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Randomized Controlled Trial
. 2018 Nov 8;19(1):315.
doi: 10.1186/s12882-018-1105-0.

Fructose increases risk for kidney stones: potential role in metabolic syndrome and heat stress

Richard J Johnson  1   2   3 , Santos E Perez-Pozo  4 , Julian Lopez Lillo  5 , Felix Grases  6 , Jesse D Schold  7 , Masanari Kuwabara  8 , Yuka Sato  8 , Ana Andres Hernando  8 , Gabriela Garcia  8 , Thomas Jensen  8 , Christopher Rivard  8 , Laura G Sanchez-Lozada  9 , Carlos Roncal  8 , Miguel A Lanaspa  8
Affiliations
Randomized Controlled Trial

Fructose increases risk for kidney stones: potential role in metabolic syndrome and heat stress

Richard J Johnson et al. BMC Nephrol. .

Abstract

Background: Fructose intake, mainly as table sugar or high fructose corn syrup, has increased in recent decades and is associated with increased risk for kidney stones. We hypothesized that fructose intake alters serum and urinary components involved in stone formation.

Methods: We analyzed a previously published randomized controlled study that included 33 healthy male adults (40-65 years of age) who ingested 200 g of fructose (supplied in a 2-L volume of 10% fructose in water) daily for 2 weeks. Participants were evaluated at the Unit of Nephrology of the Mateo Orfila Hospital in Menorca. Changes in serum levels of magnesium, calcium, uric acid, phosphorus, vitamin D, and intact PTH levels were evaluated. Urine magnesium, calcium, uric acid, phosphorus, citrate, oxalate, sodium, potassium, as well as urinary pH, were measured.

Results: Ingestion of fructose was associated with an increased serum level of uric acid (p < 0.001), a decrease in serum ionized calcium (p = 0.003) with a mild increase in PTH (p < 0.05) and a drop in urinary pH (p = 0.02), an increase in urine oxalate (p = 0.016) and decrease in urinary magnesium (p = 0.003).

Conclusions: Fructose appears to increase urinary stone formation in part via effects on urate metabolism and urinary pH, and also via effects on oxalate. Fructose may be a contributing factor for the development of kidney stones in subjects with metabolic syndrome and those suffering from heat stress.

Trial registration: ClinicalTrials.gov NCT00639756 March 20, 2008.

Keywords: Citrate; Fructose; Kidney stone; Magnesium; Oxalate; Sucrose; Sugar; Uric acid.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Illes Balears Community (CEIC-IB; resolution: IP IB-850/07) and was registered on ClinicalTrials.gov [NCT00639756]. All subjects provided written consent to participate.

Consent for publication

Yes

Competing interests

Dr. Johnson, Lanaspa and Sanchez-Lozada are members of Colorado Research Partners LLC that is making inhibitors of fructose metabolism. Dr. Johnson is also on the Scientific Board of Kibow, Inc. and XORT therapeutics. Dr. Johnson has also received honoraria from Danone and Astra.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

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