Statins significantly alter urinary stone-related urine biochemistry in calcium kidney stone patients with dyslipidemia

Objective: To investigate whether the use of statins would alter 24-h urine biochemistry in male patients with calcium kidney stones. Methods: We prospectively recruited 78 male patients with calcium kidney stones between May 2017 and December 2017, and 30 male controls with matching sex and age, but without kidney stones. All patients were classified into higher- and lower-risk groups of atherosclerotic cardiovascular disease according to the American College of Cardiology/American Heart Association guidelines. Atorvastatin 20 mg per day was prescribed for 12 weeks to the higher risk patients. For kidney stone group, 24-h urine collections were carried out before and after statin therapy. Results: A total of 78 patients and 30 controls were included. Higher-risk patients had significantly higher urine uric acid and calcium levels than lower-risk patients. After atorvastatin treatment for 12 weeks, urine citrate significantly increased (P ' 0.001) accompanied with increased urine pH (P ' 0.001), whereas urine uric acid significantly decreased after treatment. Although urine oxalate significantly increased after treatment (P = 0.037), we did not find any significant difference in urine calcium, ion activity product of calcium oxalate and ion activity product of calcium phosphate. Conclusion: These findings suggest that atorvastatin administration might increase urinary citrate and decrease urinary uric acid in patients with calcium kidney stones and dyslipidemia.