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Bnaya A, Kafka IZ, Barhoum H, Shavit L. Vascular calcification in kidney stone formers: the impact of age and stone composition. Urolithiasis 2024; 52:97. [PMID: 38904673 DOI: 10.1007/s00240-024-01597-w] [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: 05/10/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
An increased prevalence of vascular calcification (VC) has been reported in kidney stone formers (KSFs), along with an elevated cardiovascular risk. The aim of the current study is to assess whether VC in these patients develops at a younger age and is influenced by stone composition. This single-center, matched case-control study included KSFs with uric acid or calcium oxalate stones (diagnosed based on stone analysis) and age- and sex-matched controls without a history of nephrolithiasis. The prevalence and severity of abdominal aortic calcification (AAC) and bone mineral density (BMD) were compared between KSFs and non-KSFs. In total, 335 patients were investigated: 134 with calcium oxalate stones, 67 with uric acid stones, and 134 controls. Overall, the prevalence of AAC was significantly higher among calcium stone formers than among the controls (67.9% vs. 47%, p = 0.002). In patients under 60 years of age, those with calcium oxalate stones exhibited both a significantly elevated AAC prevalence (61.9% vs. 31.3%, p = 0.016) and severity (94.8 ± 15.4 vs. 30.3 ± 15.95, p = 0.001) compared to the controls. Within the age group of 40-49, osteoporosis was identified only in the KSFs. Multivariate analysis identified age, smoking, and the presence of calcium stones as independent predictors of AAC. This study highlights that VC and osteoporosis occur in KSFs at a younger age than in non-stone-formers, suggesting potential premature VC. Its pathogenesis is intriguing and needs to be elucidated. Early evaluation and intervention may be crucial for mitigating the cardiovascular risk in this population.
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Affiliation(s)
- Alon Bnaya
- Institute of Nephrology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, P.O Box 3235, Jerusalem, 91031, Israel.
| | - Ilan Z Kafka
- Department of Urology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Hezi Barhoum
- Internal medicine department, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel
| | - Linda Shavit
- Institute of Nephrology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, P.O Box 3235, Jerusalem, 91031, Israel
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Huang L, Hu J, Xue C, Ding J, Guo Z, Yu B. Vascular calcification on the risk of kidney stone: a meta-analysis. Ren Fail 2023; 45:2183727. [PMID: 36866867 PMCID: PMC9987734 DOI: 10.1080/0886022x.2023.2183727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The association between vascular calcification (VC) and kidney stone is still inconclusive. Therefore, we conducted a meta-analysis to estimate the risk of kidney stone disease in subjects with VC. METHODS To identify publications from related clinical studies, we performed a search on PubMed, Web of Science, Embase, and Cochrane Library databases from their inceptions until 1 September 2022. According to obvious heterogeneity, a random-effects model was used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Subgroup analysis was conducted trying to dissect the effects of VC in different segments and population regions in predicting kidney stone risk. RESULTS Seven articles were included with a total number of 69,135 patients, of which 10,052 have vascular calcifications and 4728 have kidney stones. There was a significantly higher risk of kidney stone disease in participants with VC versus control (OR = 1.54, 95% CI: 1.13-2.10). Sensitivity analysis confirmed the stability of the results. VC can be separated into abdominal, coronary, carotid, and splenic aortic calcification while pooled analysis of abdominal aorta calcification did not indicate a significant higher kidney stone risk. An obvious higher risk of kidney stone was observed in Asian VC patients (OR = 1.68, 95% CI: 1.07-2.61). CONCLUSION Combined evidence of observational studies suggested patients with VC may be associated with an increased risk of kidney stone disease. Despite the predictive value was relatively low, it is still worth noting that patients with VC are under the threat of kidney stone disease.
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Affiliation(s)
- Linxi Huang
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Junjie Hu
- Department of Cell Biology, Center for Stem Cell and Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Cheng Xue
- Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Jiarong Ding
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Zhiyong Guo
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Bing Yu
- Department of Cell Biology, Center for Stem Cell and Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
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Tian Y, Zhao J, Chen L, Zhang C, Chu X, Xia Y. Sanjin Paishi Decoction improves the imbalance of gut microbiota and regulates MAPK signaling pathway to inhibit calcium oxalate stones in rats. Int Urol Nephrol 2023; 55:2421-2429. [PMID: 37368087 DOI: 10.1007/s11255-023-03641-x] [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: 04/06/2023] [Accepted: 05/14/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Sanjin Paishi Decoction (SJPSD) has positive effects on stone prevention; however, there is a lack of convincing evidence in the prevention of calcium oxalate stones. This study aimed investigates the effect of SJPSD on calcium oxalate stones and to explore its mechanism. METHODS The rat model of calcium oxalate stones was established and rats were treated with different doses of SJPSD. The pathological damage of kidney tissues was observed by HE staining, the deposition of calcium oxalate crystals in kidney tissues was examined by Von Kossa staining, and the levels of creatinine (CREA), urea (UREA), calcium (Ca), phosphorus (P), and magnesium (Mg) in serum were analyzed biochemically, the levels of IL-1β, IL-6, and TNF-α in serum were measured by ELISA, and the protein expression of Raf1, MEK1, p-MEK1, ERK1/2, p-ERK1/2, and Cleaved caspase-3 in kidney tissues was analyzed by Western blot. Moreover, the changes in gut microbiota were analyzed by 16S rRNA sequencing. RESULTS SJPSD attenuated the pathological damage of renal tissues, reduced the levels of CREA, UREA, Ca, P, and Mg, and inhibited the expression of Raf1, p-MEK1, p-ERK1/2, and Cleaved caspase-3 in renal tissues (P < 0.05). SJPSD treatment affected the composition of intestinal microbiota in rats with calcium oxalate stones. CONCLUSION The mechanism of SJPSD inhibition of calcium oxalate stone injury in rats may be related to the inhibition of the MAPK signaling pathway and regulation of gut microbiota imbalance.
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Affiliation(s)
- Ying Tian
- Department of Urology Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China
| | - Juan Zhao
- Department of Urology Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China
| | - Lan Chen
- Department of Urology Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China
| | - Chuang Zhang
- Department of Urology Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China
| | - Xin Chu
- Department of Nursing, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China.
| | - Yuguo Xia
- Department of Urology Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Road, Jinniu District, Chengdu, 610072, Sichuan Province, China.
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Chen W, Xiong L, Xu Q, Chen L, Huang X. The Association between Aortic Calcification Index and Urinary Stones: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11195884. [PMID: 36233750 PMCID: PMC9570948 DOI: 10.3390/jcm11195884] [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: 08/01/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background: It is believed that vascular calcification and urinary stones may possibly have a shared mechanism. However, the association between vascular calcification and urinary stones is largely unexplored. Using the aortic calcification index (ACI) as a clinical indicator of vascular calcification, the present study aimed to examine the association between the ACI and urinary stones. Methods: This cross-sectional study included 282 patients hospitalized for either urinary stones or other urological diseases from January 2020 to December 2021 at the Department of Urology and Lithotripsy in Peking University People’s Hospital. Among them, 137 and 145 patients were divided into the stone group and the non-stone group. Multivariable logistic regression analysis was performed to examine the association between the ACI and urinary stones. The restricted cubic splines model was used to further explore the dose−response relationship between the ACI and urinary stones. Results: The median (Q1−Q3) age of the study population was 59.0 (47.0−67.0) years. After adjusting coronary heart disease, triglycerides, glucose, serum creatinine, uric acid, urea, calcium, and eGFR, the ACI was independently associated with urinary stones (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03−1.11) in a linear dose−response pattern (p for non-linearity =0.153). Age was found to interact with the effect of the ACI on urinary stones (p for interaction <0.001). Conclusions: This study found that the ACI was independently associated with urinary stones in a linear dose−response manner. Our results indicate that the ACI might be a helpful indicator for identifying populations at risk for urinary stones.
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Moore JP, Mauler DJ, Narang GL, Stern KL, Humphreys MR, Keddis MT. Etiology, urine metabolic risk factors, and urine oxalate patterns in patients with significant hyperoxaluria and recurrent nephrolithiasis. Int Urol Nephrol 2022; 54:2819-2825. [PMID: 35917078 DOI: 10.1007/s11255-022-03311-4] [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: 05/09/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE American Urology Association guidelines recommend genetic testing for patients with recurrent stones and urine oxalate > 75 mg/day. The goal of this study was to examine the treatment of patients in this category in a large multidisciplinary adult stone clinic. METHODS Patients were evaluated from a single institution between 2006 and 2019. Those with at least one level of urinary oxalate excretion (uOx) above 75 mg/day were identified. A chart review identified enteric risk factors and genetic testing results. Patients without an identifiable enteric cause were considered idiopathic. RESULTS A total of 4229 separate 24-h urine collections in 1302 patients were reviewed. At least one measurement of uOx above 75 mg/day was found in 103 (7.9%) patients. Enteric hyperoxaluria (EH) was seen in 28 (27%) and idiopathic hyperoxaluria (IH) in 76 (74%). 20 (71%) patients in the EH group had undergone gastric bypass. The median uOx was significantly higher level in the EH group (121.0 vs. 93.0 mg/day). For the entire cohort, there was a drop in uOx (- 33.8 mg/day) with medical and dietary therapy after a follow-up of 46.6 months. The final oxalate was higher in EH (88.9 vs. 60.1 mg/day). Only one patient had referral for genetic testing and was found to have primary hyperoxaluria type 2. CONCLUSIONS The most common cause of significant hyperoxaluria in patients with recurrent nephrolithiasis remains idiopathic. Patients with IH have more significant improvement in uOx compared to EH; however, both groups had hyperoxaluria at last follow-up. Rate of genetic testing is low despite guideline recommendations.
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Affiliation(s)
- Jonathan P Moore
- Department of Urologic Surgery, UC Davis Medical Center, Sacramento, CA, USA
| | - David J Mauler
- Department of Urology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Gopal L Narang
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Karen L Stern
- Department of Urology, Mayo Clinic Arizona, Phoenix, AZ, USA.
| | | | - Mira T Keddis
- Department of Nephrology, Mayo Clinic Arizona, Phoenix, AZ, USA
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Rudenko T, Kamyshova E, Bobkova I. Kidney stone disease and abdominal aortic calcification: possible relationship and clinical significance. Int Urol Nephrol 2022; 54:3291-3292. [PMID: 35717451 DOI: 10.1007/s11255-022-03261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/02/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Tatiana Rudenko
- Department of Internal and Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Elena Kamyshova
- Department of Internal and Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
| | - Irina Bobkova
- Department of Internal and Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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