinary lithogenic potential. We therefore hypothesize
that the association between renal stone disease and hypertension, diabetes
mellitus, metabolic syndrome, and osteoporosis may be related by a common pathway
of programming in early life, which, if validated, would implicate the
developmental origins hypothesis in the etiology of nephrolithiasis.
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