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Cao C, Li F, Ding Q, Jin X, Tu W, Zhu H, Sun M, Zhu J, Yang D, Fan B. Potassium sodium hydrogen citrate intervention on gut microbiota and clinical features in uric acid stone patients. Appl Microbiol Biotechnol 2024; 108:51. [PMID: 38183479 PMCID: PMC10771603 DOI: 10.1007/s00253-023-12953-y] [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: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/08/2024]
Abstract
The high recurrence rate of renal uric acid stone (UAS) poses a significant challenge for urologists, and potassium sodium hydrogen citrate (PSHC) has been proven to be an effective oral dissolution drug. However, no studies have investigated the impact of PSHC on gut microbiota and its metabolites during stone dissolution therapy. We prospectively recruited 37 UAS patients and 40 healthy subjects, of which 12 patients completed a 3-month pharmacological intervention. Fasting vein blood was extracted and mid-stream urine was retained for biochemical testing. Fecal samples were collected for 16S ribosomal RNA (rRNA) gene sequencing and short chain fatty acids (SCFAs) content determination. UAS patients exhibited comorbidities such as obesity, hypertension, gout, and dyslipidemia. The richness and diversity of the gut microbiota were significantly decreased in UAS patients, Bacteroides and Fusobacterium were dominant genera while Subdoligranulum and Bifidobacterium were poorly enriched. After PSHC intervention, there was a significant reduction in stone size accompanied by decreased serum uric acid and increased urinary pH levels. The abundance of pathogenic bacterium Fusobacterium was significantly downregulated following the intervention, whereas there was an upregulation observed in SCFA-producing bacteria Lachnoclostridium and Parasutterella, leading to a significant elevation in butyric acid content. Functions related to fatty acid synthesis and amino acid metabolism within the microbiota showed upregulation following PSHC intervention. The correlation analysis revealed a positive association between stone pathogenic bacteria abundance and clinical factors for stone formation, while a negative correlation with SCFAs contents. Our preliminary study revealed that alterations in gut microbiota and metabolites were the crucial physiological adaptation to PSHC intervention. Targeted regulation of microbiota and SCFA holds promise for enhancing drug therapy efficacy and preventing stone recurrence. KEY POINTS: • Bacteroides and Fusobacterium were identified as dominant genera for UAS patients • After PSHC intervention, Fusobacterium decreased and butyric acid content increased • The microbiota increased capacity for fatty acid synthesis after PSHC intervention.
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Affiliation(s)
- Cheng Cao
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Feng Li
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Qi Ding
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Xiaohua Jin
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Wenjian Tu
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Hailiang Zhu
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Mubin Sun
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Jin Zhu
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Dongrong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Fan
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China.
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Gao M, Liu M, Zhang Y, Tang L, Chen H, Zhu Z. The impact of anxiety on the risk of kidney stone disease: Insights into eGFR-mediated effects. J Affect Disord 2024; 364:125-131. [PMID: 39147144 DOI: 10.1016/j.jad.2024.08.061] [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: 02/14/2024] [Revised: 06/14/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Previous studies have linked kidney stone disease (KSD) with depression, but there are no reports on the relationship between anxiety and KSD, and the mechanism underlying the potential relationship remains unclear. METHODS Associations of anxiety and incident KSD were assessed in the National Health and Nutrition Examination Survey (NHENES) using multivariate logistic regression. Two-sample bidirectional Mendelian randomization studies and a two-step two-sample MR was used to estimate the mediating factors that influence KSD risk. RESULTS Examinations of NHANES data revealed that a rise in the frequency and intensity of anxiety were independently associated with incident KSD. In MR analysis, anxiety (uk-a-51 and uk-b-6519) were from the UK Biobank, with sample sizes of 328,717 and 450,765 respectively. KSD data were from the FinnGen, including 8597 cases and 333,128 controls. In the IVW analysis, genetically predicted anxieties (ukb-a-51 and ukb-b-6519) were found to be causally associated with a higher risk of KSD, with odds ratios of 6.18 (95 % CI 2.54-15.04) and 3.44 (95 % CI 1.67-7.08), respectively. There were no reverse causal effects. Further mediation analysis indicated that anxiety increases the risk of KSD by raising eGFR, through which 11.8 % of the effect of anxiety on KSD risk was mediated. LIMITATIONS The research was confined to individuals of European heritage, and there could be specific genetic variances among diverse ethnicities. CONCLUSION The current study suggests anxiety as an independent causal risk factor for KSD and unveils a new pathogenic mechanism, showing that anxiety raises eGFR, thereby increasing the risk of KSD.
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Affiliation(s)
- Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Youjie Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Liang Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Chmiel JA, Stuivenberg GA, Wong JFW, Nott L, Burton JP, Razvi H, Bjazevic J. Predictive Modeling of Urinary Stone Composition Using Machine Learning and Clinical Data: Implications for Treatment Strategies and Pathophysiological Insights. J Endourol 2024; 38:778-787. [PMID: 37975292 DOI: 10.1089/end.2023.0446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Purpose: Preventative strategies and surgical treatments for urolithiasis depend on stone composition. However, stone composition is often unknown until the stone is passed or surgically managed. Given that stone composition likely reflects the physiological parameters during its formation, we used clinical data from stone formers to predict stone composition. Materials and Methods: Data on stone composition, 24-hour urine, serum biochemistry, patient demographics, and medical history were prospectively collected from 777 kidney stone patients. Data were used to train gradient boosted machine and logistic regression models to distinguish calcium vs noncalcium, calcium oxalate monohydrate vs dihydrate, and calcium oxalate vs calcium phosphate vs uric acid stone types. Model performance was evaluated using the kappa score, and the influence of each predictor variable was assessed. Results: The calcium vs noncalcium model differentiated stone types with a kappa of 0.5231. The most influential predictors were 24-hour urine calcium, blood urate, and phosphate. The calcium oxalate monohydrate vs dihydrate model is the first of its kind and could discriminate stone types with a kappa of 0.2042. The key predictors were 24-hour urine urea, calcium, and oxalate. The multiclass model had a kappa of 0.3023 and the top predictors were age and 24-hour urine calcium and creatinine. Conclusions: Clinical data can be leveraged with machine learning algorithms to predict stone composition, which may help urologists determine stone type and guide their management plan before stone treatment. Investigating the most influential predictors of each classifier may improve the understanding of key clinical features of urolithiasis and shed light on pathophysiology.
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Affiliation(s)
- John A Chmiel
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
| | - Gerrit A Stuivenberg
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
| | - Jennifer F W Wong
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Linda Nott
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Jeremy P Burton
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Hassan Razvi
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, Canada
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Yoodee S, Peerapen P, Rattananinsruang P, Detsangiamsak S, Sukphan S, Thongboonkerd V. Large-scale identification of calcium oxalate stone inhibitory proteins in normal human urine. Int J Biol Macromol 2024; 275:133646. [PMID: 38969041 DOI: 10.1016/j.ijbiomac.2024.133646] [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: 05/20/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
Recent evidence has shown that proteins in normal human urine can inhibit calcium oxalate (CaOx) kidney stone formation. Herein, we performed fast protein liquid chromatography (FPLC) to fractionate normal human urinary proteins using anion-exchange (DEAE) and size-exclusion (Superdex 200) materials. FPLC fractions (F1-F15) were examined by CaOx crystallization, growth, aggregation and crystal-cell adhesion assays. The fractions with potent inhibitory activities against CaOx crystals were then subjected to mass spectrometric protein identification. The data revealed that 13 of 15 fractions showed inhibitory activities in at least one crystal assay. Integrating CaOx inhibitory scores demonstrated that F6, F7 and F8 had the most potent inhibitory activities. NanoLC-ESI-Qq-TOF MS/MS identified 105, 93 and 53 proteins in F6, F7 and F8, respectively. Among them, 60 were found in at least two fractions and/or listed among known inhibitors with solid experimental evidence in the StoneMod database (https://www.stonemod.org). Interestingly, 10 of these 60 potential inhibitors have been reported with lower urinary levels in CaOx stone formers compared with healthy (non-stone) individuals, strengthening their roles as potent CaOx stone inhibitors. Our study provides the largest dataset of potential CaOx stone inhibitory proteins that will be useful for further elucidations of stone-forming mechanisms and ultimately for therapeutic/preventive applications.
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Affiliation(s)
- Sunisa Yoodee
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Paleerath Peerapen
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Piyaporn Rattananinsruang
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sasinun Detsangiamsak
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sirirat Sukphan
- 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.
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Namba T, Ichii O, Natsuga K, Nakamura T, Otani Y, Kon Y. Collagen 17A1 in the Urothelium Regulates Epithelial Cell Integrity and Local Immunologic Responses in Obstructive Uropathy. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:1550-1570. [PMID: 38768778 DOI: 10.1016/j.ajpath.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 05/22/2024]
Abstract
Collagen 17A1 (COL17A1), an epidermal hemidesmosome component, is ectopically induced in the urothelium of mouse and human renal pelvis (RP) in parallel with urinary tract-associated lymphoid structure development. Here, COL17A1 was induced in obstructive uropathy-prone ureter of humans and cats. To ascertain its function, murine urinary organs with unilateral ureteral obstruction (UUO) were analyzed during 1 week after surgery. One day after UUO, COL17A1 expression increased in urothelial cells of RP and ureter, and was positively correlated with renal tubulointerstitial lesions. A portion of RP where the smooth muscle layer from the ureter was interrupted was sensitive to urothelium deciduation and COL17A1 induction, showing urine leaked from the RP lumen into the parenchyma. After urine stimulation, cultured immune cells expressed Cxcl2, also up-regulated in CD11b+ cells following COL17A1 stimulation. One day after UUO, CXCL2+ CD11b+ cells infiltrated the urothelium-disrupted area. However, these numbers were significantly lower in Col17a1-deficient mice. COL17A1+ urothelial cells partially co-expressed cytokeratin-14, a progenitor cell marker for urothelium, whereas Col17a1-deficient mice had lower numbers of cytokeratin-14+ cells. Gene Ontology analysis revealed that expression of epithelial- and immune-associated genes was up-regulated and down-regulated, respectively, in the ureter of Col17a1-deficient mice 4 days after UUO. Thus, COL17A1 maintains urothelium integrity by regulating urothelial cell adhesion, proliferation, and differentiation, and activates local immune responses during obstructive uropathy in mammals.
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Affiliation(s)
- Takashi Namba
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Osamu Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan; Laboratory of Agrobiomedical Science, Faculty of Agriculture, Hokkaido University, Sapporo, Japan.
| | - Ken Natsuga
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Teppei Nakamura
- Laboratory of Laboratory Animal Science and Medicine, Department of Applied Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Yuki Otani
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuhiro Kon
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Šálek T, Musil P, Vermeersch P, Marrington R, Dikmen ZG, Poláchová R, Kipman U, Kouri TT, Cadamuro J. Preservation of urine specimens for metabolic evaluation of recurrent urinary stone formers. Clin Chem Lab Med 2024; 0:cclm-2024-0773. [PMID: 39072394 DOI: 10.1515/cclm-2024-0773] [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: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Stability of concentrations of urinary stone-related metabolites was analyzed from samples of recurrent urinary stone formers to assess necessity and effectiveness of urine acidification during collection and storage. METHODS First-morning urine was collected from 20 adult calcium-stone forming patients at Tomas Bata Hospital in the Czech Republic. Urine samples were analyzed for calcium, magnesium, inorganic phosphate, uric acid, sodium, potassium, chloride, citrate, oxalate, and urine particles. The single-voided specimens were collected without acidification, after which they were divided into three groups for storage: samples without acidification ("NON"), acidification before storage ("PRE"), or acidification after storage ("POST"). The analyses were conducted on the day of arrival (day 0, "baseline"), or after storage for 2 or 7 days at room temperature. The maximum permissible difference (MPD) was defined as ±20 % from the baseline. RESULTS The urine concentrations of all stone-related metabolites remained within the 20 % MPD limits in NON and POST samples after 2 days, except for calcium in NON sample of one patient, and oxalate of three patients and citrate of one patient in POST samples. In PRE samples, stability failed in urine samples for oxalate of three patients, and for uric acid of four patients after 2 days. Failures in stability often correlated with high baseline concentrations of those metabolites in urine. CONCLUSIONS Detailed procedures are needed to collect urine specimens for analysis of urinary stone-related metabolites, considering both patient safety and stability of those metabolites. We recommend specific preservation steps.
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Affiliation(s)
- Tomáš Šálek
- Department of Clinical Biochemistry and Pharmacology, 37742 Tomas Bata Hospital Zlín , Zlín, Czech Republic
- Institute of Clinical Biochemistry and Diagnostics, Medical Faculty in Hradec Králové, Charles University, Prague, Czech Republic
| | - Pavel Musil
- Department of Clinical Biochemistry and Pharmacology, 37742 Tomas Bata Hospital Zlín , Zlín, Czech Republic
| | - Pieter Vermeersch
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Rachel Marrington
- Birmingham Quality (UK NEQAS), University Hospitals NHS Foundation Trust, Birmingham, UK
| | - Zeliha G Dikmen
- Clinical Pathology Laboratory, Department of Medical Biochemistry and Hacettepe University Hospitals, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Radka Poláchová
- Department of Clinical Biochemistry and Pharmacology, 37742 Tomas Bata Hospital Zlín , Zlín, Czech Republic
| | | | - Timo T Kouri
- Department of Clinical Chemistry, University of Helsinki, Espoo, Finland
- Hospital District of Helsinki and Uusimaa, HUS Diagnostic Center, HUSLAB, Helsinki, Finland
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
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Haberal HB, Ibis MA, Akpinar S, Uyanikoglu B, Ekmen H, Sadioglu FE, Senocak C, Bozkurt OF. Comparative analysis of scoring systems for patients undergoing retrograde intrarenal surgery with isolated lower calyx stones. World J Urol 2024; 42:447. [PMID: 39066919 DOI: 10.1007/s00345-024-05165-0] [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: 04/19/2024] [Accepted: 07/05/2024] [Indexed: 07/30/2024] Open
Abstract
PURPOSE It is critical to provide patients with accurate information on potential surgical outcomes during the preoperative phase. Several scoring systems have been developed for this specific purpose. This study aimed to examine the predicted efficacy of scoring systems in patients with isolated lower calyx stones who underwent retrograde intrarenal surgery (RIRS). METHODS We performed a retrospective analysis of 85 patients who underwent RIRS for lower calyx stones between 2016 and 2023. The study computed each participant's Resorlu-Unsal Stone score (RUSS), R.I.R.S. scoring system score, Modified Seoul National University Renal Stone Complexity (S-ReSC) score, S.T.O.N.E. score, Ito's nomogram, and T.O.HO score. Residual stones less than 4 mm were classified as clinically insignificant residual fragments (CIRFs) and regarded as successful. Following that, we used receiver-operating characteristic (ROC) curves to compare various scoring systems' success predictions. RESULTS The median scores for RUSS, R.I.R.S. scoring system, Modified S-ReSC, S.T.O.N.E., Ito's nomogram, and T.O.HO score were 1 (1), 7 (2), 2 (0), 11 (1), 18 (4), and 7 (1), respectively. When CIRF cases were included, the stone-free rate increased to 80%. Only Ito's nomogram from scoring systems has a statistically significant cut-off value for success in ROC analysis (p = 0.021). In multivariate analysis, stone volume and preoperative hydronephrosis were associated with success (p = 0.004 and p = 0.035, respectively). CONCLUSION In the multivariate analysis, none of the scoring systems were significantly associated with success. Hence, a new scoring system must be developed exclusively for patients with isolated lower pole stones undergoing RIRS.
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Affiliation(s)
- Hakan Bahadir Haberal
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey.
| | - Muhammed Arif Ibis
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Serkan Akpinar
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Burak Uyanikoglu
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Halil Ekmen
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Fahri Erkan Sadioglu
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Cagri Senocak
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
| | - Omer Faruk Bozkurt
- Department of Urology, Ministry of Health, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, 06290, Turkey
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Chen Q, Bao W, Kong X, Zhu J, Hou S, Zhang Y, Ye R, Fang C, Li C, Miao F, Chen W, Wu L. Association between the oxidative balance score and kidney stones in adults. World J Urol 2024; 42:425. [PMID: 39037613 DOI: 10.1007/s00345-024-05144-5] [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: 10/08/2023] [Accepted: 06/23/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVES This study was to investigate the correlation between oxidative balance score (OBS) and the prevalence of kidney stones in the general adult population. MATERIALS AND METHODS We conducted an analysis using data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) project, including 17,988 participants. The OBS was computed based on previous research, combining 16 dietary factors and 4 lifestyle factors. Multiple logistic regressions and restricted cubic spline (RCS) regressions were utilized to explore the associations between OBS and kidney stone prevalence. RESULTS Our analysis included 1,622 adults with kidney stones and 16,366 adults without kidney stones. The average age of participants was 46.86 ± 0.27 years, with 50.72% being male. The median OBS was 22.00 (17.00, 27.00). After adjusting for all covariates, each one-unit increase in OBS was associated with a 3% decrease in kidney stone prevalence (odds ratio [OR] = 0.97 [0.96-0.98], P < 0.001). Moreover, compared to the first quartile, the fourth quartile of OBS (OR = 0.65 [0.50-0.84], P = 0.001) exhibited a negative association with kidney stone prevalence after adjusting for multiple variables. Furthermore, we observed a non-linear negative relationship between OBS and kidney stone prevalence, with inflection points at 18.2 (P for nonlinearity = 0.048). Stratified analysis did not identify any variables significantly affecting the results. CONCLUSION Our findings indicate that a higher OBS is associated with a decreased prevalence of kidney stones in the general adult population.
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Affiliation(s)
- Qiongqiu Chen
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Wenshuo Bao
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Xianghui Kong
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Jun Zhu
- Department of Plastic and Cosmetic Surgery, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Saimiao Hou
- Department of Intensive Care Unit, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Yuanfeng Zhang
- Department of Urology, Shantou Central Hospital, Shantou, 515000, P.R. China
| | - RuXian Ye
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Chongguo Fang
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Chengpeng Li
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Feilong Miao
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Wu Chen
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China
| | - Linbin Wu
- Department of Urology, Wenzhou People's Hospital, Wenzhou, 325000, P.R. China.
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Toumia M, Sassi S, Dhaoui R, Kouraichi C, Bel Haj Ali K, Sekma A, Zorgati A, Jaballah R, Yaakoubi H, Youssef R, Beltaief K, Mezgar Z, Khrouf M, Sghaier A, Jerbi N, Zemni I, Bouida W, Grissa MH, Boubaker H, Boukef R, Msolli MA, Nouira S. Magnesium Sulfate Versus Lidocaine as an Adjunct for Renal Colic in the Emergency Department: A Randomized, Double-Blind Controlled Trial. Ann Emerg Med 2024:S0196-0644(24)00348-2. [PMID: 39033450 DOI: 10.1016/j.annemergmed.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 07/23/2024]
Abstract
STUDY OBJECTIVE We wished to determine whether the addition of magnesium sulfate (MgSO4) or lidocaine to diclofenac could improve the analgesic efficacy in emergency department (ED) patients with acute renal colic. METHODS In this prospective, double-blinded, randomized controlled trial of patients aged 18 to 65 years with suspected acute renal colic, we randomized them to receive 75 mg intramuscular (IM) diclofenac and then intravenous (IV) MgSO4, lidocaine, or saline solution control. Subjects reported their pain using a numerical rating scale (NRS) before drug administration and then 5, 10, 20, 30, 60, and 90 minutes afterwards. Our primary outcome was the proportion of participants achieving at least a 50% reduction in the NRS score 30 minutes after drug administration. RESULTS We enrolled 280 patients in each group. A 50% or greater reduction in the NRS score at 30 minutes occurred in 227 (81.7%) patients in the MgSO4 group, 204 (72.9%) in the lidocaine group, and 201 (71.8%) in the control group, with significant differences between MgSO4 and lidocaine (8.8%, 95% confidence interval [CI] [1.89 to 15.7], P=.013) and between MgSO4 and control (9.9%, 95% CI [2.95 to 16.84], P=.004). Despite this, differences between all groups at every time point were below the accepted 1.3 threshold for clinical importance. There were no observed differences between groups in the frequency of rescue analgesics and return visits to the ED for renal colic. There were more adverse events, although minor, in the MgSO4 group. CONCLUSION Adding intravenous MgSO4, but not lidocaine, to IM diclofenac offered superior pain relief but at levels below accepted thresholds for clinical importance.
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Affiliation(s)
- Marwa Toumia
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Haj Ali Soua Regional Hospital, Monastir, Tunisia
| | - Sarra Sassi
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Randa Dhaoui
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Cyrine Kouraichi
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Khaoula Bel Haj Ali
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Adel Sekma
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Asma Zorgati
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Rahma Jaballah
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Hajer Yaakoubi
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Rym Youssef
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Kaouthar Beltaief
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Zied Mezgar
- Emergency Department, Hached University Hospital, Sousse, Tunisia
| | - Mariem Khrouf
- Emergency Department, Hached University Hospital, Sousse, Tunisia
| | - Amira Sghaier
- Emergency Department, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Nahla Jerbi
- Emergency Department, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Wahid Bouida
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mohamed Habib Grissa
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hamdi Boubaker
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Riadh Boukef
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Mohamed Amine Msolli
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Semir Nouira
- Research Laboratory LR12SP18, Monastir University, Monastir, Tunisia; Emergency Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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Cheng Y, Zheng H, Yin H, Yin D, Wang H, Wang Y, Tang Q, Gu S. Changes in metabolic overweight phenotypes over time and risk of nephrolithiasis: a cohort study. BMC Public Health 2024; 24:1898. [PMID: 39014388 PMCID: PMC11251252 DOI: 10.1186/s12889-024-19229-8] [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: 11/21/2023] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Overweight/obesity is considered an independent risk factor for nephrolithiasis, but little is known about its effect on nephrolithiasis according to metabolic health status. OBJECTIVES We aimed to investigate the association between various metabolic overweight phenotypes and the occurrence of nephrolithiasis. It also explores whether changes in these phenotypes over time influence the risk of nephrolithiasis. MATERIALS AND METHODS A total of 10,315 participants free of nephrolithiasis who underwent an annual health checkup from 2017 to 2022 were included in our prospective cohort study. They were categorized into four groups according to the presence of overweight and metabolic abnormalities (MA). The primary endpoint was the occurrence of renal stones. Multivariable Cox analysis was conducted to elucidate the relationship between metabolic overweight phenotypes and incident nephrolithiasis. RESULTS During a median follow-up duration of 4.02 years, nephrolithiasis occurred in 1,468 (14.23%) participants. In the full cohort, we observed that the 5-year cumulative incidences of nephrolithiasis were highest in the metabolically healthy overweight (MHO) and metabolically abnormal overweight (MAO) groups. The hazard ratios (HRs) for nephrolithiasis, relative to metabolically healthy normal weight (MHNW), ranged from 1.19 (95% CI:1.03-1.37; MHO) to 1.32 (95% CI:1.15-1.51; MAO). Furthermore, individuals with persistent MHO throughout follow-up were at a 1.42-fold increased risk of nephrolithiasis (P < 0.001), and 32.17% of individuals experienced changes in phenotype during follow-up. Among MAO subjects, those who transitioned to MHO and MHNW had a 26% and 45% lower risk of incident nephrolithiasis, respectively, compared to those who persisted in the MAO phenotype. CONCLUSION Individuals in the MHO and MAO groups exhibit an elevated risk of incident nephrolithiasis in this prospective cohort study. A significant proportion of nephrolithiasis cases may be potentially preventable through the appropriate management of metabolic risk factors for MAO subjects.
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Affiliation(s)
- Yang Cheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Zheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hongli Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Donghua Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Ying Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China.
| | - Qiang Tang
- School of Sports and Health, Nanjing Sport Institute, 8 Ling-Gu Temple Road, Nanjing, 210014, China.
- Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, China.
| | - Shouyong Gu
- Institute of Geriatric Medicine, Jiangsu Province Geriatric Hospital, 65 Jiang-Su Road, Nanjing, 210009, China.
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Sun P, Yue J, Lu C, Ji K, Yang R, Lu J, Song X, Hu H, Zhao J, Yang Y, Xu Y. Targeting urinary calcium oxalate crystallization with inulin-type AOFOS from Aspidopterys obcordata Hemsl. for the management of rat urolithiasis. JOURNAL OF ETHNOPHARMACOLOGY 2024; 329:118149. [PMID: 38580188 DOI: 10.1016/j.jep.2024.118149] [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: 02/24/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Calcium oxalate crystals play a key role in the development and recurrence of kidney stones (also known as urolithiasis); thus, inhibiting the formation of these crystals is a central focus of urolithiasis prevention and treatment. Previously, we reported the noteworthy in vitro inhibitory effects of Aspidopterys obcordata fructo oligosaccharide (AOFOS), an active polysaccharide of the traditional Dai medicine Aspidopterys obcordata Hemsl. (commonly known as Hei Gai Guan), on the growth of calcium oxalate crystals. AIM OF THE STUDY To investigated the effectiveness and mechanism of AOFOS in treating kidney stones. MATERIALS AND METHODS A kidney stones rats model was developed, followed by examining AOFOS transport dynamics and effectiveness in live rats. Additionally, a correlation between the polysaccharide and calcium oxalate crystals was studied by combining crystallization experiments with density functional theory calculations. RESULTS The results showed that the polysaccharide was transported to the urinary system. Furthermore, their accumulation was inhibited by controlling their crystallization and modulating calcium ion and oxalate properties in the urine. Consequently, this approach helped effectively prevent kidney stone formation in the rats. CONCLUSIONS The present study emphasized the role of the polysaccharide AOFOS in modulating crystal properties and controlling crystal growth, providing valuable insights into their potential therapeutic use in managing kidney stone formation.
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Affiliation(s)
- Peng Sun
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | - Jiarui Yue
- Dehong Vocational College, Mangshi, 678400, Yunnan, China; School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, 650500, China
| | - Chuanli Lu
- Institute of Nanfan & Seed Industry, Guangdong Academy of Sciences, Guangzhou, Guangdong, 510316, China
| | - Kailong Ji
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | - Raoqiong Yang
- Key Laboratory of Tropical Forest Ecology, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | - Jianmei Lu
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | - Xingzhen Song
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | - Huabin Hu
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China
| | | | - Yongping Yang
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China.
| | - Youkai Xu
- Key Laboratory of Tropical Plant Resources and Sustainable Use, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun, Mengla, Yunnan, 666303, China.
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12
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Su B, Ren Y, Yao W, Su Y, He Q. Mitochondrial dysfunction and NLRP3 inflammasome: key players in kidney stone formation. BJU Int 2024. [PMID: 38967108 DOI: 10.1111/bju.16454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
The mitochondrion serves as a critical intracellular organelle, engaging in essential roles in the regulation of energy production, oxidative stress management, calcium homeostasis, and apoptosis. One such disease that has been particularly associated with these functions is kidney stone disease (KSD), specifically calcium oxalate (CaOx). It is underpinned by oxidative stress and tissue inflammation. Recent studies have shed light on the vital involvement of mitochondrial dysfunction, the nucleotide-binding domain and leucine-rich repeat containing protein 3 (NLRP3) inflammasome, endoplasmic reticulum stress and subsequent cell death in CaOx crystal retention and aggregation. These processes are pivotal in the pathogenesis of kidney stone formation. This review focuses on the pivotal roles of mitochondria in renal cell functions and provides an overview of the intricate interconnectedness between mitochondrial dysfunction and NLRP3 inflammasome activation in the context of KSD. It is essential to recognise the utmost significance of gaining a comprehensive understanding of the mechanisms that safeguard mitochondrial function and regulate the NLRP3 inflammasome. Such knowledge carries significant scientific implications and opens up promising avenues for the development of innovative strategies to prevent the formation of kidney stones.
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Affiliation(s)
- Boyan Su
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nepho-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - YaLin Ren
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nepho-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- College of Animal Science and Technology, Guangxi University, Nanning, Guangxi, China
| | - Weimin Yao
- Department of Urology, Tongji Medical College Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Su
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Qiqi He
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nepho-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Abdel Gawad AM, Moustafa BEA, Abouelgreed TA, Elnady EA, Khater S, Rehan M, Elebiary MF, Fathy BA, Shaalan A, Ramadan N, Hindawy M, Abdelkader SF. Exploring the potential of combined B-mode features and color Doppler ultrasound in the diagnosis of ureteric stone as an alternative to ionizing radiation exposure by computed tomography. Arch Ital Urol Androl 2024; 96:12523. [PMID: 38934522 DOI: 10.4081/aiua.2024.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/11/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE To assess the diagnostic efficacy of integrating B-mode and color Doppler capabilities of ultrasound (US) to establish a robust standalone diagnostic tool for the diagnosis of ureteric stones as an alternative to non-contrast-enhanced computed tomography (NCCT). METHODS A total of 140 consecutive patients diagnosed with ureteric stones using NCCT were enrolled. On the same day, US in both B-mode and Color Doppler was performed by an experienced radiologist who was blinded to the NCCT scan results. The diagnostic rate of US for stone detection was recorded. Additionally, baseline patient and stone characteristics were analyzed for their association with the accuracy of stone detection using US. RESULTS US exhibited a high sensitivity of 91.43%, detecting 128 out of 140 stone foci. Notably, ureteric stones in the proximal and uretero-vesical junction (UVJ) segments were readily identifiable compared to those in the pelvic region (p = 0.0003). Additionally, hydronephrosis enhanced the US's ability to detect stones (p < 0.0001). Conversely, abdominal gases and obesity adversely affected US capabilities (p < 0.0001 and p = 0.009, respectively). Stone side, size, and density showed no statistically significant impact (p > 0.05). CONCLUSIONS US with its color Doppler capabilities could serve as a reliable and safe alternative imaging modality in the diagnostic work up of patients with ureterolithiasis. Factors including stone location, Hydronephrosis, weight and abdominal gases significantly influenced its accuracy.
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Affiliation(s)
| | | | | | - Esam A Elnady
- Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta.
| | - Saed Khater
- Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta.
| | - Mohamed Rehan
- Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta.
| | | | - Basem A Fathy
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo.
| | - Ahmed Shaalan
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo.
| | | | - Mohamed Hindawy
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo.
| | - Salma F Abdelkader
- Department of Radiology, Faculty of Medicine, Ain shams University, Cairo.
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Wang Q, Zhang J, Yin X, Liu T, Li C, Yuan H, Li D. Antiurolithiatic effect of triptonide in ethylene glycol-induced urolithiasis in rats. Toxicol Mech Methods 2024:1-10. [PMID: 38922301 DOI: 10.1080/15376516.2024.2364882] [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: 11/21/2023] [Accepted: 06/01/2024] [Indexed: 06/27/2024]
Abstract
Urolithiasis is one of the most prevalent benign urological disorders globally with a high incidence rate. Male Sprague-Dawley rats were chemically induced to have urolithiasis and treated with triptonide and the standard antiurolithic drug cystone. Kidney weight was measured to detect calculi formation, and urinary parameters such as pH, 24-h urine volume, and protein content were measured to analyze the urolithiasis induction in rats. The inorganic ions, organic solutes, antioxidant levels, and inflammatory cytokines were measured in the experimental rats. Triptonide treatment significantly modulated the urinary pH, decreased the protein concentration, and increased the urinary outflow in urolithiasis induced rats. It also significantly decreased the urinary excretion of calcium and phosphorous and increased the excretion of magnesium, potassium, sodium, creatinine, and uric acid. SOD, CAT, and GPx levels were increased in triptonide-treated rats, and it significantly reduced the MDA levels. Triptonide treatment also decreased the levels of inflammatory cytokines and prevented the renal tissue from inflammation. To conclude, our results prove that triptonide significantly prevents calculi formation and protects renal tissue from urolithiasis-induced damage in rats. Further studies may prove triptonide a potent alternative to currently available antiurolithic drugs.
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Affiliation(s)
- Qiang Wang
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Jinghong Zhang
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Xiaosong Yin
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Tongwei Liu
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Chuangui Li
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Haibo Yuan
- Department of Urology, Baoding First Central Hospital, Baoding, China
| | - Ding Li
- Department of Urology, Baoding First Central Hospital, Baoding, China
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15
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Omar M, Miller LE, Bhattacharyya S, Monga M. Implications of the Revised US Demographic Standards on Understanding Kidney Stone Disease Disparities in Middle Eastern and North African Americans. Urology 2024:S0090-4295(24)00489-8. [PMID: 38942393 DOI: 10.1016/j.urology.2024.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/26/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Affiliation(s)
- Mohamad Omar
- Urology Department, Menoufia University, Shibin El Kom, Egypt
| | - Larry E Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN.
| | | | - Manoj Monga
- University of California San Diego, San Diego, CA
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16
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Sierra A, Etcheverry B, Alvarez-Maestro M, López JM, Fiol M, Torrecilla C, Vigués F, Martínez C, Carbonell E, Martinez-Perez S, Alcaraz A, Luque MP, Musquera M. Management of deceased and living kidney donor with lithiasis: a multicenter retrospective study on behalf of the renal transplant group of the Spanish urological association. J Nephrol 2024:10.1007/s40620-024-01960-5. [PMID: 38907824 DOI: 10.1007/s40620-024-01960-5] [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: 11/26/2023] [Accepted: 04/24/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND To maximize the availability of suitable grafts and ensure effective management, several reports have demonstrated successful outcomes when using kidney grafts with urolithiasis. This multicenter study reports on the management and long-term outcomes of kidney transplantation using renal grafts with lithiasis. METHODS Retrospective data from three Spanish hospitals were analyzed for kidney transplants involving grafts with nephrolithiasis performed between December 2009 and August 2023. The study included adult patients, excluding those with incomplete records. It evaluated stone characteristics, complications, and outcomes in recipients and in living kidney donors. RESULTS Out of 38 analyzed kidney transplants, 57.9% were cadaveric and 42.1% were from living kidney donors. Most diagnoses were incidental during donor evaluation, with an average stone size of 7.06 mm. After follow-up (median 26 months), all recipients but one had functioning grafts, and there were no stone recurrences in both recipients and living kidney donors. Conservative management was adopted in 28 cases, while 10 cases required ex-vivo flexible ureterorenoscopy for stone removal. Following conservative management, 5 patients needed additional treatments for stone-related events. CONCLUSIONS Kidneys with lithiasis can be considered for transplantation in selected cases, resulting in good functional outcomes with no stone recurrence in recipients or living donors.
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Affiliation(s)
- Alba Sierra
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Begoña Etcheverry
- Department of Urology, Hospital de Bellvitge-University of Barcelona, Barcelona, Spain
| | | | - Juan Manuel López
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Maria Fiol
- Department of Urology, Hospital de Bellvitge-University of Barcelona, Barcelona, Spain
| | - Carlos Torrecilla
- Department of Urology, Hospital de Bellvitge-University of Barcelona, Barcelona, Spain
| | - Francesc Vigués
- Department of Urology, Hospital de Bellvitge-University of Barcelona, Barcelona, Spain
| | - Carmen Martínez
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Enric Carbonell
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | | | - Antonio Alcaraz
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Maria Pilar Luque
- Department of Urology, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Mireia Musquera
- Departament de Cirurgia i Especialitats Médicoquirúrgiques, Universitat de Barcelona, Barcelona, Spain.
- Servei Urología, Hospital clínic, Barcelona, Spain.
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17
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Zhu H, Chen Y, Feng Y, Chen H. Association between the composite dietary antioxidant index and the prevalence and recurrence of kidney stones: results of a nationwide survey. Front Nutr 2024; 11:1413937. [PMID: 38962435 PMCID: PMC11220257 DOI: 10.3389/fnut.2024.1413937] [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: 04/08/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Aim This study aims to evaluate the relationship between the Composite Dietary Antioxidant Index (CDAI) and the prevalence and recurrence of kidney stones. Methods Data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2014 were used in this cross-sectional analysis. The CDAI was derived by standardizing the intake of dietary antioxidants from 24 h dietary recalls. The study assessed the prevalence and recurrence of kidney stones based on questionnaire responses. The association between the CDAI and both the prevalence and recurrence of kidney stones was investigated using multivariable logistic regression. Subgroup analyses and interaction tests further evaluated the robustness of this relationship. Results The study included 20,743 participants, and the reported incidence and recurrence rates of kidney stones were 9.09 and 2.90%, respectively. After stratifying the CDAI into tertiles, an inverse trend was observed in both kidney stones' prevalence and recurrence probabilities with increasing CDAI levels. Adjusting for confounding factors, individuals in the top tertile had a 23% lower prevalence of kidney stones (OR = 0.77, 95% CI: 0.66, 0.90, p = 0.0011) and a 39% lower recurrence rate (OR = 0.61, 95% CI: 0.47, 0.80, p = 0.0003) than those in the bottom tertile. In addition, interaction tests showed that age, gender, body mass index, hypertension, and diabetes did not significantly affect the relationship between CDAI levels and kidney stone prevalence and recurrence rates. Conclusion Our study suggests that increased levels of CDAI are associated with reduced incidence and recurrence rates of kidney stones. Therefore, increasing the intake of dietary antioxidants may be an effective strategy for preventing kidney stones and their recurrence.
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Affiliation(s)
| | | | - Yue Feng
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hui Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
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18
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Balawender K, Łuszczki E, Mazur A, Wyszyńska J. The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review. Nutrients 2024; 16:1932. [PMID: 38931286 PMCID: PMC11206918 DOI: 10.3390/nu16121932] [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: 05/21/2024] [Revised: 06/15/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.
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Affiliation(s)
- Krzysztof Balawender
- Institute of Medical Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland;
- Clinical Department of Urology and Urological Oncology, Municipal Hospital, Rycerska 4, 35-241 Rzeszow, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland; (E.Ł.); (J.W.)
| | - Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland;
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland; (E.Ł.); (J.W.)
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Li J, Ke K, Zhang B, Liu Y, Bai J, Wang M, Li H. Association of single nucleotide genetic polymorphisms of vitamin D receptor and calcium-sensitive receptor with calcium-containing kidney stones in Chinese Dai populations: a prospective multi-center study. Int Urol Nephrol 2024:10.1007/s11255-024-04109-2. [PMID: 38886300 DOI: 10.1007/s11255-024-04109-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To evaluate the association between vitamin D receptor (VDRs) and calcium-sensitive receptor (CaSR) gene polymorphisms and calcium-containing kidney stones (CCKS) in Dai populations. METHODS A total of 160 CCKS patients and 87 healthy controls were included in this study. CCKS was confirmed using urological computed tomography (CT), plain abdominal radiograph, or surgical lithotomy. Stone samples obtained during surgery were analyzed using infrared spectroscopy. Venous blood and 24-h urine samples were collected and analyzed using Sanger sequencing and high-performance liquid chromatography, respectively. Genetic variants in the VDR gene (rs7975232, rs2228570, rs731236, and rs1544410) and CaSR gene (rs7652589, rs1801725, and rs1042636) were identified through sequence analysis. RESULTS Analysis of genotype and allele frequencies revealed that the rs7975232 polymorphism in the VDR gene and the rs7652589 allele in the CaSR gene were significantly associated with CCKS. Furthermore, patients carrying the AC and AA genotypes of rs7975232 showed a higher incidence of hypocitraturia compared to those with other genotypes (p < 0.05). The AA and GG genotypes of rs1042636 and the AA genotype of rs7652589 were significantly associated with hypercalciuria (p < 0.05). CONCLUSION CCKS in this study population may be closely related to hypocitraturia caused by the VDR locus rs7975232 polymorphism and hypercalciuria caused by the CaSR locus rs1042636 and rs7652589 polymorphism.
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Affiliation(s)
- Ji Li
- Department of Urinary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
- Department of Urinary Surgery, Yunnan Dehong People's Hospital, Dehong, 678400, Yunnan, China
| | - Kunbin Ke
- Department of Urinary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Baiyu Zhang
- Department of Urinary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Yidao Liu
- Department of Urinary Surgery, Yunnan Dehong People's Hospital, Dehong, 678400, Yunnan, China
| | - Jing Bai
- Department of Urinary Surgery, Yunnan Dehong People's Hospital, Dehong, 678400, Yunnan, China
| | - Mengyue Wang
- Department of Urinary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Hao Li
- Department of Urinary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China.
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20
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Mavridis C, Bouchalakis A, Tsagkaraki V, Somani BK, Mamoulakis C, Tokas T. Recurrent Urinary Stone Formers: Imaging Assessment and Endoscopic Treatment Strategies: A Systematic Search and Review. J Clin Med 2024; 13:3461. [PMID: 38929988 PMCID: PMC11204450 DOI: 10.3390/jcm13123461] [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: 05/13/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: Nephrolithiasis is a heterogeneous disease with a high prevalence and recurrence rate. Although there has been much progress regarding the surgical treatment of stones, a standardized follow-up, especially in recurrent stone formers (SFs), has yet to be decided. This fact leads to the overuse of computed tomography (CT) scans and many reoperations in patients, thus increasing their morbidity and the financial burden on the health systems. This review systematically searched the literature for original articles regarding imaging strategies and endoscopic treatment for patients with recurrent urolithiasis, aiming to identify optimal strategies to deal with these patients. Methods: We systematically searched the Medline database (accessed on 1 April 2024) for articles regarding imaging modalities and endoscopic treatment for patients with recurrent urinary tract lithiasis. Results: No specific follow-up or endoscopic treatment strategy exists for patients with recurrent urolithiasis. CT scan was the imaging modality most used in the studies, followed by X-ray, ultrasonography, and digital tomosynthesis. A transparent algorithm could not be identified. Percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and ureteroscopy (URS) were used in the studies for endoscopic treatment. PCNL showed the best stone-free (SFr) rate and lowest hazard ratio (HR) for reoperation. RIRS showed superiority over extracorporeal shockwave lithotripsy for recurrent SFs, but fragments over 4 mm increased the recurrent rate. URS has an increased HR for reoperation for bilateral stones. Conclusions: The heterogeneity of urolithiasis leaves urologists without a standardized plan for recurrent SFs. Thus, each patient's follow-up should be planned individually and holistically. Pre-stenting is not to be avoided, especially in high-risk patients, and SFr status needs to be the aim. Finally, CT scans should not be generally overused but should be part of a patient's treatment plan. Prospective studies are required to define SFr status, the size of significant residual fragments, and the modalities of intervention and follow-up.
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Affiliation(s)
- Charalampos Mavridis
- Department of Urology, School of Medicine, University General Hospital of Heraklion, 71110 Heraklion, Greece
| | - Athanasios Bouchalakis
- Department of Urology, School of Medicine, University General Hospital of Heraklion, 71110 Heraklion, Greece
| | | | - Bhaskar Kumar Somani
- Department of Urology, University Hospitals Southampton, NHS Trust, Southampton SO16 6YD, UK
| | - Charalampos Mamoulakis
- Department of Urology, School of Medicine, University General Hospital of Heraklion, 71110 Heraklion, Greece
| | - Theodoros Tokas
- Department of Urology, School of Medicine, University General Hospital of Heraklion, 71110 Heraklion, Greece
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, 6060 Hall in Tirol, Austria
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21
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Lin H, Lin H, Liu C, Lin T, He Y, Shen Z, Ruan M. Clinical study of UMP and RIRS in 1.0-2.0 cm diameter renal/upper ureteral calculi. World J Urol 2024; 42:376. [PMID: 38869843 DOI: 10.1007/s00345-024-05076-0] [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: 09/17/2023] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND The purpose of this study was to compare the efficacy and safety of Ultra-mini-percutaneous nephrolithotomy (UMP) and Retrograde intrarenal surgery (RIRS) for renal/upper ureteral calculi in 1.0-2.0 cm diameter. METHODS From October 2017 to October 2022, the surgical treatment of patients with renal/upper ureteral calculi in 1.0-2.0 cm diameter who were admitted to our hospital was retrospectively analyzed. They were divided into two groups, the UMP group (sixty-two cases) and the RIRS group (one hundred and nine cases), according to the different surgical methods. Baseline data includes general information, stone size, location, CT value, hydronephrosis, creatinine level, etc. RESULTS: Intraoperative blood loss was 33.6 ± 8.5 ml in the UMP group was significantly more than 4.3 ± 0.7 ml in the RIRS group (P < 0.05). Intraoperative renal pelvis pressure of UMP group 10.5 ± 1.3 mmHg was significantly lower than RIRS group 23.6 ± 5.6 mmHg (P < 0.05). The incidence of postoperative infection was higher in the RIRS group (thirteen cases [11.93%]), and one case ([1.61%]) in the UMP group (P < 0.05). Routine CT scans on the second day and two months after surgery showed that the stone clearance rates in the UMP group were 87.1% and 93.5%, respectively, higher than those in the RIRS group (69.7% and 79.8%, respectively; P < 0.05). CONCLUSION UMP has the advantage of a higher stone-free rate but a higher risk of injury and bleeding. The advantages of RIRS include less trauma, less bleeding, and faster recovery, but lower stone-free rates and a higher risk of infection.
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Affiliation(s)
- Haili Lin
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Huiying Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Chenyu Liu
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Tianqi Lin
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Yongxin He
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Zaixiong Shen
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Minyi Ruan
- Department of Science and Education, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
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22
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Pan W, Yun T, Ouyang X, Ruan Z, Zhang T, An Y, Wang R, Zhu P. A blood-based multi-omic landscape for the molecular characterization of kidney stone disease. Mol Omics 2024; 20:322-332. [PMID: 38623715 DOI: 10.1039/d3mo00261f] [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: 04/17/2024]
Abstract
Kidney stone disease (KSD, also named renal calculi, nephrolithiasis, or urolithiasis) is a common urological disease entailing the formation of minerals and salts that form inside the urinary tract, frequently caused by diabetes, high blood pressure, hypertension, and monogenetic components in most patients. 10% of adults worldwide are affected by KSD, which continues to be highly prevalent and with increasing incidence. For the identification of novel therapeutic targets in KSD, we adopted high-throughput sequencing and mass spectrometry (MS) techniques in this study and carried out an integrative analysis of exosome proteomic data and DNA methylation data from blood samples of normal and KSD individuals. Our research delineated the profiling of exosomal proteins and DNA methylation in both healthy individuals and those afflicted with KSD, finding that the overexpressed proteins and the demethylated genes in KSD samples are associated with immune responses. The consistency of the results in proteomics and epigenetics supports the feasibility of the comprehensive strategy. Our insights into the molecular landscape of KSD pave the way for a deeper understanding of its pathogenic mechanism, providing an opportunity for more precise diagnosis and targeted treatment strategies for KSD.
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Affiliation(s)
- Weibing Pan
- Department of Urology, Shenzhen Pingshan People's Hospital, Shenzhen, Guangdong 518118, China
| | - Tianwei Yun
- Department of Urology, Shenzhen Pingshan People's Hospital, Shenzhen, Guangdong 518118, China
| | - Xin Ouyang
- Department of Laboratory Medicine, Shenzhen Pingshan People's Hospital, Shenzhen, Guangdong 518118, China.
| | - Zhijun Ruan
- Pingshan Translational Medicine Center, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518020, China.
| | - Tuanjie Zhang
- Pingshan Translational Medicine Center, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518020, China.
| | - Yuhao An
- Pingshan Translational Medicine Center, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518020, China.
| | - Rui Wang
- Pingshan Translational Medicine Center, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518020, China.
| | - Peng Zhu
- Department of Laboratory Medicine, Shenzhen Pingshan People's Hospital, Shenzhen, Guangdong 518118, China.
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23
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Gao C, Gao M, Huang Y. Association between serum 25-hydroxyvitamin D concentrations and kidney stone: a cohort study in the UK Biobank. Int Urol Nephrol 2024:10.1007/s11255-024-04111-8. [PMID: 38842659 DOI: 10.1007/s11255-024-04111-8] [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: 02/15/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To investigate the association between serum 25(OH)D and kidney stone disease (KSD) in participants from the UK Biobank. METHODS We used data from the UK Biobank. Our analysis involved Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the association between serum 25(OH)D levels (measured at the time of recruitment) and the risk of KSD, which was determined using hospital records. RESULTS This study involved 444,343 participants, with 4,458 cases of KSD identified during an average follow-up period of 12.6 years. Higher 25(OH)D levels were not associated with developing kidney stones in general population model 3 (HR = 0.88 [95% CI 0.77-1.01]). Interestingly, higher serum 25(OH)D concentrations in women over 60 years old were associated with a lower risk of kidney stone disease. The multivariate HRs and 95% CIs for participants who had serum 25(OH)D ≥ 50 nmol/L or ≥ 75 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.74 (0.58-0.95), 0.60 (0.43-0.85) for KSD, respectively (P for trend < 0.01). However, this trend was not statistically significant in the subgroup analysis of serum calcium ion concentration. CONCLUSION High 25(OH)D levels were not associated with a higher incidence of kidney stones if serum calcium levels are within a normal range. The findings alleviate physiological concerns regarding the supplementation of vitamin D alone to raise serum 25(OH)D concentration.
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Affiliation(s)
- Chao Gao
- Affiliated Changsha Hospital of Hunan Normal University, Changsha, 410008, China
- Department of Emergency, The Fourth Hospital of Changsha, Changsha, 410008, China
| | - Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Yan Huang
- Affiliated Changsha Hospital of Hunan Normal University, Changsha, 410008, China.
- Department of Emergency, The Fourth Hospital of Changsha, Changsha, 410008, China.
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24
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Mohammadi A, Zareian Baghdadabad L, Zahmatkesh P, Moradi Tabriz H, Khajavi A, Mesbah G, Nikoofar P, Aghamir SMK. Effects of the Surgical Ligation of the Ureter in Different Locations on the Kidney over Time in the Rat Model. Adv Urol 2024; 2024:6611081. [PMID: 38962754 PMCID: PMC11221982 DOI: 10.1155/2024/6611081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 07/05/2024] Open
Abstract
Purpose To evaluate the effects of the surgical ligation of the ureter in different locations on the kidney over time in the rat model. Methods A total of 155 rats were enrolled and randomly divided into the case (n = 150) and control (n = 5) groups. The case group included three separate groups (fifty rats in each group) that underwent surgical ureteral ligation at the proximal, middle, and distal ureter. The laboratory tests, and tumor necrosis factor α (TNF-α), were measured in groups. The pathological evaluation for glomerular changes, tubular dilation, interstitial fibrosis, and interstitial infiltration of the inflammatory cells following the obstruction was performed (severity of tubular atrophy categorized too mild (+), moderate (++), and severe (+++)). To compare the continuous variables between the groups and between the measurement times, the analysis of variance (ANOVA) was used. Results Our results revealed that the creatinine four weeks after the obstruction was significantly higher in the proximal group obstruction (p value: 0.046). The three groups had no significant differences regarding urine creatinine, serum sodium, and serum TNF (p value: 0.261). Obstruction did not change the glomerular morphology in three intervention groups after six weeks. The commencing of severe tubular atrophy in proximal, middle, and distal ureteral obstruction was at weeks three, four, and six, respectively. Conclusion The location of ureteral obstruction is also crucial in deciding to intervene to relieve the complete ureteral obstruction. Severe tubular damage occurs in weeks three, four, and six in proximal, middle, and distal ureteral obstruction, respectively.
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Affiliation(s)
- Abdolreza Mohammadi
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Parisa Zahmatkesh
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hedieh Moradi Tabriz
- Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khajavi
- Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Mesbah
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parsa Nikoofar
- Department of Urology, Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
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25
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Balasingam B, Varothayan S, Rajendra S, Satchithanantham V, Sarma ST, Sri Pandurangana S, Vithyasahar S, Jothini T, Vishnuja S, Paramanathan S. Assessment of Urinary Stone Chemical Compositions and Prevalence of Metabolic Disorders Among Urolithiasis Patients in Northern Sri Lanka: A Prospective Study. Cureus 2024; 16:e63377. [PMID: 39077304 PMCID: PMC11283912 DOI: 10.7759/cureus.63377] [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: 06/28/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Urolithiasis, a common urological disorder affecting the global population, demonstrates geographical diversity due to factors such as water quality, climate variations, health conditions, and dietary habits. This study, conducted in Northern Sri Lanka, examines urinary stone compositions and assesses the prevalence of metabolic disorders among urolithiasis patients. Methods This prospective cross-sectional study, conducted at Jaffna Teaching Hospital, Jaffna, Sri Lanka, from July 2022 to June 2023, focused on surgically treated urolithiasis patients. Institutional ethical clearance was obtained. Patient details and investigational findings were collected through questionnaires and data extraction forms. Stone analysis utilized Fourier transform infrared spectroscopy, and a detailed metabolic evaluation of a 24-hour urine collection sample was carried out. Results This study followed 153 surgically treated urolithiasis patients, primarily male (64.3%), with a mean age of 48.64. Ureteric colic (48.4%) was common, with kidney stones (45.8%) prevalent; 57.52% had recurrent stones. Diabetes mellitus (DM; 23.5%) was the top comorbidity. Calcium oxalate monohydrate (COM) stones (78.4%) were the most frequent, followed by uric acid (12.4%). COM predominated in the 40-59 age group. There was no significant gender-stone type association. A total of 86.9% had metabolic abnormalities, notably hypocitraturia (60.1%). Moreover, 23% had both hypocitraturia and hypomagnesuria. Some metabolic disorders showed gender differences, with a marginal age-metabolic disorder association (p < 0.061). Urine oxalate levels were normal, with higher variability in males. Conclusion Middle-aged males with urolithiasis commonly presented with ureteric colic and predominantly had COM stones. Recurrent stones were common, often accompanied by metabolic abnormalities such as hypocitraturia and hypomagnesuria, with DM as the primary comorbidity.
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Affiliation(s)
| | | | | | | | - S T Sarma
- Surgery, Faculty of Medicine, University of Jaffna, Jaffna, LKA
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26
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Can O, Bozkurt M, Danış E, Taha Keskin E, Kandemir E, Lutfi Canat H. The effect of informative video before the procedure on anxiety levels in patients who will have ureteral stent removal under local anesthesia. Actas Urol Esp 2024; 48:377-383. [PMID: 38373480 DOI: 10.1016/j.acuroe.2024.02.014] [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: 11/21/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Our objective was to assess the impact of video-animated information on the anxiety levels of patients undergoing ureteral stent removal under local anesthesia. METHOD The study was designed as a randomized prospective trial. The one group received only verbal and written information before the surgery, while the other group received video-animated information in addition to the written and verbal instructions. The patients' anxiety levels were assessed using the STAI-S and STAI-T questionnaires, while their pain scores were evaluated using VAS scores. Tolerability and satisfaction scores were also evaluated on a 5-point Likert scale. RESULTS The video-group (Group 1) consisted of 74 patients, while the non-video group (Group 2) consisted of 82 patients. The mean pre-information STAI-T score was 34.4 ± 3.7 in Group 1 and 35.2 ± 3 in the Group 2 (p = 0.113). In the video group, pre-information STAI-S scores was 34.8 ± 3.3 and post-information STAI-S scores was 33.8 ± 3 (p < 0.001). In the non-video group, pre-information STAI-S score was 35.6 ± 2.6 and post-information STAI-S score was 35.5 ± 2.7 (p = 0.260). The mean VAS score of Group 1 is 5.7 ± 1.2 and Group 2 is 5.7 ± 1.4 (p = 0.608). The mean tolerability scores of Group 1 and Group 2 were 3.7 ± 0.9 and 2.7 ± 1, respectively. The mean satisfaction scores of Group 1 and Group 2 were 4.1 ± 0.9 and 2.6 ± 1, respectively. Both tolerability score and satisfaction score improved statistically significantly after video information (p < 0.001). CONCLUSION Providing video-animated information in addition to written and verbal information before removing the ureteral stent reduces patients' preoperative anxiety. Furthermore, patient tolerance and satisfaction are higher when informative videos are included.
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Affiliation(s)
- O Can
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey.
| | - M Bozkurt
- Servicio de Urología, Hospital Urbano Prof. Dr. Cemil Tascioglu, Estambul, Turkey
| | - E Danış
- Servicio de Urología, Hospital Urbano Prof. Dr. Cemil Tascioglu, Estambul, Turkey
| | - E Taha Keskin
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey
| | - E Kandemir
- Servicio de Urología, Universidad Karamanoglu Mehmetbey, Karaman, Turkey
| | - H Lutfi Canat
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey
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27
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Hsieh TY, Chang SJ, Chueh JSC, Lee YJ. The mayo adhesive probability score predicts postoperative fever and sepsis in retrograde intrarenal surgery. Urolithiasis 2024; 52:80. [PMID: 38819457 PMCID: PMC11142997 DOI: 10.1007/s00240-024-01586-z] [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: 03/18/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
Infectious complications are among the most common and potentially life-threatening morbidities of retrograde intrarenal surgery (RIRS). Few predictive tools on these complications include radiological signs. The Mayo adhesive probability (MAP) score is an image-based scoring system that incorporates two radiological signs: perinephric fat stranding and perinephric fat thickness. Previous studies have suggested an association between these signs and febrile urinary tract infection (UTI) following lithotripsy. This study aimed to evaluate the predictive factors, including the MAP score, for post-RIRS fever and sepsis. A total of 260 patients who underwent 306 RIRS between October 2019 to December 2023 due to renal or upper ureteral stones were included in this retrospective study. Patient demographics, perioperative characteristics, stone factors, radiological signs, and MAP scores were recorded. Multivariate logistic regression analysis was used to evaluate the risk factors associated with postoperative fever and sepsis. Postoperative fever and sepsis occurred in 20.8% and 8.5% of the patients, respectively. On multivariate analysis, female gender, history of recurrent UTI, larger maximal stone diameter, and higher MAP score were independent risk factors for postoperative fever and sepsis. Identifying the risk factors for post-RIRS infectious complications is imperative to providing the proper perioperative management. The MAP score is a promising, easily calculated, image-based scoring system that predicts post-RIRS fever and sepsis.
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Affiliation(s)
- Tsung-Yi Hsieh
- Department of Urology, National Taiwan University Hospital, 7 Chung Shan S. Road (Zhongshan S. Road), Zhongzheng Dist, Taipei, 100225, Taiwan (R.O.C.)
| | - Shang-Jen Chang
- Department of Urology, National Taiwan University Hospital, 7 Chung Shan S. Road (Zhongshan S. Road), Zhongzheng Dist, Taipei, 100225, Taiwan (R.O.C.)
| | - Jeff Shih-Chieh Chueh
- Department of Urology, National Taiwan University Hospital, 7 Chung Shan S. Road (Zhongshan S. Road), Zhongzheng Dist, Taipei, 100225, Taiwan (R.O.C.)
| | - Yuan-Ju Lee
- Department of Urology, National Taiwan University Hospital, 7 Chung Shan S. Road (Zhongshan S. Road), Zhongzheng Dist, Taipei, 100225, Taiwan (R.O.C.).
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28
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Pfau K, Lengyel I, Ossewaarde-van Norel J, van Leeuwen R, Risseeuw S, Leftheriotis G, Scholl HPN, Feltgen N, Holz FG, Pfau M. Pseudoxanthoma elasticum - Genetics, pathophysiology, and clinical presentation. Prog Retin Eye Res 2024; 102:101274. [PMID: 38815804 DOI: 10.1016/j.preteyeres.2024.101274] [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: 02/04/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
Pseudoxanthoma elasticum (PXE) is an autosomal-recessively inherited multisystem disease. Mutations in the ABCC6-gene are causative, coding for a transmembrane transporter mainly expressed in hepatocytes, which promotes the efflux of adenosine triphosphate (ATP). This results in low levels of plasma inorganic pyrophosphate (PPi), a critical anti-mineralization factor. The clinical phenotype of PXE is characterized by the effects of elastic fiber calcification in the skin, the cardiovascular system, and the eyes. In the eyes, calcification of Bruch's membrane results in clinically visible lesions, including peau d'orange, angioid streaks, and comet tail lesions. Frequently, patients must be treated for secondary macular neovascularization. No effective therapy is available for treating the cause of PXE, but several promising approaches are emerging. Finding appropriate outcome measures remains a significant challenge for clinical trials in this slowly progressive disease. This review article provides an in-depth summary of the current understanding of PXE and its multi-systemic manifestations. The article offers a detailed overview of the ocular manifestations, including their morphological and functional consequences, as well as potential complications. Lastly, previous and future clinical trials of causative treatments for PXE are discussed.
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Affiliation(s)
- Kristina Pfau
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland; Department of Ophthalmology, University Hospital Bonn, Bonn, Germany.
| | - Imre Lengyel
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom; Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | | | - Redmer van Leeuwen
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Sara Risseeuw
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Georges Leftheriotis
- University Hospital Nice, Vascular Physiology and Medicine Unit, 06000, Nice, France
| | | | - Nicolas Feltgen
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Maximilian Pfau
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Basel-Stadt, Switzerland
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Du YZ, Dong QX, Hu HJ, Guo B, Li YH, Zhang J, Li FC, Guo J. A cross-sectional analysis of the relationship between the non-high density to high density lipoprotein cholesterol ratio (NHHR) and kidney stone risk in American adults. Lipids Health Dis 2024; 23:158. [PMID: 38802797 PMCID: PMC11129406 DOI: 10.1186/s12944-024-02150-9] [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: 03/30/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Recent interest in the Non-High Density to High Density Lipoprotein Cholesterol ratio (NHHR) has emerged due to its potential role in metabolic disorders. However, the connection between NHHR and the development of kidney stones still lacks clarity. The primary goal of this research is to explore how NHHR correlates with kidney stone incidence. METHODS An analysis was conducted on the data collected by the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, focusing on adults over 20 years diagnosed with kidney stones and those with available NHHR values. Employing weighted logistic regression and Restricted Cubic Spline (RCS) models, NHHR levels' correlation with kidney stone risk was examined. Extensive subgroup analyses were conducted for enhanced reliability of the findings. RESULTS The findings indicate a heightened kidney stone risk for those at the highest NHHR levels relative to those at the lowest (reference group). A notable non-linear correlation of NHHR with kidney stone incidence has been observed, with a significant P-value (< 0.001), consistent across various subgroups. CONCLUSION A clear link exists between high NHHR levels and increased kidney stone risk in the American adult population. This study highlights NHHR's significance as a potential indicator in kidney stone formation.
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Affiliation(s)
- Yuan-Zhuo Du
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Qian-Xi Dong
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Hong-Ji Hu
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Biao Guo
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Yi-He Li
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Ji Zhang
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Fu-Chun Li
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China
| | - Ju Guo
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi Province, China.
- Jiangxi Institute of Urology, Nanchang, 330000, Jiangxi Province, China.
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Muhammad Z, Zoha R. A chemical odyssey: Exploring renal stone diversity by age and sex in Punjab, Pakistan. J Biomed Res 2024; 38:1-3. [PMID: 38832547 DOI: 10.7555/jbr.38.20240039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Zubair Muhammad
- Department of Pathology & Clinical Laboratories, Multan Institute of Kidney Diseases, Multan, Punjab 60000, Pakistan
| | - Rasool Zoha
- Department of Pathology & Clinical Laboratories, Multan Institute of Kidney Diseases, Multan, Punjab 60000, Pakistan
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Moon YJ, Jun DY, Jeong JY, Cho S, Lee JY, Jung HD. Percutaneous Nephrostomy versus Ureteral Stent for Severe Urinary Tract Infection with Obstructive Urolithiasis: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:861. [PMID: 38929478 PMCID: PMC11206041 DOI: 10.3390/medicina60060861] [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: 03/31/2024] [Revised: 05/09/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The European Association of Urology guidelines on urolithiasis highlight the limited evidence supporting the superiority of percutaneous nephrostomy (PCN) over retrograde ureteral stent placement for the primary treatment of infected hydronephrosis secondary to urolithiasis. We, therefore, conducted a systematic review and meta-analysis comparing the effects of PCN and retrograde ureteral stent in patients with severe urinary tract infections secondary to obstructive urolithiasis. Materials and Methods: Meta-analyses were performed to compare four outcomes: time for the temperature to return to normal; time for the white blood cell (WBC) count to return to normal; hospital length of stay; and procedure success rate. After a full-text review, eight studies were identified as relevant and included in our systematic review and meta-analysis. Results: No significant difference was detected between PCN and retrograde ureteral stenting for the time for the temperature to return to normal (p = 0.13; mean difference [MD] = -0.74; 95% confidence interval [CI] = -1.69, 0.21; I2 = 96%) or the time for the WBC count to return to normal (p = 0.24; MD = 0.46; 95% CI = -0.30, 1.21; I2 = 85%). There was also no significant difference between methods for hospital length of stay (p = 0.78; MD = 0.45; 95% CI = -2.78, 3.68; I2 = 96%) or procedure success rate (p = 0.76; odds ratio = 0.86; 95% CI = 0.34, 2.20; I2 = 47%). Conclusions: The clinical outcomes related to efficacy did not differ between PCN and retrograde ureteral stenting for severe urinary tract infection with obstructive urolithiasis. Thus, the choice between procedures depends mainly on the urologist's or patient's preferences.
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Affiliation(s)
- Young Joon Moon
- Department of Medicine, Graduate School, Yonsei University, Seoul 03722, Republic of Korea;
| | - Dae Young Jun
- Department of Urology, Severance Hospital, Urological Science Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea; (D.Y.J.); (J.Y.L.)
| | - Jae Yong Jeong
- Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang 10444, Republic of Korea;
| | - Seok Cho
- Department of Urology, Inje University Ilsan Paik Hospital, College of Medicine, Inje University, Goyang 10380, Republic of Korea;
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea; (D.Y.J.); (J.Y.L.)
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
| | - Hae Do Jung
- Department of Urology, Inje University Ilsan Paik Hospital, College of Medicine, Inje University, Goyang 10380, Republic of Korea;
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Ahmadi M, de Souza Goncalves L, Verkman AS, Cil O, Anderson MO. Substituted 4-methylcoumarin inhibitors of SLC26A3 (DRA) for treatment of constipation and hyperoxaluria. RSC Med Chem 2024; 15:1731-1736. [PMID: 38784456 PMCID: PMC11110725 DOI: 10.1039/d3md00644a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/27/2024] [Indexed: 05/25/2024] Open
Abstract
SLC26A3, also known as downregulated in adenoma (DRA), is an anion (Cl-, HCO3- and oxalate) exchanger in the luminal membrane of intestinal epithelial cells. Loss of DRA function in mice and humans causes congenital chloride-losing diarrhea and reduces urinary excretion of oxalate, a major constituent of kidney stones. Thus, inhibition of DRA is a potential treatment approach for constipation and calcium oxalate kidney stones. High-throughput screening previously identified 4,8-dimethylcoumarins (4a-4c) as DRA inhibitors, with lead candidate 4b having an IC50 of 40-50 nM for DRA inhibition. Here, we explored the effects of varying substituents at the 8-position, and replacing 8-methyl by 5-methyl (4e-4h). A focused library of 17 substituted compounds (4d-4t) was synthesized with good yield and purity. Compounds were tested for DRA inhibition potency using Fischer rat thyroid cells stably expressing DRA and a halide-sensitive YFP. Structure-activity analysis revealed that 8-bromo- (4m-4p) and 8-fluoro-coumarins (4q-4t) were slightly less potent than the corresponding 8-chloro analogs, demonstrating that the size of methyl or chloro substituents at the coumarin 8 position affects the potency. An analog containing 8-chlorocoumarin (4k) had ∼2-fold improved potency (IC50 25 nM) compared with the original lead candidate 4b. 5,8-Dimethylcoumarins were active against DRA, but with much lower potency than 4,8-disubstituted coumarins. In mice, orally administered 4k at 10 mg kg-1 reduced constipation and normalized stool water content in a loperamide-induced constipation model with comparable efficacy to 4b. Pharmacokinetic analysis of orally administered 4k at 10 mg kg-1 in mice indicated serum levels of >10 μM for at least six hours after single dose. This study expands SAR knowledge of 4,8-disubstituted coumarin inhibitors of DRA as novel drug candidates for constipation and kidney stones.
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Affiliation(s)
- Maria Ahmadi
- Department of Chemistry and Biochemistry, San Francisco State University San Francisco CA USA
| | | | - Alan S Verkman
- Department of Medicine, University of California, San Francisco San Francisco CA USA
| | - Onur Cil
- Department of Pediatrics, University of California, San Francisco San Francisco CA USA
| | - Marc O Anderson
- Department of Chemistry and Biochemistry, San Francisco State University San Francisco CA USA
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Lv G, Li X, Zhou X, Wang Y, Gu Y, Yang X. Predictive ability of novel and traditional anthropometric measurement indices for kidney stone disease: a cross-sectional study. World J Urol 2024; 42:339. [PMID: 38767720 DOI: 10.1007/s00345-024-05035-9] [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: 10/06/2023] [Accepted: 04/14/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND The aim of our research was to examine the association of novel anthropometric indices (a body shape index (ABSI), waist-to-height ratio (WtHR), conicity index (CI) and body roundness index (BRI)) and traditional anthropometric indices (body mass index (BMI), and waist (WC)) with prevalence of kidney stone disease (KSD) in the general population of United States (U.S.). METHODS In this study, we conducted a cross-sectional analysis among the participants in the National Health and Nutrition Examination Survey between the years 2007 and 2020. Weighted multivariable logistic regression analysis, restricted cubic spline (RCS), receiver operating characteristic (ROC) curves, and subgroup analysis were performed to analyze the association of ABSI, BRI, WtHR, CI, BMI and WC with prevalence of KSD. RESULTS In total, 11,891 individuals were included in our study. The RCS plot shown that the linear positive association was found between ABSI, BRI, WtHR, CI, BMI and WC and KSD risk. Additionally, the ROC curve demonstrated that the area under the curve of ABSI, BRI, WtHR, and CI was significantly higher than traditional anthropometric indices, including BMI and WC. CONCLUSIONS Our study found that the discriminant ability of ABSI, BRI, WtHR, and CI for KSD was higher than BMI and WC. Consequently, ABSI, BRI, WtHR, and CI have the potential to become new indicators for the detection of KSD risk in clinical practice.
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Affiliation(s)
- Guanglin Lv
- Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, Jiangsu, China
| | - Xiang Li
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Xin Zhou
- Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, Jiangsu, China
| | - Yang Wang
- Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, Jiangsu, China
| | - Ye Gu
- Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, Jiangsu, China
| | - Xianfa Yang
- Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, Jiangsu, China.
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Aiumtrakul N, Thongprayoon C, Suppadungsuk S, Krisanapan P, Pinthusopon P, Mao MA, Arayangkool C, Vo KB, Wannaphut C, Miao J, Cheungpasitporn W. Global Trends in Kidney Stone Awareness: A Time Series Analysis from 2004-2023. Clin Pract 2024; 14:915-927. [PMID: 38804404 PMCID: PMC11130814 DOI: 10.3390/clinpract14030072] [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: 02/14/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Despite the prevalence and incidence of kidney stones progressively increasing worldwide, public awareness of this condition remains unclear. Understanding trends of awareness can assist healthcare professionals and policymakers in planning and implementing targeted health interventions. This study investigated online search interest in "kidney stone" by analyzing Google Trends, focusing on stationarity of the trends and predicting future trends. METHODS We performed time series analysis on worldwide Google monthly search data from January 2004 to November 2023. The Augmented Dickey-Fuller (ADF) test was used to assess the stationarity of the data, with a p-value below 0.05 indicating stationarity. Time series forecasting was performed using the autoregressive integrated moving average to predict future trends. RESULTS The highest search interest for "kidney stone" (score 100) was in August 2022, while the lowest was in December 2007 (score 36). As of November 2023, search interest remained high, at 92. The ADF test was significant (p = 0.023), confirming data stationarity. The time series forecasting projected continued high public interest, likely reflecting ongoing concern and awareness. Notably, diverse regions such as Iran, the Philippines, Ecuador, the United States, and Nepal showed significant interest, suggesting widespread awareness of nephrolithiasis. CONCLUSION This study highlighted that "kidney stone" is a consistently relevant health issue globally. The increase and stationarity of search trends, the forecasted sustained interest, and diverse regional interest emphasize the need for collaborative research and educational initiatives. This study's analysis serves as a valuable tool for shaping future healthcare policies and research directions in addressing nephrolithiasis related health challenges.
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Affiliation(s)
- Noppawit Aiumtrakul
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA; (N.A.); (C.A.); (K.B.V.); (C.W.)
| | - Charat Thongprayoon
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (C.T.); (S.S.); (P.K.); (J.M.)
| | - Supawadee Suppadungsuk
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (C.T.); (S.S.); (P.K.); (J.M.)
- Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Samut Prakan 10540, Thailand
| | - Pajaree Krisanapan
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (C.T.); (S.S.); (P.K.); (J.M.)
- Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
| | | | - Michael A. Mao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Chinnawat Arayangkool
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA; (N.A.); (C.A.); (K.B.V.); (C.W.)
| | - Kristine B. Vo
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA; (N.A.); (C.A.); (K.B.V.); (C.W.)
| | - Chalothorn Wannaphut
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA; (N.A.); (C.A.); (K.B.V.); (C.W.)
| | - Jing Miao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (C.T.); (S.S.); (P.K.); (J.M.)
| | - Wisit Cheungpasitporn
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (C.T.); (S.S.); (P.K.); (J.M.)
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Liu Y, Ku PW, Li Z, Yang H, Zhang T, Chen L, Xia Y, Bai S. Intensity-Specific Physical Activity Measured by Accelerometer, Genetic Susceptibility, and the Risk of Kidney Stone Disease: Results From the UK Biobank. Am J Kidney Dis 2024:S0272-6386(24)00760-1. [PMID: 38754804 DOI: 10.1053/j.ajkd.2024.03.022] [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: 08/14/2023] [Revised: 03/01/2024] [Accepted: 03/09/2024] [Indexed: 05/18/2024]
Abstract
RATIONALE & OBJECTIVE Kidney stone disease (KSD), a significant health care problem within both developed and developing countries, has been associated with genetic risk factors. An association between physical activity and KSD risk also has been hypothesized, but studies have yielded inconsistent findings. This study investigated the association between the intensity of physical activity and the incidence of KSD accounting for genetic risk. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS A total of 80,473 participants from the UK Biobank Study. EXPOSURE Physical activity levels, including total physical activity (TPA), moderate-to-vigorous intensity physical activity (MVPA), and light-intensity physical activity (LPA), were measured using accelerometers and quantified using a machine learning model. A polygenic risk score (PRS) for KSD was also constructed. OUTCOME Individuals with KSD were identified using the International Classification of Diseases, Tenth Revision (ICD-10), and procedure codes for KSD surgery. ANALYTICAL APPROACH A Fine and Gray survival model was used to estimate the associations of incident KSD with TPA, MVPA, LPA, and PRS (as categorical variables). Restricted cubic splines were used to examine potential nonlinear associations within the fully adjusted models. RESULTS During an average follow-up of 6.19 years, 421 participants developed KSD. Participants in the highest quartiles of TPA, MVPA, and LPA had lower adjusted rates of KSD compared with those in the lowest quartiles: HR, 0.50 (95% CI, 0.44-0.56), 0.57 (95% CI, 0.51-0.64), and 0.66 (95% CI, 0.59-0.74), respectively. TPA, MVPA, and LPA were associated with a lower risk of KSD in participants with low and high genetic predisposition for KSD. LIMITATIONS Selection bias as participants who provided accelerometry data may have been more adherent to health care. CONCLUSIONS Physical activity was negatively associated with the risk of KSD, regardless of the genetic risk. Future large studies are warranted to confirm and explain the mechanisms underlying these associations. PLAIN-LANGUAGE SUMMARY The association between the intensity of physical activity (PA) and the incidence of kidney stone disease (KSD) after accounting for genetic risk is unclear. We conducted a comprehensive prospective cohort study utilizing participants from the UK Biobank to assess the intensity of PA using accelerometers. Our study findings indicated that greater total PA, moderate-to-vigorous-intensity PA, and light-intensity PA were each associated with a lower risk of KSD irrespective of an individual's genetic risk. Our study informs the understanding of risk factors for KSD.
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Affiliation(s)
- Yashu Liu
- Department of General Surgery, Shenyang
| | - Po-Wen Ku
- Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung; Department of Kinesiology, National Tsing Hua University, Hsinchu City, Taiwan; Department of Behavioural Science and Health, University College London, London, United Kingdom
| | | | - Honghao Yang
- Department of Clinical Epidemiology, Shenyang; Shengjing Hospital of China Medical University, and Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang
| | | | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yang Xia
- Department of Clinical Epidemiology, Shenyang; Shengjing Hospital of China Medical University, and Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang.
| | - Song Bai
- Department of Urology Surgery, Shenyang.
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Asali M, Hallak O. Dynamic renal scans as a modality for follow-up of flexible ureteroscopy. Arch Ital Urol Androl 2024; 96:12393. [PMID: 38742419 DOI: 10.4081/aiua.2024.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/31/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE To determine whether dynamic renal scans - DTPA or MAG3 - routinely performed after flexible ureteroscopies (f-URS) could detect the development of an obstruction and thus promote prompt early intervention for kidney preservation. PATIENTS AND METHODS In this retrospective study, with all the data recorded prospectively between April 2010 and October 2023, 250 renal units in 242 patients with upper urinary tract stones (UUTS) who underwent ureterorenoscopy by one surgeon in the same medical center were evaluated. Stone-free rate (SFR) was defined as no residual fragments at all using an intraoperative "triple test". The following characteristics were examined: gender, BMI, age, Hounsfield unit, stone diameter, laterality, renal/ureteral stones, stone-free rate, and auxiliary procedures per renal unit. The Clavien-Dindo classification was used to report complications. Renal units with residual stones were scheduled for a 2nd f-URS. Post- flexible ureteroscopy ureteral obstruction and renal function were detected using renal scan DTPA or MAG-3. The primary outcome was renal/ ureteral obstruction. RESULTS The mean patient age was 53 years. The mean stone size was 12.3 mm. Stones in renal pelvis, upper, middle and lower calyces were treated in 9.2% (23), 27.6% (69), and 30.8% (77) of cases, respectively; 44% (110) ureteral stones were also treated. The single- and second-session SFRs were 94.8% and 99.7%, respectively. A third auxiliary procedure was needed in one renal unit (0.4%). The mean number of procedures per renal unit was 1.06 (264/250). Ureteral double-J stents were inserted in 53.6% (134) of the cases. In 37 (14.8%) cases, a stent was placed before surgery. Post-operative complications were minor, with readmission and pain control needed in only two patients (0.8%). No avulsion or perforation of the ureters was observed. In six patients with t1/2 between 10-20 minutes, a second renal scan revealed spontaneous improvement and no obstruction in five patients. One patient with large stones and a history of prior ureteroscopy developed a ureteral stricture (0.4%) and needed treatment with laser endoureterotomy. CONCLUSIONS Post-flexible ureteroscopy obstruction due to ureteral stricture is very rare. A routine renal scan post-operatively may be used in potentially high-risk patients.
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Affiliation(s)
- Murad Asali
- Urology Department, Barzilai Medical Center, Ben Gurion University of the Negev, Beer Sheva; Assuta Medical Center, Ramat Hyal, Ben Gurion University of the Negev, Beer Sheva.
| | - Osman Hallak
- Urology Department, Barzilai Medical Center, Ben Gurion University of the Negev, Beer Sheva.
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Grases F, Tomàs Nadal F, Julià Florit F, Costa-Bauza A. Cystine Renal Calculi: New Aspects Related to Their Formation and Development. J Clin Med 2024; 13:2837. [PMID: 38792383 PMCID: PMC11122214 DOI: 10.3390/jcm13102837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Crystallization experiments of renal-calculi-forming compounds (calcium oxalate, calcium phosphates, uric acid) are normally performed by monitoring these processes during periods of time similar to the residence of urine inside the kidney. Nevertheless, cystine requires high supersaturation for its crystallization, and most experiments last for longer periods. It must be considered that at high supersaturation, the inhibitors of crystalline development have poor effects. Methods: The induction time of crystallization (ti) of cystine in experimental conditions similar to those of the formation of cystine renal calculi and the effect of different cystine-binding thiol agents was determined through turbidimetric measurements. We also studied the macro- and microstructure of 30 cystine kidney stones through stereoscopic microscopy and scanning electron microscopy. Results: Under the studied conditions, the ti in absence of crystallization inhibitors was 15 min, and the presence of 9 mM of penicillamine, tiopronin, or N-acetylcysteine totally inhibited crystallization, as their effects relate to the formation of complexes with cystine, although N-acetylcysteine also delayed cystine crystalline development and modified cystine crystal morphology. Cystine stones have traditionally been classified as smooth and rough. The study of their structure shows that all of them begin their formation from a few crystals that generate a compact radial structure. Their subsequent growth, depending on the renal cavity where they are located, gives rise to the rough structure in the form of large blocks of cystine crystals or the smooth structure with small crystals. Conclusions: To prevent the development of cystine renal stones, the formation of small crystals must be avoided by reducing urinary cystine supersaturation, with N-acetylcysteine being the most effective among the studied cystine-binding thiol agents. Also, the removal of cystine crystals through increased water intake and physical activity can be a very important preventive measure.
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Affiliation(s)
| | | | | | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (F.G.); (F.T.N.); (F.J.F.)
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Yin K, Yin Z, Liu Z, Yao J, Wu Y, Su S. Exploring the association between multiple factors and urolithiasis: A retrospective study and Mendelian randomization analysis. Medicine (Baltimore) 2024; 103:e37968. [PMID: 38701290 PMCID: PMC11062715 DOI: 10.1097/md.0000000000037968] [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: 03/07/2024] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
To investigate the relationship between several factors and urinary stone as well as different stone compositions. To guide the diagnosis, treatment, and prevention of urinary stone recurrence. We used bidirectional Mendelian randomization to analyze the causal relationship between hypertension and urinary stones, diabetes and urinary stones, and body mass index (BMI) and urinary stones. We retrospectively analyzed the medical records of patients with urinary stones admitted to a tertiary care hospital in Chongqing, China, from July 2015 to October 2022. Patients were included when they were first diagnosed with urinary stones. The odds ratio of calculi on hypertension estimated by inverse variance weighted was 8.46 (95%CI: 4.00-17.90, P = 2.25 × 10-8). The stone composition analysis showed that there were 3101 (67.02%) mixed, 1322 (28.57%) calcium oxalate monohydrate, 148 (3.20%) anhydrous uric acid, 16 (0.35%) magnesium ammonium phosphate hexahydrate, 11 (0.24%) dicalcium phosphate dihydrate, 10 (0.22%) carbonate apatite, 8 (0.17%) L-cystine, 4 ammonium uric acid (0.09%), and 7 other stone types (0.15%). Mendelian randomization studies have proven that urinary stones may be a potential risk factor for hypertension, while there is no causal relationship between diabetes and stones, BMI, and stones. Our retrospective study has shown that urinary stone components are closely associated with sex, age, hypertension, diabetes, and BMI. It is reasonable to suspect that treating a single stone component is ineffective in preventing recurrence. We also found that the peak incidence of urinary stones was at the most active stage of most people's working lives.
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Affiliation(s)
- Kexin Yin
- The First Clinical College of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhikang Yin
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhenyu Liu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Junjie Yao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuzhou Wu
- The First Clinical College of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Shuai Su
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Wang Y, Wang J, Sun X. The Effect of High- and Low-power Holmium Laser Settings for Transurethral Lithotripsy in the Management of Adults with Ureteral Stone. JOURNAL OF PHYSIOLOGICAL INVESTIGATION 2024; 67:153-160. [PMID: 38904360 DOI: 10.4103/ejpi.ejpi-d-24-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
Since there is insufficient evidence to determine the best treatment of transurethral laser lithotripsy (TLL) in ureteral stones, this study compared the effectiveness and safety of TLL using high-power (HP) (100 W) and low-power (LP) (20 W) laser settings. All patients with maximally sized ureteral stones who were planned for transurethral holmium laser lithotripsy were enrolled in this open study. One of the two laser setting groups-LP or HP-was allocated to each alternate patient. Using IBM SPSS Statistics 24, the treatment groups were compared for operating time, intraoperative and postoperative problems (up to 1 year), and rates of stone-free recovery. Welch tests were employed to compare continuous data, whereas Fisher's exact or Chi-square tests were used to assess categorical variables. At P < 0.05, statistical significance was established. A total of 207 individuals were included and preoperative data were comparable between the two groups. The HP group had a considerably greater ablation rate and a significantly shorter procedure duration (42.61 ± 11.74 min) than the LP group (78.56 ± 25.91 min) ( P = 0.025). The Overactive Bladder Symptom Score and International Prostate Symptom Score were considerably higher in the HP group than in the LP group. Treatment effectiveness was considerably impacted by the location of the ureteral stone, according to univariate and multivariate logistic regression models. A HP laser setting of up to 100 W greatly shortens the duration of the process for treating ureteral stones without raising the risk of problems.
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Affiliation(s)
- Yuhuan Wang
- Department of Urology, Chengde Central Hospital, Chengde, Hebei, China
| | - Jun Wang
- Department of Urology, Chengde Central Hospital, Chengde, Hebei, China
| | - Xiaoping Sun
- The Second Ward of the Department of Critical Care, Chengde Central Hospital, Chengde, Hebei, China
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Tung YH, Li WM, Juan YS, Huang TY, Wang YC, Yeh HC, Lee HY. New infundibulopelvic angle measurement method can predict stone-free rates following retrograde intrarenal surgery. Sci Rep 2024; 14:9891. [PMID: 38688919 PMCID: PMC11061286 DOI: 10.1038/s41598-024-60248-7] [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: 01/22/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024] Open
Abstract
To enhance the accuracy of predicting stone-free rates after retrograde intrarenal surgery, we devised a novel approach to assess the renal infundibulopelvic angle. We conducted a retrospective review of patient records for those who underwent retrograde intrarenal surgery for renal stones between April 2018 and August 2019. Patient demographics, stone characteristics, and perioperative data were recorded. Subsequently, we introduced a modified angle measurement called the pelvic stone angle and evaluated its predictive performance for stone-free rates by comparing it with the traditional method in scoring systems. A total of 43 individuals were included in this study. Notable differences in stone burden and Hounsfield unit measurements were found between stone-free and non-stone-free patients. The pelvic stone angle demonstrated a good model fit when used in scoring systems, performing equally well as the conventional approach. The area under the receiver operating characteristic curve for the R.I.R.S. scoring system using the pelvic stone angle and the conventional approach did not show a significant difference. In conclusion, the predictive ability of the pelvic stone angle for stone-free rates was comparable to the old measurement method. Moreover, scoring systems using the pelvic stone angle exhibited a better model fit than those using the conventional approach.
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Affiliation(s)
- Yu-Hung Tung
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
| | - Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan
- Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan
- Department of Urology, Kaohsiung Medical University Gang-Shan Hospital, Kao-hsiung, Taiwan
| | - Yung-Shun Juan
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan
| | - Tsung-Yi Huang
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
| | - Yen-Chun Wang
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
| | - Hsin-Chih Yeh
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kao-hsiung, Taiwan
| | - Hsiang-Ying Lee
- Department of Urology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kao-hsiung, 80708, Taiwan.
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kao-hsiung, Taiwan.
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Mao X, Yang Y, Yang J, Chen M, Hao Z. Association between body roundness index and prevalence of kidney stone in the U.S: a study based on the NHANES database. BMC Urol 2024; 24:93. [PMID: 38643130 PMCID: PMC11031997 DOI: 10.1186/s12894-024-01433-8] [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: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the potential association between the body roundness index (BRI) and kidney stone prevalence in adults in the United States. METHODS A cohort of participants from the National Health and Nutrition Examination Survey (NHANES) database spanning 2007-2018 were gathered for analysis. Logistic regression analyses, subgroup assessments, and calculations were employed to examine the potential link between BRI and kidney stone prevalence. RESULTS The study included 30,990 participants aged > 20 years, of which 2,891 declared a kidney stone history. After modulating all relevant confounding factors, each unit increase in the BRI was linked to a 65% increase in kidney stone prevalence (OR = 1.65, 95% CI: 1.47, 1.85). Sensitivity analyses conducted by categorizing the BRI into three groups revealed a 59% increase in kidney stone prevalence in the highest tertile BRI group compared to the lowest one (OR = 1.59, 95% CI: 1.42, 1.79). Furthermore, dose-response curves depicted a positive near-linear correlation between the BRI and the risk of kidney stone prevalence. CONCLUSION These findings suggest a clinically noteworthy positive correlation between higher BRI values and kidney stone prevalence among the studied US adult population. However, it is essential to acknowledge that the observed relationship does not establish a causal link.
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Affiliation(s)
- Xike Mao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yuehan Yang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Junping Yang
- Department of General Practice, Wuhu City SecondPeoplès Hospital, Wuhu, Anhui, China
| | - Mingwei Chen
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Zongyao Hao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China.
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Abushamma F, Zyoud SH. Analyzing global research trends and focal points in the utilization of laser techniques for the treatment of urolithiasis from 1978 to 2022: visualization and bibliometric analysis. Urolithiasis 2024; 52:67. [PMID: 38630266 DOI: 10.1007/s00240-024-01568-1] [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: 02/09/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
Laser lithotripsy is gaining global prominence and is a dynamically progressing field marked by a continual influx of new and comprehensive research each year. Recently, there has been a noticeable shift toward the adoption of various kinds of lasers, such as holmium: yttrium-aluminum-garnet (Ho:YAG) and thulium fiber (TFL) lasers. Consequently, we aim to conduct a bibliometric analysis to analyze key areas of research activity within scientific publications that center on the utilization of laser techniques in urolithiasis. A search of the literature spanning from 1978 to 2022 was carried out on 25 December 2023 using the Scopus database to explore research related to the application of laser techniques for urolithiasis treatment. Visualization analysis was performed using VOSviewer software (version 1.6.20). We examined 962 publications that met the specified criteria, 791 (82.22%) of which were original articles. The analysis of the retrieved publications indicated a consistent increase in research output from 1978 to 2022; a particularly noteworthy surge occurred after 2003. In particular, the U.S. claimed the leading position as the most productive country, contributing 211 articles (21.93%). However, India had the highest research productivity according to the adjustment index of 19.08. In the European region, 324 publications (33.68% of the total) originated from 25 countries. The Journal of Endourology contributed the most between 1978 and 2022 (n = 96, 9.98%). The most cited paper examined the effectiveness of holmium: yttrium-aluminum-garnet (Ho:YAG) lasers, while a subsequent study focused on the use of a thulium fiber laser (TFL), an emerging laser technology that has gained increased recognition. Co-occurrence analysis revealed three distinct clusters focusing on the types of laser technology, minimally invasive approaches, and success rate/postoperative complications. This comprehensive investigation delves into the global landscape of laser use for the treatment of urolithiasis. This review supports the emerging clinical concept of using various types of laser technology for urolithiasis treatment. Moreover, the hot issues that researchers should focus on based on the findings of this study are the use of different types of laser lithotripsy in view of the surgical approach, success rate and complications.
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Affiliation(s)
- Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Urology, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Phromprathum P, Srinualnad S, Leewansangtong S, Taweemonkongsap T, Phinthusophon K, Jitpraphai S, Ramart P, Woranisarakul V, Suk-Ouichai C, Mankongsrisuk T, Hansomwong T, Jongjitaree K, Chotikawanich E. In vitro Comparison of the Mechanical and Optical Characteristics of 5 Disposable Flexible Ureteroscopes. Urol Int 2024; 108:367-376. [PMID: 38599181 PMCID: PMC11251662 DOI: 10.1159/000538760] [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: 10/27/2023] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Disposable (single-use) flexible ureteroscopes are alternatives to reusable ureteroscopes. With their superior surgical efficacy and safety in the presence of upper urinary calculi, disposable ureteroscopes aim to overcome the main limitations of conventional reusable ureteroscopes. However, studies on the performance of the most recently developed models of single-use flexible ureteroscopes are scarce. This study aimed to compare the in vitro performance of several recently introduced, single-use, flexible ureteroscopes. METHODS Five disposable flexible ureteroscopes were tested in vitro to evaluate their mechanical and optical characteristics. To this end, their degrees of deflection, irrigation flow rates, and image qualities were investigated. The models examined were Innovex US31-B12, OTU-100RR, Redpine RP-U-C12, Sciavita SUV-2A-B, and Seplou URS3016E. Their performance was also compared with that of a reusable flexible ureteroscope, Olympus URV-F. RESULTS The OTU device had the highest degrees of deflection and the smallest loop diameter of the disposable ureteroscopes. The single-use ureteroscopes had identical image resolutions at a distance of 1 cm. The Innovex and Redpine devices had the best color representation. CONCLUSIONS Of the tested disposable ureteroscopes, the OTU device had the best mechanical attributes, given its small loop diameter, high deflection angles, and low irrigation flow loss. As to their optical properties, the resolutions of all 5 single-use models were identical at an image distance of 1 cm.
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Affiliation(s)
- Phirawat Phromprathum
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sittiporn Srinualnad
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunai Leewansangtong
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tawatchai Taweemonkongsap
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kittipong Phinthusophon
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Siros Jitpraphai
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patkawat Ramart
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varat Woranisarakul
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalairat Suk-Ouichai
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thawatchai Mankongsrisuk
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thitipat Hansomwong
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kantima Jongjitaree
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ekkarin Chotikawanich
- Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Fu W, Zhu B, Chen J, Jin X. Risk relationship between inflammatory bowel disease and urolithiasis: A two-sample Mendelian randomization study. PLoS One 2024; 19:e0301545. [PMID: 38593126 PMCID: PMC11003619 DOI: 10.1371/journal.pone.0301545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/17/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The causal genetic relationship between common parenteral manifestations of inflammatory bowel disease (IBD) and urolithiasis remains unclear because their timing is difficult to determine. This study investigated the causal genetic association between IBD and urolithiasis using Mendelian randomization (MR) based on data from large population-based genome-wide association studies (GWASs). METHODS A two-sample MR analysis was performed to assess the potential relationship between IBD and urolithiasis. Specific single nucleotide polymorphism data were obtained from GWASs, including IBD (n = 59957) and its main subtypes, Crohn's disease (CD) (n = 40266) and ulcerative colitis (UC) (n = 45975). Summarized data on urolithiasis (n = 218792) were obtained from different GWAS studies. A random-effects model was analyzed using inverse-variance weighting, MR-Egger, and weighted medians. RESULTS Genetic predisposition to IBD and the risk of urolithiasis were significantly associated [odds ratio (OR), 1.04 (95% confidence interval [CI], 1.00-.08), P = 0.01]. Consistently, the weighted median method yielded similar results [OR, 1.06 (95% CI, 1.00-1.12), P = 0.02]. The MR-Egger method also demonstrated comparable findings [OR, 1.02 (95% CI, 0.96-1.08), P = 0.45]. Both funnel plots and MR-Egger intercepts indicated no directional pleiotropic effects between IBD and urolithiasis. CD was strongly associated with it in its subtype analysis [OR, 1.04 (95% CI, 1.01-1.07), P = 0.01], and UC was also causally associated with urolithiasis, although the association was not significant [OR, 0.99 (95% CI, 0.95-1.03), P = 0.71]. CONCLUSION A unidirectional positive causal correlation was identified between IBD and urolithiasis, with varying degrees of association observed among the different subtypes of IBD. Recognizing the increased incidence of urolithiasis in patients with IBD is crucial in clinical practice. Early detection and surveillance of IBD, improved patient awareness, adoption of preventive strategies, and promotion of collaborative efforts among healthcare providers regarding treatment methodologies are vital for improving patient outcomes.
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Affiliation(s)
- Wenqiang Fu
- Affiliated Hospital, Anorectal, Panzhihua University, Panzhihua, Sichuan, China
| | - Bin Zhu
- Outpatient Department, Tibet Military Region General Hospital of PLA, Lhasa, China
| | - Jun Chen
- Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Xuelin Jin
- Affiliated Hospital, Anorectal, Panzhihua University, Panzhihua, Sichuan, China
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Hu X, Li X, Ye N, Zhou Z, Li G, Jiang F. Association of serum soluble α‑klotho with risk of kidney stone disease: a population-based cross-sectional study. World J Urol 2024; 42:219. [PMID: 38587631 DOI: 10.1007/s00345-024-04837-1] [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: 10/16/2023] [Accepted: 01/16/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The aim of the study was to explore the association of serum soluble klotho with kidney stone disease (KSD) in the general population over the age of 40 years in the United States. METHODS We integrated the data in National Health and Nutrition Examination Survey from 2007 to 2016 years. The relationship between serum soluble α‑klotho and prevalence of KSD was analyzed by constructing weighted multivariable logistic regression model, restricted cubic spline (RCS) curve, and subgroup analyses. RESULTS In the study, a total of 13,722 individuals were included in our study. A U-shaped association between serum soluble klotho and the risk of KSD was shown by the RCS curve (P value for nonlinear < 0.05). In the full adjusted model, compared with the lowest quartile of serum soluble α‑klotho, the adjusted odd ratios (95% confidence intervals) for KSD across the quartiles were (0.999 (0.859, 1.164), 1.005 (0.858, 1.176), and 1.061 (0.911, 1.235)). Subgroup analyses also showed that the U-shaped association of serum soluble α‑klotho with KSD was found among subjects who were age < 60 years, female or male, with or without hypertension, and BMI ≥ 30 kg/m2. CONCLUSIONS Our findings suggested that serum klotho levels had a U-shaped correlation with risk of KSD. When the Klotho level is at 818.66 pg/mL, prevalence of KSD is lowest. Therefore, maintaining a certain level of serum soluble α‑klotho could prevent the occurrence of KSD.
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Affiliation(s)
- Xudong Hu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, 100 Huaihai Road, Hefei, 230000, Anhui, China
- Department of Urology, Anhui Public Health Clinical Center, 100 Huaihai Road, Hefei, 230000, Anhui, China
| | - Xiang Li
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Nan Ye
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, 100 Huaihai Road, Hefei, 230000, Anhui, China
- Department of Urology, Anhui Public Health Clinical Center, 100 Huaihai Road, Hefei, 230000, Anhui, China
| | - Zhenwen Zhou
- Department of Urology, Anqing First People's Hospital of Anhui Province, 42 Xiaosu Road, Anqing, 246000, Anhui, China
| | - Guangyuan Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, 100 Huaihai Road, Hefei, 230000, Anhui, China.
- Department of Urology, Anhui Public Health Clinical Center, 100 Huaihai Road, Hefei, 230000, Anhui, China.
| | - Fang Jiang
- Department of Urology, Anqing First People's Hospital of Anhui Province, 42 Xiaosu Road, Anqing, 246000, Anhui, China.
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Persaud SA, Jankie S, Andrews R, Varachhia S, Morris M. High Self-Reported Prevalence of Kidney Stones in Trinidad and Tobago: Results of a Cross-Sectional Online Survey. Cureus 2024; 16:e57651. [PMID: 38707028 PMCID: PMC11070117 DOI: 10.7759/cureus.57651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction No data exist on the prevalence of kidney stone disease in Trinidad and Tobago. Local clinicians have noted that the disease is very common, and this study represents the first attempt to investigate the prevalence of urolithiasis in these islands. Objectives The objective is to estimate the prevalence of kidney stone disease in Trinidad and Tobago and to investigate the epidemiology of the disease. Methods An online survey using the online tool Survey Monkey was distributed among members of the public via instant messaging and social media. The survey captured data relating to the stone status and demographics of respondents. Results 1225 patients completed the survey of whom 46.5% were males and 53.5% were females. Respondents were equally distributed throughout the country. 16.74% of those surveyed indicated that they were currently affected by stones confirmed by imaging. Kidney stones were more common among Trinidadians of East Indian ancestry (20.6% vs 10.6%). Positive correlations were established between kidney stones and the presence of hypertension, diabetes, and gout. Persons with kidney stones were more likely to have a family member with the disease - 45.6% vs 31.4% among those without kidney stones. Conclusion This study demonstrates a high self-reported prevalence of kidney stones in Trinidad and Tobago.
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Affiliation(s)
- Satyendra A Persaud
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Satish Jankie
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Roger Andrews
- Department of Physics, University of the West Indies, St Augustine, TTO
| | - Saleem Varachhia
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Michael Morris
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
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Jahrreiss V, Seitz C, Quhal F. Medical management of urolithiasis: Great efforts and limited progress. Asian J Urol 2024; 11:149-155. [PMID: 38680579 PMCID: PMC11053322 DOI: 10.1016/j.ajur.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/05/2023] [Indexed: 05/01/2024] Open
Abstract
Objective To provide a comprehensive review on the existing literature on medical management of urolithiasis. Methods A thorough literature review was performed using Medline, PubMed/PMC, Embase, and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of urolithiasis. Studies that assessed dietary and pharmacologic management of urolithiasis were reviewed; studies on medical expulsive therapy were not included in this review. Results Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution therapies. While most treatment concepts have been long established, large randomized controlled trials are scarce. Dietary modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis. A major limitation for medical management of urolithiasis is poor patient compliance. Conclusion Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing stones. Although medical management can be effective in limiting stone recurrence, medical interventions often fail due to poor compliance.
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Affiliation(s)
- Victoria Jahrreiss
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Christian Seitz
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Fahad Quhal
- Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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Anderson T, Hopper C, MacCraith E, McCabe A, Shortt CP. Assessment of clinically significant urolithiasis positivity rate using CT KUB for suspected renal colic. Ir J Med Sci 2024; 193:1009-1013. [PMID: 37542633 DOI: 10.1007/s11845-023-03477-5] [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: 05/24/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Unenhanced low-dose computed tomography of the kidneys, ureter and bladder (CT KUB) is the gold standard diagnostic imaging modality in the assessment of suspected renal colic. As the radiation dose is not negligible, it is important to monitor the diagnostic yield of CT KUBs. The aim of this study is to evaluate the diagnostic yield of CT KUB studies performed for suspected renal colic in patients presenting to the emergency department. METHODS A retrospective review was performed of 500 patients who underwent CT KUB for suspected renal colic over a seven month period from June 2019 to January 2020. Clinical information and imaging was reviewed for each patient. Statistical analysis was performed using GraphPad Prism 8 (GraphPad Software, San Diego, CA, USA). RESULTS Forty-nine percent of patients in the series were female (248/500) and the mean age was 45. The positivity rate for obstructing ureteral calculus was 34% (169/500). Concerningly, there was a significantly lower positivity rate in females compared to males (19% versus 48%; p < 0.0001) which raises the issue of unnecessary radiation exposure to this cohort. In the 200 female patients who were negative for obstructing urolithiasis, the mean age was 43. Females also had a significantly higher rate of negative CT KUB (62% versus 37%; p < 0.0001) where no underlying alternative pathology was diagnosed. CONCLUSIONS Women are less likely than men to have obstructing urolithiasis on CT KUB for suspected renal colic. This difference is not accounted for by a higher rate of alternative diagnoses among female patients. The findings of this study should prompt clinicians to exercise caution when considering this imaging modality in this patient cohort.
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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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50
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Dornbier RA, Doshi CP, Desai SC, Bajic P, Van Kuiken M, Khemmani M, Farooq AV, Bresler L, Turk TM, Wolfe AJ, Baldea KG. Metabolic syndrome and the urinary microbiome of patients undergoing percutaneous nephrolithotomy. Asian J Urol 2024; 11:316-323. [PMID: 38680585 PMCID: PMC11053299 DOI: 10.1016/j.ajur.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/13/2022] [Indexed: 05/01/2024] Open
Abstract
Objective To identify possible stone-promoting microbes, we compared the profiles of microbes grown from stones of patients with and without metabolic syndrome (MetS). The association between MetS and urinary stone disease is well established, but the exact pathophysiologic relationship remains unknown. Recent evidence suggests urinary tract dysbiosis may lead to increased nephrolithiasis risk. Methods At the time of percutaneous nephrolithotomy, bladder urine and stone fragments were collected from patients with and without MetS. Both sample types were subjected to expanded quantitative urine culture (EQUC) and 16 S ribosomal RNA gene sequencing. Results Fifty-seven patients included 12 controls (21.1%) and 45 MetS patients (78.9%). Both cohorts were similar with respect to demographics and non-MetS comorbidities. No controls had uric acid stone composition. By EQUC, bacteria were detected more frequently in MetS stones (42.2%) compared to controls (8.3%) (p=0.041). Bacteria also were more abundant in stones of MetS patients compared to controls. To validate our EQUC results, we performed 16 S ribosomal RNA gene sequencing. In 12/16 (75.0%) sequence-positive stones, EQUC reliably isolated at least one species of the sequenced genera. Bacteria were detected in both "infectious" and "non-infectious" stone compositions. Conclusion Bacteria are more common and more abundant in MetS stones than control stones. Our findings support a role for bacteria in urinary stone disease for patients with MetS regardless of stone composition.
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Affiliation(s)
- Ryan A. Dornbier
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Chirag P. Doshi
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Shalin C. Desai
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Petar Bajic
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | | | - Mark Khemmani
- Loyola University Chicago, Department of Microbiology and Immunology, Maywood, IL, USA
| | - Ahmer V. Farooq
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Larissa Bresler
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Thomas M.T. Turk
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
| | - Alan J. Wolfe
- Loyola University Chicago, Department of Microbiology and Immunology, Maywood, IL, USA
| | - Kristin G. Baldea
- Loyola University Medical Center, Department of Urology, Maywood, IL, USA
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