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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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Tuntiwongmetee T, Khumngern S, Nontipichet N, Romportong S, Thavarungkul P, Kanatharana P, Numnuam A. Flow injection amperometric uric acid biosensor based on AuNPs-GO-CS porous composite cryogel coated on PB-PEDOT:PSS modified screen-printed carbon electrode. Bioelectrochemistry 2024; 158:108725. [PMID: 38714062 DOI: 10.1016/j.bioelechem.2024.108725] [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: 02/17/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/09/2024]
Abstract
An enzymatic amperometric uric acid (UA) biosensor was successfully developed by modifying a screen-printed carbon electrode (SPCE) with Prussian blue-poly(3,4-ethylene dioxythiophene) polystyrene sulfonate composite (PB-PEDOT:PSS). The modified SPCE was coated with gold nanoparticles-graphene oxide-chitosan composite cryogel (AuNPs-GO-CS cry). Uricase (UOx) was directly immobilized via chemisorption on AuNPs. The nanocomposite was characterized by scanning electron microscopy, transmission electron microscopy, ultraviolet-visible spectroscopy, and Fourier transform infrared spectroscopy. The electrochemical characterization of the modified electrode was performed by cyclic voltammetry and electrochemical impedance spectroscopy. UA was determined using amperometric detection based on the reduction current of PB which was correlated with the amount of H2O2 produced during the enzymatic reaction. Under optimal conditions, the fabricated UA biosensor in a flow injection analysis (FIA) system produced a linear range from 5.0 to 300 μmol L-1 with a detection limit of 1.88 μmol L-1. The proposed sensor was stable for up to 221 cycles of detection and analysis was rapid (2 min), with good reproducibility (RSDs < 2.90 %, n = 6), negligible interferences, and recoveries from 94.0 ± 3.9 to 101.1 ± 2.6 %. The results of UA detection in blood plasma were in agreement with the enzymatic colorimetric method (P > 0.05).
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Affiliation(s)
- Thanawath Tuntiwongmetee
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Suntisak Khumngern
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Natha Nontipichet
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Supapich Romportong
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Panote Thavarungkul
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Proespichaya Kanatharana
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Apon Numnuam
- Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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Fukui S, Okada M, Shinozaki T, Asano T, Nakai T, Tamaki H, Kishimoto M, Hasegawa H, Matsuda T, Marrugo J, Tedeschi SK, Choi H, Solomon DH. Changes in alcohol intake and serum urate changes: longitudinal analyses of annual medical examination database. Ann Rheum Dis 2024; 83:1072-1081. [PMID: 38418204 PMCID: PMC11250628 DOI: 10.1136/ard-2023-225389] [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: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Despite the established cross-sectional association between alcohol intake and serum urate (SU), its longitudinal association remains unknown. This study aimed to determine whether changes in alcohol intake have a clinically relevant association with SU change. METHOD We conducted retrospective analyses using systematically collected annual medical examination data from October 2012 to October 2022 in a Japanese preventive medicine centre. The exposure was changes in alcohol intake between two consecutive visits. The association of SU changes with alcohol intake changes was estimated by mixed-effect linear regression with adjustment for relevant covariates. RESULTS We analysed 63 486 participants (median age, 47.0 years; 55% women; 58.6% regular alcohol drinkers with a median of 1.4 drinks/day) with 370 572 visits. The median SU level was 5.3 mg/dL, and 506 (0.8%) participants had diagnoses of gout or hyperuricemia without medication use during the study period. Decreasing one daily alcohol intake had a clinically small association with SU changes (-0.019 (95% CI: -0.021 to -0.017) mg/dL). Beer had the largest association with SU (-0.036 (95% CI: -0.039 to -0.032) mg/dL for one beer decrease). Complete discontinuation of any alcohol from a mean of 0.8 drinks/day was associated with -0.056 mg/dL (95% CI: -0.068 to -0.043) decrease in SU; the association became larger in hyperuricemic participants (-0.110 mg/dL (95% CI: -0.154 to -0.066) for alcohol discontinuation from a mean of 1.0 drinks/day). CONCLUSIONS This study revealed changes in alcohol intake had small associations with SU change at the general Japanese population level. Complete discontinuation of alcohol in hyperuricemic participants had only modest improvement in SU.
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Affiliation(s)
- Sho Fukui
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
- Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Masato Okada
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Takahiro Asano
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
| | - Takehiro Nakai
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
| | - Hiromichi Tamaki
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Immuno-Rheumatology Center, St. Luke's international Hospital, Tokyo, Japan
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroshi Hasegawa
- Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Takeaki Matsuda
- Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Javier Marrugo
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sara K Tedeschi
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hyon Choi
- Arthritis Research Canada, Richmond, Virginia, Canada
- Division of Rheumatology, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel H Solomon
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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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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Abu-Omar A, Murray N, Ali IT, Khosa F, Barrett S, Sheikh A, Nicolaou S, Tamburrini S, Iacobellis F, Sica G, Granata V, Saba L, Masala S, Scaglione M. Utility of Dual-Energy Computed Tomography in Clinical Conundra. Diagnostics (Basel) 2024; 14:775. [PMID: 38611688 PMCID: PMC11012177 DOI: 10.3390/diagnostics14070775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Advancing medical technology revolutionizes our ability to diagnose various disease processes. Conventional Single-Energy Computed Tomography (SECT) has multiple inherent limitations for providing definite diagnoses in certain clinical contexts. Dual-Energy Computed Tomography (DECT) has been in use since 2006 and has constantly evolved providing various applications to assist radiologists in reaching certain diagnoses SECT is rather unable to identify. DECT may also complement the role of SECT by supporting radiologists to confidently make diagnoses in certain clinically challenging scenarios. In this review article, we briefly describe the principles of X-ray attenuation. We detail principles for DECT and describe multiple systems associated with this technology. We describe various DECT techniques and algorithms including virtual monoenergetic imaging (VMI), virtual non-contrast (VNC) imaging, Iodine quantification techniques including Iodine overlay map (IOM), and two- and three-material decomposition algorithms that can be utilized to demonstrate a multitude of pathologies. Lastly, we provide our readers commentary on examples pertaining to the practical implementation of DECT's diverse techniques in the Gastrointestinal, Genitourinary, Biliary, Musculoskeletal, and Neuroradiology systems.
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Affiliation(s)
- Ahmad Abu-Omar
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Nicolas Murray
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Ismail T. Ali
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Faisal Khosa
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Sarah Barrett
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Adnan Sheikh
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Savvas Nicolaou
- Department of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada (I.T.A.)
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, A. Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy;
| | - Giacomo Sica
- Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy;
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS Di Napoli, 80131 Naples, Italy
| | - Luca Saba
- Medical Oncology Department, AOU Cagliari, Policlinico Di Monserrato (CA), 09042 Monserrato, Italy
| | - Salvatore Masala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy; (S.M.)
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy; (S.M.)
- Department of Radiology, Pineta Grande Hospital, 81030 Castel Volturno, Italy
- Department of Radiology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK
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Alshubaili AM, Alotaibi AF, Alsaleh KA, Almogarri AI, Alanizi AA, Alsaif SS, Alghamdi AS, Alnazari NM, Almalki A. The Prevalence of Nephrolithiasis and Associated Risk Factors Among the Population of the Riyadh Province, Saudi Arabia. Cureus 2024; 16:e55870. [PMID: 38595876 PMCID: PMC11002709 DOI: 10.7759/cureus.55870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Background and objective Kidney stones, also referred to as nephrolithiasis or renal calculi, is a condition where crystal depositions are formed within the kidney and ideally excreted from the body via the urethra with no pain; however, larger calculi may cause significant pain and require further medical assistance. The vast majority of patients who develop renal calculi form calcium stones, which are either a composition of calcium oxalate or calcium phosphate. Other types include uric acid, struvite, and cysteine. While kidney stones are one of the most significant diseases among the Saudi population, which require an acute emergency intervention to prevent serious long-term complications, there are limited studies published regarding this condition in Saudi communities. In light of this, we performed this study to assess the prevalence, incidence, and risk factors of kidney stones among the population of Riyadh, Saudi Arabia. Methods This was a cross-sectional study conducted in Riyadh, Saudi Arabia between August and October 2023, aiming to estimate the prevalence and risk factors of nephrolithiasis among residents of the Riyadh province. Data were collected through an electronic questionnaire in both Arabic and English and distributed via social media in addition to barcode handouts in various selected venues in Riyadh. The questionnaire involved 12 questions categorized into three sections. The first section obtained demographical information while the second section collected data about the past medical history of the participants. Lastly, the third section aimed to assess the prevalence of nephrolithiasis among participants or any history of the condition among their families. Results A total of 1,043 participants were surveyed, of whom 533 were males (51.1%). The prevalence of kidney stones was reported in 98 individuals (9.4%) overall. Individuals in the age groups of 36-50, 51-60, and >60 years showed significantly more renal stone prevalence than those in younger age groups (p<0.001). The prevalence was found to be higher in participants who were smokers, diabetic, hypertensive, and those who suffered from inflammatory bowel disease (IBD), gout, chronic kidney disease (CKD), hyperthyroidism, and hyperparathyroidism. Participants who took calcium supplements or had a positive family history of renal stones were found to have a higher prevalence of renal stones as well. However, only hypertension, gout, and family history showed any statistical significance (p<0.05). Conclusions A direct correlation was observed between hypertension, gout, positive family history, and aging and an increased prevalence of kidney stones among the inhabitants of the Riyadh province. Therefore, we encourage the local authorities to raise awareness of kidney stones and their related risk factors among the general public. Moreover, further local studies need to be conducted to gain deeper insights into kidney stone prevalence, especially pertaining to associated comorbidities and the pattern of the disease itself.
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Affiliation(s)
- Abdullah M Alshubaili
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz F Alotaibi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Khalid A Alsaleh
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz I Almogarri
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdullah A Alanizi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Saif S Alsaif
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Ahmad S Alghamdi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Nasser M Alnazari
- Department of Hepatobiliary Sciences and Organ Transplant, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Amwaj Almalki
- Biostatistics and Epidemiology, King Abdullah International Medical Research Center, Riyadh, SAU
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7
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Kanbay M, Copur S, Bakir CN, Hatipoglu A, Sinha S, Haarhaus M. Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group. Clin Kidney J 2024; 17:sfae023. [PMID: 38410685 PMCID: PMC10896178 DOI: 10.1093/ckj/sfae023] [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: 12/31/2023] [Indexed: 02/28/2024] Open
Abstract
The lifetime incidence of kidney stones is 6%-12% in the general population. Nephrolithiasis is a known cause of acute and chronic kidney injury, mediated via obstructive uropathy or crystal-induced nephropathy, and several modifiable and non-modifiable genetic and lifestyle causes have been described. Evidence for epidemiology and management of nephrolithiasis after kidney transplantation is limited by a low number of publications, small study sizes and short observational periods. Denervation of the kidney and ureter graft greatly reduces symptomatology of kidney stones in transplant recipients, which may contribute to a considerable underdiagnosis. Thus, reported prevalence rates of 1%-2% after kidney transplantation and the lack of adverse effects on allograft function and survival should be interpreted with caution. In this narrative review we summarize current state-of-the-art knowledge regarding epidemiology, clinical presentation, diagnosis, prevention and therapy of nephrolithiasis after kidney transplantation, including management of asymptomatic stone disease in kidney donors. Our aim is to strengthen clinical nephrologists who treat kidney transplant recipients in informed decision-making regarding management of kidney stones. Available evidence, supporting both surgical and medical treatment and prevention of kidney stones, is presented and critically discussed. The specific anatomy of the transplanted kidney and urinary tract requires deviation from established interventional approaches for nephrolithiasis in native kidneys. Also, pharmacological and lifestyle changes may need adaptation to the specific situation of kidney transplant recipients. Finally, we point out current knowledge gaps and the need for additional evidence from future studies.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Cicek N Bakir
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Alper Hatipoglu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Smeeta Sinha
- Department of Renal Medicine, Salford Royal NHS Institute, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Mathias Haarhaus
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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8
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Shim KH, Choi KB, Kim WB, Yang SW, Kim DK, Choo MS, Chung DY, Jung HD, Lee SW, Kim BS, Jeon SH, Kang SH, Paick S, Lee JY. Urolithiasis in Kidney Transplant Patients: A Multicenter KSER Research Series. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:132. [PMID: 38256393 PMCID: PMC10819323 DOI: 10.3390/medicina60010132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Urolithiasis occurrence is uncommon in kidney transplantation patients, though it has serious implications, including acute kidney injury in the transplanted kidney. This study investigates the leading causes of urolithiasis in kidney transplantation patients, the diagnostic process, and the outcomes of multimodal management. Materials and Methods: Data collection spanned from January 1997 to December 2021, involving kidney transplantation patients with urolithiasis from the database of the Korean Society of Endourology and Robotics (KSER) research committee. Analysis encompassed factors triggering urolithiasis, the diagnostic process, stone attributes, treatment methods, and outcomes. Results: Our analysis included 58 kidney transplantation patients with urolithiasis from eight medical centers. Of these patients, 37 were male and 4 had previous urolithiasis diagnoses. The mean age was 59.09 ± 10.70 years, with a mean duration from kidney transplantation to diagnosis of 76.26 ± 183.14 months. The most frequent method of stone detection was through asymptomatic routine check-ups (54.7%). Among the 58 patients, 51 underwent stone treatment. Notably, 95.3% of patients with ureter stones received treatment, a significantly higher rate than the 66.7% of patients with renal stones (p = 0.010). Success rates showed no significant differences between renal (70%) and ureter stone (78.0%) groups (p = 0.881). Conclusions: Urolithiasis in transplanted kidneys constitutes an acute condition requiring emergency intervention. Endo-urological interventions are effective for kidney transplantation patients with urolithiasis. To ensure prevention and early detection, diligent follow-up and routine imaging tests are necessary.
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Affiliation(s)
- Kang Hee Shim
- Department of Urology, Ajou University School of Medicine, Suwon 16499, Republic of Korea;
| | - Kwi Bok Choi
- Department of Urology, National Police Hospital, Seoul 05715, Republic of Korea;
| | - Woong Bin Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Republic of Korea;
| | - Seung Woo Yang
- Department of Urology, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea;
- Department of Urology, U-well Urology Clinic, Daejeon 35233, Republic of Korea
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Republic of Korea;
| | - Min Soo Choo
- Department of Urology, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea;
| | - Doo Yong Chung
- Department of Urology, Inha University College of Medicine, Incheon 22212, Republic of Korea;
| | - Hae Do Jung
- Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea;
| | - Sin Woo Lee
- Department of Urology, Seoul Medical Center, Seoul 02053, Republic of Korea;
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Seung Hyun Jeon
- Department of Urology, Kyung Hee University School of Medicine, Seoul 02447, Republic of Korea;
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul 02841, Republic of Korea;
| | - Sunghyun Paick
- Department of Urology, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
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Takahashi T, Sasaki M, Shimizu T, Yamaguchi S. Changes in Urinary Uric Acid Concentration after Dotinurad Administration to Patients with Hyperuricemia: A Post Hoc Analysis of Two Clinical Trials in Japan. Clin Pharmacol Drug Dev 2024; 13:87-95. [PMID: 37559414 DOI: 10.1002/cpdd.1317] [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: 05/22/2023] [Accepted: 07/23/2023] [Indexed: 08/11/2023]
Abstract
Dotinurad has been approved in Japan as a selective urate reabsorption inhibitor for the treatment of gout and hyperuricemia. The relationship between uric acid crystallization and the use of uricosuric drugs is widely acknowledged; however, the relationship between changes in urinary uric acid concentration and urine pH or volume has not been sufficiently analyzed. Therefore, we investigated the changes in urinary uric acid concentration following dotinurad administration as well as the relationship between urine pH or volume and urinary uric acid concentration. This post hoc analysis used data from 2 clinical trials that included 12 and 26 patients with hyperuricemia who received dotinurad treatment (for 7 days on an inpatient basis and 14 weeks on an outpatient basis, respectively). The urinary uric acid concentration transiently increased in the early stages of dotinurad use and when its dose was increased, but decreased over time. No uric acid concentrations exceeded the soluble limit at any urine pH. An inverse correlation was observed between urine volume and urinary uric acid concentration. This study highlights the significance of adequately managing urinary uric acid concentrations by increasing urine volume and alkalinizing urine to prevent uric acid crystallization during dotinurad administration.
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Affiliation(s)
| | - Minoru Sasaki
- Medical Affairs Division, Medical Communication Department, Fuji Yakuhin Co., Ltd, Tokyo, Japan
| | | | - Satoshi Yamaguchi
- Department of Urology, Urinary Stone Medical Center, Kitasaito Hospital, Asahikawa, Hokkaido, Japan
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10
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Akpakli EA, Asante E, Kyei MY, Klufio K, Toboh B, Mensah JE. Analysis, treatment modality and demographic characteristics of urolithiasis patients visiting Korle-Bu Teaching Hospital in Ghana. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2024; 14:94-101. [PMID: 38486658 PMCID: PMC10936895 DOI: 10.4103/jwas.jwas_86_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/09/2023] [Indexed: 03/17/2024]
Abstract
Background Globally urolithiasis is on the rise and gradually becoming a public health concern due to the associated complications. This study reviewed the demographic characteristics, the chemical composition of stones, treatment modality and duration of hospitalisation of urolithiasis patients at Korle-Bu Teaching Hospital, Accra, Ghana. Materials and Methods This was a retrospective study conducted between March 2019 and April 2022. Data from consecutive patients treated for urolithiasis were used for this study. Data on demographic characteristics, stones chemical composition, urine factors, urolithiasis treatment modality and duration of hospital stay after therapy were collated and analysed using descriptive and inferential approaches. Results The age of the patients ranged from 2 to 75 years with a mean of 45 (±13.4). The predominant age group for stone formation was 30-39 years - 52(26.3%). Urolithiasis was common among patients in the formal employment sector: 81(40.9%). All stones had two or more chemical compositions, with the combination of calcium oxalate monohydrate, calcium oxalate dihydrate and uric acid being the predominant stone type: 88(57.5%). Ureteroscopy with semi-rigid and Percutaneous nephrolithotomy were the predominant treatment modalities: 105(53.0%) and 74(37.4%), respectively. Escherichia coli was responsible for most urinary tract infections in urolithiasis patients 8(4.0%) and the least duration of hospital stay after the procedure was associated with the use of semi-rigid ureteroscope as the treatment modality with a median duration of 2 days (1-2 days) with P < 0.0001. Conclusions Urolithiasis was predominant among professionals in the formal sector. All stones were mixed with Calcium oxalate monohydrate, calcium oxalate dihydrate, and uric acid combination being the majority. Ureteroscopy with semi-rigid and percutaneous nephrolithotomy were the common treatment modality.
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Affiliation(s)
| | - Emmanuel Asante
- Department of Surgery, University of Ghana Medical Centre, Accra, Ghana
| | | | - Kenneth Klufio
- Department of Surgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Bernard Toboh
- Department of Surgery, Korle-Bu Teaching Hospital, Accra, Ghana
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11
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Abdul Aziz SFN, Hui OS, Salleh AB, Normi YM, Yusof NA, Ashari SE, Alang Ahmad SA. Enhancing uric acid electrochemical detection with copper ion-activated mini protein mimicking uricase within ZIF-8: response surface methodology (RSM) optimization. Anal Bioanal Chem 2024; 416:227-241. [PMID: 37938411 DOI: 10.1007/s00216-023-05011-z] [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: 08/02/2023] [Revised: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023]
Abstract
This study aims to investigate the influence of copper(II) ions as a cofactor on the electrochemical performance of a biocomposite consisting of a mini protein mimicking uricase (mp20) and zeolitic immidazolate framework-8 (ZIF-8) for the detection of uric acid. A central composite design (CCD) was utilized to optimize the independent investigation, including pH, deposition potential, and deposition time, while the current response resulting from the electrocatalytic oxidation of uric acid was used as the response. The statistical analysis of variance (ANOVA) showed a good correlation between the experimental and predicted data, with a residual standard error percentage (RSE%) of less than 2% for predicting optimal conditions. The synergistic effect of the nanoporous ZIF-8 host, Cu(II)-activated mp20, and reduced graphene oxide (rGO) layer resulted in a highly sensitive biosensor with a limit of detection (LOD) of 0.21 μM and a reproducibility of the response (RSD = 0.63%). The Cu(II)-activated mp20@ZIF-8/rGO/SPCE was highly selective in the presence of common interferents, and the fabricated layer exhibited remarkable stability with signal changes below 4.15% after 60 days. The biosensor's reliable performance was confirmed through real sample analyses of human serum and urine, with comparable recovery values to conventional HPLC.
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Affiliation(s)
- Siti Fatimah Nur Abdul Aziz
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- School of Chemical Sciences, Universiti Sains Malaysia (USM), 11800, Gelugor, Pulau Pinang, Malaysia.
| | - Ong Sin Hui
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Abu Bakar Salleh
- Enzyme and Microbial Technology Research Centre (EMTech), Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor, Malaysia
| | - Yahaya M Normi
- Enzyme and Microbial Technology Research Centre (EMTech), Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor, Malaysia
- Department of Cell and Molecular Biology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Institute of Nanoscience and Nanotechnology (ION2), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Nor Azah Yusof
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Institute of Nanoscience and Nanotechnology (ION2), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Siti Efliza Ashari
- Centre of Foundation Studies for Agricultural Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Shahrul Ainliah Alang Ahmad
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- Institute of Nanoscience and Nanotechnology (ION2), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
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12
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Yang M, Li Y, Chen Y, Huang F. Association of low-dose aspirin use for primary prevention with self-reported kidney stones prevalence: a cross-sectional study. World J Urol 2023; 41:3753-3758. [PMID: 37838641 DOI: 10.1007/s00345-023-04657-9] [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: 11/24/2022] [Accepted: 09/24/2023] [Indexed: 10/16/2023] Open
Abstract
OBJECTIVE To investigate the association between low-dose aspirin use for primary prevention and self-reported kidney stones prevalence in the 40-79 years old population. METHODS We conducted a cross-sectional study based on the United States population data from the National Health and Nutrition Examination Survey 2011-2018. Baseline demographical and clinical data were collected. The univariate and multivariate regression was performed to identify confounding factors and assess the relationship between aspirin use for primary prevention and the prevalence of self-reported kidney stones. A propensity-score matching was used to identify patients with similar baseline characteristics to adjust for the bias caused by confounding factors. RESULTS A total of 10,256 low-dose aspirin-use participants were included in this study. 10.4% of participants reported a history of kidney stones, and 18.5% reported a continuous use of low-dose prophylactic aspirin. Multivariate logistic regression analysis showed that low-dose preventive aspirin use had significantly increased the odds of self-reported kidney stones (OR = 1.245; 95% CI: 1.063-1.459; p = 0.007). In subgroup analysis, this finding was primarily limited to males (OR = 1.311), non-hypertensive participants (OR = 1.443), diabetic participants (OR = 1.380), and older (60 ≤ Age < 80) (OR = 1.349). The propensity-score matched analyses supported this result after adjusting for the bias caused by potential confounders (OR = 1.216; 95% CI: 1.011-1.462; p = 0.038). CONCLUSION In this study, there exists a significant relationship between low-dose aspirin for primary prevention and self-reported kidney stones, primarily among males, no hypertensive participants, diabetics, or older adults. Further studies are needed to elucidate the mechanisms underlying these findings in the future.
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Affiliation(s)
- Miaomiao Yang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yongchao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yingji Chen
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Fang Huang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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13
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Qu Y, Yu Y, Pan J, Li H, Cui C, Liu D. Systematic review and model-based analysis to identify whether renal safety risks of URAT1 inhibitors are fully determined by uric acid-lowering efficacies. Semin Arthritis Rheum 2023; 63:152279. [PMID: 37866004 DOI: 10.1016/j.semarthrit.2023.152279] [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: 08/02/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Renal safety risk is currently an important factor that hinders the development of uric acid transporter 1 (URAT1) inhibitors. This study aimed to compare the renal safety and uric acid-lowering efficacy of different URAT1 inhibitors and clarify the association between them. METHODS A systematic review of published randomized controlled trials on URAT1 inhibitors was conducted to investigate the incidence of renal safety events. A model-based analysis was performed to predict the uric acid-lowering efficacy of representative URAT1 inhibitors. RESULTS The overall renal safety event incidences of lesinurad, verinurad, dotinurad, SHR4640, and benzbromarone in patients with hyperuricemia were 11.2 % (142/1264), 12.0 % (34/284), 0.5 % (2/421), 2.3 % (5/213), and 1.3 % (5/393), respectively. A semi-mechanistic pharmacokinetic/pharmacodynamic model was used to establish the dose-exposure-effect relationship of lesinurad, verinurad, dotinurad, and SHR4640 with or without the combination of xanthine oxidase inhibitors (XOIs). The efficacy ranking of the intermediate dose of URAT1 inhibitors with once-daily dosing was 2 mg dotinurad > 10 mg verinurad > 5 mg SHR4640 > 400 mg lesinurad. The combination of 80 mg febuxostat and 600 mg allopurinol reduced the 24-h cumulative renal uric acid excretion by 48.4 % and 48.3 %, respectively. CONCLUSION Uric acid-lowering efficacy is not an independent factor for the renal safety risk of different URAT1 inhibitors, and structural differences could be responsible for the difference. The adverse renal effects of URAT1 inhibitors are dose-dependent, and the combination with high doses of XOIs can significantly reduce the renal safety risk by reducing uric acid excretion by the kidneys.
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Affiliation(s)
- Yuchen Qu
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yunli Yu
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Pan
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Haiyan Li
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China; Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China; Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Cheng Cui
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China; Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China; Department of Cardiology, Peking University Third Hospital, Beijing, China.
| | - Dongyang Liu
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China; Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Third Hospital, Beijing, China.
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14
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González-Enguita C, Bueno-Serrano G, López de Alda-González A, García-Giménez R. Environmental Conditions as Determinants of Kidney Stone Formation. ACS APPLIED BIO MATERIALS 2023; 6:5030-5036. [PMID: 37913796 PMCID: PMC10863387 DOI: 10.1021/acsabm.3c00722] [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: 08/30/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
Urolithiasis is a disease characterized by the presence of stones in the urinary tract, whether in the kidneys, ureters, or bladder. Its origin is multiple, and causes can be cited as hereditary, environmental, dietary, anatomical, metabolic, or infectious factors. A kidney stone is a biomaterial that originates inside the urinary tract, following the principles of crystalline growth, and in most cases, it cannot be eliminated naturally. In this work, 40 calculi from the Don Benito, Badajoz University Hospital are studied and compared with those collected in Madrid to establish differences between both populations with the same pathology and located in very different geographical areas. Analysis by cathodoluminescence offers information on the low crystallinity of the phases and their hydration states, as well as the importance of the bonds with the Ca cation in all of the structures, which, in turn, is related to environmental and social factors of different population groups such as a high intake of proteins, medications, bacterial factors, or possible contamination with greenhouse gases, among other factors.
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Affiliation(s)
- Carmen González-Enguita
- Hospital
Universitario Fundación Jiménez Díaz, Avenida Reyes Católicos,
2, 28040 Madrid, Spain
| | - Gonzalo Bueno-Serrano
- Hospital
Universitario Fundación Jiménez Díaz, Avenida Reyes Católicos,
2, 28040 Madrid, Spain
| | | | - Rosario García-Giménez
- Departamento
de Geología y Geoquímica, Facultad de Ciencias, Universidad Autónoma, 28049 Madrid, Spain
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15
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Wu YC, Hou CP, Weng SC. Lifestyle and Diet as Risk Factors for Urinary Stone Formation: A Study in a Taiwanese Population. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1895. [PMID: 38003945 PMCID: PMC10673421 DOI: 10.3390/medicina59111895] [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: 08/29/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Urinary tract stones have long been a common ailment afflicting the population, with a high incidence and a wide distribution across different age groups. Effectively preventing the occurrence of urinary tract stones is of paramount importance. The primary aim of this study is to investigate the correlations between individual characteristics, water consumption habits, dietary habits, exercise habits, and the occurrence of urinary tract stones in a Taiwanese population. Materials and Methods: This study is cross-sectional research conducted over one month in 2022. One hundred eligible urinary stone cases were recruited through physician screening at outpatient clinics, and an additional one hundred samples from surgical outpatients without urinary tract stones were included as the control group. A questionnaire survey was employed to gather information on demographic variables, dietary habits, water consumption, and exercise habits of the cases. Descriptive statistics, chi-square tests, and logistic regression were used to explore the impact of relevant factors on urinary stone formation. Results: The analysis results revealed that among the demographic variables, males exhibited a higher risk of contracting urinary tract stones than females, and the majority of cases fell within the 40- to 49-year-old age group. Unhealthy lifestyle habits such as smoking and betel nut chewing also demonstrated a higher susceptibility to urinary tract stones. A logistic regression analysis showed that individuals who engaged in physical activity more than three times per week and those with inadequate water intakes had a higher risk of developing urinary tract stones. Conclusions: There is a close relationship between lifestyle and urinary tract stones. It is recommended that individuals continue to hydrate adequately during exercise.
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Affiliation(s)
- Ya-Chun Wu
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
- Hsinchu Branch, Taipei Veterans General Hospital, Hsinchu 310, Taiwan
| | - Chen-Pang Hou
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Shu-Chuan Weng
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
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16
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Song BI, Lee J, Jung W, Kim BS. Pure uric acid stone prediction model using the variant coefficient of stone density measured by thresholding 3D segmentation-based methods: A multicenter study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107691. [PMID: 37418801 DOI: 10.1016/j.cmpb.2023.107691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023]
Abstract
Urinary stones are common urological diseases with increasing prevalence and incidence worldwide. Among the various types of stones, uric acid stones can be dissolved by oral chemolysis without any surgical procedure. Therefore, our study demonstrates that variant coefficient of stone density measured by thresholding a three-dimensional segmentation-based method from noncontrast computed tomography images can be used to identify pure uric acid stones from non-pure uric acid stones. This study provides a preoperative pure uric acid stone prediction model that could reduce invasive procedural treatments. The pure uric acid stone prediction model may offer optimized clinical decision-making for patients with urinary stones. BACKGROUND AND OBJECTIVES While most urinary stones are managed with interventional therapy, uric acid (UA) stones can be dissolved by oral chemolysis without invasive procedures. This study aimed to develop and validate a pure UA (pUA) stone prediction model using a variant coefficient of stone density (VCSD) measured by thresholding a three-dimensional (3D) segmentation-based method. METHODS Patients with urolithiasis treated at Keimyung University Dongsan Hospital between January 2017 and December 2020 were divided into training and internal validation sets, and patients from Kyungpook National University Hospital between January 2017 and December 2018 were used as an external validation set. Each stone was segmented by a thresholding 3D segmentation-based method using an attenuation threshold of 130 Hounsfield units. VCSD was calculated as the stone heterogeneity index divided by the mean stone density. RESULTS A total of 1175 urinary stone cases in 1023 patients were enrolled in this study. Of these, 224 (19.1%) were pUA stone cases. Among the potential predictors, thresholding 3D segmentation-based VCSD, age, sex, radio-opacity, hypertension, diabetes, and urine pH were identified as independent pUA stone predictors, and VCSD was the most powerful indicator. The pUA stone prediction model showed good discrimination, yielding area under the receiver operating characteristic curve of 0.960 (95% confidence interval (CI): 0.940-0.979, P < 0.001), 0.931 (95% CI: 0.875-0.987, P < 0.001), and 0.938 (95% CI: 0.912-0.965, P < 0.001) in the training, internal validation, and external validation sets, respectively. CONCLUSIONS VCSD measured using 3D segmentation was a decisive independent predictive factor for pUA stones. Furthermore, the established prediction model with VCSD can serve as a noninvasive preoperative tool to identify pUA stones.
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Affiliation(s)
- Bong-Il Song
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea (the Republic of)
| | - Jinny Lee
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea (the Republic of)
| | - Wonho Jung
- Department of Urology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of).
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17
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Chew BH, Wong VKF, Halawani A, Lee S, Baek S, Kang H, Koo KC. Development and external validation of a machine learning-based model to classify uric acid stones in patients with kidney stones of Hounsfield units < 800. Urolithiasis 2023; 51:117. [PMID: 37776331 DOI: 10.1007/s00240-023-01490-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: 07/02/2023] [Accepted: 09/11/2023] [Indexed: 10/02/2023]
Abstract
The correct diagnosis of uric acid (UA) stones has important clinical implications since patients with a high risk of perioperative morbidity may be spared surgical intervention and be offered alkalization therapy. We developed and validated a machine learning (ML)-based model to identify stones on computed tomography (CT) images and simultaneously classify UA stones from non-UA stones. An international, multicenter study was performed on 202 patients who received percutaneous nephrolithotomy for kidney stones with HU < 800. Data from 156 (77.2%) patients were used for model development, while data from 46 (22.8%) patients from a multinational institution were used for external validation. A total of 21,074 kidney and stone contour-annotated CT images were trained with the ResNet-18 Mask R-convolutional neural network algorithm. Finally, this model was concatenated with demographic and clinical data as a fully connected layer for stone classification. Our model was 100% sensitive in detecting kidney stones in each patient, and the delineation of kidney and stone contours was precise within clinically acceptable ranges. The development model provided an accuracy of 99.9%, with 100.0% sensitivity and 98.9% specificity, in distinguishing UA from non-UA stones. On external validation, the model performed with an accuracy of 97.1%, with 89.4% sensitivity and 98.6% specificity. SHAP plots revealed stone density, diabetes mellitus, and urinary pH as the most important features for classification. Our ML-based model accurately identified and delineated kidney stones and classified UA stones from non-UA stones with the highest predictive accuracy reported to date. Our model can be reliably used to select candidates for an earlier-directed alkalization therapy.
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Affiliation(s)
- Ben H Chew
- Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, Vancouver, BC, Canada
| | - Victor K F Wong
- Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, Vancouver, BC, Canada
| | | | - Sujin Lee
- Infinyx, AI research team, Daegu, Republic of Korea
| | | | - Hoyong Kang
- Infinyx, AI research team, Daegu, Republic of Korea
| | - Kyo Chul Koo
- Department of Urology, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
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18
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Sun M, Cui C, Chen H, Wang D, Zhang W, Guo W. Enzymatic and Non-Enzymatic Uric Acid Electrochemical Biosensors: A Review. Chempluschem 2023; 88:e202300262. [PMID: 37551133 DOI: 10.1002/cplu.202300262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/09/2023]
Abstract
In recent years, the development of electrochemical biosensors for uric acid has made great achievements. Firstly, uric acid electrochemical biosensors were classified according to their reaction mechanism. Then, the reaction mechanism of the uric acid sensor and the application of nano-modified materials were deeply analyzed from the perspective of non-enzyme and enzymes. In this paper, the catalytic oxidation capacity, enzyme adsorption effect, conductivity, robustness, detection range, and detection limit of uric acid sensors were discussed and compared. Finally, the advantages of acid-sensitive electrochemical biosensors were summarized, and the constructive recommendations were proposed for improving the deficiencies of acid biosensors. The potential for further development in this area was also discussed.
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Affiliation(s)
- Miao Sun
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
| | - Chuanjin Cui
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
| | - Hongshuo Chen
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
| | - Dengling Wang
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
| | - Wensi Zhang
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
| | - Wenjin Guo
- North China University of Science and Technology, College of Electrical Engineering, Tangshan, 063210, P. R. China
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Abdulrhman A, Alsweed A, Alotaibi MR, Aldakhil AY, Alahmadi SF, Albishri SM, Alhmed NI. Urolithiasis in patients with inflammatory bowel disease: A systematic review and meta-analysis of 13,339,065 individuals. Medicine (Baltimore) 2023; 102:e33938. [PMID: 37327280 PMCID: PMC10270553 DOI: 10.1097/md.0000000000033938] [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: 09/26/2022] [Accepted: 05/16/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND This study aimed to summarize the current literature regarding the prevalence of renal stones in patients with inflammatory bowel disease (IBD). Moreover, we aimed to evaluate the risk factors of urolithiasis in patients with IBD and the difference between patients with IBD and healthy controls in terms of urinary profile. METHODS On February 23, 2022, a computerized search was conducted on PubMed, OVID via MEDLINE, Web of Science, and Scopus using relevant keywords. Three independent reviewers performed 2-stage screening and data extraction. The National Institutes of Health tools were employed for quality assessment. Review Manager 5.4 software was used to calculate the mean difference (MD) between IBD patients and non-IBD in terms of urine profile using the Inverse-variance model and to estimate the odds ratio of reported risk factors for renal stones with the Generic Inverse-Variance model. RESULTS Thirty-two articles (n = 13,339,065 patients) were included. The overall prevalence of renal stones in patients with IBD was 6.3%, 95% Confidence interval (4.8%-8.3%). The prevalence of urolithiasis was more common in Chron's disease vs Ulcerative colitis (7.9% vs 5.6%) and in old studies (1964-2009) than in more recent studies (2010-2022) (7.3% vs 5.2%), respectively. Compared to non-IBD patients, patients with IBD were associated with significantly lower urine volume (MD = -518.84 mL/day, P < .00001), calcium 24-hour urine (MD = -28.46 mg/day, P < .0001), citrate 24-hour urine (MD = -144.35 mg/day, P < .00001), sodium 24-hour urine (MD = -23.72 mg/day, P = .04), and magnesium 24-hour urine (MD = -33.25 mg/day, P < .00001). CONCLUSION The overall prevalence of renal stones in patients with IBD was comparable to the general population. Patients with Chron's disease were associated with a higher prevalence of urolithiasis compared to Ulcerative colitis. Drugs that induce renal calculi should be stopped in high-risk patients.
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Affiliation(s)
- Aldukhayel Abdulrhman
- Department of Family and Community Medicine, Qassim University, College of Medicine, Buraidah, Saudi Arabia
| | - Adil Alsweed
- PHC Physician, Ministry of Health, Qassim, Saudi Arabia
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Miake J, Hisatome I, Tomita K, Isoyama T, Sugihara S, Kuwabara M, Ogino K, Ninomiya H. Impact of Hyper- and Hypo-Uricemia on Kidney Function. Biomedicines 2023; 11:biomedicines11051258. [PMID: 37238929 DOI: 10.3390/biomedicines11051258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
Uric acid (UA) forms monosodium urate (MSU) crystals to exert proinflammatory actions, thus causing gout arthritis, urolithiasis, kidney disease, and cardiovascular disease. UA is also one of the most potent antioxidants that suppresses oxidative stress. Hyper andhypouricemia are caused by genetic mutations or polymorphism. Hyperuricemia increases urinary UA concentration and is frequently associated with urolithiasis, which is augmented by low urinary pH. Renal hypouricemia (RHU) is associated with renal stones by increased level of urinary UA, which correlates with the impaired tubular reabsorption of UA. Hyperuricemia causes gout nephropathy, characterized by renal interstitium and tubular damage because MSU precipitates in the tubules. RHU is also frequently associated with tubular damage with elevated urinary beta2-microglobulin due to increased urinary UA concentration, which is related to impaired tubular UA reabsorption through URAT1. Hyperuricemia could induce renal arteriopathy and reduce renal blood flow, while increasing urinary albumin excretion, which is correlated with plasma xanthine oxidoreductase (XOR) activity. RHU is associated with exercise-induced kidney injury, since low levels of SUA could induce the vasoconstriction of the kidney and the enhanced urinary UA excretion could form intratubular precipitation. A U-shaped association of SUA with organ damage is observed in patients with kidney diseases related to impaired endothelial function. Under hyperuricemia, intracellular UA, MSU crystals, and XOR could reduce NO and activate several proinflammatory signals, impairing endothelial functions. Under hypouricemia, the genetic and pharmacological depletion of UA could impair the NO-dependent and independent endothelial functions, suggesting that RHU and secondary hypouricemia might be a risk factor for the loss of kidney functions. In order to protect kidney functions in hyperuricemic patients, the use of urate lowering agents could be recommended to target SUA below 6 mg/dL. In order to protect the kidney functions in RHU patients, hydration and urinary alkalization may be recommended, and in some cases an XOR inhibitor might be recommended in order to reduce oxidative stress.
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Affiliation(s)
- Junichiro Miake
- Division of Pharmacology, Department of Pathophysiological and Therapeutic Science, Tottori University Faculty of Medicine, Tottori 683-8503, Japan
| | - Ichiro Hisatome
- Department of Cardiology, Yonago Medical Center, Tottori 683-0006, Japan
| | - Katsuyuki Tomita
- Department of Respiratory Disease, Yonago Medical Center, Tottori 683-0006, Japan
| | - Tadahiro Isoyama
- Department of Urology, Yonago Medical Center, Tottori 683-0006, Japan
| | - Shinobu Sugihara
- Health Service Center, Shimane University, Matsue 690-0823, Japan
| | - Masanari Kuwabara
- Intensive Care Unit and Department of Cardiology, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Kazuhide Ogino
- Department of Cardiology, Tottori Red Cross Hospital, Tottori 680-0017, Japan
| | - Haruaki Ninomiya
- Department of Biological Regulation, Tottori University Faculty of Medicine, Tottori 683-8503, Japan
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Fernández-Torres J, Zamudio-Cuevas Y, Martínez-Nava GA, Martínez-Flores K, Ruíz-Dávila X, Sánchez-Sánchez R. Relationship between rs4349859 and rs116488202 polymorphisms close to MHC-I region and serum urate levels in patients with gout. Mol Biol Rep 2023; 50:4367-4374. [PMID: 36943604 DOI: 10.1007/s11033-023-08359-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/23/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Gout is the most common inflammatory rheumatic disease and elevated levels of serum urate (SU) are the main cause for its development. Major histocompatibility complex class 1 (MHC-1) plays an important role in the development of multiple inflammatory diseases; however, there is little evidence of its involvement in gout. The present study focused on evaluating the association of the rs4349859 and rs116488202 single nucleotide polymorphisms (SNPs) close to the MHC-1 region in patients with gout. METHODS AND RESULTS One hundred and seventy-six individuals of Mexican origin were included, of which 81 were patients with primary gout and 95 were healthy controls. The rs4349859 and rs116488202 SNPs were genotyped using TaqMan probes by allelic discrimination by real-time PCR. Serum concentrations of biochemical parameters were measured with enzymatic methods. Descriptive statistics were applied and P-values < 0.05 were considered significant. It was observed that the rs4349859 and rs116488202 SNPs showed significant association with the risk of gout (OR = 146, 95%CI = 44.8-480.2, P < 0.01; OR = 2885, 95%CI = 265-31398, P < 0.01, respectively). Our results also showed significantly higher serum SU levels in gout patients with respect to controls (P < 0.01) in the carriers of the GA genotype compared with the GG genotype of the rs4349859 variant, and in the carriers of the CT genotype compared with the CC genotype of the rs116488202 variant. CONCLUSION The study revealed that rs4349859 and rs116488202 SNPs close to MHC-I region confers strong susceptibility to gout in Mexican population, and the heterozygous genotypes of both were associated with higher levels of SU.
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Affiliation(s)
- Javier Fernández-Torres
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico.
- Biology Department, Facultad de Química, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
| | - Yessica Zamudio-Cuevas
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
| | | | - Karina Martínez-Flores
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
| | | | - Roberto Sánchez-Sánchez
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
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22
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Wang Z, Yang G, Wang X, Cao Y, Jiao W, Niu H. A combined model based on CT radiomics and clinical variables to predict uric acid calculi which have a good accuracy. Urolithiasis 2023; 51:37. [PMID: 36745218 DOI: 10.1007/s00240-023-01405-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: 11/22/2022] [Accepted: 01/02/2023] [Indexed: 02/07/2023]
Abstract
The aim of this study was to develop a CT-based radiomics and clinical variable diagnostic model for the preoperative prediction of uric acid calculi. In this retrospective study, 370 patients with urolithiasis who underwent preoperative urinary CT scans were enrolled. The CT images of each patient were manually segmented, and radiomics features were extracted. Sixteen radiomics features were selected by one-way analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO). Logistic regression (LR), random forest (RF) and support vector machine (SVM) were used to model the selected features, and the model with the best performance was selected. Multivariate logistic regression was used to screen out significant clinical variables, and the radiomics features and clinical variables were combined to construct a nomogram model. The area under the receiver operating characteristic (ROC) curve (AUC), etc., were used to evaluate the diagnostic performance of the model. Among the three machine learning models, the LR model had the best performance and good robustness of the dataset. Therefore, the LR model was used to construct the nomogram. The AUCs of the nomogram model in the training set and validation set were 0.878 and 0.867, respectively, which were significantly higher than those of the radiomics model and the clinical feature model. The CT-based radiomics model based has good performance in distinguishing uric acid stones from nonuric acid stones, and the nomogram model has the best diagnostic performance among the three models. This model can provide an effective reference for clinical decision-making.
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Affiliation(s)
- Zijie Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, 16th Jiangsu Road, Qingdao, 266012, China
| | - Guangjie Yang
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xinning Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, 16th Jiangsu Road, Qingdao, 266012, China
| | - Yuanchao Cao
- Department of Urology, The Affiliated Hospital of Qingdao University, 16th Jiangsu Road, Qingdao, 266012, China
| | - Wei Jiao
- Department of Urology, The Affiliated Hospital of Qingdao University, 16th Jiangsu Road, Qingdao, 266012, China.
| | - Haitao Niu
- Department of Urology, The Affiliated Hospital of Qingdao University, 16th Jiangsu Road, Qingdao, 266012, China.
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A High-Fidelity Artificial Urological System for the Quantitative Assessment of Endoscopic Skills. J Funct Biomater 2022; 13:jfb13040301. [PMID: 36547561 PMCID: PMC9784860 DOI: 10.3390/jfb13040301] [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: 11/20/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Minimally-invasive surgery is rapidly growing and has become a standard approach for many operations. However, it requires intensive practice to achieve competency. The current training often relies on animal organ models or physical organ phantoms, which do not offer realistic surgical scenes or useful real-time feedback for surgeons to improve their skills. Furthermore, the objective quantitative assessment of endoscopic skills is also lacking. Here, we report a high-fidelity artificial urological system that allows realistic simulation of endourological procedures and offers a quantitative assessment of the surgical performance. The physical organ model was fabricated by 3D printing and two-step polymer molding with the use of human CT data. The system resembles the human upper urinary tract with a high-resolution anatomical shape and vascular patterns. During surgical simulation, endoscopic videos are acquired and analyzed to quantitatively evaluate performance skills by a customized computer algorithm. Experimental results show significant differences in the performance between professional surgeons and trainees. The surgical simulator offers a unique chance to train endourological procedures in a realistic and safe environment, and it may also lead to a quantitative standard to evaluate endoscopic skills.
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24
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Miyazaki S, Hamada T, Isoyama T, Okada S, Tomita K, Endo Y, Kuwabara M, Sugihara S, Ogino K, Ninomiya H, Ichida K, Yamamoto K, Takenaka A, Hisatome I. Characterization of Urate Metabolism and Complications of Patients with Renal Hypouricemia. Intern Med 2022. [PMID: 36418091 PMCID: PMC10372278 DOI: 10.2169/internalmedicine.0457-22] [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] [Indexed: 11/23/2022] Open
Abstract
Background Both renal hypouricemia (RHU) and gout are associated with renal dysfunction and urolithiasis. The difference in renal complications associated with RHU and gout, however, has not been studied. We characterized the urate metabolism and complications of patients with RHU and compared them with patients with gout. Methods Eighteen patients with RHU who had a serum uric acid (SUA) level <2 mg/dL (10 men and 8 women), 44 patients with gout (44 men) and 16 normouricemic patients (4 men and 12 women) were included. The blood and urinary biochemical data were evaluated. A genetic analysis of uric acid transporter 1 (URAT1) was also conducted in 15 cases with RHU. Results The SUA level of RHU was 0.9±0.5/mg/dl, and the Uur/Ucr and Cur/Ccr were 0.56%±0.14% and 45.7%±18.0%, respectively. A genetic analysis of URAT1 in 15 RHU patients showed that 13 harbored a URAT1 gene mutation, whereas 2 harbored the wild-type gene. The SUA level was significantly lower in RHU patients (n=11) than in either gout patients (n=44) or normouricemic patients (n=16). This reduction was accompanied by the elevation of Cua/Ccr. Urinary beta 2-microglobulin levels were higher in RHU patients than in gout or normouricemia patients. Cua/Ccr correlated with normalized urinary beta 2-microglobulin levels. The prevalence of urolithiasis was 18.2% in RHU cases and 6.8% in gout cases. A homozygous URAT1 mutation was associated with urolithiasis. Conclusion Besides urolithiasis, RHU can be associated with tubular dysfunction, such as elevated urinary beta 2-microglobulin levels.
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Affiliation(s)
| | - Toshihiro Hamada
- Department of Community-Based Family Medicine, Faculty of Medicine, Tottori University, Japan
| | | | | | | | - Yusuke Endo
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Japan
| | | | | | - Kazuhide Ogino
- Department of Cardiology, Tottori Red Cross Hospital, Japan
| | - Haruaki Ninomiya
- Department of Biological Regulation, Faculty of Medicine, Tottori University, Japan
| | - Kimiyoshi Ichida
- Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Japan
| | - Kazuhiro Yamamoto
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Japan
| | | | - Ichiro Hisatome
- Department of Cardiovascular Medicine, Yonago Medical Center, Japan
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25
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Modulatory Effect of Limosilactobacillus fermentum grx08 on the Anti-Oxidative Stress Capacity of Liver, Heart, and Kidney in High-Fat Diet Rats. FERMENTATION 2022. [DOI: 10.3390/fermentation8110594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
To explore the modulating effect of Limosilactobacillus fermentum (L. fermentum) grx08 on anti-oxidative stress in the liver, heart, and kidney of high-fat diet in rats, a low-fat diet as a control and a high-fat diet was used to induce oxidative stress injury in rats. L. fermentum grx08 and its heat-inactivated bacteria were used to intervene. The results showed that the high-fat diet had caused oxidative stress injury in the liver, heart, and kidney of rats. L. fermentum grx08 significantly reduced the serum levels of liver, heart, and kidney injury markers (ALT, AST, LDH, CK-MB, UA, and Crea), while restoring the balance of lipid metabolism in the liver. It also enhanced the activity of antioxidant enzymes such as GSH-Px in the liver, heart, and kidney, scavenging NO radicals and reducing the content of MDA, a product of lipid peroxidation, which can regulate the anti-oxidative stress capacity of the liver, heart, and kidney to varying degrees. Among them, L. fermentum grx08 showed better modulating effect on kidney anti-oxidative stress, followed by liver, and the weakest modulating effect on heart. At the same time, L. fermentum grx08 heat-inactivated bacteria also had a partial modulatory effect as well as a similar effect profile to that of live bacteria.
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26
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Zhao P, Liu Y, Chen Y, Yang M, Zhao S, Qi N, Wang Y, Huo D, Hou C. Hemin-Functionalized Microfluidic Chip with Dual-Electric Signal Outputs for Accurate Determination of Uric Acid. ACS APPLIED MATERIALS & INTERFACES 2022; 14:41369-41378. [PMID: 36048632 DOI: 10.1021/acsami.2c07660] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Herein, we develop a hemin-functionalized microfluidic chip with dual-electric signal outputs for accurate determination of uric acid (UA). Hemin is designed as the catalyst, which could trigger a built-in reference signal. Carbon nanotube (CNT) and alkalinized titanium carbide (alk-Ti3C2Tx) are used as attachment substrates to strengthen the signal. Benefiting from the synergistic action of hemin, CNT, and alk-Ti3C2Tx, the hybrid functionalized sensor shows prominent electrochemical capacity, desirable catalytic activity, and unique built-in signal ability. Through density functional theory calculations, the structure-reactivity relationship and possible signal output mechanism are deeply investigated. The functionalized sensor is further integrated into a microfluidic chip to prepare a portable electrochemical sensing platform, in which multiple sample processing steps including primary filtration, target enrichment, and reliable analysis can be conducted step-by-step. Based on the abovementioned designs, the developed functionalized microfluidic platform presents desirable performance in UA determination with a detection limit of 0.41 μM. Furthermore, it is capable of accurately detecting UA in urine samples, providing a promising idea for biomolecule monitoring.
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Affiliation(s)
- Peng Zhao
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Yiyi Liu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Yuanyuan Chen
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Mei Yang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Shixian Zhao
- Chongqing Key Laboratory of Bio-perception & Intelligent Information Processing, School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, PR China
- Chongqing Engineering and Technology Research Center of Intelligent Rehabilitation and Eldercare, Chongqing City Management College, Chongqing 401331, China
| | - Na Qi
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Yongzhong Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Danqun Huo
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
| | - Changjun Hou
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, PR China
- Chongqing Key Laboratory of Bio-perception & Intelligent Information Processing, School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, PR China
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27
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Tu JF, Cao Y, Wang LQ, Shi GX, Jia LC, Liu BL, Yao WH, Pei XL, Cao Y, Li HW, Yan SY, Yang JW, Qu ZC, Liu CZ. Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2225735. [PMID: 35943743 PMCID: PMC9364130 DOI: 10.1001/jamanetworkopen.2022.25735] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Renal colic is described as one of the worst types of pain, and effective analgesia in the shortest possible time is of paramount importance. OBJECTIVES To examine whether acupuncture, as an adjunctive therapy to analgesics, could accelerate pain relief in patients with acute renal colic. DESIGN, SETTING, AND PARTICIPANTS This single-center, sham-controlled, randomized clinical trial was conducted in an emergency department in China between March 2020 and September 2020. Participants with acute renal colic (visual analog scale [VAS] score ≥4) due to urolithiasis were recruited. Data were analyzed from October 2020 to January 2022. INTERVENTIONS After diagnosis and randomization, all patients received 50 mg/2 mL of diclofenac sodium intramuscular injection immediately followed by 30-minute acupuncture or sham acupuncture. MAIN OUTCOMES AND MEASURES The primary outcome was the response rate at 10 minutes after needle manipulation, which was defined as the proportion of participants whose VAS score decreased by at least 50% from baseline. Secondary outcomes included response rates at 0, 5, 15, 20, 30, 45, and 60 minutes, rescue analgesia, and adverse events. RESULTS A total of 115 participants were screened and 80 participants (66 men [82.5%]; mean [SD] age, 45.8 [13.8] years) were enrolled, consisting of 40 per group. The response rates at 10 minutes were 77.5% (31 of 40) and 10.0% (4 of 40) in the acupuncture and sham acupuncture groups, respectively. The between-group differences were 67.5% (95% CI, 51.5% to 83.4%; P < .001). The response rates of acupuncture were also significantly higher than sham acupuncture at 0, 5, 15, 20 and 30 minutes, whereas no significant difference was detected at 45 and 60 minutes. However, there was no difference between the 2 groups in rescue analgesia rate (difference 2.5%; 95% CI -8.8% to 13.2%; P > .99). No adverse events occurred during the trial. CONCLUSIONS AND RELEVANCE These findings suggest that acupuncture plus intramuscular injection of diclofenac is safe and provides fast and substantial pain relief for patients with renal colic compared with sham acupuncture in the emergency setting. However, no difference in rescue analgesia was found, possibly because of the ceiling effect caused by subsequent but robust analgesia of diclofenac. Acupuncture can be considered an optional adjunctive therapy in relieving acute renal colic. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1900025202.
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Affiliation(s)
- Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Cao
- Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lian-Cheng Jia
- Urinary Surgery, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Bao-Li Liu
- Office of Academic Research, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Wei-Hai Yao
- Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Xiao-Lu Pei
- Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yan Cao
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - He-Wen Li
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Cheng Qu
- Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Cao C, Fan B, Zhu J, Zhu N, Cao JY, Yang DR. Association of Gut Microbiota and Biochemical Features in a Chinese Population With Renal Uric Acid Stone. Front Pharmacol 2022; 13:888883. [PMID: 35662733 PMCID: PMC9160931 DOI: 10.3389/fphar.2022.888883] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 12/31/2022] Open
Abstract
Previous studies suggest that patients with nephrolithiasis exhibit dysbiosis in their gut microbiota, but those studies were conducted in calcium oxalate stone patients. We aimed to explore the association of gut microbiota and biochemical features of renal uric acid stone (UAS) patients in a Chinese population and identify the related bacteria that may affect the pathopoiesis of UAS. A case-control study of 117 patients with UAS, 123 patients with gout, and 135 healthy controls were included from January 2014 to October 2020. For each subject, data on demographics, biochemical parameters of blood and urine were analyzed. Fifteen patients with gout, 16 patients with UAS, 17 UAS patients with gout, and 17 healthy subjects were enrolled and provided fecal samples. The characteristics of gut microbiota were explored by using 16S ribosomal RNA (rRNA) gene sequencing and analyzed by using a combination of software mother and R. Hyperuricemia was the main risk factor for the development of gout and UAS. Obesity, dyslipidemia, and aciduria were unique risk factors for UAS patients. The richness, diversity, and relative abundance of dominant bacteria at the phylum and genus levels of gut microbiota in UAS patients were significantly distinct from other subjects. Abundance of Bacteroides and Fusobacterium was significantly positively correlated with the serum uric acid (UA) level of UAS patients. Fusobacteria was involved in the metabolism and degradation of certain short-chain fatty acids, amino acids, and sugars in pathopoiesis of UAS, and inhibited their synthesis pathways. Fusobacteria may be related to the pathogenesis of UAS, and this finding contributes to the personalized treatment of UAS from the perspective of maintaining micro-ecological equilibrium in gut.
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Affiliation(s)
- Cheng Cao
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Urology, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Bo Fan
- Department of Urology, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Jin Zhu
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Dong-Rong Yang, ; Jin Zhu,
| | - Na Zhu
- Department of Rheumatology, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Jing-Yuan Cao
- Department of Nephrology, Taizhou People’s Hospital, Taizhou, China
| | - Dong-Rong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Dong-Rong Yang, ; Jin Zhu,
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Kandav G, Bhatt DC, Singh SK. Effect of Different Molecular Weights of Chitosan on Formulation and Evaluation of Allopurinol-Loaded Nanoparticles for Kidney Targeting and in Management of Hyperuricemic Nephrolithiasis. AAPS PharmSciTech 2022; 23:144. [PMID: 35578122 DOI: 10.1208/s12249-022-02297-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022] Open
Abstract
Present research study was conducted to formulate kidney-targeted allopurinol (AO)-loaded chitosan nanoparticles (ANPs) for management of hyperuricemic related nephrolithiasis. Different molecular weights of chitosan were used for fabricating ANP formulation by adopting modified ionotropic gelation method. The prepared batches were than evaluated for particle size analysis, entrapment efficiency, transmission electron microscopy, X-ray diffraction, Differential Scanning Calorimetry, in vitro release and in vivo animal study. The in vivo study depicted that post 2 h of administration of different formulations and pure drug; ANPs prepared from low molecular weight chitosan showed maximum concentration of AO in kidney signifying successful kidney targeting of drug (25.92 fold) whereas no or very less amount of AO was seen in other animal groups. Effectiveness (p < 0.01) of formulation in management of hyperuricemia-associated nephrolithiasis was also evaluated via estimation of urine pH and serum and urine uric acid levels of mice. Further histological study was also performed on kidney samples which again affirmed these results. Present investigation demonstrated that ANPs prepared from low MW chitosan depicted maximum kidney-targeting ability that might be due to its specific uptake by the kidneys as well as its higher solubility than other two polymers, which results in enhanced release rate from the formulation and also offers an efficient strategy for the management of hyperuricemic nephrolithiasis.
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Wen W, Li Y, Chen Q, Li J. Serum and urine uric acid level may have different predictive value for urinary stone composition: a retrospective cohort study of 718 patients in Chinese population. Int Urol Nephrol 2022; 54:2247-2254. [PMID: 35089471 DOI: 10.1007/s11255-022-03121-8] [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: 05/03/2021] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We launched a retrospective cohort study to explore the interactions among serum uric acid (UA), urine UA, and stone types. METHODS Clinical characteristics of urolithiasis patients in Beijing Tsinghua Changgung Hospital from October 2015 to August 2017 were retrospectively collected. Participants were categorized according to the quartiles of SUA and UUA respectively. Logistic regression model was built to identify the relationship between stone composition and UA level. Cubic spline was fitted to explore the correlation between 24-h urine UA and serum UA. RESULTS 718 hospitalized patients (51.1 ± 14.3 years, male 63.4%) with urinary calculi were included. Higher serum UA is associated with male, alcohol use, multiple serum and urine electrolytes (e.g. potassium, chloride, calcium, phosphorus), and lower estimated glomerular filtration rate. The risk of UA stone and carbonate apatite stone was associated with serum UA while the risk of calcium oxalate (CaOx) stone and ammonium magnesium hexahydrate (AMH) was dependent on urine UA. In the unadjusted model (Model 1), higher risks of UA stones were observed in the third quartile (OR 3.26, 95% CIs 1.63-6.53, P = 0.001) and the fourth quartile (OR 3.55, 95% CIs 1.78-7.08, P < 0.001) of serum UA compared with the first quartile. The risks of carbonate apatite stone were lowered in the third (OR 0.48, 95% CIs 0.31-0.73, P = 0.001) and fourth quartile (OR 0.40, 95% CIs 0.42-0.98, P = 0.042) of serum UA. The risk of CaOx stone was increased in the fourth quartile (OR 2.14, 95% CIs 1.15-3.99, P = 0.017) while the risk of AMH stone was decreased in the third (OR 0.46, 95% CIs 0.22-0.94, P = 0.034) and fourth quartile (OR 0.35, 95% CIs 0.16-0.78, P = 0.009) of urine UA. The elevated risks of UA stones in high levels of serum UA were demonstrated in the adjusted model (Model 2). An M-shaped association was found between serum UA and urine UA in our population. CONCLUSIONS Serum UA and urine UA might cast different impact on urinary calculus composition. Proper control of the parameters should be considered based on different predisposing factors in individual patients.
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Affiliation(s)
- Wen Wen
- Department of Nephrology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, China
| | - Yuehong Li
- Department of Nephrology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, China.
| | - Qi Chen
- Department of Nephrology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, China
| | - Jianxing Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, 102218, China
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Huang Y, Wu CX, Guo L, Zhang XX, Xia DZ. Effects of polysaccharides-riched Prunus mume fruit juice concentrate on uric acid excretion and gut microbiota in mice with adenine-induced chronic kidney disease. Curr Res Food Sci 2022; 5:2135-2145. [DOI: 10.1016/j.crfs.2022.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022] Open
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Tsaturyan A, Bosshard P, Bokova E, Bonny O, Stritt K, Roth B. The impact of stenting prior to oral chemolysis of upper urinary tract uric acid stones. Int Urol Nephrol 2021; 54:37-45. [PMID: 34850328 DOI: 10.1007/s11255-021-03072-6] [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: 08/24/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the impact of ureteral stenting on the success rate of oral chemolysis in the management of suspected uric acid upper urinary tract (UUT) stones. METHODS Retrospective matched-pair analysis of 172 patients treated with oral chemolysis from 01/2010 to 12/2019. Patients with low density (upon non-contrast enhanced computer tomography [NCCT]), radiolucent (on plain radiography) urinary stones, a low urine pH (< 6) and/or history of uric acid urolithiasis were included. Potassium citrate and/or sodium bicarbonate were used for alkalization (target urine pH: 6.5-7.2). Patient 1:1 matching was performed for the presence of indwelling ureteral stent, stone diameter, stone density, and stone localization. Stone-free status was evaluated after 12 weeks using NCCT. Multivariable logistic regression analysis was used to assess factors affecting the outcome. RESULTS Mean patient age was 61 years (73% males). Mean stone size was 12 mm. Overall success rates after 12-weeks of chemolysis for stones at any localization in the UUT and ureteral stones were 60.5 and 77.3%, respectively. Smaller stone size (OR = 0.94; CI 0.888-0.992; p = 0.026) and lower pre-treatment urine pH (OR = 0.131; CI 0.023-0.737; p = 0.021) significantly increased the success of oral chemolysis. Ureteral stenting did not have any impact on the efficacy of oral chemolysis. CONCLUSION Oral chemolysis is an effective treatment modality for patients with UUT stones suspected of uric acid content irrespective of ureteral stenting. Smaller stone diameter and lower urine pH at diagnosis increase its efficacy.
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Affiliation(s)
- Arman Tsaturyan
- Department of Urology, Inselspital, University of Bern, Bern, Switzerland
| | - Piet Bosshard
- Department of Urology, Inselspital, University of Bern, Bern, Switzerland
- Department of Urology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011, Lausanne, Switzerland
| | - Elizaveta Bokova
- Department of General Medicine, First Moscow State Medical University After I.M. Sechenov, Moscow, Russia
| | - Olivier Bonny
- Department of Nephrology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Kevin Stritt
- Department of Urology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011, Lausanne, Switzerland
| | - Beat Roth
- Department of Urology, Inselspital, University of Bern, Bern, Switzerland.
- Department of Urology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, 1011, Lausanne, Switzerland.
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Liu J, Yang HL, Sun XW, Zhang YM, Yao H, Wei TB, Lin Q. A simple pillar[5]arene assembled multi-functional material with ultrasensitive sensing, self-healing, conductivity and host-guest stimuli-responsive properties. SOFT MATTER 2021; 17:8308-8313. [PMID: 34550160 DOI: 10.1039/d1sm01001h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Multi-functional materials have received wide attention due to their potential applications in various fields; therefore, developing a simple and easy strategy for the preparation of multi-functional materials is an interesting issue. In this work, a novel supramolecular gel, TP-QG, has been successfully constructed via the assembly of a simple methoxyl-pillar[5]arene host (TP) and a tripodal (tri-pyridine-4-yl)-amido-benzene guest (Q). Interestingly, TP-QG could act as a multi-functional material and showed strong fluorescence, good self-healing, host-guest stimuli-responsiveness and conductive properties. Due to these properties, TP-QG shows a fascinating application prospect. For instance, TP-QG could exhibit ultrasensitive fluorescence response for Fe3+ and F- in water via the fluorescence "ON-OFF-ON" pathway; the lowest detection limit (LOD) of TP-QG for Fe3+ was 2.32 × 10-10 M and the LOD of TP-QG-Fe for F- was 4.30 × 10-8 M. These properties permit TP-QG to act as not only a Fe3+ and F- sensor, but also an "ON-OFF-ON" fluorescence display material and an efficient logic gate. Meanwhile, the xerogel of TP-QG could remove Fe3+ from water, and the adsorption ratio was 98.68%; the xerogel of TP-QG-Fe could also remove F- from water; the removal ratio was about 87.92%. This work provides a feasible way to construct multi-functional smart materials by host-guest assembly.
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Affiliation(s)
- Juan Liu
- College of Chemical Engineering, Key Laboratory for Utility of Environment-Friendly Composite Materials and Biomass in University of Gansu Province, Northwest Minzu University (Northwest University for Nationalities), Lanzhou, 730070, China.
| | - Hai-Long Yang
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - Xiao-Wen Sun
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - You-Ming Zhang
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - Hong Yao
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - Tai-Bao Wei
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - Qi Lin
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education, Key Laboratory of Eco-environmental Polymer Materials of Gansu Province, College of Chemistry and Chemical Engineering, Northwest Normal University, Lanzhou, 730070, China.
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Kim I, Kim YI, Lee SW, Jung HG, Lee G, Yoon DS. Highly permselective uric acid detection using kidney cell membrane-functionalized enzymatic biosensors. Biosens Bioelectron 2021; 190:113411. [PMID: 34118760 DOI: 10.1016/j.bios.2021.113411] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023]
Abstract
Abnormal blood uric acid (UA) levels can lead to its crystallization in the joints, consequently resulting in gout. Accurate detection of UA in the blood is imperative for the early diagnosis of gout. However, electrochemical UA biosensors are vulnerable to antioxidants in the blood, limiting accurate UA detection. To address this issue, we focused on the function of uric acid transporter 1 (URAT1), which is selectively permeable to UA. URAT1 is abundant in the kidney cell membrane (KCM). To apply URAT1 to a sensor, we developed a KCM-coated UA biosensor (called the KCM sensor) that could selectively detect UA through URAT1. The KCM coating in the fabricated KCM sensor was verified via scanning electron microscopy, atomic force microscopy, and confocal microscopy. The KCM sensor enabled the detection of UA in the range of 0-1000 μM, with a limit of detection of 8.5 μM, suggesting that it allows the diagnosis of the early stages of gout. On the other hand, the UA permeability of the KCM sensor was significantly reduced in the presence of a URAT1 inhibitor, implying that URAT1 is a key factor for UA detection. The selectivity of the KCM sensor was demonstrated by measuring the amount for UA in the presence of various antioxidants. Finally, the KCM sensor was capable of measuring UA in human serum and was reproducible with 0.5-1.6% deviation. The UA permeability and selectivity of the KCM sensor were maintained even after 3 weeks of storage.
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Affiliation(s)
- Insu Kim
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea
| | - Young Im Kim
- Department of BioNano Technology, Gachon University, Seongnam, 13120, South Korea
| | - Sang Won Lee
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea
| | - Hyo Gi Jung
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, South Korea
| | - Gyudo Lee
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, 30019, South Korea; Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, 30019, South Korea.
| | - Dae Sung Yoon
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, South Korea.
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Uric Acid Sensor Based on PEDOT:PSS Modified Screen-Printed Carbon Electrode Fabricated with a Simple Painting Technique. JURNAL KIMIA SAINS DAN APLIKASI 2021. [DOI: 10.14710/jksa.24.2.43-50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A screen-printed carbon electrode is a suitable electrode for electrochemical sensors due to its simplicity and portability. This study aimed to fabricate a screen-printed carbon electrode modified with poly (3,4-ethylenedioxythiophene) polystyrene sulfonate (SPCE-PEDOT:PSS) to improve the electrochemical performance for uric acid detection. The SPCE was fabricated using a layer-by-layer painting process of conductive ink consisting of graphite as a conductive material, polystyrene as a polymeric binder, and dichloromethane solvent on a polyvinyl chloride paper substrate. The fabricated SPCE was then modified with PEDOT:PSS by a drop-casting method. The characterization of SPCE-PEDOT:PSS surface morphology was performed using the scanning electron microscopy technique. The SPCE-PEDOT:PSS provided an acceptable linearity (R2 = 0.9985, 0.9993, 0.9985), sensitivity (0.070, 0.015, 0.024 µA/µM), precision (%RSD = 2.70%, 2.89%, 2.40%), limit of detection (1.61 µM, 1.14 µM, 1.62 µM), and limit of quantitation (5.37 µM, 3.81 µM to 5.39 µM) in measurement of uric acid standard solution using cyclic voltammetry, amperometry, and differential pulse voltammetry techniques, respectively. The studies using SPCE-PEDOT:PSS indicated that the electrode could be applied in the electrochemical measurement of uric acid in the human urine sample.
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Chávez‐Reyes J, Hernández‐Cuellar E, González‐Ponce HA, Rodríguez MG. Growth Kinetics Analysis and Morphological Characterization by Electron Microscopy of Anhydrous Uric Acid Crystals. CRYSTAL RESEARCH AND TECHNOLOGY 2021. [DOI: 10.1002/crat.202000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jesús Chávez‐Reyes
- Departamento de Fisiología y Farmacología Centro de Ciencias Básicas Universidad Autónoma de Aguascalientes Ciudad Universitaria Aguascalientes Ags 20131 México
| | - Eduardo Hernández‐Cuellar
- Departamento de Fisiología y Farmacología Centro de Ciencias Básicas Universidad Autónoma de Aguascalientes Ciudad Universitaria Aguascalientes Ags 20131 México
| | - Herson A. González‐Ponce
- Laboratorio de Ingeniería y Tecnología del Agua Instituto Tecnológico de Aguascalientes Aguascalientes Ags 20256 México
| | - Martín Gerardo Rodríguez
- Departamento de Fisiología y Farmacología Centro de Ciencias Básicas Universidad Autónoma de Aguascalientes Ciudad Universitaria Aguascalientes Ags 20131 México
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Single-energy CT predicts uric acid stones with accuracy comparable to dual-energy CT-prospective validation of a quantitative method. Eur Radiol 2021; 31:5980-5989. [PMID: 33635394 PMCID: PMC8270827 DOI: 10.1007/s00330-021-07713-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/10/2020] [Accepted: 01/21/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To prospectively validate three quantitative single-energy CT (SE-CT) methods for classifying uric acid (UA) and non-uric acid (non-UA) stones. METHODS Between September 2018 and September 2019, 116 study participants were prospectively included in the study if they had at least one 3-20-mm urinary stone on an initial urinary tract SE-CT scan. An additional dual-energy CT (DE-CT) scan was performed, limited to the stone of interest. Additionally, to include a sufficient number of UA stones, eight participants with confirmed UA stone on DE-CT were retrospectively included. The SE-CT stone features used in the prediction models were (1) maximum attenuation (maxHU) and (2) the peak point Laplacian (ppLapl) calculated at the position in the stone with maxHU. Two prediction models were previously published methods (ppLapl-maxHU and maxHU) and the third was derived from the previous results based on the k-nearest neighbors (kNN) algorithm (kNN-ppLapl-maxHU). The three methods were evaluated on this new independent stone dataset. The reference standard was the CT vendor's DE-CT application for kidney stones. RESULTS Altogether 124 participants (59 ± 14 years, 91 men) with 106 non-UA and 37 UA stones were evaluated. For classification of UA and non-UA stones, the sensitivity, specificity, and accuracy were 100% (37/37), 97% (103/106), and 98% (140/143), respectively, for kNN-ppLapl-maxHU; 95% (35/37), 98% (104/106), and 97% (139/143) for ppLapl-maxHU; and 92% (34/37), 94% (100/106), and 94% (134/143) for maxHU. CONCLUSION A quantitative SE-CT method (kNN-ppLapl-maxHU) can classify UA stones with accuracy comparable to DE-CT. KEY POINTS • Single-energy CT is the first-line diagnostic tool for suspected renal colic. • A single-energy CT method based on the internal urinary stone attenuation distribution can classify urinary stones into uric acid and non-uric acid stones with high accuracy. • This immensely increases the availability of in vivo stone analysis.
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Yang M, Wang H, Liu P, Cheng J. A 3D electrochemical biosensor based on Super-Aligned Carbon NanoTube array for point-of-care uric acid monitoring. Biosens Bioelectron 2021; 179:113082. [PMID: 33601134 DOI: 10.1016/j.bios.2021.113082] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/20/2022]
Abstract
Uric acid analysis is extremely important for gout prognosis, diagnosis and treatment. Previous technologies either lack specificity or exhibit poor performance, and thus could not meet the need of Point-of-Care (POC) uric acid monitoring. Here we present for the first time, a novel electrochemical biosensor based on 3D Super-Aligned Carbon NanoTube (SACNT) array to facilitate POC uric acid monitoring. The working electrode of the biosensor is composed of an orderly 3D SACNT array immobilized with uricase through a precipitation and crosslinking procedure. Such biosensor possesses a higher enzyme density, significantly larger contact area with reactants and could maintain the intact SACNT structure and its excellent conductivity after modification. The developed 3D SACNT array electrochemical biosensor benefits from high specific surface area, high electro-catalytic activity and large contact area with analytes, and demonstrates high sensitivity of 518.8 μA/(mM⋅cm2), wide linear range of 100-1000 μM and low limit of detection of 1 μM for uric acid. Dynamic uric acid monitoring has been achieved using the presented biosensor. And the obtained results in serum samples had no significant difference compared with those obtained using the FDA-approved electrochemical analyzer (Paired T-test, p > 0.05). These demonstrated that the technology can potentially be applied in POC monitoring of other biomolecules to improve prognosis, diagnosis and treatment outcomes of metabolic diseases.
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Affiliation(s)
- Muqun Yang
- Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute(TBSI), Tsinghua University, Shenzhen, 518055, China; Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Han Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China.
| | - Peng Liu
- Tsinghua-Foxconn Nanotechnology Research Center & State Key Laboratory of Low-Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - Jing Cheng
- Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute(TBSI), Tsinghua University, Shenzhen, 518055, China; Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China.
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Deng J, Wei K, Li M, Wang X, Tang Q. Paravertebral block reduces pain in elderly patients with percutaneous nephrolithotomy: A randomized controlled study protocol. Medicine (Baltimore) 2020; 99:e23761. [PMID: 33371139 PMCID: PMC7748350 DOI: 10.1097/md.0000000000023761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To assess the effectiveness of paravertebral block for the percutaneous nephrolithotomy (PCNL) patients. Method: This study will be implemented from May 2021 to March 2022 at Affiliated Hospital of Youjiang Medical University for Nationalities and it was granted through the Research Ethics Committee of Affiliated Hospital of Youjiang Medical University for Nationalities (No.60192038). This study includes a total of 100 patients. The criteria for inclusion of patients involves: The criteria for exclusion involves: The visual analogue scores, heart rate, the diastolic and systolic blood pressure, complications, and side effects, the consumption of opioid and extra analgesic needs are recorded in rehabilitation room 1 hour after the surgery and in the first 24 hours of urological service. Results: Table 1 shows the postoperative data among 2 groups. Conclusion: In comparison with traditional analgesia, the ultrasound-guided paraventric block is an effective analgesic approach in PCNL, and no additional complications are encountered. Trial registration number: research registry 6259.
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Affiliation(s)
- Jun Deng
- Graduation School, Jinan University, Guangzhou
- Department of Anesthesiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi
| | - Ke Wei
- Department of Anesthesiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi
| | - Mingliang Li
- Department of Anesthesiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi
| | - Xiaoping Wang
- Department of Pain Management, the First Hospital of Jinan University, Guangzhou
| | - Qianli Tang
- Department of Gastrointestinal surgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi, China
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Kim HJ. Non-surgical treatment of urinary stone. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.11.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Some patients with urinary stones can be managed non-surgically through observation, medication, or extracorporeal shockwave lithotripsy (ESWL). Symptomatic urinary stones can initially be treated conservatively using analgesics and hydration. When uncontrolled pain or infection is present, immediate diversion via either percutaneous nephrostomy or ureteral stenting may be necessary. Medical expulsive therapy utilizing alpha-blocker may benefit a selected group of patients with stones larger than 5 mm. Oral or percutaneous chemolysis is a well-established non-invasive option with a reasonable success rate for patients with a certain component such as uric acid. When medical treatment is applied, its unintended side effects should be considered and routinely monitored. Extracorporeal shockwave lithotripsy is a highly effective and safe modality in treating urinary stones when adequately indicated. In addition to the size and location of the stone, information obtained from non-enhanced computed tomography such as stone density, stone heterogenicity index, and stone-to-skin distance can be applied to predict the possibility of ESWL failure. Modifications in shock wave delivery by altering shock rate and voltage can improve shock wave efficacy. Urinary stones can be managed effectively and safely using non-surgical approaches.
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Abstract
The prevalence of urolithiasis in humans is increasing worldwide; however, non-surgical treatment and prevention options remain limited despite decades of investigation. Most existing laboratory animal models for urolithiasis rely on highly artificial methods of stone induction and, as a result, might not be fully applicable to the study of natural stone initiation and growth. Animal models that naturally and spontaneously form uroliths are an underused resource in the study of human stone disease and offer many potential opportunities for improving insight into stone pathogenesis. These models include domestic dogs and cats, as well as a variety of other captive and wild species, such as otters, dolphins and ferrets, that form calcium oxalate, struvite, uric acid, cystine and other stone types. Improved collaboration between urologists, basic scientists and veterinarians is warranted to further our understanding of how stones form and to consider possible new preventive and therapeutic treatment options.
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Chuang WY, Lin LJ, Hsieh YC, Chang SC, Lee TT. Effects of Saccharomyces cerevisiae and phytase co-fermentation of wheat bran on growth, antioxidation, immunity and intestinal morphology in broilers. Anim Biosci 2020; 34:1157-1168. [PMID: 33152224 PMCID: PMC8255880 DOI: 10.5713/ajas.20.0399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/13/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the effects of different amounts of wheat bran (WB) inclusion and postbiotics form by Saccharomyces cerevisiae and phytase cofermented wheat bran (FWB) on the growth performance and health status of broilers. METHODS Study randomly allocated a total of 300 male broilers to a control and 4 treatment groups (5% WB, 5% FWB, 10% WB, and 10% FWB inclusion, respectively) with each pen having 20 broilers and 3 pens per treatment. RESULTS The WB does not contain enzymes, but there are 152.8, 549.2, 289.5, and 147.1 U/g dry matter xylanase, protease, cellulase and β-glucanase in FWB, respectively. Furthermore, FWB can decrease nitric oxide release of lipopolysaccharide stimulated chicken peripheral blood mononuclear cells by about two times. Results show that 10% FWB inclusion had significantly the highest weight gain (WG) at 1 to 21 d; 5% FWB had the lowest feed conversion rate at 22 to 35 d; 10% WB and 10% FWB inclusion have the highest villus height and Lactobacillus spp. number in caecum; and both 5% and 10% FWB can increase ash content in femurs. Compared to control group, all treatments increase mucin 2, and tight junction (TJ), such as occludin, claudin-1, zonula occludens-1, and mRNA expression in ileum by at least 5 folds. In chicken peripheral blood mononuclear cells, nicotinamide adenine dinucleotide phosphate-oxidase-1 mRNA expression decreases from 2 to 5 times, and glutamate-cysteine ligase catalytic subunit mRNA expression also increases in all treatment groups compared to control group. The mRNA expression of pro-inflammatory cytokines, including interleukin-6 (IL-6), nuclear factor-κB, and IL-1β, decreases in 5% and 10% FWB groups compared to control group. CONCLUSION To summarize, both WB and FWB inclusion in broilers diets increase TJ mRNA expression and anti-oxidation and anti-inflammation, but up to 10% FWB groups have better WG in different stages of broiler development.
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Affiliation(s)
- Wen-Yang Chuang
- Department of Animal Science, National Chung Hsing University, Taichung, 402, Taiwan
| | - Li-Jen Lin
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 402, Taiwan
| | - Yun-Chen Hsieh
- Department of Animal Science, National Chung Hsing University, Taichung, 402, Taiwan
| | - Shen-Chang Chang
- Kaohsiung Animal Propagation Station, Livestock Research Institute, Council of Agriculture, 912, Taiwan
| | - Tzu-Tai Lee
- Department of Animal Science, National Chung Hsing University, Taichung, 402, Taiwan.,The iEGG and Animal Biotechnology Center, National Chung Hsing University, Taichung, 402, Taiwan
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43
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Zhang W, Xu JZ, Lu XH, Li H, Wang D, Wang JG. Ambulatory blood pressure in relation to interaction between dietary sodium intake and serum uric acid in the young. Blood Press 2020; 30:60-66. [PMID: 33030062 DOI: 10.1080/08037051.2020.1829458] [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: 10/23/2022]
Abstract
PURPOSE We hypothesise that dietary sodium intake interacts with serum uric acid to influence blood pressure (BP) in children and adolescents. In the present study, we investigated ambulatory BP in relation to hyperuricaemia, dietary sodium intake and their interaction in children and adolescents with hypertension. MATERIALS AND METHODS A total of 616 study participants were 10-24 years old and had primary hypertension diagnosed after admission in a specialised inpatient ward. Ambulatory BP monitoring was performed during hospitalisation. 24-h urine was collected for measurements of electrolytes. Hyperuricaemia was defined as a serum uric acid of ≥327.25 μmol/L in patients <18 years old and of ≥420 and ≥360 μmol/L, respectively, in male and female patients ≥18 years old. RESULTS In adjusted analyses, patients with hyperuricaemia (n = 283), compared with those with normal serum uric acid, had similar 24-h systolic BP (131.7 mmHg, p = 0.54) and a significantly (p ≤ 0.005) lower 24-h diastolic BP (77.5 vs. 80.9 mmHg) and higher 24-h pulse pressure (54.2 vs. 51.7 mmHg). In similar adjusted analyses, 24-h ambulatory pulse pressure, but not systolic/diastolic BP (p ≥ 0.12), significantly differed across the quartile distributions of urinary sodium excretion (p for trend ≤ 0.04). Further adjusted analyses showed significant (p ≤ 0.04) interaction between serum uric acid and urinary sodium excretion in relation to 24-h systolic BP. In patients with hyperuricaemia (p = 0.04), but not those with normal serum uric acid (p = 0.13), 24-h systolic BP was significantly associated with urinary sodium excretion, with a 6.5 ± 2.1 mmHg difference between quartiles 4 and 1. Similar results were observed for daytime and night-time BP and pulse pressure. CONCLUSIONS Both hyperuricaemia and higher dietary sodium intake were associated with higher pulse pressure, and their interaction further heightened systolic BP.
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Affiliation(s)
- Wei Zhang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian-Zhong Xu
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Hong Lu
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Li
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dian Wang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.,Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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44
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Oral chemolysis is an effective, non-invasive therapy for urinary stones suspected of uric acid content. Urolithiasis 2020; 48:501-507. [PMID: 32770255 PMCID: PMC7666279 DOI: 10.1007/s00240-020-01204-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Despite the possible benefit from avoiding stone surgery with all its possible complications, oral chemolysis is rarely performed in patients with urinary stones suspected of uric acid content. Among the reasons for its limited use is the sparse and low-quality data on its efficacy and the lack of reliable factors predicting its outcome. We thus performed a retrospective single-center cohort study of 216 patients (median patient age 63 years) with 272 renal (48%) and/or ureteral (52%) stones treated with oral chemolysis from 01/2010 to 12/2019. Patients with low urine pH (< 6), low stone density upon non-contrast enhanced computed tomography (NCCT), radiolucent urinary stones on plain radiography, and/or a history of uric acid urolithiasis were included. Potassium citrate and/or sodium/magnesium bicarbonate were used for alkalization (target urine pH 6.5–7.2). Median stone size was 9 mm, median stone density 430 Hounsfield Units. Patients with ureteral stones < 6 mm were excluded since stones this small are very likely to pass spontaneously. The stone-free status of each patient was evaluated after 3 months using NCCT. Oral chemolysis was effective with a complete and partial response rate of stones at 3 months of 61% and 14%, respectively; 25% of stones could not be dissolved. Lower stone density (OR = 0.997 [CI 0.994–0.999]; p = 0.008) and smaller stone size (OR = 0.959 [CI 0.924–0.995]; p = 0.025) significantly increased the success rate of oral chemolysis in multivariate logistic regression analysis. More precise stone diagnostics to exclude non-uric-acid stones could further improve outcome.
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45
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Patel PM, Kandabarow AM, Druck A, Hart S, Blackwell RH, Kadlec A, Farooq A, Turk TMT, Baldea KG. Association of Impaired Renal Function With Changes in Urinary Mineral Excretion and Stone Composition. Urology 2020; 141:45-49. [PMID: 32294484 DOI: 10.1016/j.urology.2020.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/03/2020] [Accepted: 03/15/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effect of kidney function on stone composition and urinary mineral excretion in patients undergoing surgical intervention for nephrolithiasis. METHODS Using our institutional kidney stone database, we performed a retrospective review of stone patients who underwent surgical intervention between 2004 and 2015. Patients' demographic information, 24-hour urinary mineral excretion, and stone characteristics were reported. The patients' estimated glomerular filtration rates (eGFR) were compared with their stone compositions and 24-hour urine mineral excretions. RESULTS A statistically significant difference was noted between the groups, with uric acid stones being associated with lower eGFR and calcium phosphate stones associated with higher eGFR. No relationship could be demonstrated between eGFR and calcium oxalate or struvite stones. Patients with lower eGFR also demonstrated a statistically significant association with lower urinary pH as well as lower urinary excretion of calcium and citrate. CONCLUSION While various factors have been found to play significant roles in kidney stone formation and composition, our findings demonstrate a definite relationship between these and renal function. This paper highlights the fact that renal function evaluation should be considered an important component in the evaluation, counseling, and management of patients with nephrolithiasis.
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Affiliation(s)
- Parth M Patel
- Department of Urology, Loyola University Medical Center, Maywood, IL.
| | | | - Aleksander Druck
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL
| | - Spencer Hart
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | | | | | - Ahmer Farooq
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Thomas M T Turk
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Kristin G Baldea
- Department of Urology, Loyola University Medical Center, Maywood, IL
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46
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Ko M, Mendecki L, Eagleton AM, Durbin CG, Stolz RM, Meng Z, Mirica KA. Employing Conductive Metal-Organic Frameworks for Voltammetric Detection of Neurochemicals. J Am Chem Soc 2020; 142:11717-11733. [PMID: 32155057 DOI: 10.1021/jacs.9b13402] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper describes the first implementation of an array of two-dimensional (2D) layered conductive metal-organic frameworks (MOFs) as drop-casted film electrodes that facilitate voltammetric detection of redox active neurochemicals in a multianalyte solution. The device configuration comprises a glassy carbon electrode modified with a film of conductive MOF (M3HXTP2; M = Ni, Cu; and X = NH, 2,3,6,7,10,11-hexaiminotriphenylene (HITP) or O, 2,3,6,7,10,11-hexahydroxytriphenylene (HHTP)). The utility of 2D MOFs in voltammetric sensing is measured by the detection of ascorbic acid (AA), dopamine (DA), uric acid (UA), and serotonin (5-HT) in 0.1 M PBS (pH = 7.4). In particular, Ni3HHTP2 MOFs demonstrated nanomolar detection limits of 63 ± 11 nM for DA and 40 ± 17 nM for 5-HT through a wide concentration range (40 nM-200 μM). The applicability in biologically relevant detection was further demonstrated in simulated urine using Ni3HHTP2 MOFs for the detection of 5-HT with a nanomolar detection limit of 63 ± 11 nM for 5-HT through a wide concentration range (63 nM-200 μM) in the presence of a constant background of DA. The implementation of conductive MOFs in voltammetric detection holds promise for further development of highly modular, sensitive, selective, and stable electroanalytical devices.
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Affiliation(s)
- Michael Ko
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Lukasz Mendecki
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Aileen M Eagleton
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Claudia G Durbin
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Robert M Stolz
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Zheng Meng
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
| | - Katherine A Mirica
- Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, New Hampshire 03755, United States
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Kandav G, Bhatt DC, Jindal DK, Singh SK. Formulation, Optimization, and Evaluation of Allopurinol-Loaded Bovine Serum Albumin Nanoparticles for Targeting Kidney in Management of Hyperuricemic Nephrolithiasis : Formulation, optimization, and evaluation of ABNPs for kidney targeting. AAPS PharmSciTech 2020; 21:164. [PMID: 32488630 DOI: 10.1208/s12249-020-01695-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/17/2020] [Indexed: 01/21/2023] Open
Abstract
The aim of present research work was to design, fabricate, optimize, and evaluate allopurinol (ALLO)-loaded bovine serum albumin nanoparticles (ABNPs) for kidney targeting of the drug and exploring the potential of fabricated ABNPs for management of hyperuricemia-related nephrolithiasis. ABNP formulation was prepared by employing desolvation technique, and its optimization was conducted by 2-factor-3-level central composite design (CCD) in order to achieve minimum particle size (PSA) and polydispersity index (PDI), maximum entrapment efficiency (EE), and zeta potential (ZP). Further, the optimized formulation (ABNPsopt) was also assessed for in vitro drug release study, TEM, DSC, XRD analysis, FTIR spectroscopy, and in vivo animal study. The in vivo study revealed that after 2 h of ABNPsopt administration, a significant concentration of ALLO was present in kidney (21.26-fold) as compared with serum while in case of standard pure drug group; no drug was seen in mice kidney and serum post 2 h administration, which indicates successful targeting of ALLO by formulating its albumin nanoparticles. Also, uric acid and pH levels were measured in serum and urine samples of mice which showed significant (P < 0.01) efficacy of ABNPsopt formulation in management of hyperuricemia-related nephrolithiasis. Histological studies on kidney samples also confirmed these outcomes. Findings of present study indicate higher kidney uptake of allopurinol from formulated ABNPsopt, which could be due to the specificity of albumin polymer for cubilin and megalin receptors, and it also serves as effective strategy in management of hyperuricemic-related nephrolithiasis.
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48
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Leere JS, Karmisholt J, Robaczyk M, Lykkeboe S, Handberg A, Steinkohl E, Brøndum Frøkjær J, Vestergaard P. Denosumab and cinacalcet for primary hyperparathyroidism (DENOCINA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol 2020; 8:407-417. [PMID: 32333877 DOI: 10.1016/s2213-8587(20)30063-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Medical treatment options for primary hyperparathyroidism are scarce. We aimed to assess the efficacy of denosumab and combined with cinacalcet in patients with primary hyperparathyroidism. METHODS In this randomised, single-centre, proof-of-concept, double-blind trial, patients aged at least 18 years with primary hyperparathyroidism were recruited from the Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. Key eligibility criteria were a T-score between -1·0 and -3·5 at the lumbar spine, femoral neck, or total hip. Patients were assigned (1:1:1) via permuted block randomisation to receive 30 mg cinacalcet per day plus 60 mg denosumab subcutaneously every 6 months (n=14; combination group) for 1 year, denosumab plus placebo (n=16; denosumab group) for 1 year, or placebo plus placebo injection (n=15; placebo group) for 1 year. Primary outcomes were changes in bone mineral density (BMD) measured by dual x-ray absorptiometry at the lumbar spine, total hip, femoral neck, and distal forearm after 1 year. Additionally, effects on bone-metabolic biochemistry were explored. Patients and investigators were masked. All enrolled patients were included in efficacy analyses. The trial was done in an outpatient setting and is registered at ClinicalTrials.gov, NCT03027557, and has been completed. FINDINGS Between March 14, 2017, and March 16, 2018 we recruited 285 participants. 16 patients were randomly allocated to the denosumab group, 15 to the combination group, and 15 to the placebo group. Dropout was limited to one patient in the combination group. Compared with placebo, BMD improved in groups receiving denosumab: lumbar spine (combination group 5·4% [95% CI 2·7-8·1], denosumab group 6·9% [95% CI 4·2-9·6]; p<0·0001), total hip (combination group 5·0% [3·0-6·9], denosumab group 4·1% [2·5-5·8]; p<0·0001), and femoral neck (combination group 4·5% [1·9-7·9]; p=0·0008, denosumab group 3·8% [1·4-6·3]; p=0·0022]). Changes in BMD at the third distal forearm were borderline significant. Six non-fatal serious adverse events occurred (combination group [n=2], denosumab group [n=1], placebo group [n=3]). The overall prevalence of adverse events did not differ between treatment groups, and no fatal adverse events occurred. INTERPRETATION Evidence suggested denosumab was effective in improving BMD and lowering bone turnover in patients with primary hyperparathyroidism irrespective of cinacalcet treatment and might be a valid option for patients in which surgery is undesirable. FUNDING Aalborg University Hospital and Aalborg University, Denmark.
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Affiliation(s)
| | - Jesper Karmisholt
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Endocrinology, Aalborg University, Aalborg, Denmark
| | - Maciej Robaczyk
- Department of Endocrinology, Aalborg University, Aalborg, Denmark
| | - Simon Lykkeboe
- Department of Clinical Biochemistry, Aalborg University, Aalborg, Denmark
| | - Aase Handberg
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Clinical Biochemistry, Aalborg University, Aalborg, Denmark
| | - Emilie Steinkohl
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Radiology, Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Radiology, Aalborg University, Aalborg, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Endocrinology, Aalborg University, Aalborg, Denmark; Steno Diabetes Center North Jutland, Aalborg, Denmark
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Roger C, Abid N, Dubourg L, Auvergnon C, Lemoine S, Machon C. Composition of urinary calculi: Lessons from a French epidemiologic retrospective study. Prog Urol 2020; 30:339-345. [PMID: 32312624 DOI: 10.1016/j.purol.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Urolithiasis is a common urological disease whose incidence increases in developed countries. We studied relations between composition of urinary calculi, age and gender. MATERIAL An epidemiologic study was conducted in a French population of patients encountered analysis of urinary calculi between 2013 and 2017. This retrospective cohort study was performed from urinary calculi samples analysed in a clinical biochemistry laboratory of University Hospital of Lyon in France. A total of 5782 samples were included. Data, according to stone composition, presence of a papillary umbilication and a Randall's plaque, age and gender, were investigated. Statistical analyses used the Chi2 test (R software). RESULTS The overall male to female sex ratio was equal to 1.76. The average and the median of age were 52.1 and 53.0 years, respectively. Whewellite was the most frequent main component in our population (44.4%). Carbapatite, weddellite and uric acid represented the main component in 14.0%, 13.4% and 13.0% of samples, respectively. Differences between genders were shown. Whewellite and uric acid were more frequent in men (P<0.001), while carbapatite and struvite were predominant in women (P<0.001). CONCLUSIONS Our study provided recent data on the composition of urinary calculi in a French population and the relations between composition of urinary calculi and age and gender. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- C Roger
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - N Abid
- Service d'urologie, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - L Dubourg
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Auvergnon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - S Lemoine
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Machon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France.
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50
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Hosoya T, Furuno K, Kanda S. A clinical pharmacology study of the novel, selective urate reabsorption inhibitor dotinurad in outpatients. Clin Exp Nephrol 2020; 24:103-111. [PMID: 32067130 PMCID: PMC7066296 DOI: 10.1007/s10157-020-01857-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Dotinurad is a novel, selective urate reabsorption inhibitor (SURI), which reduces serum uric acid levels by selective inhibition of the urate transporter 1 (URAT1). The Japanese guideline for the management of hyperuricemia and gout recommends that drug selection should be based on classification of hyperuricemia as a fundamental principle. However, there may be some cases where this principle is not observed. We investigated the pharmacodynamics and safety of dotinurad in outpatients with uric acid overproduction or uric acid underexcretion type. METHODS This was a multicenter, open-label, forced titration study. Patients were classified as uric acid overproduction or underexcretion type. Study treatment was initiated at 0.5 mg/day, followed by dose titration to the estimated maximum dose of 4 mg/day over 14 weeks. The primary endpoint was urinary uric acid excretion at each 24-h urine collection. RESULTS A total of 26 hyperuricemic patients with or without gout were enrolled in the study and assigned to the uric acid overproduction group (overproduction group) or the uric acid underexcretion group (underexcretion group). Although urinary uric acid excretion, the primary endpoint, tended to be slightly greater in the overproduction group, no notable difference was noted between the two hyperuricemic types. Neither type had noteworthy safety concerns associated with dotinurad. CONCLUSION The results of the study demonstrated no relevant differences between the hyperuricemic types in terms of pharmacodynamic action and safety of dotinurad.
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Affiliation(s)
- Tatsuo Hosoya
- Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuki Furuno
- Clinical Research Department, Mochida Pharmaceutical Co., Ltd., 1-22 Yotsuya, Shinjuku-ku, Tokyo, 160-0004, Japan.
| | - Shingo Kanda
- Clinical Research Department, Mochida Pharmaceutical Co., Ltd., 1-22 Yotsuya, Shinjuku-ku, Tokyo, 160-0004, Japan
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