1
|
Zhu S, Wang Q, Sun F, Jiang K. Baicalin attenuated oxidative stress and inflammation in ethylene glycol-induced urolithiasis in adult male SD rats. Tissue Cell 2024; 89:102453. [PMID: 38964085 DOI: 10.1016/j.tice.2024.102453] [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: 04/04/2024] [Revised: 06/15/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
AIMS Baicalin is a flavonoid derived from the root of the medicinal plant Scutellaria baicalensis Georgi (S. baicalensis) and is known for its various pharmacological properties. This study aimed to investigate the impact of baicalin (BAI) on the occurrence of kidney calcium oxalate crystal formation induced by ethylene glycol in male SD rats. MAIN METHODS A rat model of renal stones was created and various concentrations of baicalin were used for intervention. Samples of urine, blood, and kidney tissue were taken from the rats, and they were euthanized for biochemical and histopathological examinations. KEY FINDINGS Our results show that baicalin treatment improved the weight loss induced by ethylene glycol (EG) and ammonium chloride (AC) in rats. Baicalin also reduced the formation of calcium oxalate crystals and protected kidney function in rats with urolithiasis. Furthermore, it lowered the level of malondialdehyde (MDA) and elevated the activity of antioxidant enzymes compared to the stone control group. Additionally, baicalin notably alleviated renal inflammation in rats with urolithiasis. SIGNIFICANCE The present study attributed clinical evidence first time that claiming the significant antiurolithic effect of baicalin and could be a cost-effective candidate for the prevention and treatment of urolithiasis.
Collapse
Affiliation(s)
- Siqi Zhu
- Guizhou Medical University, Guiyang, Guizhou 550004, China; Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, China
| | - Qing Wang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, China
| | - Fa Sun
- Guizhou Medical University, Guiyang, Guizhou 550004, China; Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, China.
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, China.
| |
Collapse
|
2
|
Noonin C, Thongboonkerd V. Beneficial roles of gastrointestinal and urinary microbiomes in kidney stone prevention via their oxalate-degrading ability and beyond. Microbiol Res 2024; 282:127663. [PMID: 38422861 DOI: 10.1016/j.micres.2024.127663] [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: 11/17/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Formation of calcium oxalate (CaOx) crystal, the most common composition in kidney stones, occurs following supersaturation of calcium and oxalate ions in the urine. In addition to endogenous source, another main source of calcium and oxalate ions is dietary intake. In the intestinal lumen, calcium can bind with oxalate to form precipitates to be eliminated with feces. High intake of oxalate-rich foods, inappropriate amount of daily calcium intake, defective intestinal transporters for oxalate secretion and absorption, and gastrointestinal (GI) malabsorption (i.e., from gastric bypass surgery) can enhance intestinal oxalate absorption, thereby increasing urinary oxalate level and risk of kidney stone disease (KSD). The GI microbiome rich with oxalate-degrading bacteria can reduce intestinal oxalate absorption and urinary oxalate level. In addition to the oxalate-degrading ability, the GI microbiome also affects expression of oxalate transporters and net intestinal oxalate transport, cholesterol level, and short-chain fatty acids (SCFAs) production, leading to lower KSD risk. Recent evidence also shows beneficial effects of urinary microbiome in KSD prevention. This review summarizes the current knowledge on the aforementioned aspects. Potential benefits of the GI and urinary microbiomes as probiotics for KSD prevention are emphasized. Finally, challenges and future perspectives of probiotic treatment in KSD are discussed.
Collapse
Affiliation(s)
- Chadanat Noonin
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
| |
Collapse
|
3
|
Wang X, Wang Q. Current Dietary and Medical Prevention of Renal Calcium Oxalate Stones. Int J Gen Med 2024; 17:1635-1649. [PMID: 38706742 PMCID: PMC11067920 DOI: 10.2147/ijgm.s459155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
Kidney stones refer to abnormal crystal formation that occurs in the kidney. Among a variety of components of kidney stones, calcium oxalate (CaOx) is the most common type. Despite many efforts to investigate the pathogenesis of CaOx stones, the pathogenesis remains an issue of debate. With high occurrence and recurrence, individuals with stone formation are prone to frequently consult a doctor and to be hospitalized, and the treatment of kidney stones poses a heavy burden on the patients. Concerns should be focused not only on treatment but also on prevention. Herein, we reviewed the studies on prevention methods of CaOx stones through diet, lifestyle, and medication extending until the current time frame. As hyperoxaluria is the most common metabolic disorder among CaOx stone formations, we also included several studies on the treatment and prevention of hyperoxaluria. Our objective was to outline the effective methods to prevent renal CaOx stone formation.
Collapse
Affiliation(s)
- Xiaodong Wang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Qing Wang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| |
Collapse
|
4
|
Hong Y, Yu L, Huang X, An L, Xiong L, Xu Q, Xu T. Composition analysis of renal and ureteral calculi in a single center in northern China in the past decade. Medicine (Baltimore) 2024; 103:e37374. [PMID: 38457575 PMCID: PMC10919492 DOI: 10.1097/md.0000000000037374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 03/10/2024] Open
Abstract
The current report aimed to evaluate the characteristics of stone composition in 3637 renal and ureteral calculi patients in a single center while clarifying its relationship with sex, age, and time. Out of 3637 cases of upper urinary tract stones, stone specimens were analyzed retrospectively. There were 2373 male patients aged 6 months-87 years, with an average age of 44.73 ± 15.63 years, and 1264 female patients aged 4 months-87 years, with an average age of 46.84 ± 16.00 years. The male-female ratio was 1.88:1. Five hundred twelve patients had ureteral calculi, and 3125 had renal calculi. The SPSS software helped analyze the relationship between renal and ureteral calculi composition and sex, age, and time. Stone composition demonstrated 2205 cases of calcium oxalate stones (60.6%), 518 carbonate apatite (14.2%), 386 uric acids (10.6%), 232 magnesium ammonium phosphate (6.4%), 117 calcium phosphate (3.2%), 76 cystine (2.1%), 47 sodium urate (1.3%), 31 others (0.9%), and 25 ammonium urate (0.7%) cases. The overall male-to-female sex ratio was 1.88:1. Stones in the upper urinary tract were significantly more frequent in men than in women between the ages of 31 and 60. However, such stones were significantly more frequent in women than men over 80 (P < .05). Cystine, Sodium urate, Carbonated apatite, and uric acid indicated significant differences between different age categories (all P < .001). Stone composition analyses revealed that the frequency of calcium oxalate calculi has increased annually, while cystine and carbonated apatite incidences have dropped annually over the past decade. The components of renal and ureteral calculi vary significantly based on age and sex, with calcium oxalate calculi being more frequent in men while magnesium ammonium phosphate stones are more frequent in female patients. The age between 31 and 60 years is the most prevalent for renal and ureteral calculi in men and women.
Collapse
Affiliation(s)
- Yang Hong
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Luping Yu
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Xiaobo Huang
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Lizhe An
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Liulin Xiong
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Qingquan Xu
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| | - Tao Xu
- The Department of Urology, Peking University People’s Hospital, BeiJing, China
- Peking University applied Lithotripsy Institute, BeiJing, China
| |
Collapse
|
5
|
Wang X, Zhang X, Wang L, Zhang R, Zhang Y, Cao L. Purslane-induced oxalate nephropathy: case report and literature review. BMC Nephrol 2023; 24:207. [PMID: 37443012 PMCID: PMC10347717 DOI: 10.1186/s12882-023-03236-9] [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: 09/24/2022] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The kidney is particularly vulnerable to toxins due to its abundant blood supply, active tubular reabsorption, and medullary interstitial concentration. Currently, calcium phosphate-induced and calcium oxalate-induced nephropathies are the most common crystalline nephropathies. Hyperoxaluria may lead to kidney stones and progressive kidney disease due to calcium oxalate deposition leading to oxalate nephropathy. Hyperoxaluria can be primary or secondary. Primary hyperoxaluria is an autosomal recessive disease that usually develops in childhood, whereas secondary hyperoxaluria is observed following excessive oxalate intake or reduced excretion, with no difference in age of onset. Oxalate nephropathy may be overlooked, and the diagnosis is often delayed or missed owning to the physician's inadequate awareness of its etiology and pathogenesis. Herein, we discuss the pathogenesis of hyperoxaluria with two case reports, and our report may be helpful to make appropriate treatment plans in clinical settings in the future. CASE PRESENTATION We report two cases of acute kidney injury, which were considered to be due to oxalate nephropathy in the setting of purslane (portulaca oleracea) ingestion. The two patients were elderly and presented with oliguria, nausea, vomiting, and clinical manifestations of acute kidney injury requiring renal replacement therapy. One patient underwent an ultrasound-guided renal biopsy, which showed acute tubulointerstitial injury and partial tubular oxalate deposition. Both patients underwent hemodialysis and were discharged following improvement in creatinine levels. CONCLUSIONS Our report illustrates two cases of acute oxalate nephropathy in the setting of high dietary consumption of purslane. If a renal biopsy shows calcium oxalate crystals and acute tubular injury, oxalate nephropathy should be considered and the secondary causes of hyperoxaluria should be eliminated.
Collapse
Affiliation(s)
- Xiangtuo Wang
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China.
| | - Xiaoyan Zhang
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China
| | - Liyuan Wang
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China
| | - Ruiying Zhang
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China
| | - Yingxuan Zhang
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China
| | - Lei Cao
- Department of Nephrology, Harrison International Peace Hospital, Renmin Road, Hengshui, 053000, Hebei Province, People's Republic of China.
| |
Collapse
|
6
|
Aziz F, Jorgenson M, Garg N. Secondary oxalate nephropathy and kidney transplantation. Curr Opin Organ Transplant 2023; 28:15-21. [PMID: 36342385 DOI: 10.1097/mot.0000000000001035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Secondary hyperoxaluria is associated with poor kidney allograft outcomes after the kidney transplant. Calcium oxalate (CaOx) deposition is common in early allograft biopsies leading to acute tubular necrosis and poor kidney allograft function. Though treatment options for secondary hyperoxaluria are limited, it is crucial to identify patients at increased risk of oxalate nephropathy after the transplant. RECENT FINDINGS Recent data suggest that significant changes in renal replacement therapies and dietary modifications in high-risk patients can prevent kidney allograft damage from the calcium oxalate deposition leading to improve allograft outcomes. SUMMARY The accurate and timely diagnosis of secondary oxalate nephropathy in kidney transplant recipients is paramount to preserving graft function in the long-term. This review will discuss the incidence, risk factors, prevention, and management of oxalate nephropathy in the kidney allograft.
Collapse
Affiliation(s)
- Fahad Aziz
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health
| | - Margaret Jorgenson
- Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA
| | - Neetika Garg
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health
| |
Collapse
|
7
|
Fluid intake recommendations in urolithiasis and general advice to patients without metabolic risk factors. World J Urol 2023; 41:1251-1259. [PMID: 36692534 DOI: 10.1007/s00345-023-04285-3] [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: 12/04/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
Urolithiasis is a highly prevalent global disease with substantially increasing incidence in the last two decades. Data from the literature suggests that 26%-50% of patients will have a recurrence within 10 years after an initial symptomatic stone episode. Therefore, interest has been raised in preventive strategies, aiming to modify the risk factors of stone recurrence by implementing dietary and lifestyle changes and specific medical treatments for stone formers, depending on their recurrence risk factors. Certain dietary factors are thought to contribute significantly to the increased incidence of urolithiasis, particularly a diet low in fiber and high in animal protein, fat, and sodium. Fluid intake is perhaps the most important and modifiable step in the prevention of urolithiasis, irrespective of stone composition. However, the amount of fluid to be consumed and the implications of various fluid types on stone formation are still controversial. In this article, the relationship between fluid intake, beverage types and stone formation-prevention will be discussed. Moreover, general dietary recommendations for patients without metabolic risk factors will be reviewed based on the current literature.
Collapse
|
8
|
Nanjala C, Odago WO, Rono PC, Waswa EN, Mutinda ES, Oulo MA, Muema FW, Wanga VO, Mkala EM, Kuja J, Njire MM, Hu GW. A review on ethnobotany, phytochemistry, and pharmacology of the genus Didymocarpus wall. (Gesneriaceae). JOURNAL OF ETHNOPHARMACOLOGY 2022; 295:115404. [PMID: 35643208 DOI: 10.1016/j.jep.2022.115404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/15/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Medicinal plants have been extensively used to treat various illnesses since the dawn of civilization. The genus Didymorcapus Wall. comprises 100 species widely distributed in the tropical regions of Asia, with a few found scattered in Africa and Australia. Species in this genus have long been used in folk medicine to treat various illnesses, including wounds, kidney stones, inflammations, asthma, flu, eczema, dysentery, fractures, colic etc. Some species have applications as weight loss agents, laxatives, and protective medication after childbirth. AIM To provide comprehensive information on the current knowledge of the ethnobotanical uses, phytochemical compounds, pharmacological applications, and toxicology of genus Didymocarpus to reveal its therapeutic potential, offering insights into future research opportunities. MATERIALS AND METHODS Data were systematically obtained from books and online databases such as PubMed, Web of Science, Scopus, Sci Finder, Google Scholar, Science direct, ACS Publications, Elsevier, Wiley Online Library. RESULTS Seventeen Didymocarpus species have applications in traditional medicine in different Asian countries. A total of 166 compounds have been isolated from the genus Didymocarpus including terpenoids, flavonoids, phenolic compounds, fatty acids, chalcones, steroids, and others. Among these constituents, terpenoids, flavonoids, chalcones, and phenolics are the significant contributors to pharmacological activities of the genus Didymocarpus, possessing wide-reaching biological activities both in vivo and in vitro. The crude extracts and isolated phytochemical compounds from this genus have been shown to exhibit various pharmacological activities, including antiurolithiatic, nephro-protective, antimicrobial, anticancer, antidiabetic, cytotoxic, wound healing, and antioxidant activities. CONCLUSIONS Traditional uses and scientific evaluation of Didymocarpus indicate that Didymocarpus pedicellata is one of the most widely used species in some parts of the world. Although substantial progress on the chemical and pharmacological properties of Didymocarpus species has been made, further studies on the pharmacology and toxicology of these species are needed to ensure safety, efficacy, and quality. Also, further research on the structure-activity relationship of some of the isolated phytocompounds may improve their biological potency and scientific exploitation of traditional uses of the Didymocarpus taxa.
Collapse
Affiliation(s)
- Consolata Nanjala
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Wyclif Ochieng Odago
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Peninah Cheptoo Rono
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Emmanuel Nyongesa Waswa
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Elizabeth Syowai Mutinda
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Millicent Akinyi Oulo
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Felix Wambua Muema
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Vincent Okelo Wanga
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Elijah Mbandi Mkala
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Josiah Kuja
- Department of Biology, University of Copenhagen, Copenhagen, 101165, Denmark
| | - Moses Mucugi Njire
- Botany Department, Jomo Kenyatta University of Agriculture and Technology, 62 000 - 00200 Nairobi, Kenya
| | - Guang-Wan Hu
- CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture, Wuhan Botanical Garden, Chinese Academy of Sciences, Wuhan, 430074, China; Center of Conservation Biology, Core Botanical Gardens, Chinese Academy of Sciences, Wuhan, 430074, China; Sino-Africa Joint Research Center, Chinese Academy of Sciences, Wuhan, 430074, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
| |
Collapse
|
9
|
Nanjala C, Odago WO, Rono PC, Waswa EN, Mutinda ES, Oulo MA, Muema FW, Wanga VO, Mkala EM, Kuja J, Njire MM, Hu GW. A review on ethnobotany, phytochemistry, and pharmacology of the genus Didymocarpus wall. (Gesneriaceae). JOURNAL OF ETHNOPHARMACOLOGY 2022; 295:115404. [DOI: https:/doi.org/10.1016/j.jep.2022.115404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
|
10
|
The effects of drinking bicarbonate-rich mineral water in calcium oxalate stone formers: an open label prospective randomized controlled study in an Asian cohort. Int Urol Nephrol 2022; 54:2133-2140. [PMID: 35781772 DOI: 10.1007/s11255-022-03256-8] [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: 03/02/2022] [Accepted: 05/14/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To examine the effects of drinking bicarbonate-rich mineral water in patients with calcium oxalate stones. MATERIALS AND METHODS This was an open label prospective randomized controlled study comparing the effects of a bicarbonate-rich mineral water versus plain water on urine biochemistry in patients with calcium oxalate stones. The mineral water group were instructed to consume 1.25 L of mineral water per day at meal times, and supplemented by plain water. Their total intake was up to 3 L/day. Control group consumed only plain water up to 3 L/day. 24 h urine analyses were performed at baseline, 1, 4, 8 and 12 weeks after starting protocol. RESULTS 58 patients were recruited for the study. 51 patients were included in the final analysis. Baseline data were comparable between the two groups. Over the course of 12 weeks, compared to patients drinking plain water, those drinking mineral water had higher overall urinary volume (difference = 644.0 ml/24 h, 95% CI = (206.7, 1081.3)), higher overall urinary magnesium (difference = 1.894 mmol/24 h, 95% CI = (1.006, 2.782)), and pH (difference = 0.477, 95% CI = (0.149, 0.804)). However, there was no difference in urinary oxalate and Tiselius index. Mineral water group had net increase of urinary citrate (at each study point compared to baseline) which was sustained until week 12, whereas plain water group showed no significant change. CONCLUSIONS Drinking bicarbonate-rich mineral water in calcium oxalate stone formers increased stone inhibitors such as magnesium, citrate and moderate degree of urinary alkalinization compared to patients drinking plain water, but it did not alter Tiselius index or urinary oxalate after 12 weeks.
Collapse
|
11
|
Naciu AM, Tabacco G, Bilezikian JP, Santonati A, Bosco D, Incognito GG, Gaspa G, Manfrini S, Falchetti A, Trimboli P, Mazziotti G, Napoli N, Sanson G, Cesareo R, Vescini F, Palermo A. Calcium Citrate Versus Calcium Carbonate in the Management of Chronic Hypoparathyroidism: A Randomized, Double-Blind, Crossover Clinical Trial. J Bone Miner Res 2022; 37:1251-1259. [PMID: 35466449 PMCID: PMC9542059 DOI: 10.1002/jbmr.4564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022]
Abstract
In hypoparathyroidism (HypoPT), calcium supplementation is virtually always required, although the disease is likely to be associated with an increased risk of nephrolithiasis. The use of calcium citrate (Ca-Cit) theoretically could have a positive impact on the nephrolithiasis risk because citrate salts are used to reduce this risk. Our objective was to evaluate the potential therapeutic advantage of Ca-Cit in comparison with calcium carbonate (CaCO3 ) in HypoPT, on nephrolithiasis risk factors, as well as to their ability to maintain desirable serum calcium levels. We also evaluated these preparations on quality of life (QOL). This randomized, double-blind, crossover trial recruited 24 adults with postsurgical chronic hypoparathyroidism at Campus Bio-Medico University of Rome. Participants were randomized 1:1 to Ca-Cit or CaCO3 for 1 month and then crossed over to the other treatment for another month. The primary outcomes were changes in albumin-adjusted serum calcium and in ion activity product of calcium oxalate levels (AP[CaOx] index). Secondary efficacy outcomes included changes in SF-36 survey score, fatigue score, constipation, and adverse events. No difference in terms of AP(CaOx) index was observed between the two groups. However, Ca-Cit was associated with a significant reduction in the oxalate/creatinine ratio compared with CaCO3 (-2.46 mmol/mol [SD 11.93] versus 7.42 mmol/mol [SD 17.63], p = 0.029). Serum calcium and phosphorus concentration was not different between the two calcium preparations. Ca-Cit was associated with less constipation (p = 0.047). No difference was found in QOL scores. Although Ca-Cit did not modify the AP(CaOx) index when compared with CaCO3, it was associated with a reduction in urinary oxalate excretion that could have a potential beneficial effect on nephrolithiasis risk. These results are likely to have clinical implications in HypoPT, particularly those who do not tolerate CaCO3 and those affected by nephrolithiasis. A longer-term experience is needed to confirm these findings. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.,Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome
| | - Gaia Tabacco
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.,Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome
| | - John P Bilezikian
- Department of Medicine, Division of Endocrinology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Assunta Santonati
- Department of Endocrinology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Daniela Bosco
- Department of Endocrinology, San Giovanni Addolorata Hospital, Rome, Italy
| | | | - Gianluigi Gaspa
- Department of Food Science and Nutrition, University Campus Bio-Medico, Rome, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome
| | - Alberto Falchetti
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Pierpaolo Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | | | - Nicola Napoli
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.,Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome
| | - Gianfranco Sanson
- Clinical Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Cesareo
- UOS Malattie Metaboliche, Santa Maria Goretti Hospital, Latina, Italy
| | - Fabio Vescini
- Endocrinology and Metabolism Unit, University-Hospital S. M. Misericordia of Udine, Udine, Italy
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.,Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome
| |
Collapse
|
12
|
Cil O, Chu QT, Lee S, Haggie PM, Verkman AS. Small molecule inhibitor of intestinal anion exchanger SLC26A3 for therapy of hyperoxaluria and nephrolithiasis. JCI Insight 2022; 7:153359. [PMID: 35608921 PMCID: PMC9310519 DOI: 10.1172/jci.insight.153359] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
Nephrolithiasis is a common and recurrent disease affecting 9% of the US population. Hyperoxaluria is major risk factor for calcium oxalate kidney stones, which constitute two-thirds of all kidney stones. SLC26A3 (DRA, downregulated in adenoma) is an anion exchanger of chloride, bicarbonate, and oxalate thought to facilitate intestinal oxalate absorption, as evidenced by approximately 70% reduced urine oxalate excretion in knockout mice. We previously identified a small-molecule SLC26A3 inhibitor (DRAinh-A270) that selectively inhibited SLC26A3-mediated chloride/bicarbonate exchange (IC50 ~ 35 nM) and, as found here, oxalate/chloride exchange (IC50 ~ 60 nM). In colonic closed loops in mice, luminal DRAinh-A270 inhibited oxalate absorption by 70%. Following oral sodium oxalate loading in mice, DRAinh-A270 largely prevented the 2.5-fold increase in urine oxalate/creatinine ratio. In a mouse model of oxalate nephropathy produced by a high-oxalate low-calcium diet, vehicle-treated mice developed marked hyperoxaluria with elevated serum creatinine, renal calcium oxalate crystal deposition, and renal injury, which were largely prevented by DRAinh-A270 (10 mg/kg twice daily). DRAinh-A270 administered over 7 days to healthy mice did not show significant toxicity. Our findings support a major role of SLC26A3 in intestinal oxalate absorption and suggest the therapeutic utility of SLC26A3 inhibition for treatment of hyperoxaluria and prevention of calcium oxalate nephrolithiasis.
Collapse
Affiliation(s)
- Onur Cil
- Department of Medicine and Physiology, University of California, San Francisco, San Francisco, United States of America
| | - Qi Tifany Chu
- Department of Pediatrics, University of California, San Francisco, San Francisco, United States of America
| | - Sujin Lee
- Department of Medicine and Physiology, University of California, San Francisco, San Francisco, United States of America
| | - Peter M Haggie
- Department of Medicine and Physiology, University of California, San Francisco, San Francisco, United States of America
| | - Alan S Verkman
- Department of Medicine and Physiology, University of California, San Francisco, San Francisco, United States of America
| |
Collapse
|
13
|
Xu X, Chen J, Lv H, Xi Y, Ying A, Hu X. Molecular mechanism of Pyrrosia lingua in the treatment of nephrolithiasis: Network pharmacology analysis and in vivo experimental verification. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 98:153929. [PMID: 35104754 DOI: 10.1016/j.phymed.2022.153929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/27/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evidence exists reporting that Pyrrosia lingua (PL, Xinhui Pharmaceutical, Polypodiaceae) alleviates nephrolithiasis in rat models. The precipitation of calcium oxalate may result in kidney stones, and the intestinal microbiota is critical for oxalate metabolism. Therefore, we attempt to delineate the molecular mechanism underlying the effect of PL on nephrolithiasis and its association with gut microbiota. METHODS Following differential flora analysis in gutMEGA, the network relationship of PL and nephrolithiasis was analyzed based on the TCMSP, DisGeNET and STRING databases. Moreover, the kidney stone model rats were fed with different doses of PL powder and PL extract. In addition, metabolomics technology was employed to identify the active ingredients in PL extract and the microbial metabolites in rat feces. RESULTS The effect of PL on the nephrolithiasis was based on quercetin and kaempferol by mediating the toll-like receptor signaling pathway and regulating the expression levels of interleukin 6, tumor necrosis factor, mitogen activated protein kinase 8, and secreted phosphoprotein 1. PL significantly reduced the levels of urine oxalic acid, urine calcium, and osteopontin (OPN) levels in rat models of nephrolithiasis. Notably, PL extract decreased these two indicators to lower levels. Furthermore, contents of Oxalobacter formigenes, Bacteriodetes, Bifidobacterium and Fecalibacterium were obviously reduced after treatment with PL extract. CONCLUSION PL powder and its active extracts reduce the oxalate level in urine by regulating oxalate metabolism, thus ameliorating the damage of kidney tissues and preventing kidney stone formation. This study suggests the use of PL and its extracts as an alternative source of promising agents that might directly or indirectly inhibit the progression of kidney stone diseases.
Collapse
Affiliation(s)
- Xiangwei Xu
- Department of Pharmacy, Yongkang First People's Hospital Affiliated to Hangzhou Medical College, Yongkang 321300, PR China
| | - Jun Chen
- Department of Pharmacy, Yongkang First People's Hospital Affiliated to Hangzhou Medical College, Yongkang 321300, PR China
| | - Haiou Lv
- Department of Urology Surgery, Yongkang First people's Hospital Affiliated to Hangzhou Medical College, 599 jinshan West Road, Dongcheng Street, Yongkang, Zhejiang Province 321300, PR China
| | - Yiyuan Xi
- School of Pharmacy, Wenzhou Medical University, PR China
| | - Aiying Ying
- Department of Urology Surgery, Yongkang First people's Hospital Affiliated to Hangzhou Medical College, 599 jinshan West Road, Dongcheng Street, Yongkang, Zhejiang Province 321300, PR China
| | - Xiang Hu
- Department of Urology Surgery, Yongkang First people's Hospital Affiliated to Hangzhou Medical College, 599 jinshan West Road, Dongcheng Street, Yongkang, Zhejiang Province 321300, PR China.
| |
Collapse
|
14
|
Numerical characterization of astronaut CaOx renal stone incidence rates to quantify in-flight and post-flight relative risk. NPJ Microgravity 2022; 8:2. [PMID: 35091560 PMCID: PMC8799707 DOI: 10.1038/s41526-021-00187-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Changes in urine chemistry potentially alter the risk of renal stone formation in astronauts. Quantifying spaceflight renal stone incidence risk compared to pre-flight levels remains a significant challenge for assessing the appropriate vehicle, mission, and countermeasure design. A computational biochemistry model representing CaOx crystal precipitation, growth, and agglomeration is combined with a probabilistic analysis to predict the in- and post-flight CaOx renal stone incidence risk ratio (IRR) relative to pre-flight values using 1517 astronaut 24-h urine chemistries. Our simulations predict that in-flight fluid intake alone would need to increase from current prescriptions of 2.0–2.5 L/day to ~3.2 L/day to approach the CaOx IRR of the pre-flight population. Bone protective interventions would reduce CaOx risk to pre-flight levels if Ca excretion alone is reduced to <150 mg/day or if current levels are diminished to 190 mg/day in combination with increasing fluid intake to 2.5–2.7 L/day. This analysis provides a quantitative risk assessment that can influence the critical balance between engineering and astronaut health requirements.
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Wei Z, Cui Y, Tian L, Liu Y, Yu Y, Jin X, Li H, Wang K, Sun Q. Probiotic Lactiplantibacillus plantarum N-1 could prevent ethylene glycol-induced kidney stones by regulating gut microbiota and enhancing intestinal barrier function. FASEB J 2021; 35:e21937. [PMID: 34606628 DOI: 10.1096/fj.202100887rr] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 02/05/2023]
Abstract
Defective permeability barrier is considered to be an incentive of hyperuricemia, however, the link between them has not been proven. Here, we evaluated the potential preventive effects of Lactiplantibacillus plantarum N-1 (LPN1) on gut microbiota and intestinal barrier function in rats with hyperoxaluria-induced kidney stones. Male rats were supplied with 1% ethylene glycol (EG) dissolved in drinking water for 4 weeks to develop hyperoxaluria, and some of them were administered with LPN1 for 4 weeks before EG treatment as a preventive intervention. We found that EG not only resulted hyperoxaluria and kidney stone formation, but also promoted the intestinal inflammation, elevated intestinal permeability, and gut microbiota disorders. Supplementation of LPN1 inhibited the renal crystalline deposits through reducing urinary oxalic acid and renal osteopontin and CD44 expression and improved EG-induced intestinal inflammation and barrier function by decreasing the serum LPS and TLR4/NF-κB signaling and up-regulating tight junction Claudin-2 in the colon, as well as increasing the production of short-chain fatty acid (SCFAs) and the abundance of beneficial SCFAs-producing bacteria, mainly from the families of Lachnospiraceae and Ruminococcaceae. Probiotic LPN1 could prevent EG-induced hyperoxaluria by regulating gut microbiota and enhancing intestinal barrier function.
Collapse
Affiliation(s)
- Zhitao Wei
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Yaqian Cui
- Key Laboratory of Bio-Resources and Eco-Environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Lei Tian
- Key Laboratory of Bio-Resources and Eco-Environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Yu Liu
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Yang Yu
- National-Local Joint Engineering Laboratory of Breeding and Cultivation of Edible and Medicinal Fungi, Soil and Fertilizer Institute, Sichuan Academy of Agricultural Sciences, Chengdu, China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Hong Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Qun Sun
- Key Laboratory of Bio-Resources and Eco-Environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| |
Collapse
|
17
|
Handa V, Thakur K, Arya SK. Exploit of oxalate and phytate from the oilseeds with phytase treated seeds for dietary improvement. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2021. [DOI: 10.1016/j.bcab.2021.102168] [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]
|
18
|
Gopala SK, Joe J. Effect of calcium content of diet on crystal formation in urine of patients with calcium oxalate stones: a randomized crossover clinical trial. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00222-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Patients with idiopathic calcium oxalate stones are advised to consume a low-oxalate diet to prevent recurrence. In this study, on patients with calcium oxalate stones we have attempted to determine the effect of calcium content of diet on the formation of calcium oxalate crystals in urine by in vitro supersaturation study of fresh postprandial urine samples and observing the morphology of the crystals formed using polarized optical microscopy.
Methods
The trial was conducted as a prospective interventional randomised crossover clinical trial in a repeated measures design. Sixty patients with calcium oxalate stones and no metabolic abnormalities in urine treated by lithotripsy at a tertiary care centre during the period May 2016 to May 2019 were recruited. Following a 14 h overnight fasting, urine samples were collected after providing the patient with either a low- or high-calcium meal for breakfast followed four hours later, by high-oxalate meal for lunch. Urine was tested for multiple parameters including urine pH, specific gravity, calcium/creatinine ratio and supersaturation of urine with sodium oxalate followed by optical density measurement by spectrophotometry and microscopic analysis of crystals formed.
Results
Optical density values and calcium/creatinine ratio of urine samples obtained after high-calcium meal are significantly higher than in corresponding sample obtained after low-calcium meal (p < 0.001). These findings were reflected in the morphology of formed crystals in their size, shape and number. When urinary calcium levels were low, no crystals were formed during supersaturation study of postprandial urine samples following a high-oxalate diet.
Conclusions
High calcium content in diet significantly contributes to kidney stone formation. There is a lower risk of kidney stone formation with a low-calcium meal even on consumption of a high-oxalate diet.
Collapse
|
19
|
Uebanso T, Suyama M, Shimohata T, Mawatari K, Takahashi A. Effect of Vitamin B2-Deficient Diet on Hydroxyproline- or Obesity-Induced Hyperoxaluria in Mice. Mol Nutr Food Res 2021; 65:e2100226. [PMID: 34110671 DOI: 10.1002/mnfr.202100226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/16/2021] [Indexed: 12/17/2022]
Abstract
SCOPE Hyperoxaluria is a major cause of kidney stone disease. Around half of the oxalate in mammals is supplied from the diet and the other half is endogenously synthesized from glyoxylate. Reduction of hepatic glycolate oxidase (GO) activity is one approach to reduce endogenous production of oxalate. However, there are currently few effective dietary approaches to reduce hepatic GO activity. METHODS AND RESULTS In the present study, it is investigated whether restriction of dietary vitamin B2 (VB2) can reduce hepatic GO activity and oxalate excretion in mice with hyperoxaluria induce by hydroxyproline (Hyp) or obesity. It is found that VB2 restriction significantly reduces hepatic GO activity in both the Hyp- and obesity-induced model of hyperoxaluria in mice. However, VB2 restriction reduces urinary oxalate excretion only in the Hyp-treated mice and not the obese mice. This difference could be due to the contribution of endogenous oxalate production that manifests as increased hepatic GO activity in Hyp-treated mice but not obese mice. CONCLUSION Together these results suggest that VB2 restriction could be a new dietary approach to improve hyperoxaluria when endogenous production of oxalate is increased.
Collapse
Affiliation(s)
- Takashi Uebanso
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Mai Suyama
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Takaaki Shimohata
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Kazuaki Mawatari
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Akira Takahashi
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| |
Collapse
|
20
|
El-Ashmawy NE, El-Bahrawy HA, Ashmawy HH, Khedr EG. Amelioration of lithiatic injury to renal tissue by candesartan and sodium thiosulfate in a rat model of nephrolithiasis. PLoS One 2021; 16:e0251408. [PMID: 33984042 PMCID: PMC8118324 DOI: 10.1371/journal.pone.0251408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/27/2021] [Indexed: 11/18/2022] Open
Abstract
AIM Nephrolithiasis is a chronic metabolic condition affecting 10% of population worldwide. The present study aimed to investigate the possible protective role of candesartan (CAND) and sodium thiosulfate (STS) in ameliorating ethylene glycol (EG) induced nephrolithiasis. METHODS One hundred male Wistar rats were divided into five groups: Normal control group, nephrolithiasis (EG) group (1% EG in drinking water), Cystone (CYS) group (EG + 750 mg/kg CYS, orally, once daily), STS group (EG + 0.4 gm/kg STS, intraperitoneally, 3 times/week) and CAND group (EG + 70 μg/mL CAND in drinking water). Treatments and EG administration commenced on the same day and continued for 28 days. CYS was used as reference drug. Urine, blood, and renal tissues were collected at the end of the experiment for assessment of kidney function tests (serum creatinine and urea), urinary (8-hydroxydeoxyguanosine (8-OHdG), calcium and oxalate), inflammatory and oxdative stress biomarkers (transforming growth factor beta (TGF-β), osteopontin (OPN) and ratio of reduced glutathione to oxidized glutathione (GSH/GSSG)) in renal tissue. RESULTS Serum (creatinine and urea), urinary (8-OHdG and oxalate) and renal (OPN and TGF-β) were significantly reduced in CAND and STS groups compared to EG group. Furthermore, renal GSH/GSSG and urinary calcium were significantly increased in CAND and STS groups compared to EG group. Histopathological results support the biochemical findings; CAND and STS groups showed less retention of crystals and necrotic damage in kidney. Also, microscopic examination of urine revealed less crystal for CAND and STS groups. CONCLUSION Candesartan and sodium thiosulfate exhibited protective effect against nephrolithiasis.
Collapse
Affiliation(s)
- Nahla E. El-Ashmawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Hoda A. El-Bahrawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Heba H. Ashmawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Eman G. Khedr
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| |
Collapse
|
21
|
|
22
|
Crivelli JJ, Mitchell T, Knight J, Wood KD, Assimos DG, Holmes RP, Fargue S. Contribution of Dietary Oxalate and Oxalate Precursors to Urinary Oxalate Excretion. Nutrients 2020; 13:nu13010062. [PMID: 33379176 PMCID: PMC7823532 DOI: 10.3390/nu13010062] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 02/07/2023] Open
Abstract
Kidney stone disease is increasing in prevalence, and the most common stone composition is calcium oxalate. Dietary oxalate intake and endogenous production of oxalate are important in the pathophysiology of calcium oxalate stone disease. The impact of dietary oxalate intake on urinary oxalate excretion and kidney stone disease risk has been assessed through large cohort studies as well as smaller studies with dietary control. Net gastrointestinal oxalate absorption influences urinary oxalate excretion. Oxalate-degrading bacteria in the gut microbiome, especially Oxalobacter formigenes, may mitigate stone risk through reducing net oxalate absorption. Ascorbic acid (vitamin C) is the main dietary precursor for endogenous production of oxalate with several other compounds playing a lesser role. Renal handling of oxalate and, potentially, renal synthesis of oxalate may contribute to stone formation. In this review, we discuss dietary oxalate and precursors of oxalate, their pertinent physiology in humans, and what is known about their role in kidney stone disease.
Collapse
Affiliation(s)
| | | | | | | | | | - Ross P. Holmes
- Correspondence: ; Tel.: +1-(205)-996-8765; Fax: +1-(205)-934-4933
| | | |
Collapse
|
23
|
Hashmi SB, Jafri L, Majid H, Talati J, Aziz W, Khan AH. Relationship of spot urine oxalate to creatinine ratio and 24 hours urinary oxalate excretion in patients with urolithiasis. Ann Med Surg (Lond) 2020; 60:330-333. [PMID: 33224485 PMCID: PMC7666312 DOI: 10.1016/j.amsu.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022] Open
Abstract
Background The evaluation of 24 h urinary oxalate excretion is the gold standard for diagnosing hyperoxaluria in patients with recurrent urolithiasis. However, 24 h urine sample collection is cumbersome. Therefore we aim to see if oxalate to creatinine ratio in random urine sample can be used as an alternative. Materials and methods A cross-sectional study was conducted at Section of Chemical Pathology, Department of Pathology and Laboratory Medicine Aga Khan University Karachi from 1st February to December 31, 2019. A total of 62 adult patients, 18–60 years of age with history of kidney stones presenting to the clinical laboratory for 24 h urine oxalate estimation were invited to participate in the study after informed consent. Clinical details were recorded on a structured questionnaire and patients were guided to submit 24 h urine and a random spot urine sample. Urinary oxalate was measured on Micro lab 300 using a kit based on oxalate oxidase principle by Trinity Biotech plc, Wicklow, Ireland following standard operating procedures. Urinary creatinine was measured on ADVIA 1800 by Siemens, US using kinetic Jaffe reaction according to the manufacturer's instructions. The data was analyzed on SPSS. Results In a period of ten months, a total of 62 subjects were recruited; mean age was 32.4 ± 2.6 years. Males were 49 (79.0%) and females were 13 (20.9%). Correlation was found to be (r = 0.289) by Spearman correlation (p value < 0.005). Taking 24 h urinary oxalate as gold standard the sensitivity, specificity, positive predictive value and negative predictive value of spot oxalate to creatinine ratio was 83.3%, 17.8%, 9.8% and 90.9% respectively. Conclusion The random spot urine test cannot replace the 24 h urinary oxalate estimation in patients with urolithiasis. Oxalate to creatinine ratio is proposed as an alternative to 24 h urine. Sensitivity & specificity of spot ox:cr ratio was 83.3% and 17.8% respectively. PPV and NPV of spot ox:cr ratio was 9.8% and 90.9% respectively. Studies taking diet and molecular testing into consideration are needed.
Collapse
Affiliation(s)
- Syed Bilal Hashmi
- Section of Chemical Pathology, Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan
| | - Lena Jafri
- Section of Chemical Pathology, Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan
| | - Hafsa Majid
- Section of Chemical Pathology, Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan
| | - Jamsheer Talati
- Section of Urology, Department of Surgery, Aga Khan University, Pakistan
| | - Wajahat Aziz
- Section of Urology, Department of Surgery, Aga Khan University, Pakistan
| | - Aysha Habib Khan
- Section of Chemical Pathology, Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan
| |
Collapse
|
24
|
Abstract
The prevalence of urolithiasis in humans is increasing worldwide; however, non-surgical treatment and prevention options remain limited despite decades of investigation. Most existing laboratory animal models for urolithiasis rely on highly artificial methods of stone induction and, as a result, might not be fully applicable to the study of natural stone initiation and growth. Animal models that naturally and spontaneously form uroliths are an underused resource in the study of human stone disease and offer many potential opportunities for improving insight into stone pathogenesis. These models include domestic dogs and cats, as well as a variety of other captive and wild species, such as otters, dolphins and ferrets, that form calcium oxalate, struvite, uric acid, cystine and other stone types. Improved collaboration between urologists, basic scientists and veterinarians is warranted to further our understanding of how stones form and to consider possible new preventive and therapeutic treatment options.
Collapse
|
25
|
Dietary Oxalate Intake and Kidney Outcomes. Nutrients 2020; 12:nu12092673. [PMID: 32887293 PMCID: PMC7551439 DOI: 10.3390/nu12092673] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/25/2020] [Accepted: 08/30/2020] [Indexed: 12/16/2022] Open
Abstract
Oxalate is both a plant-derived molecule and a terminal toxic metabolite with no known physiological function in humans. It is predominantly eliminated by the kidneys through glomerular filtration and tubular secretion. Regardless of the cause, the increased load of dietary oxalate presented to the kidneys has been linked to different kidney-related conditions and injuries, including calcium oxalate nephrolithiasis, acute and chronic kidney disease. In this paper, we review the current literature on the association between dietary oxalate intake and kidney outcomes.
Collapse
|
26
|
Nimesh S, Ashwlayan VD, Rani R, Prakash O. Advantages of Herbal Over Allopathic Medicine in the Management of Kidney and Urinary Stones Disease. BORNEO JOURNAL OF PHARMACY 2020. [DOI: 10.33084/bjop.v3i3.1415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Kidney and urinary stone disease (Nephrolithiasis and urolithiasis) are the condition where urinary stones or calculi are formed in the urinary tract. The problem of urinary stones is very ancient; these stones are found in all parts of the urinary tract, kidney, ureters, and the urinary bladder and may vary considerably in size. It is a common disease estimated to occur in approximately 12% of the population, with a recurrence rate of 70-81% in males and 47-60% in females. The treatment of kidney and urinary stone diseases such as a western (allopathy) medicine and surgery is now in trends. However, most people preferred plant-based (herbal) therapy because of the overuse of allopathic drugs, which results in a higher incidence rate of adverse or severe side effects. Therefore, people every year turn to herbal therapy because they believe plant-based medicine is free from undesirable side effects, although herbal medicines are generally considered to be safe and effective. In the present article, an attempt has been made to emphasize an herbal therapy is better than allopathic therapy for the management of the kidney and urinary stone disease.
Collapse
Affiliation(s)
| | | | - Rubi Rani
- NKBR College of Pharmacy and Research Centre
| | | |
Collapse
|
27
|
Šálek T. Extreme diet without calcium may lead to hyperoxaluria and kidney stone recurrence-A case study. J Clin Lab Anal 2020; 34:e23512. [PMID: 32761639 PMCID: PMC7755765 DOI: 10.1002/jcla.23512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the study was to present a case study of a 56‐year‐old woman with hyperoxaluria induced by calcium‐free diet that resulted in kidney stone recurrence. Methods A 24‐hour urine collection and serum tests for kidney stone risk factors identification were performed. The monitoring of urine risk factors was done by untimed urine samples and 24‐hour urine collections. Polarized light microscopy was performed for kidney stone analysis. Results The results of urine collection showed hyperoxaluria of 0.551 mmoL per 24 hours. After adding calcium‐containing products to the diet the oxaluria decreased to reference range value of 0.352 mmoL/24 hours and all untimed oxalate to creatinine ratios returned to reference ranges. Polarized light microscopy revealed 100% calcium oxalate kidney stone composition (It was 50% Weddellite and 50% Whewellite). Conclusions The case study shows the importance of calcium intake in the prevention of calcium oxalate kidney stone recurrence. Particularly, unsuitable diet without calcium can induce kidney stone recurrence. Knowledge of diet habits is important for interpretation of kidney stone risk factors and their inhibitors excreted in urine.
Collapse
Affiliation(s)
- Tomáš Šálek
- Department of Biomedical Sciences, Medical Faculty, University of Ostrava, Ostrava, The Czech Republic.,Department of Clinical biochemistry and pharmacology, The Tomas Bata Hospital in Zlín, Zlín, The Czech Republic
| |
Collapse
|
28
|
Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients 2020; 12:nu12030779. [PMID: 32183500 PMCID: PMC7146511 DOI: 10.3390/nu12030779] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
Nephrolithiasis is a common medical condition influenced by multiple environmental factors, including diet. Since nutritional habits play a relevant role in the genesis and recurrence of kidney stones disease, dietary manipulation has become a fundamental tool for the medical management of nephrolithiasis. Dietary advice aims to reduce the majority of lithogenic risk factors, reducing the supersaturation of urine, mainly for calcium oxalate, calcium phosphate, and uric acid. For this purpose, current guidelines recommend increasing fluid intake, maintaining a balanced calcium intake, reducing dietary intake of sodium and animal proteins, and increasing intake of fruits and fibers. In this review, we analyzed the effects of each dietary factor on nephrolithiasis incidence and recurrence rate. Available scientific evidence agrees on the harmful effects of high meat/animal protein intake and low calcium diets, whereas high content of fruits and vegetables associated with a balanced intake of low-fat dairy products carries the lowest risk for incident kidney stones. Furthermore, a balanced vegetarian diet with dairy products seems to be the most protective diet for kidney stone patients. Since no study prospectively examined the effects of vegan diets on nephrolithiasis risk factors, more scientific work should be made to define the best diet for different kidney stone phenotypes.
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW The review of potential therapies in the treatment of hyperoxaluria is timely, given the current excitement with clinical trials and the mounting evidence of the importance of oxalate in both kidney stone and chronic kidney disease. RECENT FINDINGS Given the significant contribution of both endogenous and dietary oxalate to urinary oxalate excretions, it is not surprising therapeutic targets are being studied in both pathways. This article covers the existing data on endogenous and dietary oxalate and the current targets in these pathways. SUMMARY In the near future, there will likely be therapies targeting both endogenous and dietary oxalate, especially in subsets of kidney stone formers.
Collapse
|
30
|
Abstract
OBJECTIVES Patients requiring oral and/or enteral nutrition support, delivered via nasogastric, gastric, or intestinal routes, have a relatively high incidence of calcium oxalate (CaOx) kidney stones. Nutrition formulas are frequently made from corn and/or or soy, both of which contain ample oxalate. Excessive oxalate intake contributes to hyperoxaluria (>45 mg urine oxalate/day) and CaOx stones especially when unopposed by concomitant calcium intake, gastrointestinal malabsorption is present, and/or oxalate degrading gut bacteria are limiting or absent. Our objective was to assess the oxalate content of commonly used commercial enteral nutrition formulas. METHODS Enteral nutrition formulas were selected from the formulary at our clinical inpatient institution. Multiple samples of each were assessed for oxalate concentration with ion chromatography. RESULTS Results from 26 formulas revealed highly variable oxalate concentration ranging from 4 to 140 mg oxalate/L of formula. No definitive patterns for different types of formulas (eg, flavored vs unflavored, high protein vs not) were evident. Coefficients of variation for all formulas ranged from 0.68% to 43% (mean ± SD 19% ± 12%; median 18%). CONCLUSIONS Depending on the formula and amount delivered, patients requiring nutrition support could obtain anywhere from 12 to 150 mg oxalate/day or more and are thus at risk for hyperoxaluria and CaOx stones.
Collapse
|
31
|
Abstract
PURPOSE OF REVIEW With recent advances in sequencing technologies and increasing research into the gut microbiome (GMB), studies have revealed associations between the GMB and urinary stone disease (USD). We sought to determine whether the evidence pointed towards a few specific gut bacteria or the broader GMB network is seemingly responsible for this relationship. RECENT FINDINGS Initially, Oxalobacter formigenes (OF) was pursued as the main link between GMB and USD given its ability to degrade oxalate in the gut. However, the latest studies consistently suggest that the entire GMB is much more likely to be involved in handling oxalate absorption and other risk factors for urinary stone formation, rather than just a few microbiota. The GMB has complex networks that are likely involved in the pathophysiology of USD, although the causal mechanisms remain unclear. With increasing interest and research, potential modalities that act on the GMB may help to prevent incidence of USD.
Collapse
Affiliation(s)
- Justin A Lee
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Joshua M Stern
- Department of Urology, Montefiore Medical Center, 1250 Waters Place - Tower 2 - 9th floor, Bronx, NY, 10461, USA.
| |
Collapse
|
32
|
Bazyar H, Ahmadi A, Zare Javid A, Irani D, Mohammadi Sartang M, Haghighizadeh MH. The association between dietary intakes and stone formation in patients with urinary stones in Shiraz. Med J Islam Repub Iran 2019; 33:8. [PMID: 31086787 PMCID: PMC6504976 DOI: 10.34171/mjiri.33.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Indexed: 01/12/2023] Open
Abstract
Background: Kidney stone is a common and costly disease, but it may be improved by a healthy diet. The aim of this study was to evaluate the association between dietary intake and stone formation in patients with urinary stones in Shiraz. Methods: In this cross sectional study, 110 patients with kidney stone were selected from Faghihi hospital, Shiraz. Demographic information was collected, and anthropometric indices, disease-related variables, physical activity (using IPAQ), and dietary intake (using food frequency questionnaire, analyzed by Nut 4 software, to estimate micro and macro nutrients) were evaluated. Independent sample t test and one-way ANOVA were used to compare the quantitative variables between the 2 groups and multi groups, respectively. Chi square test was also used to compare qualitative variables. The correlation between variables was determined using Pearson test. Results: Out of 110 participants in this study, 37 (33.6%) were female, with the mean BMI of 27.0 ± 4.68 kg/m2, and 73 (66.4%) were male, with the mean BMI of 24.21±2.96 kg/m2. The mean intake of calcium-containing foods (p=0.02) and high-fructose beverages (p=0.03) was significantly greater in patients with calcium stones compared to those with uric acid stones. The mean intake of high-purine foods was significantly higher in patients with uric acid stones than in those with calcium stones (p=0.007). The mean intake of vitamin A (p=0.02), beta-carotene (p=0.03), and fructose (p=0.03) was significantly higher in patients with calcium stones than in those with uric acid stones, while caffeine intake was significantly higher in patients with uric acid than in those with calcium stones (p=0.01). There was a significant correlation between consumption of high-oxalic beverages (p=0.005, correlation coefficient = 0.26) and high-fructose (p=0.048, correlation coefficient = 0.18) with spontaneous stone expulsion. Conclusion: There was a significant relationship between consuming vitamin A, beta-carotene, and foods containing calcium, purine, fructose, and oxalate and formation of kidney stones. Therefore, adopting a healthy diet and increasing physical activity may be effective in the treatment of kidney stones.
Collapse
Affiliation(s)
- Hadi Bazyar
- Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Afsane Ahmadi
- Research Center for Health Sciences, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dariush Irani
- Department of Surgery, Shaheed Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | |
Collapse
|
33
|
Stern JM, Urban‐Maldonado M, Usyk M, Granja I, Schoenfeld D, Davies KP, Agalliu I, Asplin J, Burk R, Suadicani SO. Fecal transplant modifies urine chemistry risk factors for urinary stone disease. Physiol Rep 2019; 7:e14012. [PMID: 30789675 PMCID: PMC6383111 DOI: 10.14814/phy2.14012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/01/2019] [Accepted: 02/03/2019] [Indexed: 01/04/2023] Open
Abstract
Urinary stone disease (USD) is a major health concern. There is a need for new treatment modalities. Recently, our group provided evidence for an association between the GMB composition and USD. The accessibility of the Gut Microbiome (GMB) makes it an attractive target for investigation and therefore, in these studies we have evaluated the extent to which the whole gut microbial community in fecal transplants can affect urinary stone risk parameters in an animal model. Fresh fecal pellets were collected from Zucker lean rats, homogenized in PBS (100 mg/mL), filtered through a 70 μm strainer and then orally gavaged into C57BL/6NTac germ-free mice. Twenty-four hours urine collections and GMB analysis were performed over time for 1 month. Kidney and gut tissue were harvested from transplanted mice for western blot analysis of expression levels of the Slc26a6 transporter involved in oxalate balance. Urinary calcium decreased after fecal transplant by 55% (P < 0.001). Urinary oxalate levels were on average 24% lower than baseline levels (P < 0.001). Clostridiaceae family was negatively correlated with urinary oxalate at 4 weeks after transplant (r = -0.83, P < 0.01). There was a 0.6 unit average increase in urinary pH from a baseline of 5.85 (SE ± 0.028) to 6.49 (SE ± 0.04) (P < 0.001) after transplant. There was a concomitant 29% increase in gastrointestinal alkali absorption (P < 0.001) 4-weeks after fecal transplant. Slc26a6 expression increased by 90% in the cecum after transplant. Our results suggest that the gut microbiome may impact metabolism, alters urinary chemistry, and thereby may influence USD; the accessibility of the GMB can potentially be leveraged for therapeutic interventions.
Collapse
Affiliation(s)
- Joshua M. Stern
- Department of UrologyAlbert Einstein College of MedicineBronxNew York
| | | | - Mykhaylo Usyk
- Department of MicrobiologyAlbert Einstein College of MedicineBronxNew York
| | | | - Daniel Schoenfeld
- Department of UrologyAlbert Einstein College of MedicineBronxNew York
| | - Kelvin P. Davies
- Department of UrologyAlbert Einstein College of MedicineBronxNew York
| | - Ilir Agalliu
- Department of EpidemiologyAlbert Einstein College of MedicineBronxNew York
| | | | - Robert Burk
- Department of MicrobiologyAlbert Einstein College of MedicineBronxNew York
| | | |
Collapse
|
34
|
ICER MA, GEZMEN-KARADAG M. The potential effects of dietary food and beverage intakes on the risk of kidney stone formation. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e190029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To determine the effect of nutritional habits on kidney stone formation and recurrence. Methods This study was conducted on 44 healthy individuals and 44 patients diagnosed with nephrolithiasis and aging between 20 and 65 years. Participants shared their salt consumption habits, daily fluid consumption amounts and general information about themselves in a questionnaire form. In addition, food and beverage consumption frequencies of participants were recorded through a food frequency questionnaire. Results Salt consumption frequencies of patients are higher than that of healthy individuals in both genders (p<0.05). It was found out that male individuals in the patient group salt dishes without tasting more frequently (p<0.05). Daily total water consumption of both genders in patient group is lower than that of healthy individuals (p<0.05). Meat consumption of male patients (51.6±31.35g/day) was found to be higher than that of healthy group (34.1±22.58g/day) (p<0.05). Additionally, individuals in the patient group consume less stinging nettle, corn, plum, loquat, orange juice and lemonade than healthy individuals (p<0.05). Conclusion Results of the study showed that total fluid intake, salt consumption habits, and vegetable, fruit and beverage consumption may be correlated with stone formation risk and nutrition habits may affect stone recurrence.
Collapse
|
35
|
Mitchell T, Kumar P, Reddy T, Wood KD, Knight J, Assimos DG, Holmes RP. Dietary oxalate and kidney stone formation. Am J Physiol Renal Physiol 2018; 316:F409-F413. [PMID: 30566003 PMCID: PMC6459305 DOI: 10.1152/ajprenal.00373.2018] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Dietary oxalate is plant-derived and may be a component of vegetables, nuts, fruits, and grains. In normal individuals, approximately half of urinary oxalate is derived from the diet and half from endogenous synthesis. The amount of oxalate excreted in urine plays an important role in calcium oxalate stone formation. Large epidemiological cohort studies have demonstrated that urinary oxalate excretion is a continuous variable when indexed to stone risk. Thus, individuals with oxalate excretions >25 mg/day may benefit from a reduction of urinary oxalate output. The 24-h urine assessment may miss periods of transient surges in urinary oxalate excretion, which may promote stone growth and is a limitation of this analysis. In this review we describe the impact of dietary oxalate and its contribution to stone growth. To limit calcium oxalate stone growth, we advocate that patients maintain appropriate hydration, avoid oxalate-rich foods, and consume an adequate amount of calcium.
Collapse
Affiliation(s)
- Tanecia Mitchell
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Parveen Kumar
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Thanmaya Reddy
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Kyle D Wood
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - John Knight
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Dean G Assimos
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| | - Ross P Holmes
- Department of Urology, University of Alabama at Birmingham , Birmingham, Alabama
| |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Falony G. Beyond Oxalobacter: the gut microbiota and kidney stone formation. Gut 2018; 67:2078-2079. [PMID: 29884611 DOI: 10.1136/gutjnl-2018-316639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 05/27/2018] [Indexed: 12/08/2022]
Affiliation(s)
- Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.,Center for Microbiology, Leuven, Belgium
| |
Collapse
|
38
|
Dominguez-Gutierrez PR, Kusmartsev S, Canales BK, Khan SR. Calcium Oxalate Differentiates Human Monocytes Into Inflammatory M1 Macrophages. Front Immunol 2018; 9:1863. [PMID: 30186283 PMCID: PMC6113402 DOI: 10.3389/fimmu.2018.01863] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/27/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose A number of hyperoxaluric states have been associated with calcium oxalate (CaOx) deposits in the kidneys. In animal models of stone disease, these crystals interact with circulating monocytes that have migrated into the kidney as part of innate immunity. Similarly, macrophages surround CaOx crystals in kidneys of patients excreting high levels of oxalate. We investigate the effect of this exposure and subsequent human immunological response in vitro. Materials and methods Primary human monocytes were collected from healthy donors and exposed to CaOx, potassium oxalate, and zinc oxalate (ZnOx). Cytokine production was measured with a multiplex ELISA. Quantitative reverse transcription-polymerase chain reaction was done to validate the mRNA profile expression. M1 macrophage phenotype was confirmed with immunofluorescence microscopy. Results Both primary monocytes and THP-1 cells, a human monocytic cell line, respond strongly to CaOx crystals in a dose-dependent manner producing TNF-α, IL-1β, IL-8, and IL-10 transcripts. Exposure to CaOx followed by 1 h with LPS had an additive effect for cytokine production compared to LPS alone, however, LPS followed by CaOx led to significant decrease in cytokine production. Supernatants taken from monocytes were previously exposed to CaOx crystals enhance M2 macrophage crystal phagocytosis. CaOx, but not potassium or ZnOx, promotes monocyte differentiation into inflammatory M1-like macrophages. Conclusion In our in vitro experiment, human monocytes were activated by CaOx and produced inflammatory cytokines. Monocytes recognized CaOx crystals through a specific mechanism that can enhance or decrease the innate immune response to LPS. CaOx promoted M1 macrophage development. These results suggest that monocytes have an important role promoting CaOx-induced inflammation.
Collapse
Affiliation(s)
| | - Sergei Kusmartsev
- Department of Urology, University of Florida, Gainesville, FL, United States
| | - Benjamin K Canales
- Department of Urology, University of Florida, Gainesville, FL, United States
| | - Saeed R Khan
- Department of Urology, University of Florida, Gainesville, FL, United States.,Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
39
|
Berman CM, Merritt RJ. Stoned-A Syndrome of D-Lactic Acidosis and Urolithiasis. Nutr Clin Pract 2018; 33:897-901. [DOI: 10.1002/ncp.10063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Casey M. Berman
- New York Presbyterian-Columbia University; New York New York USA
| | - Russell J. Merritt
- Children's Hospital Los Angeles; Keck School of Medicine; University of Southern California; Los Angeles California USA
| |
Collapse
|
40
|
Liu N, Xie H, Ping H, Wang L, Liu Z, Tao F, Guo J, Su BL. Shape and structure controlling of calcium oxalate crystals by a combination of additives in the process of biomineralization. RSC Adv 2018; 8:11014-11020. [PMID: 35541543 PMCID: PMC9078945 DOI: 10.1039/c8ra00661j] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/05/2018] [Indexed: 11/21/2022] Open
Abstract
Combination of casein and small molecules regulates morphogenesis of calcium oxalate crystals.
Collapse
Affiliation(s)
- Nian Liu
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Hao Xie
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Hang Ping
- Laboratory of Living Materials at the State Key Laboratory of Advanced Technology for Materials Synthesis and Processing
- Wuhan University of Technology
- Wuhan
- China
| | - Lin Wang
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Zewen Liu
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Fei Tao
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Junhui Guo
- School of Chemistry
- Chemical Engineering and Life Sciences
- Wuhan University of Technology
- Wuhan
- China
| | - Bao-Lian Su
- Laboratory of Living Materials at the State Key Laboratory of Advanced Technology for Materials Synthesis and Processing
- Wuhan University of Technology
- Wuhan
- China
- Laboratory of Inorganic Materials Chemistry
| |
Collapse
|
41
|
Abstract
Nephrolithiasis is a condition marked by the presence or formation of stones in kidneys. Several factors contribute to kidney stones development such as environmental conditions, type of dietary intake, gender and gastrointestinal flora. Most of the kidney stones are composed of calcium phosphate and calcium oxalate, which enter in to the body through diet. Both sources of oxalates become dangerous when normal flora of gastrointestinal tract is disturbed. Oxalobacter and Lactobacillus species exist symbiotically in the human gut and prevent stone formation by altering some biochemical pathways through production of specific enzymes which help in the degradation of oxalate salts. Both Oxalobacter and Lactobacillus have potential probiotic characteristics for the prevention of kidney stone formation and this avenue should be further explored.
Collapse
Affiliation(s)
- Humaira Sadaf
- Department of Biosciences, University of Wah, Wah City, Pakistan
| | - Syed Irfan Raza
- Department of Biosciences, University of Wah, Wah City, Pakistan
| | | |
Collapse
|