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Erschienen in: Urolithiasis 4/2006

01.08.2006 | Original Paper

The increased risk of urinary stone disease in betel quid chewers

verfasst von: Siân E. Allen, Sadmeet Singh, William G. Robertson

Erschienen in: Urolithiasis | Ausgabe 4/2006

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Abstract

The chewing of betel quid is a common practice in many countries of the world, particularly in Southeast Asia. The quid consists of a preparation of areca nut, betel leaf and calcium hydroxide “lime” paste (“chuna”). For the first time, we present a study that links its use to urinary stone disease. Eight patients (seven male and one female) who presented to our Stone Unit with recurrent urinary stones were included in the study. All were from the Indian subcontinent and were found to regularly chew betel. The patients underwent metabolic screening including blood, random urine and 24-h urine tests, quantitative chemical analysis of their calculi (where possible) and each completed a 7-day Diet Diary on his/her free, home diet. The study demonstrated a high incidence of hypercalciuria, a tendency to pass an alkaline urine and low urinary citrate excretion among the patients. Together these urinary risk factors increase the probability of developing both calcium phosphate-containing and calcium oxalate-containing stones. In support of this hypothesis, the patients were found to form stones consisting mainly of calcium phosphate but mixed with calcium oxalate. It is concluded that the use of calcium hydroxide “chuna” in the betel quid is the major contributor to the cause of urinary stones in its users. Moreover, the development of urinary lithiasis in such patients may be a precursor to milk-alkali syndrome in those individuals whose chewing habit is more extensive than in the patients in this study and who do not seek to decrease their habit over the long term.
Literatur
1.
Zurück zum Zitat Gupta PC, Ray CS (2004) Epidemiology of betel quid usage. Ann Acad Med Singapore 33(4 Suppl):31–36PubMed Gupta PC, Ray CS (2004) Epidemiology of betel quid usage. Ann Acad Med Singapore 33(4 Suppl):31–36PubMed
2.
3.
Zurück zum Zitat Chu NS (2001) Effects of betel chewing on the central and autonomic nervous systems. J Biomed Sci 8(3):229–236PubMedCrossRef Chu NS (2001) Effects of betel chewing on the central and autonomic nervous systems. J Biomed Sci 8(3):229–236PubMedCrossRef
4.
Zurück zum Zitat Nelson BS, Heischober B (1999) Betel nut: a common drug used by naturalized citizens from India, Far East Asia, and the South Pacific Islands. Ann Emerg Med 34(2):238–243PubMedCrossRef Nelson BS, Heischober B (1999) Betel nut: a common drug used by naturalized citizens from India, Far East Asia, and the South Pacific Islands. Ann Emerg Med 34(2):238–243PubMedCrossRef
5.
Zurück zum Zitat Van Wyk CW, Stander I, Padayachee A, Grobler-Rabie AF (1993) The areca nut chewing habit and oral squamous cell carcinoma in South African Indians. A retrospective study. S Afr Med J 83(6):425–429PubMed Van Wyk CW, Stander I, Padayachee A, Grobler-Rabie AF (1993) The areca nut chewing habit and oral squamous cell carcinoma in South African Indians. A retrospective study. S Afr Med J 83(6):425–429PubMed
6.
Zurück zum Zitat Wu MT, Lee YC, Chen CJ, Yang PW, Lee CJ, Wu DC, Hsu HK, Ho CK, Kao EL, Lee JM (2001) Risk of betel chewing for oesophageal cancer in Taiwan. Br J Cancer 85(5):658–660PubMedCrossRef Wu MT, Lee YC, Chen CJ, Yang PW, Lee CJ, Wu DC, Hsu HK, Ho CK, Kao EL, Lee JM (2001) Risk of betel chewing for oesophageal cancer in Taiwan. Br J Cancer 85(5):658–660PubMedCrossRef
7.
Zurück zum Zitat Lin SH, Lin YF, Cheema-Dhadli S, Davids MR, Halperin ML (2002) Hypercalcaemia and metabolic alkalosis with betel nut chewing: emphasis on its integrative pathophysiology. Nephrol Dial Transplant 17(5):708–714PubMedCrossRef Lin SH, Lin YF, Cheema-Dhadli S, Davids MR, Halperin ML (2002) Hypercalcaemia and metabolic alkalosis with betel nut chewing: emphasis on its integrative pathophysiology. Nephrol Dial Transplant 17(5):708–714PubMedCrossRef
8.
Zurück zum Zitat Wu KD, Chuang RB, Wu FL, Hsu WA, Jan IS, Tsai KS (1996) The milk-alkali syndrome caused by betel nuts in oyster shell paste. J Toxicol Clin Toxicol 34(6):741–745PubMedCrossRef Wu KD, Chuang RB, Wu FL, Hsu WA, Jan IS, Tsai KS (1996) The milk-alkali syndrome caused by betel nuts in oyster shell paste. J Toxicol Clin Toxicol 34(6):741–745PubMedCrossRef
9.
10.
Zurück zum Zitat Bullamore JR, Wilkinson R, Gallagher JC, Nordin BE, Marshall DH (1970) Effect of age on calcium absorption. Lancet 2(7672):535–537PubMedCrossRef Bullamore JR, Wilkinson R, Gallagher JC, Nordin BE, Marshall DH (1970) Effect of age on calcium absorption. Lancet 2(7672):535–537PubMedCrossRef
11.
Zurück zum Zitat Duthie JS, Solanki HP, Krishnamurthy M, Chertow BS (1995) Milk-alkali syndrome with metastatic calcification. Am J Med 99(1):102–103PubMedCrossRef Duthie JS, Solanki HP, Krishnamurthy M, Chertow BS (1995) Milk-alkali syndrome with metastatic calcification. Am J Med 99(1):102–103PubMedCrossRef
12.
Zurück zum Zitat Martini LA, Cuppari L, Cunha MA, Schor N, Heilberg IP (1998) Potassium and sodium intake and excretion in calcium stone forming patients. J Ren Nutr 8(3):127–131PubMedCrossRef Martini LA, Cuppari L, Cunha MA, Schor N, Heilberg IP (1998) Potassium and sodium intake and excretion in calcium stone forming patients. J Ren Nutr 8(3):127–131PubMedCrossRef
Metadaten
Titel
The increased risk of urinary stone disease in betel quid chewers
verfasst von
Siân E. Allen
Sadmeet Singh
William G. Robertson
Publikationsdatum
01.08.2006
Verlag
Springer-Verlag
Erschienen in
Urolithiasis / Ausgabe 4/2006
Print ISSN: 2194-7228
Elektronische ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-006-0050-8

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