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Tanthanuch M, Jakjaroenrit N, Boonchai S, Bejrananda T. The changing composition of urinary calculi in Southern Thailand over the past 14 years. Urol Ann 2023; 15:82-87. [PMID: 37006209 PMCID: PMC10062514 DOI: 10.4103/ua.ua_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/23/2022] [Indexed: 04/04/2023] Open
Abstract
Objective A worldwide increased incidence of urolithiasis has been observed over the past few decades. Insight into the composition of these stones can lead to enhanced medical treatment and outcomes. The objective of this study was to examine the distribution and chemical composition of urinary calculi in Southern Thailand over the past decade. Materials and Methods An analysis was conducted on 2611 urinary calculi submitted to the Stone Analysis Laboratory, Songklanagarind Hospital, a single stone analysis laboratory in Southern Thailand. The analysis was performed from 2007 to 2020 using Fourier-transform infrared spectroscopy. The demographic results were described using descriptive statistical analyses, and the Chi-square test for trends was performed to identify changes in urinary calculi composition. Results The patients' demographic data revealed a male-to-female ratio of 2.2:1; the most common age group of affected men was 50-69 years, whereas the most common age group of affected women was 40-59 years. The most common components found in the calculi were uric acid (30.6%), mixed calcium oxalate with calcium phosphate (29.2%), and calcium oxalate (26.7%). We noted a trend of increasing uric acid calculi for 14 years (P = 0.00493), whereas the trend for the other major components was decreasing. Conclusion The most common component of urinary calculi analyzed in Southern Thailand was uric acid, with a significant rising trend in proportion in the past decade; the trend of other major components, such as mixed calcium oxalate-calcium phosphate and calcium oxalate, decreased.
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Affiliation(s)
- Monthira Tanthanuch
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Nattawit Jakjaroenrit
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Sarayuth Boonchai
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Tanan Bejrananda
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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2
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Deffert C, Stoermann Chopard C, Lambeng N. 10,000 urinary stones for 10 years of analysis: a retrospective study in western Switzerland. CR CHIM 2022. [DOI: 10.5802/crchim.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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3
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Almannie RM, Alsufyani AK, Alturki AU, Almuhaideb M, Binsaleh S, Althunayan AM, Alomar MA, Albarraq KM, Alyami FA. Neural Network Analysis of Crystalluria Content to Predict Urinary Stone Type. Res Rep Urol 2022; 13:867-876. [PMID: 35004390 PMCID: PMC8721952 DOI: 10.2147/rru.s322580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the relationship between urinary stone type and the type of crystals in the urine. Patients and Methods This retrospective study involved 485 patients with urinary stones treated at King Saud University Medical City from May 2015 to June 2017. Clinical data were obtained from medical records. Different statistical analysis methods were applied, including basic contingency analysis, analysis of variance, logistic regression, discriminant analysis, partition modeling, and neural network evaluations. Results Of 485 patients, 47 had crystals detected by urinalysis. The most common type of crystal was calcium oxalate (n = 31), which had the highest association with calcium oxalate stones. Uric acid crystals (n = 8) were associated with uric acid stones. The neural network model used for determining the sensitivity and specificity showed an R-square value of 0.88, with an area under the curve of 0.94 for calcium oxalate, 0.94 for carbonate apatite, and 1.0 for uric acid. Conclusion The predictive algorithm developed in the present study may be used with a patient's clinical parameters to predict the stone type. This approach predicts the stone types associated with certain patient characteristics with a high sensitivity and specificity, indicating that the models may be a valuable clinical tool in the diagnosis, management, and monitoring of stone diseases.
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Affiliation(s)
- Raed M Almannie
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah K Alsufyani
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah U Alturki
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mana Almuhaideb
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz M Althunayan
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Alomar
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M Albarraq
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Alyami
- Division of Urology, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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4
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Trends in urinary stone composition in 23,182 stone analyses from 2011 to 2019: a high-volume center study in China. World J Urol 2021; 39:3599-3605. [PMID: 33779819 DOI: 10.1007/s00345-021-03680-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/20/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate the distribution and dynamic trends in constituents of urinary stones in China. MATERIALS AND METHODS The composition of 23,182 stones were analyzed and then recorded between January 2011 and December 2019. The characteristics in terms of stone patient's gender, age and calendar year were analyzed. RESULTS Most stones (22,172, 95.64%) had several crystal components, among which 40.25% (8925/22,172) were mixtures with infection components. Calcium oxalate (CaOx) and uric acid (UA) stones were more commonly encountered in men, but calcium phosphate (CaP), magnesium ammonium phosphate (MAP) and carbonate apatite (CA) stones were more prevalent in women (p < 0.05). In males, the proportion of CaOx stones increased up to the age of 40, but subsequently decreased (p < 0.001). Interestingly, females showed an inverse trend regarding CaOx stones (p < 0.001). The proportion of UA stones increased with age (p < 0.001), and CA stones most frequently were recorded at age 20-49. Over the past 9 years, UA, CA, and MAP stones increased over time, whereas there was a tendency for CaOx stones to decrease (p < 0.05). CONCLUSIONS The scarcity of pure stones and a certain proportion of mixtures with infection stone components (e.g., mixtures of CaOx and CA) suggest that treatment directed against a single stone component is insufficient for effective recurrence prevention. Age and gender were significant determinants of stone composition, and according to the observed chronological trends, it seems that in the future, more UA, CA and MAP stones and fewer CaOx stones may be encountered in the studied population.
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Zhang D, Li S, Zhang Z, Li N, Yuan X, Jia Z, Yang J. Urinary stone composition analysis and clinical characterization of 1520 patients in central China. Sci Rep 2021; 11:6467. [PMID: 33742013 PMCID: PMC7979884 DOI: 10.1038/s41598-021-85723-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/03/2021] [Indexed: 11/09/2022] Open
Abstract
A total of 1520 patients with urinary stones from central China were collected and analysed by Fourier transform infrared spectroscopy between October 1, 2016 and December 31, 2019. For all patients, age, sex, comorbidities, stone location, laboratory examination and geographic region were collected. The most common stone component was calcium oxalate (77.5%), followed by calcium phosphate (8.7%), infection stone (7.6%), uric acid (UA) stone (5.3%)and cystine (0.9%). The males had more calcium oxalate stones (p < 0.001), while infection stone and cystine stones occurred more frequently in females (p < 0.001). The prevalence peak occurred at 41-60 years in both men and women. UA stones occurred frequently in patients with lower urinary pH (p < 0.001), while neutral urine or alkaline urine (p < 0.001) and urinary infection (p < 0.001) were more likely to be associated with infection stone stones. Patients with high levels of serum creatinine were more likely to develop UA stones (p < 0.001). The proportion of UA stones in diabetics was higher (p < 0.001), and the incidence of hypertension was higher in patients with UA stones (p < 0.001). Compared to the other types, more calcium oxalate stones were detected in the kidneys and ureters (p < 0.001), whereas struvite stones were more frequently observed in the lower urinary tract (p = 0.001). There was no significant difference in stone composition across the Qinling-Huaihe line in central China except UA stones, which were more frequently observed in patients south of the line (p < 0.001).
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Affiliation(s)
- Daling Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Songchao Li
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Zhengguo Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Ningyang Li
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Xiang Yuan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Zhankui Jia
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China. .,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China.
| | - Jinjian Yang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
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6
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Song A, Zhang C, Meng X. Mechanism and application of metformin in kidney diseases: An update. Biomed Pharmacother 2021; 138:111454. [PMID: 33714781 DOI: 10.1016/j.biopha.2021.111454] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 01/08/2023] Open
Abstract
Metformin is an oral antihyperglycemic drug widely used to treat type 2 diabetes mellitus (T2DM), acting via indirect activation of 5' Adenosine monophosphate-activated Protein Kinase (AMPK). Beyond the anti-diabetic effect, accumulative pieces of evidence have revealed that metformin also everts a beneficial effect in diverse kidney diseases. In various acute kidney diseases (AKI) animal models, metformin protects renal tubular cells from inflammation, apoptosis, reactive oxygen stress (ROS), endoplasmic reticulum (ER) stress, epithelial-mesenchymal transition (EMT) via AMPK activation. In diabetic kidney disease (DKD), metformin also alleviates podocyte loss, mesangial cells apoptosis, and tubular cells senescence through AMPK-mediated signaling pathways. Besides, metformin inhibits cystic fibrosis transmembrane conductance regulator (CFTR)-mediated fluids secretion and the mammalian target of rapamycin (mTOR)-involved cyst formation negatively regulated by AMPK in autosomal dominant polycystic kidney disease (APDKD). Furthermore, metformin also contributes to the alleviation of urolithiasis and renal cell carcinoma (RCC). As the common pathway for chronic kidney disease (CKD) progressing towards end-stage renal disease (ESRD), renal fibrosis is ameliorated by metformin, to a great extent dependent on AMPK activation. However, clinical data are not always consistent with preclinical data, some clinical investigations showed the unmeaningful even detrimental effect of metformin on T2DM patients with kidney diseases. Most importantly, metformin-associated lactic acidosis (MALA) is a vital issue restricting the application of metformin. Thus, we conclude the application of metformin in kidney diseases and uncover the underlying molecular mechanisms in this review.
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Affiliation(s)
- Anni Song
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xianfang Meng
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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7
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Cunha TDS, Rodriguez A, Heilberg IP. Influence of socioeconomic disparities, temperature and humidity in kidney stone composition. J Bras Nefrol 2020; 42:454-460. [PMID: 32716471 PMCID: PMC7860642 DOI: 10.1590/2175-8239-jbn-2019-0206] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/01/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Large variations in demographic, economic and environmental factors might influence the worldwide distribution of urolithiasis, but scarce data are available concerning their associations with stone composition. We aimed to evaluate the frequency and composition of kidney stones and their associations with temperature, humidity, and human development index (HDI). MATERIALS AND METHODS A total of 1,158 stones from distinct patients (47±14 years old, male/female 2:1) were included. The mean annual temperature and relative humidity of each town were considered separately. RESULTS Calcium oxalate monohydrate (COM) was disclosed in 38.8% of patients, calcium oxalate dihydrate (COD) in 22.1%, mixed COD/apatite in 9.4%, pure apatite in 1.9%, brushite in 1.8%, struvite in 8.3%, pure uric acid in 11.1%, mixed uric acid/COM in 5.6%, and cystine/rare types in 0.8%. Mean HDI of all pooled cities was 0.780±0.03. However, people living in HDI<0.800 regions had twice the odds of having a struvite stone versus those living in HDI>0.800 (OR=2.14, 95% CI 1.11-4.11). Furthermore, a progressive increase in the struvite stones frequency from 4.5 to 22.8% was detected from HDI>0.800 through HDI<0.700. No significant difference for other stone types was disclosed. Separate logistic regression models assessed the association of each stone composition with gender, temperature, humidity and HDI as covariates. CONCLUSION Patients living in low HDI areas are more prone to develop struvite stones, possibly due to lower access to healthcare. Temperature and humidity did not represent a specific risk factor for any stone type in the present sample.
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Affiliation(s)
- Tamara da Silva Cunha
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Divisão de Nefrologia, São Paulo, SP, Brazil.,Universidade Federal do Rio de Janeiro, Divisão de Nefrologia, Rio de Janeiro, RJ, Brazil
| | - Adrian Rodriguez
- Universita Cattolica del Sacro Cuore, Department of Medical Sciences, Rome, Italy
| | - Ita Pfeferman Heilberg
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Divisão de Nefrologia, São Paulo, SP, Brazil
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8
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Wang S, Zhang Y, Zhang X, Tang Y, Li J. Upper urinary tract stone compositions: the role of age and gender. Int Braz J Urol 2020; 46:70-80. [PMID: 31851461 PMCID: PMC6968895 DOI: 10.1590/s1677-5538.ibju.2019.0278] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/31/2019] [Indexed: 02/08/2023] Open
Abstract
Objective: To analyze the compositions of upper urinary tract stones and investigate their distributions in different gender and age groups. Materials and Methods: Patients diagnosed with upper urinary tract stone disease between December 2014 and March 2018 were retrospectively reviewed. Patient's age, gender, BMI, comorbidities, stone event characteristics, and compositions were collected, and proportions of stone components in different gender and age groups were analyzed. Results: A total of 1532 stone analyses were performed (992 from males and 540 from females). The mean age was younger in males (p <0.001). Males included more cases with larger BMI, hyperuricemia, and obesity, while females had more urinary tract infections. Multiple components were present in 61.8% of stones. Calcium oxalate (CaOx) (67.0%) was the most common component, followed by uric acid (UA) (11.8%), infection stone (11.4%), calcium phosphate (CaP) (8.0%), cystine (1.1%), brushite (0.4%), and 2, 8-dihydroxyadenine (0.2%). Men contributed with more CaOx stones than women at age 30-49 years (all p <0.01) and more UA stones at 30-59 years (all p <0.05). Women contributed with more infection stones than men in age groups 30-49 and 60-69 years (all p <0.05), and more CaP stones at 30-49 years. The prevalence peak was 50-59 years in men and 60-69 years in women. Both genders had the lowest prevalence in adolescence. Prevalence of UA stones increased while that of infection stones decreased with aging in both genders. Conclusions: Age and sex had a strong association with distribution of stone compositions in this Chinese cohort.
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Affiliation(s)
- Shu Wang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China.,Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Yitian Zhang
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Xin Zhang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Yuzhe Tang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jianxing Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
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9
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Talati VM, Soares RMO, Khambati A, Nadler RB, Perry KT. Trends in urinary calculi composition from 2005 to 2015: a single tertiary center study. Urolithiasis 2019; 48:305-311. [PMID: 31372690 DOI: 10.1007/s00240-019-01151-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
The goal of this study was to investigate recent changes in stone composition and patient demographics to identify factors influencing stone formation for the purpose of reducing the incidence of urolithiasis and preventing stone recurrence. This retrospective analysis includes patients who underwent percutaneous nephrolithotripsy or ureteroscopy at our institution from 2005 to 2015. Northwestern Medicine Enterprise Data Warehouse was used to retrieve demographic information and stone composition analyses. The composition of mixed stones containing uric acid (UA) and calcium oxalate monohydrate (COM) was analyzed further. Chi-squared tests were used for categorical variables and logistic regression was used to assess trends. From 2005 to 2015, 5268 stones were treated. COM was predominant in 42.2% and only 16.6% were pure. The male/female ratio decreased significantly from 1.8 to 1.08 and patient age increased (p < 0.001) with 45.6% of patients being 60 or older in 2015. Females formed more CO dihydrate (COD; p = 0.008) and struvite (p = 0.001) overall. The incidence of COM (p = 0.007) and UA (p < 0.001) rose significantly in men whereas both sexes saw a decrease in carbonate apatite (CA; p < 0.001). COM increased considerably from 12 to 75% amongst mixed stones with UA over the 11-year span. We concluded that stone formers have become older and more gender-equal. The increase in female patients parallels the increase in female obesity in the US. The rising predominance of COM, including when mixed with UA, and the scarcity of pure stones indicates it may be necessary to develop new approaches to managing and preventing urolithiasis.
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Affiliation(s)
- Vidit M Talati
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Ricardo M O Soares
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA.
| | - Aziz Khambati
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Robert B Nadler
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Kent T Perry
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
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10
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Yang X, Yang T, Li J, Yang R, Qi S, Zhao Y, Li L, Li J, Zhang X, Yang K, Xu Y, Liu C. Metformin prevents nephrolithiasis formation by inhibiting the expression of OPN and MCP-1 in vitro and in vivo. Int J Mol Med 2019; 43:1611-1622. [PMID: 30720053 PMCID: PMC6414169 DOI: 10.3892/ijmm.2019.4084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/16/2019] [Indexed: 11/30/2022] Open
Abstract
Treatment targeting osteopontin (OPN) and monocyte chemoattractant protein 1 (MCP-1) has been recognized as a novel approach in renal crystal formation. The present study was designed to investigate the suppressive effects of metformin on nephrolithiasis formation and its potential mechanism. The cytotoxicity of metformin on MDCK and HK-2 cells was determined using a Cell Counting Kit-8 assay in vitro. Subsequently, the mRNA transcription and protein expression levels of MCP-1 and OPN were detected by reverse transcription-quantitative-polymerase chain reaction analysis, western blot analysis and ELISA. Male Sprague-Dawley rats were divided into a control group, ethylene glycol (EG) group and EG + metformin group. The expression levels of MCP-1 and OPN and crystal formations were evaluated in renal tissues following an 8-week treatment period. In vitro, metformin significantly inhibited the production of MCP-1 and OPN induced by oxalate at the mRNA and protein expression levels. In vivo, increased expression levels of MCP-1 and OPN were detected in the EG group compared with the controls, and this upregulation was reversed in the EG + metformin group. Renal crystal deposition in the EG + metformin group was markedly decreased compared with that in the EG group. Therefore, the results of the study suggest that metformin suppressed urinary crystal deposit formation, possibly by mediating the expression of inflammatory mediators OPN and MCP-1.
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Affiliation(s)
- Xiong Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Tong Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Jie Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Rui Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Shiyong Qi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Yang Zhao
- Department of Radiology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Liang Li
- Department of Radiology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Jingjin Li
- Department of Radiology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Xuening Zhang
- Department of Radiology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Kuo Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Yong Xu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
| | - Chunyu Liu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Hexi, Tianjin 300211, P.R. China
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11
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Grant C, Guzman G, Stainback RP, Amdur RL, Mufarrij P. Variation in Kidney Stone Composition Within the United States. J Endourol 2018; 32:973-977. [PMID: 30039712 DOI: 10.1089/end.2018.0304] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Kidney stone incidence has been known to vary with temperature and climate. However, little is known about any variation in the composition of kidney stones across different regions of the United States. We attempted to evaluate whether stone composition changes depending on region. METHODS We were given access to de-identified data from LABCORPs database of kidney stone composition from August 1, 2016, to October 24, 2016, for states in seven representative areas of the country: Virginia, Minnesota, Florida, Arizona, Colorado, California, and Texas. We analyzed each component of kidney stones with optical microscopy supplemented with Fourier-transform infrared spectroscopy (FT-IR) spectrometry using both the percentage of the stone that was composed of that component as well as a binary variable coded none vs any. Univariate associations between component and state were examined using chi-square or Fisher's exact test for the binary indicator, and analysis of variance for the continuous percentage. The same set of analyses was used for decade of age vs each component. The association between age and state was examined using analysis of variance. RESULTS Data were available for 4335 kidney stones, from patients in the 7 states mentioned. The most common components across all stones were calcium oxalate monohydrate and calcium phosphate (both present in 93% of stones), calcium oxalate dihydrate (in 57% of stones), and uric acid (in 12% of stones). Stone composition did not vary widely across regions, except for uric acid stones, which were more prevalent in Florida compared to other states, with an odds ratio of 1.43 (95% confidence interval 1.12, 1.83). CONCLUSION Kidney stone composition does not vary widely by region within the United States. Although temperature and humidity play a role in stone incidence, there does not appear to be a large variation between different climates, with the exception of uric acid stone formation in Florida.
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Affiliation(s)
- Campbell Grant
- 1 Department of Urology, George Washington University Hospital , Washington, District of Columbia
| | - Gabe Guzman
- 2 George Washington University School of Medicine and Health Sciences , Washington, District of Columbia
| | | | - Richard L Amdur
- 3 Laboratory Corporation of America , Silver Spring, Maryland
| | - Patrick Mufarrij
- 1 Department of Urology, George Washington University Hospital , Washington, District of Columbia
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Xu LHR, Adams-Huet B, Poindexter JR, Maalouf NM, Moe OW, Sakhaee K. Temporal Changes in Kidney Stone Composition and in Risk Factors Predisposing to Stone Formation. J Urol 2017; 197:1465-1471. [PMID: 28111301 DOI: 10.1016/j.juro.2017.01.057] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2017] [Indexed: 01/30/2023]
Abstract
PURPOSE The prevalence of kidney stones has increased globally in recent decades. However, studies investigating the association between temporal changes in the risk of stone formation and stone types are scarce. We investigated temporal changes in stone composition, and demographic, serum and urinary parameters of kidney stone formers from 1980 to 2015. MATERIALS AND METHODS We retrospectively analyzed the records of 1,516 patients diagnosed with either calcium or uric acid stones at an initial visit to a university kidney stone clinic from 1980 to 2015. RESULTS From 1980 to 2015, the proportion of uric acid stones in all stone formers increased from 7% to 14%. While age and body mass index increased with time in both uric acid and calcium stone formers, uric acid stone formers were consistently older and had a higher body mass index and lower urinary pH than calcium stone formers. The proportion of females with stones has increased over time but the increase in female gender was more prominent among calcium stone formers. Urinary pH, phosphorus, oxalate and sodium increased with time in calcium stone formers but remained unchanged in uric acid stone formers. After accounting for various parameters of stone risk, the strongest clinical discriminant of uric acid vs calcium stones was urinary pH. Limitations of this study include the retrospective single center design and the available number of patients with stone analysis. CONCLUSIONS From 1980 to 2015, the proportion of uric acid stones increased significantly. With time, there were proportionately more female calcium stone formers but not uric acid stone formers. Urinary pH is the most prominent factor distinguishing uric acid from calcium stones.
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Affiliation(s)
- Li Hao Richie Xu
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Beverley Adams-Huet
- Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - John R Poindexter
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Naim M Maalouf
- Division of Mineral Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Orson W Moe
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Mineral Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Khashayar Sakhaee
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Mineral Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas.
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