Sex-dependent stone formation following portacaval shunt (PCS) was investigated in 82 male and 71 female Sprague-Dawley rats. 72.6% of male PCS rats and none of the female PCS rats developed urolithiasis, in 90.2%, potassium-hydrogen-urate stones formed. Hormonal analysis revealed significant alterations in steroid hormones and glucagon postoperatively. Male PCS rats showed a significant decrease in total and free testosterone and an increase in estradiol and glucagon levels. Female PCS rats showed a marked rise in testosterone and glucagon levels as well as a decrease in estradiol plasma levels. Male PCS rats had higher urinary and plasma uric acid concentrations compared to female PCS and sham-operated rats. Loss of testosterone and rise of glucagon in males was correlated with urolithiasis in so far as stone-forming rats had higher concentrations than non-stone-forming PCS rats. Our findings suggest that hormonal alterations might contribute to sex-dependent stone formation in PCS rats.

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