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Published ahead of print on August 16, 2007
Clin J Am Soc Nephrol 2: 883-888, 2007
© 2007 American Society of Nephrology
doi: 10.2215/CJN.00670207
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Acid/Base and Electrolyte Disorders

Low Urine pH: A Novel Feature of the Metabolic Syndrome

Naim M. Maalouf*,{dagger}, Mary Ann Cameron*,{dagger}, Orson W. Moe*,{dagger}, Beverley Adams-Huet{dagger},{ddagger}, and Khashayar Sakhaee{dagger}

* The Charles and Jane Pak Center for Mineral Metabolism and Clinical Research and Departments of {dagger} Internal Medicine and {ddagger} Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas

Address correspondence to: Dr. Naim M. Maalouf, 5323 Harry Hines Boulevard, Dallas, TX 75390-8885. Phone: 214-648-0394; Fax: 214-648-2526; E-mail: naim.maalouf{at}utsouthwestern.edu

Background and Objectives: The metabolic syndrome is associated with alterations in renal function. An overly acidic urine has been described as a renal manifestation of the metabolic syndrome in patients with kidney stone disease. This study examined the association between the metabolic syndrome and urine pH in individuals without a history of nephrolithiasis.

Design, Setting, Participants, & Measurements: A total of 148 adults who were free of kidney stones were evaluated in this outpatient cross-sectional study. Height, weight, BP, fasting blood, and 24-h urine chemistries were obtained. Urine pH was measured by pH electrode. The following features of the metabolic syndrome were evaluated: BP; body mass index; and serum triglyceride, glucose, and HDL cholesterol concentrations. The degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance.

Results: Participants with the metabolic syndrome had a significantly lower 24-h urine pH compared with participants without the metabolic syndrome. Mean 24-h urine pH, adjusted for age, gender, creatinine clearance, and 24-h urine sulfate, decreased from 6.15, 6.10, 5.99, 5.85, to 5.69 with increasing number of metabolic syndrome abnormalities. An association was observed between 24-h urine pH and each metabolic feature. After adjustment for age, gender, creatinine clearance, urine sulfate, and body mass index, a significant inverse relationship was noted between 24-h urine pH and the degree of insulin resistance.

Conclusions: An unduly acidic urine is a feature of the metabolic syndrome and is associated with the degree of insulin resistance.


Related Article

Metabolic Syndrome: An Emerging Threat to Renal Function
Eberhard Ritz
Clin. J. Am. Soc. Nephrol. 2007 2: 869-871. [Full Text] [PDF]



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E. Ritz
Metabolic Syndrome: An Emerging Threat to Renal Function
Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 869 - 871.
[Full Text] [PDF]


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