Urine stone risk factors in nephrolithiasis patients with and without bowel disease  Joan H. Parks, Elaine M. Worcester, R. Corey O'Connor, Fredric L. Coe  Kidney International  Volume 63, Issue 1, Pages 255-265 (January 2003) DOI: 10.1046/j.1523-1755.2003.00725.x Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 1 Distributions of stone rates. Untransformed stone rates (x-axes, A) for bowel patients (top) and the stone rate reference patients (bottom) were not normally distributed as shown by lack of linearity when plotted against a normal distribution function (y-axes). When log transformed (B), rates were reasonably linear, indicating a fit to the normal distribution function. For bowel patients, deviation from normality was not significant (Kolmogrov-Smirnov Lilliefors, P = 0.95). For the much larger stone rate reference population, deviation was significant (P < 0.00001) although the maximal difference (0.046) was not remarkably different from the maximal difference for the bowel disease patients (0.033). Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 2 (A) Percent calcium oxalate (○) in stones formed by patients, none of whose stones contained any uric acid, and percent uric acid (•) in stones formed by patients any of whose stones contained uric acid. For the no uric acid groups (○), the remainder of the stones is comprised of calcium phosphate. The five groups are distributed along the y-axis. Differences in frequency and percent uric acid are in the Results section. (B) Time (years) between the diagnosis of bowel disease and formation of first stone (x-axis) versus bowel disease patient group (y-axis). Positive values indicate that stone formation began after diagnosis of bowel disease. Symbols are: (•) means ± SEM; (○) individual patients. Groups are defined in the Methods section: Bypass (6 ± 2) differed from Both (13 ± 2) and Small Only (11 ± 1). Colon Only (6 ± 1) differed from Both. Patients with no surgery (6 ± 2) differed from no other group (P values are in the text). Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 3 (A) Quantile plot of creatinine clearance for women (♀) and men (♂) were below same sex risk factor reference patients (adjacent darker lines). Dashed line intersects distributions at their median. (B) Quantile plots of log transformed stone rates for all five bowel patient groups exceed rates for the stone rate reference group (dark line). Patients with Bypass (×), Both (○), Colon Only (+), Small Only (▵), and None (▿) did not differ from each other. Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 4 Mean values of supersaturation. Supersaturation for calcium oxalate (z axis, height of spike) and supersaturation for calcium phosphate and uric acid (y and x axes, feet of spike) were similar between patients with no surgery (None) and the risk factor reference population (Reference). The other groups differed from the risk factor reference population (comparisons are in the Results section). Symbols are: (♦) reference; (▾) none; (▴) small only; (×) bypass; (•) both; (+) colon only. Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 5 Factors that determine supersaturation. Quantile plots show the principle factors as determined by multivariate analysis. The risk factor reference population is shown by the heavy line. Dashed lines intersect with each distribution at its median. Symbols are: Bypass (×), Both (○), Colon Only (+), Small Only (◃), None (▿). All are log transformed except for urine pH and uric acid excretion for display purposes. Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions

Figure 6 Urine and serum nutrient values. Quantile plots show the urine and serum factors that are different from the risk factor reference patients. Dashed lines intersect with each distribution at its median. Symbols are: Bypass (×), Both (○), Colon Only (+), Small Only (◃), None (▿). Kidney International 2003 63, 255-265DOI: (10.1046/j.1523-1755.2003.00725.x) Copyright © 2003 International Society of Nephrology Terms and Conditions