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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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Arivoli K, Valicevic AN, Oerline MK, Hsi RS, Patel SR, Hollingsworth JM, Shahinian VB. Preventive Pharmacological Therapy and Risk of Recurrent Urinary Stone Disease. Clin J Am Soc Nephrol 2024; 19:565-572. [PMID: 38345854 PMCID: PMC11108239 DOI: 10.2215/cjn.0000000000000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Urinary stone disease is a prevalent condition associated with a high recurrence risk. Preventive pharmacological therapy has been proposed to reduce recurrent stone episodes. However, limited evidence exists regarding its effectiveness, contributing to its underutilization by physicians. This study aimed to evaluate the association between preventive pharmacological therapy (thiazide diuretics, alkali therapy, and uric acid-lowering medications) and clinically significant urinary stone disease recurrence. METHODS Using data from the Veterans Health Administration, adults with an index episode of urinary stone disease from 2012 through 2019 and at least one urinary abnormality (hypercalciuria, hypocitraturia, or hyperuricosuria) on 24-hour urine collection were included. The primary outcome was a composite variable representing recurrent stone events that resulted in emergency department visits, hospitalizations, or surgery for urinary stone disease. Cox proportional hazards regression was performed to estimate the association between preventive pharmacological therapy use and recurrent urinary stone disease while adjusting for relevant baseline patient characteristics. RESULTS Among the cohort of patients with urinary abnormalities ( n =5637), treatment with preventive pharmacological therapy was associated with a significant 19% lower risk of recurrent urinary stone disease during the 12-36-month period after the initial urine collection (hazard ratio, 0.81; 95% confidence interval, 0.65 to 1.00; P = 0.0496). However, the effectiveness of preventive pharmacological therapy diminished over longer follow-up periods (12-48 and 12-60 months after the urine collection) and did not reach statistical significance. When examining specific urinary abnormalities, only alkali therapy for hypocitraturia was associated with a significant 26% lower recurrence risk within the 12-36-month timeframe (hazard ratio, 0.74; 95% confidence interval, 0.56 to 0.97; P = 0.03). CONCLUSIONS When considering all urinary abnormalities together, this study demonstrates that the use of preventive pharmacological therapy is associated with a lower risk of clinically significant recurrent episodes of urinary stone disease in the 12-36 month timeframe after urine collection, although only the association with the use of alkali therapy for hypocitraturia was significant when individual abnormalities were examined.
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Affiliation(s)
- Kumaran Arivoli
- University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Autumn N. Valicevic
- Veterans Administration, Veterans Affairs Medical Center, Ann Arbor, Michigan
| | - Mary K. Oerline
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Ryan S. Hsi
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sanjeevkumar R. Patel
- Veterans Administration, Veterans Affairs Medical Center, Ann Arbor, Michigan
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Vahakn B. Shahinian
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Muschialli L, Mannath A, Moochhala SH, Shroff R, Ferraro PM. Epidemiological and biological associations between cardiovascular disease and kidney stone formation: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:559-568. [PMID: 38431384 DOI: 10.1016/j.numecd.2023.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 03/05/2024]
Abstract
AIMS Previous studies find kidney stone formers (KSF) are at greater risk of developing cardiovascular disease (CVD). The underlying mechanisms are poorly understood, and many clinicians are unaware of this connection. We will: DATA SYNTHESIS: Our systematic review is registered with PROSPERO (ID CRD42021251477). We searched epidemiological and biological data. The epidemiological search generated 669 papers, narrowed down to 15. There were 4,259,869 participants (230,720 KSFs). KSF was associated with 25% higher risk of coronary artery disease (CAD) (95% confidence interval (CI): 15, 35%), 17% higher risk of stroke/transient ischemic attacks (TIA) (CI:10, 25%) and 39% higher risk of arterial disease (AD) (CI: 17 65%). Significant heterogeneity was found. Female-identifying KSFs had a higher risk of stroke (ratio = 1.10) and CAD (1.20). The biological search generated 125 papers, narrowed down to 14. Potential underlying mechanisms were extracted and discussed, including intimal/medial vascular calcification, oxidative stress via osteopontin (OPN), cholesterol-induced pathology, and endothelial dysfunction. CONCLUSIONS There is a significant association between KSF and CVD, supporting the consideration of KSF as a systemic, calcium-mediated disease. Clinicians will benefit from being aware of this connection.
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Affiliation(s)
- Luke Muschialli
- UCL Medical School, Faculty of Medical Sciences, UCL, London, UK.
| | - Ankith Mannath
- UCL Medical School, Faculty of Medical Sciences, UCL, London, UK
| | | | - Rukshana Shroff
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
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Kowalczyk NS, Prochaska ML, Worcester EM. Metabolomic profiles and pathogenesis of nephrolithiasis. Curr Opin Nephrol Hypertens 2023; 32:490-495. [PMID: 37530089 PMCID: PMC10403267 DOI: 10.1097/mnh.0000000000000903] [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] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW Kidney stone disease is caused by supersaturation of urine with certain metabolites and minerals. The urine composition of stone formers has been measured to prevent stone recurrence, specifically calcium, uric acid, oxalate, ammonia, citrate. However, these minerals and metabolites have proven to be unreliable in predicting stone recurrence. Metabolomics using high throughput technologies in well defined patient cohorts can identify metabolites that may provide insight into the pathogenesis of stones as well as offer possibilities in therapeutics. RECENT FINDINGS Techniques including 1H-NMR, and liquid chromatography paired with tandem mass spectroscopy have identified multiple possible metabolites involved in stone formation. Compared to formers of calcium oxalate stones, healthy controls had higher levels of hippuric acid as well as metabolites involved in caffeine metabolism. Both the gut and urine microbiome may contribute to the altered metabolome of stone formers. SUMMARY Although metabolomics has offered several potential metabolites that may be protective against or promote stone formation, the mechanisms behind these metabolomic profiles and their clinical significance requires further investigation.
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De Santo NG, Bisaccia C, De Santo LS. Acute Kidney Injury as a Leading Cause of Papal Deaths in the Years 1277 to 2005: A Review of 21 Cases. EXP CLIN TRANSPLANT 2023; 21:87-90. [PMID: 37496352 DOI: 10.6002/ect.iahncongress.20] [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: 07/28/2023]
Abstract
OBJECTIVES This study was devised to investigate papal deaths due to acute kidney injury, a topic for which scarce data exist. MATERIALS AND METHODS We studied all popes between John XXI, who died in 1277 of crush syndrome, and John Paul II, who died of anuria and urinary sepsis in 2005. RESULTS Between pontification years from 1277 to 2005, 21 of 78 popes (26.9%) died of acute kidney injury. Sepsis was identified as the leading cause of acute kidney injury and death in 20 of 21 popes (95.2%). Mean ± SE age at death of the 21 popes was 69.4 ± 2.26 years. Six popes (28.6%) died of stroke. CONCLUSIONS Sepsis-associated acute kidney injury, a syndrome with a complex pathogenesis and poor prognosis, which is far from being fully understood, contributed to a high number of papal deaths.
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Renal Stones and Gallstones Correlated with the Ten-Year Risk Estimation of Atherosclerotic Cardiovascular Disease Based on the Pooled Cohort Risk Assessment of Males Aged 40–79. J Clin Med 2023; 12:jcm12062309. [PMID: 36983309 PMCID: PMC10052154 DOI: 10.3390/jcm12062309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Background: The risk of developing atherosclerotic cardiovascular disease (ASCVD) is unknown for subjects with both gallstones and renal stones, nor is it known whether there is a difference in the risk between gallstones and renal stones. This study aimed to determine the risk relationship between gallstones and renal stones and the risk of ASCVD in a male population. Methods: We recruited 6371 eligible males aged 40 to 79 years old who did not have a documented ASCVD history. The ten-year ASCVD risk was calculated using the pooled cohort equations developed by the American College of Cardiology (ACC) and the American Heart Association (AHA). The ASCVD risk score was classified as a low risk (<7.5%), an intermediate risk (7.5% to 19.9%), or a high risk (≥20%). The diagnosis of gallstones and renal stones was established based on the results of abdominal sonography. Results: Both gallstones and renal stones were associated with a high level of intermediate risk (OR = 3.21, 95% CI = 1.89–5.49, p < 0.001) and high risk (OR = 3.01, 95% CI = 1.48–6.12, p < 0.001), compared to individuals with no stones at all, after adjusting for the effects of other clinical variables. The possession of gallstones was associated with a higher level of high ASCVD risk (OR = 1.84, 95% CI = 1.31–2.59, p < 0.05) than that of renal stones. Conclusions: The ASCVD risk was higher for males with gallstones than for those with renal stones. Men with both types of stones faced a risk of ASCVD that was three times higher than that of men without stones.
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Stroke and kidney stones: common predisposing factors in viewpoint of Persian medicine. Neurol Sci 2022; 43:2119-2120. [DOI: 10.1007/s10072-022-05887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
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Zhang Y, Wang C, Liu D, Zhou Z, Gu S, Zuo H. Association of total pre-existing comorbidities with stroke risk: a large-scale community-based cohort study from China. BMC Public Health 2021; 21:1910. [PMID: 34674693 PMCID: PMC8529731 DOI: 10.1186/s12889-021-12002-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023] Open
Abstract
Background Comorbidities, any other coexisting diseases in patients with a particular index disease, are known to increase the mortality of a stroke. However, the association of pre-existing comorbidities with stroke risk has not been fully studied. Methods This study included 16,246 adults from a prospective community-based cohort with a baseline survey conducted in 2013 in China. Participants were followed up with hospitalization records and the Cause of Death Registry. The association of eight pre-existing comorbidities (coronary heart disease, hyperlipidemia, hypertension, diabetes, previous stroke, chronic obstructive pulmonary disease, nephropathy, and cancer) with stroke risk was analyzed using the Cox proportional hazard model in 2020. Results At a median follow-up of 5.5 years, a total of 449 participants (206 men and 243 women) developed a stroke. Four pre-existing comorbidities (hypertension, congenital heart disease, previous stroke, and diabetes) were independently and positively associated with the risk for all types of stroke. The adjusted hazard ratios for participants with only 1 and ≥ 2 pre-existing comorbidities compared with those without pre-existing conditions were 1.96 (95% CI: 1.44, 2.67; P < 0.001) and 2.87 (95% CI; 2.09, 3.94; P < 0.001) for total stroke, respectively. Moreover, male and female participants with a combination of increased age and a higher number of pre-existing comorbidities experienced the greatest risk of stroke. Conclusions The number of pre-existing comorbidities was independently associated with an increased risk of stroke. There was a synergic effect between increased age and a higher number of pre-existing comorbidities on stroke occurrence. Our novel findings emphasize the importance and potential application of pre-existing comorbidities as a risk indicator in stroke prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12002-1.
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Affiliation(s)
- Ya Zhang
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Cuicui Wang
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Dong Liu
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Zhengyuan Zhou
- Changshu Center for Disease Control and Prevention, 6 Fuyang Rd., Suzhou, 215500, China
| | - Shujun Gu
- Changshu Center for Disease Control and Prevention, 6 Fuyang Rd., Suzhou, 215500, China.
| | - Hui Zuo
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China. .,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.
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