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de Cássia Vilhena da Silva R, Dada A, Lucietti Dick S, Odebrecht Cavichiolo M, Zanovello M, Cechinel Filho V, de Souza P. Naringen's Effects on Diuresis and Prevention of Urolithiasis in Hypertensive Rats. Chem Biodivers 2024; 21:e202400175. [PMID: 38345349 DOI: 10.1002/cbdv.202400175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
This research demonstrates the diuretic effect of naringenin, a flavanone aglycone found in citrus, on spontaneously hypertensive female and male rats (SHR). The data reinforces existing literature findings that male SHR exhibits higher systolic blood pressure than age-matched females. Urine volume assessed over 8 hours was lower when obtained from SHR males than females. When these animals were orally treated with different doses of naringenin (0.1-1 mg/kg), this increased urinary volume in both genders at the highest dose tested. In contrast, the lowest dose promoted a significant natriuretic effect. The other electrolytes analyzed in urine were not significantly altered, except potassium excretion, which was shown to be increased in the urine of SHR males. Furthermore, naringenin showed promise in reducing calcium oxalate (CaOx) crystal formation in an in vitro model, presenting potential advantages in lithiasis prevention.
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Affiliation(s)
- Rita de Cássia Vilhena da Silva
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Anelize Dada
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Sabrina Lucietti Dick
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Martina Odebrecht Cavichiolo
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Mariana Zanovello
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Valdir Cechinel Filho
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Priscila de Souza
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
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Alshubaili AM, Alotaibi AF, Alsaleh KA, Almogarri AI, Alanizi AA, Alsaif SS, Alghamdi AS, Alnazari NM, Almalki A. The Prevalence of Nephrolithiasis and Associated Risk Factors Among the Population of the Riyadh Province, Saudi Arabia. Cureus 2024; 16:e55870. [PMID: 38595876 PMCID: PMC11002709 DOI: 10.7759/cureus.55870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Background and objective Kidney stones, also referred to as nephrolithiasis or renal calculi, is a condition where crystal depositions are formed within the kidney and ideally excreted from the body via the urethra with no pain; however, larger calculi may cause significant pain and require further medical assistance. The vast majority of patients who develop renal calculi form calcium stones, which are either a composition of calcium oxalate or calcium phosphate. Other types include uric acid, struvite, and cysteine. While kidney stones are one of the most significant diseases among the Saudi population, which require an acute emergency intervention to prevent serious long-term complications, there are limited studies published regarding this condition in Saudi communities. In light of this, we performed this study to assess the prevalence, incidence, and risk factors of kidney stones among the population of Riyadh, Saudi Arabia. Methods This was a cross-sectional study conducted in Riyadh, Saudi Arabia between August and October 2023, aiming to estimate the prevalence and risk factors of nephrolithiasis among residents of the Riyadh province. Data were collected through an electronic questionnaire in both Arabic and English and distributed via social media in addition to barcode handouts in various selected venues in Riyadh. The questionnaire involved 12 questions categorized into three sections. The first section obtained demographical information while the second section collected data about the past medical history of the participants. Lastly, the third section aimed to assess the prevalence of nephrolithiasis among participants or any history of the condition among their families. Results A total of 1,043 participants were surveyed, of whom 533 were males (51.1%). The prevalence of kidney stones was reported in 98 individuals (9.4%) overall. Individuals in the age groups of 36-50, 51-60, and >60 years showed significantly more renal stone prevalence than those in younger age groups (p<0.001). The prevalence was found to be higher in participants who were smokers, diabetic, hypertensive, and those who suffered from inflammatory bowel disease (IBD), gout, chronic kidney disease (CKD), hyperthyroidism, and hyperparathyroidism. Participants who took calcium supplements or had a positive family history of renal stones were found to have a higher prevalence of renal stones as well. However, only hypertension, gout, and family history showed any statistical significance (p<0.05). Conclusions A direct correlation was observed between hypertension, gout, positive family history, and aging and an increased prevalence of kidney stones among the inhabitants of the Riyadh province. Therefore, we encourage the local authorities to raise awareness of kidney stones and their related risk factors among the general public. Moreover, further local studies need to be conducted to gain deeper insights into kidney stone prevalence, especially pertaining to associated comorbidities and the pattern of the disease itself.
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Affiliation(s)
- Abdullah M Alshubaili
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz F Alotaibi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Khalid A Alsaleh
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz I Almogarri
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdullah A Alanizi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Saif S Alsaif
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Ahmad S Alghamdi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Nasser M Alnazari
- Department of Hepatobiliary Sciences and Organ Transplant, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Amwaj Almalki
- Biostatistics and Epidemiology, King Abdullah International Medical Research Center, Riyadh, SAU
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Steely A, Worcester E, Prochaska M. Contrasting Response of Urine Stone Risk to Medical Treatment in Calcium Oxalate versus Calcium Phosphate Stone Formers. KIDNEY360 2024; 5:228-236. [PMID: 38251931 PMCID: PMC10914189 DOI: 10.34067/kid.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
Key Points Thiazide treatment successfully lowered urine calcium and both calcium oxalate and calcium phosphate supersaturations in both types of stone formers (SFs). Alkali therapy may not confer the same benefits on calcium phosphate SFs as it does on calcium oxalate SFs. Background Randomized controlled trials have shown that both thiazide diuretics and potassium citrate (K-Cit) can prevent calcium stone recurrence, but most participants formed calcium oxalate (CaOx) stones. While thiazides are expected to lower risk of calcium phosphate (CaP) stone formation, the effect of K-Cit on risk of CaP stone formation is unclear. Methods To study the effect of common calcium stone treatments, we analyzed the 24-hour urines of CaOx and CaP stone formers (SFs) by four treatment types: Lifestyle, K-Cit, Thiazide, or Both medications. Results Patients treated with thiazides reduced urine calcium in both CaOx (M =−74.4, SD =94.6 mg/d) and CaP (M =−102, SD =99.7 mg/d) SFs while those on K-Cit had no change in urine calcium. Among CaOx SFs, urine citrate rose in patients administered K-Cit with or without thiazide, but citrate did not rise significantly in CaP SFs. Urine pH rose in all CaOx SFs, but among CaP SFs, only rose in patients receiving K-Cit. CaOx supersaturation (SS) decreased in all patients who received Thiazide, and decreased among CaOx SFs treated with K-Cit. CaP SS decreased in both CaOx SFs (M =−0.46, SD =0.86) and CaP SFs (M =−0.76, SD =0.85) treated with Thiazide, except CaOx SFs who received Both. Patients treated with K-Cit alone increased CaP SS in CaOx SFs (M =0.25, SD =0.79). Conclusions Patients treated with Thiazide lowered urine calcium and SS in both stone groups. Patients treated with K-Cit had no significant changes in urine calcium and had a decrease in CaOx SS in CaOx SFs. The study raises questions about the best preventive treatment for patients with CaP stones and suggests that K-Cit may not confer the same benefits on CaP SFs as it does on CaOx SFs.
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Affiliation(s)
- Audrey Steely
- Department of Medicine, University of Chicago, Chicago, Illinois
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Siener R, Rüdy J, Herwig H, Schmitz MT, Schaefer RM, Lossin P, Hesse A. Mixed stones: urinary stone composition, frequency and distribution by gender and age. Urolithiasis 2024; 52:24. [PMID: 38189998 PMCID: PMC10774159 DOI: 10.1007/s00240-023-01521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
Proper analysis of urinary stone composition is a cornerstone for diagnosis, targeted treatment and recurrence prevention of urolithiasis. The aim of this study was to determine the composition, frequency and distribution of mixed stones according to gender and age of patients. A total of 42,519 urinary stones from 30,311 men and 12,208 women submitted between January 2007 and December 2020 were studied. Most urinary calculi consisted of two components (50.9%), followed by stones of a single constituent (27.1%) and three-component stones (21.9%), while four-component stones were only rarely identified (0.1%). Among all stones, 49.8% consisted of whewellite (COM), weddellite (COD), and mixtures of COM and COD, 33.8% were pure carbonate apatite (CA) and mixtures of CA with COM and/or COD, while 7.6% were composed of uric acid anhydrous (UAA), uric acid dihydrate (UAD), and mixed UAA and UAD. The remaining 8.8% of calculi were rare single-component stones and rare mixtures of various constituents. The number of stone components was inversely associated with age (p < 0.001). The proportion of men decreased significantly with the number of stone constituents, from 3.01:1 for single-component stones to 1.0:1 for four-component urinary calculi (p < 0.001). The vast majority of urinary calculi consisted of two or more components in varying proportions. While age was inversely associated with the number of stone constituents, the proportion of women increased significantly from single-component to four-component urinary calculi. A significant proportion of mixed stones could present a challenge for diagnosis and targeted recurrence prevention.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Jakob Rüdy
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Helena Herwig
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Marie-Therese Schmitz
- Department of Medical Biometry, Informatics and Epidemiology, Medical Faculty, Bonn, Germany
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Daudon M, Haymann JP, Estrade V, Meria P, Almeras C. 2022 Recommendations of the AFU Lithiasis Committee: Epidemiology, stone analysis and composition. Prog Urol 2023; 33:737-765. [PMID: 37918977 DOI: 10.1016/j.purol.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
The incidence of urinary lithiasis is rising steadily in industrialized countries, and its prevalence in the general population of France is estimated at 10%. Renal colic accounts for 1-2% of emergency department consultations. At a time when the new LASER stone fragmentation techniques available to urologists will lead to ever finer in situ pulverization of stones, the exact identification of the compounds that form the stone is essential for etiological diagnosis. Constitutional analysis by infrared spectrophotometry or X-ray diffraction is therefore recommended, to be complemented by morphological typing of the calculi. METHODOLOGY: These recommendations have been drawn up using two methods: the Recommendation for Clinical Practice (RPC) method and the ADAPTE method, depending on whether or not the issue was considered in the EAU recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context.
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Affiliation(s)
- M Daudon
- CRISTAL Laboratory, Tenon Hospital, SFBC, Paris, France; Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France
| | - J-P Haymann
- Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France; Service d'Explorations Fonctionnelles Multidisciplinaires, Tenon Hospital, SP, Paris, France
| | - V Estrade
- Department of Urology, CHU Pellegrin, Bordeaux, France
| | - P Meria
- Service d'Urologie, Hôpital Saint-Louis, AP-HP-Centre Université Paris Cité, Paris, France
| | - C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
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Song BI, Lee J, Jung W, Kim BS. Pure uric acid stone prediction model using the variant coefficient of stone density measured by thresholding 3D segmentation-based methods: A multicenter study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107691. [PMID: 37418801 DOI: 10.1016/j.cmpb.2023.107691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023]
Abstract
Urinary stones are common urological diseases with increasing prevalence and incidence worldwide. Among the various types of stones, uric acid stones can be dissolved by oral chemolysis without any surgical procedure. Therefore, our study demonstrates that variant coefficient of stone density measured by thresholding a three-dimensional segmentation-based method from noncontrast computed tomography images can be used to identify pure uric acid stones from non-pure uric acid stones. This study provides a preoperative pure uric acid stone prediction model that could reduce invasive procedural treatments. The pure uric acid stone prediction model may offer optimized clinical decision-making for patients with urinary stones. BACKGROUND AND OBJECTIVES While most urinary stones are managed with interventional therapy, uric acid (UA) stones can be dissolved by oral chemolysis without invasive procedures. This study aimed to develop and validate a pure UA (pUA) stone prediction model using a variant coefficient of stone density (VCSD) measured by thresholding a three-dimensional (3D) segmentation-based method. METHODS Patients with urolithiasis treated at Keimyung University Dongsan Hospital between January 2017 and December 2020 were divided into training and internal validation sets, and patients from Kyungpook National University Hospital between January 2017 and December 2018 were used as an external validation set. Each stone was segmented by a thresholding 3D segmentation-based method using an attenuation threshold of 130 Hounsfield units. VCSD was calculated as the stone heterogeneity index divided by the mean stone density. RESULTS A total of 1175 urinary stone cases in 1023 patients were enrolled in this study. Of these, 224 (19.1%) were pUA stone cases. Among the potential predictors, thresholding 3D segmentation-based VCSD, age, sex, radio-opacity, hypertension, diabetes, and urine pH were identified as independent pUA stone predictors, and VCSD was the most powerful indicator. The pUA stone prediction model showed good discrimination, yielding area under the receiver operating characteristic curve of 0.960 (95% confidence interval (CI): 0.940-0.979, P < 0.001), 0.931 (95% CI: 0.875-0.987, P < 0.001), and 0.938 (95% CI: 0.912-0.965, P < 0.001) in the training, internal validation, and external validation sets, respectively. CONCLUSIONS VCSD measured using 3D segmentation was a decisive independent predictive factor for pUA stones. Furthermore, the established prediction model with VCSD can serve as a noninvasive preoperative tool to identify pUA stones.
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Affiliation(s)
- Bong-Il Song
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea (the Republic of)
| | - Jinny Lee
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea (the Republic of)
| | - Wonho Jung
- Department of Urology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of).
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Tang QL, Liang P, Ding YF, Zhou XZ, Tao RZ. Comparative efficacy between retrograde intrarenal surgery with vacuum-assisted ureteral access sheath and minimally invasive percutaneous nephrolithotomy for 1-2 cm infectious upper ureteral stones: a prospective, randomized controlled study. Front Surg 2023; 10:1200717. [PMID: 37483661 PMCID: PMC10360123 DOI: 10.3389/fsurg.2023.1200717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/15/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To observe the efficacy and safety of retrograde intrarenal surgery combined with vacuum-assisted ureteral access sheath (V-UAS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in patients with 1-2 cm infectious upper ureteral stone. Patients and methods A total of 173 patients with 1-2 cm infectious upper ureteral stone were prospectively randomized into two groups. Eighty-six in the V-UAS group and 87 cases as control in the MPCNL group. The SFRs at different times (Postoperative 1 day, 2nd week and 4th week) was considered as the primary outcome of the study. The secondary end points were operative time, postoperative hospital stay and operative complications. Results There was no obvious difference between two groups in patients' demographics and preoperative clinical characteristics (all P > 0.05). Postoperative data showed that the SFR at postoperative 1 day in the V-UAS group was significantly lower than that in the MPCNL group (73.2% vs. 86.2%, P = 0.034). However, there was no statistical significance between two groups in SFRs during postoperative 2 weeks and 4 weeks (All P > 0.05). The levels of WBC, CRP and PCT were all significant lower in the V-UAS group than those in the MPCNL group at the postoperative 24 h and 48 h (all P < 0.05). Postoperative complications included fever (≥38.5°C), bleeding, pain and urosepsis. In terms of the rates of fever, pain and urosepsis, MPCNL group were all significantly higher than those in the V-UAS group (10.3 vs. 2.4%, P = 0.031; 14.9 vs. 2.4%, P = 0.003; 4.6 vs. 0.0%, P = 0.044; respectively). No significant difference was found between two groups in bleeding. Meanwhile, postoperative hospital stay in the V-UAS group was more shorten than that in the MPCNL group (3.7 vs. 5.9 days, P < 0.001). Conclusions Our study showed that RIRS with V-UAS, a new partnership to treat 1-2 cm infectious upper ureteral stones, was satisfying as it achieved a high SFR rate and a low rate of infectious complications. This method was safe and reproducible in clinical practice.
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Affiliation(s)
- Qing-lai Tang
- Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China
| | - Ping Liang
- Department of Hepatobiliary Surgery, The Second Hospital of Nanjing, Nanjing, China
| | - Ye-fei Ding
- Department of Urology, Liaocheng People’s Hospital, Liaocheng, China
| | - Xing-zhu Zhou
- Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China
| | - Rong-zhen Tao
- Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China
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Wu Y, Mo Q, Xie Y, Zhang J, Jiang S, Guan J, Qu C, Wu R, Mo C. A retrospective study using machine learning to develop predictive model to identify urinary infection stones in vivo. Urolithiasis 2023; 51:84. [PMID: 37256418 PMCID: PMC10232574 DOI: 10.1007/s00240-023-01457-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/21/2023] [Indexed: 06/01/2023]
Abstract
Preoperative diagnosis of urinary infection stones is difficult, and accurate detection of stone composition can only be performed ex vivo. To provide guidance for better perioperative management and postoperative prevention of infection stones, we developed a machine learning model for preoperative identification of infection stones in vivo. The clinical data of patients with urolithiasis who underwent surgery in our hospital from January 2011 to December 2015 and January 2017 to December 2021 were retrospectively analyzed. A total of 2565 patients were included in the study, and 1168 eligible patients with urinary calculi were randomly divided into training set (70%) and test set (30%). Five machine learning algorithms (Support Vector Machine (SVM), Multilayer Perceptron (MLP), Decision Tree (DT), Random Forest Classifier (RFC), and Adaptive Boost (AdaBoost)) and 14 preoperative variables were used to construct the prediction model. The performance measure was the area under the receiver operating characteristic curve (AUC) of the validation set. The importance of 14 features in each prediction model for predicting infection stones was analyzed. A total of 89 patients (5.34%) with infection stones were included in the validation set. All the five prediction models showed strong discrimination in the validation set (AUC: 0.689-0.772). AdaBoost model was selected as the final model (AUC: 0.772(95% confidence interval, 0.657-0.887); Sensitivity: 0.522; Specificity: 0.902), UC positivity, and urine pH value were two important predictors of infection stones. We developed a predictive model through machine learning that can quickly identify infection stones in vivo with good predictive performance. It can be used for risk assessment and decision support of infection stones, optimize the disease management of urinary calculi and improve the prognosis of patients.
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Affiliation(s)
- Yukun Wu
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Qishan Mo
- Department of Urology, Guangzhou Panyu Central Hospital, Guangzhou, 510080, Guangdong, China
| | - Yun Xie
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Junlong Zhang
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Shuangjian Jiang
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Jianfeng Guan
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Canhui Qu
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Rongpei Wu
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Chengqiang Mo
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.
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Zreik R, Pilosov Solomon I, Saliba W, Tor R, Cohen S, Friefeld Y, Dekel Y, Klein I. The relationship between patients' kidney stone type and demographics in Israel: analysis of 10 K patients. World J Urol 2023:10.1007/s00345-023-04424-w. [PMID: 37184690 DOI: 10.1007/s00345-023-04424-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 05/16/2023] Open
Abstract
PURPOSE To analyze urinary stone composition in Israel and assess the effects of key demographic parameters (gender, age, socioeconomic status, ethnicity, medical history and geographic region) on stone composition. METHODS A retrospective review was conducted of stone analysis of 10,633 patients from an HMO Israeli database analyzed by a central laboratory from 2014 to 2019 and subjected to Fourier-transform infrared spectroscopy. Associations between stone composition and different demographic parameters were determined using the Chi-square test. RESULTS Calcium oxalate (CaOx) monohydrate accounted for 51.9% of the stones. Of the total sample, 5776 stones had one single component (54%), whereas 4857 (46%) had mixed components. Men had a higher frequency of CaOx stones (89.6% vs. 85.6%), whereas women had a higher frequency of calcium phosphate, infection, and cystine stones (27.2%, 17.7%, and 0.9% vs. 17.2%, 7.5%, and 0.5%, respectively). Cystine stones were more abundant in Arabs (1.2% vs. 0.5% in the Jewish population). Lower socioeconomic status was associated with a higher prevalence of calcium phosphate, uric acid, and infection stones and a lower prevalence of CaOx stones. Uric acid stones were associated with medical conditions such as diabetes, hypertension, ischemic heart disease, and obesity (28.3%, 24.9%, 25.7%, and 22.6% vs. 9.6%, 8.4%, 12.3%, and 10.3%, respectively). CONCLUSIONS Stone types were highly influenced by patients' demographics. COM was the most common stone component in either pure or complex form. UA stone prevalence was found to increase with age and was associated with medical conditions such as diabetes, hypertension, ischemic heart disease, and obesity.
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Affiliation(s)
- Rani Zreik
- Department of Urology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | | | - Walid Saliba
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
- Department of Community and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Ruth Tor
- Chemistry Laboratory, Rabin Medical Center, Petah Tikva, Israel
| | - Sharon Cohen
- Chemistry Laboratory, Rabin Medical Center, Petah Tikva, Israel
| | - Yuval Friefeld
- Department of Urology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Yoram Dekel
- Department of Urology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Ilan Klein
- Department of Urology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
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Walker D, Gardner MT, Dennis H, Voutchkov M. A simple assessment of the effect of strontium on the urinary excretion of calcium in Sprague Dawley rats. Urolithiasis 2023; 51:53. [PMID: 36930293 DOI: 10.1007/s00240-023-01427-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
This study was aimed at investigating the impact of varying concentrations of strontium (Sr) on calcium (Ca) excretion via the urine and determine its impact on kidney stone formation. Twenty adult male Sprague Dawley rats weighing between 200 and 300 g were selected. The rats were randomly divided into four groups of five. One group was used as a control group while the other three groups were experimental. The diet of the rats was modulated over a 12 week period to investigate the impact of Sr on the urinary excretion of Ca. Urinary samples were collected every 2 weeks from the rats. The rats were fed water ad libitum. After the study the rats were euthanised and their kidneys harvested. Urine and kidney samples from the rats were analysed using Total Reflection X-Ray Fluorescence (TXRF). In the urine excretion of Ca increased with increased intake of Sr in the diet. Sr excretion via the urine also increased with increased dietary intake. There was a correlation of 0.835 at the significance level of 0.01 between Ca and Sr in the urine. However, for the kidneys, the varying concentration of Sr did not impact the retention of Ca in the kidneys. There was increased retention of Sr in the kidneys with increased dietary intake. In this study an increase of Sr in the diet resulted in an increase in urinary excretion of Ca.
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Affiliation(s)
- Darrion Walker
- Department of Physics, Faculty of Science and Technology, University of the West Indies Mona, Kingston, Jamaica.
- Faculty of Medical Sciences, University of the West Indies Mona, Kingston, Jamaica.
| | - Michael T Gardner
- Department of Anatomy and Histology, Faculty of Medical Sciences, University of the West Indies Mona, Kingston, Jamaica
| | - Haile Dennis
- International Centre for Environmental and Nuclear Sciences, Kingston, Jamaica
| | - Mitko Voutchkov
- Department of Physics, Faculty of Science and Technology, University of the West Indies Mona, Kingston, Jamaica
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11
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Siener R, Löhr P, Hesse A. Urinary Risk Profile, Impact of Diet, and Risk of Calcium Oxalate Urolithiasis in Idiopathic Uric Acid Stone Disease. Nutrients 2023; 15:nu15030572. [PMID: 36771279 PMCID: PMC9919786 DOI: 10.3390/nu15030572] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
The role of diet in the pathogenesis of uric acid (UA) nephrolithiasis is incompletely understood. This study investigated the effect of dietary intervention on the risk of UA stone formation under standardized conditions. Twenty patients with idiopathic UA stone disease were included in the study. Dietary intake and 24 h urinary parameters were collected on the usual diet of the patients and a standardized balanced mixed diet. Although urinary UA excretion did not change, the relative supersaturation of UA decreased significantly by 47% under the balanced diet primarily due to the significant increase in urine volume and pH. Urinary pH was below 5.8 in 85% of patients under the usual diet, and in 60% of patients under the balanced diet. The supersaturation of calcium oxalate declined significantly under the balanced diet due to the significant decrease in urinary calcium and oxalate excretion and the increase in urine volume. Dietary intervention is a key component in the management of UA nephrolithiasis. Urinary calcium and oxalate excretion should also be monitored in patients with pure UA calculi to reduce the risk of mixed stone formation with calcium oxalate. Lower urinary pH in UA stone patients can only be partially explained by diet.
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12
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Urinary stone disease in Syrian children. Pediatr Nephrol 2023:10.1007/s00467-022-05860-3. [PMID: 36662300 DOI: 10.1007/s00467-022-05860-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Pediatric urinary stone disease (USD) is a costly medical problem. This study aims to assess the clinical characteristics and outcomes of common and rare causes of pediatric USD. METHODS A retrospective descriptive cohort study included all children < 13 years of age with confirmed USD admitted to the Children's University Hospital in Damascus, Syria, from January 2013 to December 2019. The study sample was divided into two groups based on etiologies: common and rare causes groups. RESULTS We evaluated 235 patients; 147 of them were males, and the male-to-female ratio was 1.7:1. The common causes group consisted of 203 patients (mean age 3.52 ± 3.66 years) and mainly included metabolic disorders (45.5%) and anatomical abnormalities (22.3%), while the rare causes group included 32 cases (mean age 4.93 ± 4.08 years), 12 patients with uric acid stones (37.5%), 7 patients with cystinuria (21.9%), and primary hyperoxaluria in 5 patients (15.6%). In addition, 39.6% of study patients were born to consanguineous marriages. Sixty-two patients developed AKI, and eleven patients had chronic kidney disease (CKD). Patients with rare causes were more likely to have AKI, CKD, bilateral stones, and recurrent stones (P-value < 0.05). Stone analysis was performed on 83 patients, and the main stone types were calcium oxalate (34.9%), uric acid (14.4%), and struvite stones (12%). Surgery was the most performed treatment in 101 patients (56.7%). CONCLUSION Patients with rare causes of pediatric USD are at a higher risk for severe complications and require early diagnosis and management. The high rate of uric acid stones in our society requires further evaluation for possible underlying causes. A higher resolution version of the Graphical abstract is available as Supplementary information.
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13
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A Novel Infrared Spectroscopy Method for Analysis of Stone Dust for Establishing Final Composition of Urolithiasis. EUR UROL SUPPL 2022; 47:36-42. [PMID: 36601044 PMCID: PMC9806700 DOI: 10.1016/j.euros.2022.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background The introduction of the holmium laser for lithotripsy and minimally invasive techniques in endoscopy increased the popularity of stone dusting techniques. Retrieving stone pieces for an analysis increases the economic burden of surgery and operative time. Novel methods are needed for the analysis of convenient urolithiasis composition. Objective This study aims to assess the efficacy of the stone dust Fourier transform infrared spectroscopy coupled with attenuated total reflection (FTIR ATR) method for accurate stone composition determination from the dust specimens compared with simultaneously retrieved standard stone fragments. Design setting and participants From July 2021 to March 2022, a total of 75 patients who received endoscopic treatment for urolithiasis were included in this study. Outcome measurements and statistical analysis The accuracy of the FTIR ATR method was assessed via estimates of sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). The results were compared between samples of stone dust and the final stone composition. Results and limitations Total or partial biochemical composition agreement was observed in 92.7% of cases and total agreement in 82.4% of cases when stone dust was compared with stone fragments. The highest accuracy rates were obtained for uric acid stones: sensitivity 100%, specificity 98.3%, PPV 90.9%, and NPV 100%. Identification of other types of stones was also of high accuracy, reaching up to 83.3% sensitivity and 100% specificity. Conclusions The application of FTIR ATR spectroscopy for a stone dust analysis allows obtaining easy and cost-effective final composition of urolithiasis without a stone fragment analysis. This technique was shown to be feasible, and there is substantial potential for clinical practice. Patient summary This study investigates a novel method that determines accurate stone composition without acquiring the pieces of stone during surgery. The results have shown that stone dust Fourier transform infrared spectroscopy coupled with attenuated total reflection provides accurate stone composition.
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14
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Lithiase urinaire de type IVa2 et pathologies associées : à propos de 3 cas. Nephrol Ther 2022; 18:570-574. [DOI: 10.1016/j.nephro.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 11/11/2022]
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15
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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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16
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Pozdzik A, Hamade A, Racapé J, Roumeguère T, Wolff F, Cotton F. The epidemiology of kidney stones in Belgium based on Daudon’s morpho-constitutional classification: a retrospective, single-center study. CR CHIM 2022. [DOI: 10.5802/crchim.185] [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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17
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Daudon M, Petay M, Vimont S, Deniset A, Tielens F, Haymann JP, Letavernier E, Frochot V, Bazin D. Urinary tract infection inducing stones: some clinical and chemical data. CR CHIM 2022. [DOI: 10.5802/crchim.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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18
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Siener R, Herwig H, Rüdy J, Schaefer RM, Lossin P, Hesse A. Urinary stone composition in Germany: results from 45,783 stone analyses. World J Urol 2022; 40:1813-1820. [PMID: 35666268 PMCID: PMC9236976 DOI: 10.1007/s00345-022-04060-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Stone composition can provide valuable information for the diagnosis, treatment and recurrence prevention of urolithiasis. The aim of this study was to evaluate the distribution of urinary stone components and the impact of different crystal forms according to gender and age of patients in Germany. Methods A total of 45,783 urinary stones submitted from 32,512 men and 13,271 women between January 2007 and December 2020 were analyzed by infrared spectroscopy. Only the first calculus obtained per patient was included in the analysis. Results The most common main stone component was calcium oxalate (CaOx) (71.4%), followed by carbonate apatite (CA) (10.2%) and uric acid (UA) (8.3%). Struvite (2.1%), brushite (1.3%), protein (0.5%) and cystine (0.4%) stones were only rarely diagnosed. CaOx (75%) and UA stones (81%) were more frequently obtained from men than women (p < 0.001). Weddellite (COD) and uric acid dihydrate (UAD) were more common in younger ages than whewellite (COM) and anhydrous uric acid (UAA), respectively, in both men and women. The ratios of COM-to-COD and UAA-to-UAD calculi were approximately 4:1 and 8:1, respectively. The peak of stone occurrence was between the ages of 40 and 59 years. Conclusion Stone composition is strongly associated with gender and age. The peak incidence of calculi in both women and men was in the most active phase of their working life. The distinction between different crystal forms could provide clues to the activity and mechanisms of lithogenesis. Further research is needed in understanding the causative factors and the process of stone formation. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-022-04060-w.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Helena Herwig
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jakob Rüdy
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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19
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GANİYUSUFOĞLU E, KILINÇ M, RESİM S, ŞEN B, SAĞER H. Üriner Sistem Taşlarının Kimyasal Bileşiminin Yaş ve Cinsiyete Göre İncelenmesi. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1106724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Amaç: İnsanlarda metabolik ürünlerin üriner sistemin değişik bölümlerinde muhtemelen genetik ve/veya beslenme nedeniyle birikmesi ile taş oluştuğu bilinmektedir. Yörelerdeki içme suları içeriğindeki element miktarlarının katkısının olduğu da düşünülmektedir. Bu çalışmada üriner sistem taşlarının kimyasal bileşiminin yaş ve cinsiyete göre incelenmesi amaçlandı.
Gereç ve Yöntemler: Çalışmada, Ocak 2017 ile Şubat 2022 tarihleri arasında üroloji polikliniğine taşa bağlı klinik belirtilerle başvuran ve böbrek taşı saptanan 300 hastanın taş örnekleri (erkek n=207, kadın=93) incelendi. Taşların analizi FT-IR Spektrofotometre cihazında ölçüm yapılarak değerlendirildi. Yaş ve cinsiyet bilgileri arşiv taraması yoluyla elde edildi.
Bulgular: Hastaların yaş aralığı 1 ile 83 arasında değişmekteydi. Sonuçlar incelendiğinde taşlar görülme sıklığına göre kalsiyum okzalat monohidrat + kalsiyum okzalat dihidrat (n=131, %43,66), kalsiyum okzalat monohidrat (n=43, %14,33), kalsiyum okzalat monohidrat + kalsiyum okzalat dihidrat + karbonat apatit (n=28, %9,33), kalsiyum okzalat monohidrat + ürik asit (n=17, %5,66), ürik asit (n=12, %4), kalsiyum okzalat monohidrat + karbonat apatit (n=10, %3,33) ve daha az olarak karışım halinde bulunan taşlar belirlendi. Taş oluşumunu cinsiyete göre incelediğimizde erkeklerde kadınlardan daha sık görüldüğü tespit edilmiştir. Taşların kimyasal bileşimini yaşa göre incelediğimizde taş oluşumunun en sık 19-40 yaş, en az 12 -18 yaş arasında görüldüğü belirlenmiştir.
Sonuç: Kalsiyum elementinin baz alındığı taşların sık olarak görüldüğü, erkeklerde taş oluşumunun daha fazla olduğu ve yaş olarak 19-40 yaş aralığında taş oluşumunun fazla görüldüğü söylenebilir. Aralıklı olarak üriner sistem taşı oluşumuna maruz kalan kişilerin taşlarının kimyasal bileşim yönünden değerlendirilmesi ile hastalığın tedavisinin planlanması ve hastalığın tekrar etmesinin önlenmesine yardımcı olabileceği düşünülmektedir.
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20
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Chen T, Zhang Y, Dou Q, Zheng X, Wang F, Zou J, Jia R. Machine learning-assisted preoperative diagnosis of infection stones in urolithiasis patients. J Endourol 2022; 36:1091-1098. [PMID: 35369740 DOI: 10.1089/end.2021.0783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tingting Chen
- China Pharmaceutical University, 56651, School of Basic medical and Clinical pharmacy, Nanjing, Jiangsu, China
| | | | | | | | | | - Jianjun Zou
- Nanjing First Hospital, 385685, Clinical pharmarcy department, Nanjing, Nangjing, China, 210029
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21
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Tesei D, Jewczynko A, Lynch AM, Urbaniak C. Understanding the Complexities and Changes of the Astronaut Microbiome for Successful Long-Duration Space Missions. Life (Basel) 2022; 12:life12040495. [PMID: 35454986 PMCID: PMC9031868 DOI: 10.3390/life12040495] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
During space missions, astronauts are faced with a variety of challenges that are unique to spaceflight and that have been known to cause physiological changes in humans over a period of time. Several of these changes occur at the microbiome level, a complex ensemble of microbial communities residing in various anatomic sites of the human body, with a pivotal role in regulating the health and behavior of the host. The microbiome is essential for day-to-day physiological activities, and alterations in microbiome composition and function have been linked to various human diseases. For these reasons, understanding the impact of spaceflight and space conditions on the microbiome of astronauts is important to assess significant health risks that can emerge during long-term missions and to develop countermeasures. Here, we review various conditions that are caused by long-term space exploration and discuss the role of the microbiome in promoting or ameliorating these conditions, as well as space-related factors that impact microbiome composition. The topics explored pertain to microgravity, radiation, immunity, bone health, cognitive function, gender differences and pharmacomicrobiomics. Connections are made between the trifecta of spaceflight, the host and the microbiome, and the significance of these interactions for successful long-term space missions.
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Affiliation(s)
- Donatella Tesei
- Department of Biotechnology, University of Natural Resources and Life Sciences, 1190 Vienna, Austria;
| | - Anna Jewczynko
- Department of Biology, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Anne M. Lynch
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
- Graduate Program in Developmental Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Camilla Urbaniak
- ZIN Technologies Inc., Middleburg Heights, OH 44130, USA
- NASA Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
- Correspondence:
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22
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Li S, Huang X, Liu J, Yue S, Hou X, Hu L, Wu J. Trends in the Incidence and DALYs of Urolithiasis From 1990 to 2019: Results From the Global Burden of Disease Study 2019. Front Public Health 2022; 10:825541. [PMID: 35309229 PMCID: PMC8931285 DOI: 10.3389/fpubh.2022.825541] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/02/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives To provide a comprehensive assessment of the estimated burden and trend of urolithiasis at the global, regional, and national levels. Methods The age-standardized rates (ASRs) of the incidence and disability-adjusted life years (DALYs) of urolithiasis from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 database. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in urolithiasis burden. Results In 2019, the ASRs of the incidence and DALYs were 1,394.03/100,000 and 7.35/100,000, respectively. The ASRs of the incidence and DALYs of urolithiasis decreased from 1990 to 2019 with EAPCs of −0.83 and −1.77, respectively. Males had a higher burden of urolithiasis than females. In 2019, the highest burden of urolithiasis was observed in regions with high–middle sociodemographic index (SDI), particularly in Eastern Europe, Central Asia, and Southeast Asia. The burden of urolithiasis increased in most countries or territories. The burden of urolithiasis and SDI had a non-linear relationship, and the estimated value of urolithiasis burden was the highest when the SDI value was ~0.7. Conclusion Globally, the ASRs of the incidence and DALYs of urolithiasis decreased from 1990 to 2019, but an increasing trend was observed among many countries. More effective and appropriate medical and health policies are needed to prevent and early intervene in urolithiasis.
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Affiliation(s)
- Shasha Li
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Xueying Huang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Jie Liu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Suru Yue
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Xuefei Hou
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Liren Hu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
| | - Jiayuan Wu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Collaborative Innovation Engineering Technology Research Center of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Zhanjiang, China
- *Correspondence: Jiayuan Wu
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23
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Comparing the effects of different amounts of fluid treatments in addition to analgesia in patients admitted to the emergency department with renal colic: A randomized study. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1061180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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24
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Walker DC, Antoine JMR, Williams JA, Grant CN, Voutchkov MK. Elemental investigation of renal calculi in Jamaica by instrumental neutron activation analysis (INAA). J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-021-08071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Whittamore JM, Hatch M. Oxalate Flux Across the Intestine: Contributions from Membrane Transporters. Compr Physiol 2021; 12:2835-2875. [PMID: 34964122 DOI: 10.1002/cphy.c210013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Epithelial oxalate transport is fundamental to the role occupied by the gastrointestinal (GI) tract in oxalate homeostasis. The absorption of dietary oxalate, together with its secretion into the intestine, and degradation by the gut microbiota, can all influence the excretion of this nonfunctional terminal metabolite in the urine. Knowledge of the transport mechanisms is relevant to understanding the pathophysiology of hyperoxaluria, a risk factor in kidney stone formation, for which the intestine also offers a potential means of treatment. The following discussion presents an expansive review of intestinal oxalate transport. We begin with an overview of the fate of oxalate, focusing on the sources, rates, and locations of absorption and secretion along the GI tract. We then consider the mechanisms and pathways of transport across the epithelial barrier, discussing the transcellular, and paracellular components. There is an emphasis on the membrane-bound anion transporters, in particular, those belonging to the large multifunctional Slc26 gene family, many of which are expressed throughout the GI tract, and we summarize what is currently known about their participation in oxalate transport. In the final section, we examine the physiological stimuli proposed to be involved in regulating some of these pathways, encompassing intestinal adaptations in response to chronic kidney disease, metabolic acid-base disorders, obesity, and following gastric bypass surgery. There is also an update on research into the probiotic, Oxalobacter formigenes, and the basis of its unique interaction with the gut epithelium. © 2021 American Physiological Society. Compr Physiol 11:1-41, 2021.
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Affiliation(s)
- Jonathan M Whittamore
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Marguerite Hatch
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
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26
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Popovtzer B, Khusid JA, Bamberger JN, Lundon D, Gallante B, Sadiq AS, Atallah W, Lifshitz D, Gupta M. Do Infection-Associated Stone Subtypes Behave the Same Clinically? A Retrospective Bi-center Study. J Endourol 2021; 36:688-693. [PMID: 34913732 DOI: 10.1089/end.2021.0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction and Objectives Infection associated renal stones are commonly composed of magnesium-ammonium-phosphate (MAP) and carbonate apatite (CA). The clinical implications of these two different, but closely related stone types, are unknown. We sought to compare the clinical, microbiologic, and metabolic characteristics of patients with MAP and CA stone types. Methods We retrospectively reviewed the medical records of patients from two centers (one in the USA and one in Israel) who underwent ureteroscopy or percutaneous nephrolithotomy between 2012 and 2020 and identified patients with a predominant stone analysis component of CA or MAP and clinical data supporting an infection stone. We analyzed and compared demographic data, medical history, post-operative fever, stone and urinary microbiology, and 24-hour urine studies. Results A total of 79 and 75 patients met the inclusion criteria for the MAP and CA cohorts, respectively. No significant difference was found in patient demographics or comorbidities between the MAP and CA cohort. Female predominance was noted in both. Though there were no significant differences in 24-hour urine parameters between the cohorts, hypercalciuria was common in both cohorts (38% and 32% of patients in the MAP and CA cohorts, respectively). Gram negative bacteria were more common in the MAP stone cultures. Post-operative fever was significantly more common in the MAP cohort (14.7% vs 3.8%, p<0.016). Conclusions: MAP and CA stone formers share similar demographic characteristics with a clear female predominance. MAP stones patients appear more likely to develop postoperative fever, possibly related to a higher occurrence of gram-negative bacteria in the stone cultures of the MAP cohort. Although there were no significant differences amongst metabolic parameters, hypercalciuria was noted in approximately a third of the cohort. The clinical significance of this finding is yet to be determined.
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Affiliation(s)
- Baruch Popovtzer
- Rabin Medical Center, 36632, Urology, Zeev Jabotinsky St 39, Petah Tikva, Israel, 49100;
| | - Johnathan Alexander Khusid
- Icahn School of Medicine at Mount Sinai, 5925, Urology, 1 Gustave Levy Pl., New York, New York, United States, 10029-6574;
| | - Jacob N Bamberger
- Icahn School of Medicine at Mount Sinai, 5925, Department of Urology, 425 W 59th St, Suite 4F, New York, New York, United States, 10029-6574;
| | - Dara Lundon
- Icahn School of Medicine at Mount Sinai, 5925, Department of Urology, New York, New York, United States;
| | - Blair Gallante
- Icahn School of Medicine at Mount Sinai, 5925, Department of Urology, 425 W. 59th Street, Suite 9F, New York, New York, United States, 10019;
| | - Areeba Setara Sadiq
- Mount Sinai Health System, 5944, Urology, 425 W59th Street, New York, New York, United States, 10019;
| | - William Atallah
- Icahn School of Medicine at Mount Sinai, Urology, New York, New York, United States;
| | - David Lifshitz
- Rabin medical center, urology, Keren kayemet st, Petach Tikva, Israel, 65222;
| | - Mantu Gupta
- Mount Sinai Health System, 5944, Urology, 425 W. 59th Street, New York, New York, United States, 10019;
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Katz JE, Soodana-Prakash N, Jain A, Parmar M, Smith N, Kryvenko O, Austin GW, Shah HN. Influence of Age and Geography on Chemical Composition of 98043 Urinary Stones from the USA. EUR UROL SUPPL 2021; 34:19-26. [PMID: 34934963 PMCID: PMC8655393 DOI: 10.1016/j.euros.2021.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/28/2022] Open
Abstract
Background Urolithiasis is a growing issue globally, but it is heterogeneous, with a different epidemiology and pathophysiology for each different stone composition. Objective The purpose of this study is to describe the incidence of urinary stones in the USA from 2016 to 2019 by chemical composition and to investigate the influence of age and geography on these stone types. Design, setting, and participants We obtained compositional analyses for all urinary stones submitted to a national laboratory over an approximately 3-yr period. Outcome measurements and statistical analysis Data collected included the chemical constituents of a stone, patient age, and geographical origin. We describe the incidence of each stone type by frequency. Statistical testing was performed to determine the influence of age and geographical region on overall incidence of each stone composition. Results and limitations In total, 99 908 specimens were analyzed. When pure stones were ordered by frequency, we found that the most common stone type was calcium oxalate (CaOx) (79.2%), followed by uric acid (UA; 14.3%), calcium phosphate (CaPO4; 3.7%), cystine (0.51%), drug induced (0.12%), and magnesium ammonium phosphate (0.04%). CaOx, UA, and CaPO4 were often mixed with one another. Among CaOx stones, the plurality (28.0%) was made of pure calcium oxalate monohydrate (COM), and only 0.002% was pure calcium oxalate dihydrate. There was an overall association between stone composition and both geographical distribution and age (p < 0.001). Conclusions CaOx stones comprise the majority of urinary stones in the USA, of which almost 28% were pure COM. Additionally, age and geographical region are significantly associated with variations in stone composition. Patient summary We evaluated the incidence of urinary stones in the USA based on their chemical composition. The most common stone type was calcium oxalate, the majority of which was pure calcium oxalate monohydrate. We also found age and geographical region to be significantly associated with variations in stone composition.
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Affiliation(s)
- Jonathan E. Katz
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | | | - Anika Jain
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Madhumita Parmar
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Nicholas Smith
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Oleksandr Kryvenko
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
- Department of Pathology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | | | - Hemendra N. Shah
- Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
- Corresponding author. Department of Urology, Miller School of Medicine, University of Miami, Coral Gables, FL, USA. Tel. +1 3059158344.
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Sbahi K, Kacem B, Talhi R, Azaiz A, Attar A, Addou A. Retrospective epidemiological study of urolithiasis in western Algeria over a period of 50 years. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00248-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Urolithiasis is a pathology that changes with time and with the evolution of human societies. The prevalence of this pathology has gradually increased during the last decades, especially because of dietary changes.
Methods
This work is a retrospective descriptive epidemiological study of the temporal type carried out at the level of the urology service of the University Hospital Center of Oran between the first January 1965 and December 31, 2014. The objectives of this work are to study the epidemiological profile of urolithiasis and to determine the evolutionary trend of the disease over time.
Results
This study confirms some current data in the direction of an increase in surgical activity concerning the treatment of urinary stones. The analysis over time shows us a significant decrease (p < 0.01) in the male predominance between 1965 and 2014 with a M/F ratio which decreased from 3.09 to 1.82, as well as an increase in the average age, rising from 28.8 years in the period 1965–1974 to 48.3 years between 2005 and 2014.
Conclusion
The analysis of epidemiological data is essential to better evaluate the evolution of the urolithiasis disease, which was affirmed in our study, where a constant evolution of the characteristics of the disease was revealed, testifying the change of the socio-economic level in Algeria.
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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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Kuntima Diasiama PD, Moningo Molamba D, Makulo Rissasy JR, Sumaili Kiswaya E, Mafuta Musalu É, Ngoma A, Loposso Nkumu M, Punga-Maole A, Lwa Nkandi SL, Haymann JP, Daudon M. [Chemical composition of urinary stones and associated factors in the Democratic Republic of Congo]. Nephrol Ther 2021; 17:441-450. [PMID: 34187760 DOI: 10.1016/j.nephro.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/10/2021] [Accepted: 04/16/2021] [Indexed: 11/30/2022]
Abstract
To compare the chemical composition of the upper and lower urinary tract stones in Congolese patients, and to identify factors associated with the different types of stones. Stones from 119 patients originating from the upper tract and 75 from the lower tract were analyzed by infrared spectrophotometry. Among 119 patients with upper tract stones, age ranged from 10 to 81 years with a mean (SD) of 45.8 (13.6) years; males were the majority (55.5%). The main types of stones identified were whewellite (79%). For the 75 patients with lower apparatus stones, age ranged from 4 to 87 years with a mean (SD) of 51.6 (21.6) years; the majority were males (89.3%). The main types of stones were whewellite (44%) and anhydrous uric acid (22.7%). Overall, the factors associated with calcium oxalate included: site [4.95 (95% CI 2.35-10.44)] and diameter [3.03 (95% CI 1.45-6.25)]; patient's place of residence [0.05 (95% CI 0.01-0.29)] was associated with calcium phosphate. Infection stones were associated with; site [0.19 (95% CI 0.06-0.63)] and diameter [0.10 (95% CI 0.03-0.38)]. Finally, age 0.26 (95% CI 0.09-0.71) and stone site [0.23 (95% CI 0.07-0.68)] were associated with uric stones. The epidemiological and chemical profile of upper and lower tract stones were different. Several factors were associated with the chemical and crystalline composition of stones in the Democratic Republic of Congo.
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Affiliation(s)
| | - Dieudonné Moningo Molamba
- Service d'urologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Jean-Robert Makulo Rissasy
- Service de néphrologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Ernest Sumaili Kiswaya
- Service de néphrologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Éric Mafuta Musalu
- École de Santé publique, Université de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Alain Ngoma
- Service de biologie médicale, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Mathieu Loposso Nkumu
- Service d'urologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Augustin Punga-Maole
- Service d'urologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Simon Lufuma Lwa Nkandi
- Service d'urologie, cliniques universitaires de Kinshasa, BP 123, Kinshasa 11, République démocratique du Congo
| | - Jean-Philippe Haymann
- Service des explorations fonctionnelles, Hôpital Tenon, 75970 Paris cedex 20, France
| | - Michel Daudon
- Service des explorations fonctionnelles, Hôpital Tenon, 75970 Paris cedex 20, France
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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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Saver A, Lulich JP, Van Buren S, Furrow E. Calcium oxalate urolithiasis in juvenile dogs. Vet Rec 2021; 189:e141. [PMID: 34357620 DOI: 10.1002/vetr.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/10/2020] [Accepted: 01/26/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The features of juvenile-onset calcium oxalate urolithiasis in dogs have not been previously reported. METHODS Calcium oxalate urolith submissions to the Minnesota Urolith Center between 2012 and 2016 were analyzed to identify those originating from juvenile (≤2 years, n = 510) or mature (7-9 years, n = 39,093) dogs. Breed, sex, urolith salt type and urolith location were compared between groups. Breeds represented in both groups were also compared with respect to sex, urolith salt type and urolith location. RESULTS French (odds ratios [OR] = 14.7, p < 0.001) and English (OR = 14.3, p < 0.001) Bulldogs were overrepresented in juvenile submissions. All juvenile French and English Bulldogs were male. Across all breeds, juvenile dogs were more likely to be male (89%, p < 0.001) than mature dogs (79%). Juvenile dogs were also more likely to form dihydrate stones compared to mature dogs (33% versus 14%, respectively; p < 0.001). Breed differences were discovered in sex, urolith salt type and stone location. CONCLUSIONS French and English Bulldogs comprise a greater proportion of juvenile calcium oxalate urolith submissions than expected based on their rarity in mature submissions. Inherited risk factors, particularly X chromosome variants, should be investigated due to the strong breed and sex predispositions identified.
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Affiliation(s)
- Alexander Saver
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jody P Lulich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Samantha Van Buren
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Eva Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
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Zhao E, Zhang W, Geng B, You B, Wang W, Li X. Intestinal dysbacteriosis leads to kidney stone disease. Mol Med Rep 2020; 23:180. [PMID: 33655334 PMCID: PMC7809898 DOI: 10.3892/mmr.2020.11819] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/27/2020] [Indexed: 01/04/2023] Open
Abstract
The formation and physicochemical properties of kidney stones (KSs) are closely associated with diet. In view of the differences in ethnicity and dietary composition between Chinese and Western populations, the present study aimed to investigate the association between intestinal dysbacteriosis and KSs in China. The current study examined the differences in intestinal microbes between the KS disease (KSD) and the healthy control (HLT) groups, and statistically significant differences based on 16s rRNA gene amplicons were identified using a Student's t-test or one-way ANOVA. In addition, the calcium oxalate KS (COKS), uric acid KS (UAKS) and carbonate apatite KS(CCKS) groups were compared with a non-parametric statistical test. Determination of bacterial abundance was performed via the analysis of 16s rRNA marker gene sequences using next-generation sequencing. Firmicutes (F) and Bacteroides (B) levels were significantly higher in the KSD group compared with the HLT group (B/F=0.67 vs. 0.08; P<0.001), as were the overall levels of B (6.19-fold higher compared with the HLT group; 22.2 vs. 3.6%; P<0.001). The Prevotella-9 abundance levels in the KSD group were 4.65-fold higher compared with those in the HLT group (8.8 vs. 1.9%; P<0.001). The levels of Blautia and Lachnoclostridium were significantly decreased in the KSD group (13.3 vs. 6.0%; and 5.0 vs. 7.9%; both P<0.05). Moreover, Prevotella-9 levels were higher in non-calciferous KSs (UAKS) compared with calciferous KSs (COKS and CCKS). Therefore, the findings of the present study indicated a key association between specific KS components and intestinal flora, providing a theoretical basis for new treatment methods for KSs. Moreover, differences and interactions between these bacteria could initially predict specific types of urolithiasis.
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Affiliation(s)
- Enyang Zhao
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Wenfu Zhang
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Bo Geng
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Bosen You
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Wanhui Wang
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Xuedong Li
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
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The interest of oral calcium loads test in the diagnosis and management of pediatric nephrolithiasis with hypercalciuria: Experience from a tertiary pediatric centre. J Pediatr Urol 2020; 16:489.e1-489.e9. [PMID: 32593617 DOI: 10.1016/j.jpurol.2020.05.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/30/2020] [Accepted: 05/22/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The use of calcium load has been forgotten in pediatrics until recently whereas it is of utmost importance to have a practical approach to guide management of hypercalciuric nephrolithiasis. OBJECTIVE The purpose of this study was to evaluate the practical interest of oral calcium loads to improve the overall management of nephrolithiasis in children. METHODS We retrospectively studied all pediatric patients having undergone an oral calcium load in our pediatric nephrology unit between September 2015 and April 2017. RESULTS A total of 16 patients were included, at a median age of 12.0 (5.5-17.5) years. The indications of oral calcium load were: presence of an active urolithiasis without any obvious explanation after ruling out the "classical" biological abnormalities, or presence of hypercalciuria with stones composed of weddellite or carbapatite crystals. Among the 16 patients, 6 (38%) patients displayed absorptive hypercalciuria, 2 (12%) renal leak, 3 (19%) "unclassified" inadapted PTH, and 5 (31%) a normal calcium load test. The result of oral calcium load modified the clinical management in 14 (88%) patients, mainly based on the type of hypercalciuria. It allowed us to individualize nutritional advice: in patients with absorptive hypercalciuria, we proposed calcium intake within the lower normal range for age with dairy products not enriched with vitamin D, with the advice to avoid salt and calcium loads during evenings. Conversely, in patients with resorptive hypercalciuria, we proposed normal calcium intake for age. Showing the results of the calcium load is meaningful to patients and parents, and can be considered as an "educational" tool. DISCUSSION To the best of our knowledge, this study is the first to evaluate the interest of calcium load in children with nephrolithiasis in an era of routine PTH and 1-25-D assessment. Here, we demonstrate the feasibility and safety of oral calcium load in children, its interest to understand the underlying mechanisms of hypercalciuria, and its major interest as an "educational tool" for patients to explain them the underlying mechanisms and thus guide the therapeutic management using an individualized dietary approach. This study did not include many patients, but to the best of our knowledge, this is the first study evaluating and validating the feasibility of a safe and non-expensive diagnosis tool in pediatric hypercalciuria. CONCLUSION Oral calcium load is helpful to guide therapeutic adaptation in pediatrics using an individualized dietary approach.
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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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Biochemical Alterations in Patients with Oxalocalcic Lithiasis, the Influence of Sex, Age, and Body Mass Index. Nephrourol Mon 2020. [DOI: 10.5812/numonthly.103639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Urolithiasis is a disorder that has a high prevalence in the population. Also, lithiasic patients have biochemical alterations that predispose them to the formation of stones. The knowledge of these alterations may be useful for future preventive interventions. Objectives: The objectives were to describe the metabolic characteristics of patients with oxalocalcic lithiasis, identifying the most frequent biochemical alterations, and their variation with different demographic variables. In this way, we can prevent the formation of the lithiasis before it appears, instead of treating it once established. Methods: A descriptive cross-sectional study of serum and 24 hour-urine parameters in patients with oxalocalcic lithiasis was performed. The most frequent biochemical alterations were described, and their association with age, sex, and body mass index (BMI) were assessed. Results: In this study, 100% of the 151 patients had biochemical alterations, the most frequent being hypocitraturia (84.7%), hypercalciuria (51.7%), and urinary pH decrease (44.4%). There were differences according to sex, age, and BMI with regard to the biochemical alterations. Hypouricemia, hypouricosuria, hypophosphaturia and hypomagnesuria were more frequent in women. Men had a higher percentage of hyperzinquemia, hyperphosphaturia, and excess of urinary urea. Urine density in men was slightly higher than in women. A higher percentage of hyperphosphaturia, excess urinary urea, and excess of serum urea was found in overweight patients. Patients not overweight showed a higher percentage of hypouricemia and hypomagnesuria. Urinary density was slightly higher in overweight patients. Urinary volume was higher in middle-aged subjects. Conclusions: Patients with oxalocalcic lithiasis have biochemical alterations that may predispose to stone formation. These alterations vary with sex, age, and BMI.
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37
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Roger C, Abid N, Dubourg L, Auvergnon C, Lemoine S, Machon C. Composition of urinary calculi: Lessons from a French epidemiologic retrospective study. Prog Urol 2020; 30:339-345. [PMID: 32312624 DOI: 10.1016/j.purol.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Urolithiasis is a common urological disease whose incidence increases in developed countries. We studied relations between composition of urinary calculi, age and gender. MATERIAL An epidemiologic study was conducted in a French population of patients encountered analysis of urinary calculi between 2013 and 2017. This retrospective cohort study was performed from urinary calculi samples analysed in a clinical biochemistry laboratory of University Hospital of Lyon in France. A total of 5782 samples were included. Data, according to stone composition, presence of a papillary umbilication and a Randall's plaque, age and gender, were investigated. Statistical analyses used the Chi2 test (R software). RESULTS The overall male to female sex ratio was equal to 1.76. The average and the median of age were 52.1 and 53.0 years, respectively. Whewellite was the most frequent main component in our population (44.4%). Carbapatite, weddellite and uric acid represented the main component in 14.0%, 13.4% and 13.0% of samples, respectively. Differences between genders were shown. Whewellite and uric acid were more frequent in men (P<0.001), while carbapatite and struvite were predominant in women (P<0.001). CONCLUSIONS Our study provided recent data on the composition of urinary calculi in a French population and the relations between composition of urinary calculi and age and gender. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- C Roger
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - N Abid
- Service d'urologie, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - L Dubourg
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Auvergnon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - S Lemoine
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Machon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France.
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Ye Z, Zeng G, Yang H, Li J, Tang K, Wang G, Wang S, Yu Y, Wang Y, Zhang T, Long Y, Li W, Wang C, Wang W, Gao S, Shan Y, Huang X, Bai Z, Lin X, Cheng Y, Wang Q, Xu Z, Xie L, Yuan J, Ren S, Fan Y, Pan T, Wang J, Li X, Chen X, Gu X, Sun Z, Xiao K, Jia J, Zhang Q, Wang G, Sun T, Li X, Xu C, Xu C, Shi G, He J, Song L, Sun G, Wang D, Liu Y, Wang C, Han Y, Liang P, Wang Z, He W, Chen Z, Xing J, Xu H. The status and characteristics of urinary stone composition in China. BJU Int 2020; 125:801-809. [PMID: 30958622 DOI: 10.1111/bju.14765] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore characteristics of urinary stone composition in China, and determine the effects of gender, age, body mass index (BMI), stone location, and geographical region on stone composition. PATIENTS AND METHODS We prospectively used Fourier-transform infrared spectroscopy to analyse stones from consecutive patients presenting with new-onset urolithiasis at 46 hospitals in seven geographical areas of China, between 1 June 2010 and 31 May 2015. Chi-squared tests and logistic regression analyses were used to determine associations between stone composition and gender, age, BMI, stone location, and geographical region. RESULTS The most common stone constituents were: calcium oxalate (CaOx; 65.9%), carbapatite (15.6%), urate (12.4%), struvite (2.7%), and brushite (1.7%). CaOx and urate stones occurred more frequently in males, whereas carbapatite and struvite were more common in females (P < 0.01). CaOx and carbapatite were more common in those aged 30-50 and 20-40 years than in other groups. Brushite and struvite were most common amongst those aged <20 and >70 years. The detection rate of urate increased with age, whilst cystine decreased with age. Obese patients were more likely to have urate stones than carbapatite or brushite stones (P < 0.01). CaOx, carbapatite, brushite, and cystine stones were more frequently found in the kidney than other types, whereas urate and struvite were more frequent in the bladder (P < 0.01). Stone composition varied by geographical region. CONCLUSIONS The most common stone composition was CaOx, followed by carbapatite, urate, struvite, and brushite. Stone composition differed significantly in patients grouped by gender, age, BMI, stone location, and geographical region.
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Affiliation(s)
- Zhangqun Ye
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huan Yang
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Jianxin Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Kun Tang
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Guomin Wang
- Department of Urology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Shusheng Wang
- Department of Urology, GuangDong Province Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yonggang Yu
- Department of Urology, The No. 181 Hospital of the People's Liberation Army, Guilin, China
| | - Yujie Wang
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tao Zhang
- Department of Urology, The No. 5 Hospital of the People's Liberation Army, Yinchuan, China
| | - Yongfu Long
- Department of Urology, Shaoyang Central Hospital, Shaoyang, China
| | - Weibin Li
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Changmin Wang
- Department of Laboratory, The People's Hospital of Xinjiang Autonomous Region, Urumqi, China
| | - Wei Wang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Sihe Gao
- Department of Urology, Gaomi City Hospital of Traditional Chinese Medicine, Gaomi, China
| | - Yuxi Shan
- Department of Urology, The Second Hospital of Suzhou University Medical School, Suzhou, China
| | - Xiaobo Huang
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Zhiming Bai
- Department of Urology, Haikou People's Hospital, Haikou, China
| | - Xiaohan Lin
- Department of Urology, The Second Hospital of Xiamen City, Xiamen, China
| | - Yue Cheng
- Department of Urology, The First People's Hospital of Ningbo City, Ningbo University Medical School, Ningbo, China
| | - Qinzhang Wang
- Department of Urology, The First Affiliated Hospital of Shihezi University Medical School, Shihezi, China
| | - Zhuoqun Xu
- Department of Urology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Liping Xie
- Department of Urology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital of the Fourth Military Medical University, Xi'an, China
| | - Shengqiang Ren
- Department of Urology, The No. 113 Hospital of the People's Liberation Army, Ningbo, China
| | - Yuhui Fan
- Department of Urology, Xi'an Gaoxin Hospital, Xi'an, China
| | - Tiejun Pan
- Department of Urology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, China
| | - Jing Wang
- Department of Urology, The First People's Hospital of Changshu City, Changshu, China
| | - Xun Li
- Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuehua Chen
- Department of Urology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Xiaojian Gu
- Department of Urology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Zhaolin Sun
- Department of Urology, The People's Hospital of Guizhou Province, Guiyang, China
| | - Kefeng Xiao
- Department of Urology, The People's Hospital of Shenzhen City, Shenzhen, China
| | - Jianye Jia
- Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinghua Zhang
- Department of Urology, Taizhou Municipal Hospital, Taizhou, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xuedong Li
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Changbao Xu
- Department of Urology, The Second Affiliated Hospital of Zhengzhou University Medical School, Zhengzhou, China
| | - Chuangliang Xu
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Guowei Shi
- Department of Urology, The Fifth People's Hospital of Shanghai City, Shanghai, China
| | - Jiayang He
- Department of Urology, The Fifth People's Hospital of Shanghai City, Shanghai, China
| | - Leming Song
- Department of Urology, Ganzhou People's Hospital, Ganzhou, China
| | - Guang Sun
- Department of Urology, The Second Affiliated Hospital of Tianjin Medical University, Tianjin, China
| | - Dongwen Wang
- Department of Urology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, China
| | - Yili Liu
- Department of Urology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Chunxi Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Yi Han
- Department of Urology, Shenyang Red-Cross Hospital, Shenyang, China
| | - Peiyu Liang
- Department of Urology, The Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Zhiping Wang
- Department of Urology, The Second Hospital of Lanzhou University Medical School, Lanzhou, China
| | - Wei He
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Jinchun Xing
- Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hua Xu
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
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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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Bouderlique E, Tang E, Perez J, Coudert A, Bazin D, Verpont MC, Duranton C, Rubera I, Haymann JP, Leftheriotis G, Martin L, Daudon M, Letavernier E. Vitamin D and Calcium Supplementation Accelerates Randall's Plaque Formation in a Murine Model. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 189:2171-2180. [PMID: 31449775 DOI: 10.1016/j.ajpath.2019.07.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/28/2019] [Accepted: 07/26/2019] [Indexed: 11/27/2022]
Abstract
Most kidney stones are made of calcium oxalate crystals. Randall's plaque, an apatite deposit at the tip of the renal papilla, is considered to at the origin of these stones. Hypercalciuria may promote Randall's plaque formation and growth. We analyzed whether long-term exposure of Abcc6-/- mice (a murine model of Randall's plaque) to vitamin D supplementation, with or without a calcium-rich diet, would accelerate the formation of Randall's plaque. Eight groups of mice (including Abcc6-/- and wild type) received vitamin D alone (100,000 UI/kg every 2 weeks), a calcium-enriched diet alone (calcium gluconate 2 g/L in drinking water), both vitamin D supplementation and a calcium-rich diet, or a standard diet (controls) for 6 months. Kidney calcifications were assessed by 3-dimensional microcomputed tomography, μ-Fourier transform infrared spectroscopy, field emission-scanning electron microscopy, transmission electron microscopy, and Yasue staining. At 6 months, Abcc6-/- mice exposed to vitamin D and calcium supplementation developed massive Randall's plaque when compared with control Abcc6-/- mice (P < 0.01). Wild-type animals did not develop significant calcifications when exposed to vitamin D. Combined administration of vitamin D and calcium significantly accelerates Randall's plaque formation in a murine model. This original model raises concerns about the cumulative risk of vitamin D supplementation and calcium intakes in Randall's plaque formation.
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Affiliation(s)
- Elise Bouderlique
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Ellie Tang
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Joëlle Perez
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Amélie Coudert
- Unité de Formation et de Recherche d'Odontologie, Département des Sciences Biologiques, Université Paris Diderot BIologie de l'Os et du CARtilage (BIOSCAR), INSERM U1132, Hôpital Lariboisière, Paris, France
| | - Dominique Bazin
- Laboratoire de Chimie Physique, Centre National de la Recherche-Unité Mixte de Recherche 8000, Université Paris XI, Orsay, France
| | - Marie-Christine Verpont
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Christophe Duranton
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Isabelle Rubera
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Jean-Philippe Haymann
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Georges Leftheriotis
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France; Laboratory of Physiology and Molecular Medicine, Centre National de la Recherche-Université Nice Sophia-Antipolis Unité Mixte de Recherche 7370, University of Nice, Nice Cedex 2, France
| | - Ludovic Martin
- Physiopathologie MITOchondriale et cardioVASCulaire (MITOVASC) Institute, Centre National de la Recherche-Unité Mixte de Recherche 6015, INSERM U1083, Angers University, Angers, France; Pseudoxanthoma Elasticum Reference Center, Reference Centre for Genetic Dermatologic Diseases Nord Center for Rare Skin Diseases, Angers University Hospital, Angers, France
| | - Michel Daudon
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Emmanuel Letavernier
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France.
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Performance of a Natural Language Processing Method to Extract Stone Composition From the Electronic Health Record. Urology 2019; 132:56-62. [PMID: 31310771 DOI: 10.1016/j.urology.2019.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To demonstrate the utility of a natural language processing (NLP) algorithm for mining kidney stone composition in a large-scale electronic health records (EHR) repository. METHODS We developed StoneX, a pattern-matching method for extracting kidney stone composition information from clinical notes. We trained the extraction algorithm on manually annotated text mentions of calcium oxalate monohydrate, calcium oxalate dihydrate, hydroxyapatite, brushite, uric acid, and struvite stones. We employed StoneX to identify patients with kidney stone composition data and mine >125 million notes from our institutional EHR. Analyses performed on the extracted patients included stone type conversions over time, survival analysis from a second stone surgery, and disease associations by stone composition to validate the phenotyping method against known associations. RESULTS The NLP algorithm identified 45,235 text mentions corresponding to 11,585 patients. Overall, the system achieved positive predictive value >90% for calcium oxalate monohydrate, calcium oxalate dihydrate, hydroxyapatite, brushite, and struvite; except for uric acid (positive predictive value = 87.5%). Survival analysis from a second stone surgery showed statistically significant differences among stone types (P = .03). Several phenotype associations were found: uric acid-type 2 diabetes (odds ratio, OR = 2.69, 95% confidence intervals, CI = 1.91-3.79), struvite-neurogenic bladder (OR = 12.27, 95% CI = 4.33-34.79), struvite-urinary tract infection (OR = 7.36, 95% CI = 3.01-17.99), hydroxyapatite-pulmonary collapse (OR = 3.67, 95% CI = 2.10-6.42), hydroxyapatite-neurogenic bladder (OR = 5.23, 95% CI = 2.05-13.36), brushite-calcium metabolism disorder (OR = 4.59, 95% CI = 2.14-9.81), and brushite-hypercalcemia (OR = 4.09, 95% CI = 1.90-8.80). CONCLUSION NLP extraction of kidney stone composition from large-scale EHRs is feasible with high precision, enabling high-throughput epidemiological studies of kidney stone disease. These tools will enable high fidelity kidney stone research from the EHR.
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Bayne DB, Usawachintachit M, Armas-Phan M, Tzou DT, Wiener S, Brown TT, Stoller M, Chi TL. Influence of Socioeconomic Factors on Stone Burden at Presentation to Tertiary Referral Center: Data From the Registry for Stones of the Kidney and Ureter. Urology 2019; 131:57-63. [PMID: 31132427 DOI: 10.1016/j.urology.2019.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/07/2019] [Accepted: 05/16/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To determine social factors associated with advanced stone disease (defined as unilateral stone burden >2 cm) at time of presentation to a regional stone referral center. Little is known about social determinants of urolithiasis. We hypothesize that socioeconomic factors impact kidney stone severity at intake to referral centers. METHODS A retrospective review of the prospectively collected data from the Registry for Stones of the Kidney and Ureter from 2015 to 2018 was conducted to evaluate patient characteristics predictive of having a large (>2 cm) unilateral kidney stone. Data on patient age, gender, body mass index, diabetes, race, language, education level, infection, distance, income, referring regional urologist density, American Society of Anesthesiologists score, and stone analysis were evaluated. RESULTS Complete imaging and patient variable data was present in 650 of 1142 patients including 197 patients with unilateral stone burden >2 cm. On multivariate analysis, obesity, lower education level, increased distance from the referral center, and symptoms of infection predicted for unilateral stone burden greater than 2 cm. Among 191 patients with stone analysis data present, stone type, income, and urologist density predicted for unilateral stone burden greater than 2 cm. CONCLUSION In addition to known biological risk factors, patients with lower education levels and from regions of lower mean income were found to be more likely to present to our tertiary care center with stone burden greater than 2 cm. More research is needed to elucidate the social and societal determinants of advanced stone disease and the impact this has on population costs for stone treatment.
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Affiliation(s)
- David B Bayne
- University of California San Francisco, Urology, San Francisco, CA.
| | | | | | - David T Tzou
- University of Arizona College of Medicine, Tucson, AZ
| | - Scott Wiener
- University of California San Francisco, Urology, San Francisco, CA
| | - Timothy T Brown
- University of California, Berkeley, School of Public Health, Berkeley, CA
| | - Marshall Stoller
- University of California San Francisco, Urology, San Francisco, CA
| | - Thomas L Chi
- University of California San Francisco, Urology, San Francisco, CA
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Abstract
PURPOSE OF REVIEW The link between metabolic syndrome (MetS)/obesity and kidney stone disease (KSD) has gained importance over recent years due to the increasing prevalence and healthcare burden worldwide. This review analyses the literature exploring the link between MetS/obesity and KSD and the impact that obesity has on KSD management. RECENT FINDINGS Metabolic syndrome has been shown to increase an individual's risk of developing kidney stone disease, with insulin resistance forming a core component of the pathophysiology. The body habitus of an individual also influences the type of intervention that is most appropriate, with flexible ureteroscopy increasingly being the preferred option in obese patients. It is important for urologists to consider the features of metabolic syndrome to effectively manage episodes of KSD in obese patients. In addition, better quality evidence is required to effectively compare different treatment options in this group of patients.
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Menezes CJ, Worcester EM, Coe FL, Asplin J, Bergsland KJ, Ko B. Mechanisms for falling urine pH with age in stone formers. Am J Physiol Renal Physiol 2019; 317:F65-F72. [PMID: 31017011 DOI: 10.1152/ajprenal.00066.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
One of the main functions of the kidney is to excrete an acid load derived from both dietary and endogenous sources, thus maintaining the pH of other fluids in the body. Urine pH is also of particular interest in stone formers, since it determines the presence of either calcium phosphate or uric acid content in stones. Others have noted in epidemiological studies a rise in incidence of low pH-dependent uric acid stones with age, coinciding with a decrease in the incidence of high pH-dependent phosphate stones. Taken together, these trends are suggestive of a longitudinal decline in urine pH in stone-forming patients, and, if true, this could explain the observed trends in stone incidence. We studied 7,891 stone formers, all of whom collected a 24-h urine sample and matching serum. Multivariate modeling revealed that urine pH did indeed fall with age and particularly between the ages of 20 and 50 yr old in both men and women. We sought to explain this trend through the inclusion of traditionally understood determinants of urine pH such as urinary buffers, estimates of glomerular filtration, and dietary acid load, but these, taken together, accounted for but a small fraction of the pH fall. Gastrointestinal anion absorption was the strongest predictor of urine pH in all age groups, as we have previously reported in middle-aged normal men and women. However, we found that, despite a decreasing urine pH, gastrointestinal anion absorption increased monotonically with age. In fact, after adjustment for gastrointestinal anion absorption, urine pH declined more markedly, suggesting that bicarbonate-producing anion absorption is regulated in a manner that offsets the decline of urine pH.
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Affiliation(s)
- Cameron J Menezes
- Department of Medicine, University of Chicago Medicine , Chicago, Illinois
| | - Elaine M Worcester
- Department of Medicine, University of Chicago Medicine , Chicago, Illinois
| | - Fredric L Coe
- Department of Medicine, University of Chicago Medicine , Chicago, Illinois
| | - John Asplin
- Litholink, Laboratory Corporation of America Holdings , Chicago, Illinois
| | | | - Benjamin Ko
- Department of Medicine, University of Chicago Medicine , Chicago, Illinois
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Zhang J, Wang L, Putnis CV. Underlying Role of Brushite in Pathological Mineralization of Hydroxyapatite. J Phys Chem B 2019; 123:2874-2881. [PMID: 30840456 DOI: 10.1021/acs.jpcb.9b00728] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The majority of human kidney stones are composed of multiple calcium oxalate crystals with variable amounts of brushite [dicalcium phosphate dihydrate (DCPD)] and hydroxyapatite (HAP) as a nucleus, in which fluid-mediated dissolution and reprecipitation may result in the phase transformation of DCPD to HAP. However, the underlying mechanisms of the phase transition and its modulation by natural inhibitors, such as osteopontin (OPN) proteins, remain poorly understood. Here, the in vitro formation of new phases on the DCPD (010) surface is observed in situ using atomic force microscopy in a simulated hypercalciuria milieu. We demonstrate the presence of an acidic amorphous calcium phosphate (ACP) phase with a characteristic Raman band of ν1HPO42- and the octacalcium phosphate (OCP)-like phase during the transformation process. High-resolution transmission electron microscopy analyses also confirm the existence of OCP and HAP within an amorphous matrix phase. In support of clinical observations, we further demonstrate the inhibitory effect of OPN peptide segments on the dissolution of DCPD and reprecipitation of acidic ACP. The definition of respective roles of DCPD and OPN thereby provides insights into the control of nucleus formation and subsequent inhibition of pathological mineralization.
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Affiliation(s)
- Jing Zhang
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Lijun Wang
- College of Resources and Environment , Huazhong Agricultural University , Wuhan 430070 , China
| | - Christine V Putnis
- Institut für Mineralogie , University of Münster , Münster 48149 , Germany.,Department of Chemistry , Curtin University , Perth 6845 , Australia
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Keller EX, De Coninck V, Audouin M, Doizi S, Daudon M, Traxer O. Stone composition independently predicts stone size in 18,029 spontaneously passed stones. World J Urol 2019; 37:2493-2499. [DOI: 10.1007/s00345-018-02627-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/31/2018] [Indexed: 01/30/2023] Open
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Daily Green Tea Infusions in Hypercalciuric Renal Stone Patients: No Evidence for Increased Stone Risk Factors or Oxalate-Dependent Stones. Nutrients 2019; 11:nu11020256. [PMID: 30678344 PMCID: PMC6412450 DOI: 10.3390/nu11020256] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 12/12/2022] Open
Abstract
Green tea is widely used as a ‘’healthy’’ beverage due to its high level of antioxidant polyphenol compounds. However tea is also known to contain significant amount of oxalate. The objective was to determine, in a cross-sectional observational study among a population of 273 hypercalciuric stone-formers referred to our center for metabolic evaluation, whether daily green tea drinkers (n = 41) experienced increased stone risk factors (especially for oxalate) compared to non-drinkers. Stone risk factors and stone composition were analyzed according to green tea status and sex. In 24-h urine collection, the comparison between green tea drinkers and non-drinkers showed no difference for stone risk factors such as urine oxalate, calcium, urate, citrate, and pH. In females, the prevalence of calcium oxalate dihydrate (COD) and calcium phosphate stones, assessed by infrared analysis (IRS) was similar between green tea drinkers and non-drinkers, whereas prevalence of calcium oxalate monohydrate (COM) stones was strikingly decreased in green tea drinkers (0% vs. 42%, p = 0.04), with data in accordance with a decreased oxalate supersaturation index. In males, stone composition and supersaturation indexes were similar between the two groups. Our data show no evidence for increased stone risk factors or oxalate-dependent stones in daily green tea drinkers.
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Schwaderer AL, Raina R, Khare A, Safadi F, Moe SM, Kusumi K. Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex. Front Pediatr 2019; 7:32. [PMID: 30809514 PMCID: PMC6379338 DOI: 10.3389/fped.2019.00032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Urinary stones are affecting more children, and pediatric stone formers have unique pathophysiology compared to adults. While adult stone formers are most frequently male, children have an age dependent sex prevalence. Under 10 years, a majority of stone formers are boys; adolescent stone formers are mostly female. Previous adult studies have shown that stone composition is influenced by the sex and age of the stone former. Thus, we hypothesize that female and male stone forming children will also have sex and age specific stone phenotypes. Methods: Retrospective chart review of a large pediatric center's stone forming children 6/1/2009 to 6/1/2016. Patients were identified by ICD 9 codes: N20, N20.1, and N20.9. Charts were reviewed for radiographic evidence of stones or documented visualized stone passage. Results: One hundred and thirty six subjects: 54 males and 82 females. Females were older, median age 14 years [interquartile range (IQR): 11, 15] vs. males' median age 12 years (IQR: 11, 14) (p < 0.01). Females had lower height z-scores, median 0.2 (IQR: -0.8, 0.8) vs. males' median 0.8 (IQR: -0.2, 1.8) (p < 0.01). Presenting symptoms were similar except flank pain affecting 39% of females vs. 22% of males (p = 0.04). Leukocyte esterase was positive in more females than males (33 vs. 4%) (p < 0.001). Males had a higher BUN/Cr ratio, mean ± standard deviation of 19.8 ± 6.3 vs. 16.6 ± 6.5 in females (p = 0.01). Glomerular hyperfiltration was present in 9% of patients while 35% of patients had estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m2. Treatment strategies and clinical course were similar except females were told to increase dietary citrate more frequently than males (21 vs. 4%) (p < 0.01). Conclusion: We have provided a novel analysis and demonstrated that low height z-score and pyuria are more common in female stone formers. We have also shown that 9% of pediatric stone formers have labs consistent with hyperfiltration. Whether high protein intake and/or chronic dehydration are associated with hyperfiltration and long-term renal function in children with kidney stones will be an area for future research.
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Affiliation(s)
- Andrew L Schwaderer
- Division of Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rupesh Raina
- Division of Nephrology, Akron Children's Hospital, Akron, OH, United States
| | - Anshika Khare
- Northeast Ohio Medical University, Rootstown, OH, United States
| | - Fayez Safadi
- Northeast Ohio Medical University, Rootstown, OH, United States
| | - Sharon M Moe
- Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kirsten Kusumi
- Division of Nephrology, Akron Children's Hospital, Akron, OH, United States.,Northeast Ohio Medical University, Rootstown, OH, United States
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Ma RH, Luo XB, Li Q, Zhong HQ. Systemic analysis of urinary stones from the Northern, Eastern, Central, Southern and Southwest China by a multi-center study. BMC Urol 2018; 18:114. [PMID: 30545321 PMCID: PMC6293513 DOI: 10.1186/s12894-018-0428-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/29/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To provide some basis for the prevention of urinary stones in general population, we did a systemic analysis of urinary stones from Northern, Eastern, Central, Southern and Southwest China by a multi-center study. METHODS A total of 11,157 urinary stones from Northern, Eastern, Central, Southern and Southwest China were obtained and analyzed by Fourier transform infrared spectroscopy. Combined with scanning electron microscopy and X-ray energy spectrometer, urinary stones were classified into different types. Furthermore, the correlation between stone types and clinical characteristics, as well as their regional distribution were elucidated. RESULTS Calcium oxalate stones were the most common type in each region, followed by calcium oxalate-calcium phosphate mixed stones, uric acid stones and calcium phosphate stones. The distribution of calcium oxalate stones were highest prevalence in Southwest China (67.9%, P < 0.05), followed by Eastern and Northern China. Anhydrous uric acid stones, with a constituent ratio of 19.3% in Southern China, and 13.7% in Central China, were significantly higher than that in other regions (P < 0.05). Elements analysis indicated varieties among stone types as well as distribution regions. Moreover, the clinical characteristics were highly correlated with stone types and anatomical locations but not their distribution regions. CONCLUSIONS The material and elements composition of urinary stones among different regions showed some varieties. Calcium oxalate stone has the highest constituent ratio in Southwest China, while anhydrous uric acid stone has the highest constituent ratio in Southern China. Moreover, the clinical characteristics were highly correlated with stone types and anatomical locations but not their distribution regions.
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Affiliation(s)
- Rui-Hong Ma
- The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Xingye Road No. 7, Dagang Town, Nansha, Guangzhou, 511470, People's Republic of China.
| | - Xiao-Bing Luo
- The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Xingye Road No. 7, Dagang Town, Nansha, Guangzhou, 511470, People's Republic of China
| | - Qin Li
- The Department of Pulmonary, Critical Care and Sleep, Yale School of Medicine, New Haven, USA
| | - Hai-Qiang Zhong
- The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Xingye Road No. 7, Dagang Town, Nansha, Guangzhou, 511470, People's Republic of China
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