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Aksenov LI, Streeper NM, Scales CD. Leveraging behavioral modification technology for the prevention of kidney stones. Curr Opin Urol 2024; 34:14-19. [PMID: 37962162 PMCID: PMC10842369 DOI: 10.1097/mou.0000000000001142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the use of technology to help promote and maintain behaviors that decrease stone recurrence. RECENT FINDINGS Behavior change is a complex process with various interacting components. Recent developments have sought to utilize technology in combination with behavioral change techniques to promote behavior that lowers stone recurrence risk. Smart water bottles are becoming a popular way to accurately measure fluid intake with variable impact on adherence to the recommended daily fluid intake. Mobile apps have also been explored as a method to improve fluid intake. Interventions that combine smart water bottles, mobile apps, and behavioral change techniques have shown the most promise in promoting increased daily fluid intake. Other technologies, such as smart pill dispensers and hydration monitors, have potential applications in promoting behavioral change for stone disease but have yet to be evaluated for this purpose. SUMMARY There is a limited number of studies exploring technology as a means to promote and maintain behaviors that decrease urinary stone recurrence. Future research is needed to elucidate how to maximize the potential of these technologies and better understand which behavioral change techniques best promote habit formation for the prevention of stones.
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Affiliation(s)
- Leonid I. Aksenov
- Department of Urology, Duke University School of Medicine, Durham, NC
| | - Necole M. Streeper
- Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - Charles D. Scales
- Department of Urology, Duke University School of Medicine, Durham, NC
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC
- Department Population Health Science and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
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Courbebaisse M, Travers S, Bouderlique E, Michon-Colin A, Daudon M, De Mul A, Poli L, Baron S, Prot-Bertoye C. Hydration for Adult Patients with Nephrolithiasis: Specificities and Current Recommendations. Nutrients 2023; 15:4885. [PMID: 38068743 PMCID: PMC10708476 DOI: 10.3390/nu15234885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24 h urine volume, which, under physiological conditions, approximately reflects daily fluid intake. The aim of this study is to synthesize and highlight the role of hydration in the treatment of nephrolithiasis. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) and also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake to at least at 2.5 L/day to prevent stone formation, and even to 3.5-4 L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate, or magnesium content). Finally, some additional advice has to be given to avoid certain beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.
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Affiliation(s)
- Marie Courbebaisse
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Institut Necker Enfants Malades, Inserm U1151, F-75015 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Simon Travers
- Équipe Biologie, Lip(Sys)2, EA7357, UFR de Pharmacie, Université Paris-Saclay, F-91400 Orsay, France
- Clinical Chemistry Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France
| | - Elise Bouderlique
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Arthur Michon-Colin
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Michel Daudon
- Department of Multidisciplinary Functional Explorations, Tenon Hospital, AP-HP, F-75019 Paris, France
| | - Aurélie De Mul
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, F-69500 Bron, France
| | - Laura Poli
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Stéphanie Baron
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
| | - Caroline Prot-Bertoye
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
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Peerapen P, Thongboonkerd V. Kidney Stone Prevention. Adv Nutr 2023; 14:555-569. [PMID: 36906146 DOI: 10.1016/j.advnut.2023.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global health care problem that affects almost people in developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be first considered. Low urine output and dehydration are the common risks of all stone types, whereas hypercalciuria, hyperoxaluria, and hypocitraturia are the major risks of calcium stones. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/d), diuresis (>2.0-2.5 L/d), lifestyle and habit modifications (for example, maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary management [for example, sufficient calcium at 1000-1200 mg/d, limit sodium at 2 or 3-5 g/d of sodium chloride (NaCl), limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/d but increase plant proteins in patients with calcium and uric acid stone and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation] are summarized. Moreover, uses of natural bioactive products (for example, caffeine, epigallocatechin gallate, and diosmin), medications (for example, thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed. Adv Nutr 2023;x:xx-xx.
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Affiliation(s)
- Paleerath Peerapen
- Medical Proteomics Unit, Research Department, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Research Department, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Sun P, Liao SG, Yang RQ, Lu CL, Ji KL, Cao DH, Hu HB, Lu JM, Song XZ, Wu M, Jia HZ, Xiao CF, Ma ZW, Xu YK. Aspidopterys obcordata vine inulin fructan affects urolithiasis by modifying calcium oxalate crystallization. Carbohydr Polym 2022; 294:119777. [DOI: 10.1016/j.carbpol.2022.119777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/02/2022]
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Wagner S, Merkling T, Metzger M, Bankir L, Laville M, Frimat L, Combe C, Jacquelinet C, Fouque D, Massy ZA, Stengel B. Water intake and progression of chronic kidney disease: the CKD-REIN cohort study. Nephrol Dial Transplant 2021; 37:730-739. [DOI: 10.1093/ndt/gfab036] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
Abstract
Background
Optimal daily water intake to prevent chronic kidney disease (CKD) progression is unknown. Taking the kidney’s urine-concentrating ability into account, we studied the relation of kidney outcomes in patients with CKD to total and plain water intake and urine volume.
Methods
Including 1265 CKD patients [median age 69 years; mean estimated glomerular filtration rate (eGFR) 32 mL/min/1.73 m2] from the Chronic Kidney Disease–Renal Epidemiology and Information Network cohort (2013–19), we assessed fluid intake at baseline interviews, collected 24-h urine volumes and estimated urine osmolarity (eUosm). Using Cox and then linear mixed models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for kidney failure and eGFR decline associated with hydration markers, adjusting for CKD progression risk factors and eUosm.
Results
Patients’ median daily intake was 2.0 L [interquartile range (IQR) 1.6–2.6] for total water and 1.5 L (1–1.7) for plain water, median urine volume was 1.9 L/24 h (IQR 1.6–2.4) and mean eUosm was 374 ± 104 mosm/L. Neither total water intake nor urine volume was associated with either kidney outcome. Kidney failure risk increased significantly with decreasing eUosm ˂292 mosm/L. Adjusted HRs (95% CIs) for kidney failure associated with plain water intake were 1.88 (1.02–3.47), 1.59 (1.06–2.38), 1.76 (0.95–3.24) and 1.55 (1.03–2.32) in patients drinking <0.5, 0.5–1.0, 1.5–2.0 and >2.0 L/day compared with those drinking 1.0–1.5 L/day. High plain water intake was also significantly associated with faster eGFR decline.
Conclusions
In patients with CKD, the relation between plain water intake and progression to kidney failure appears to be U-shaped. Both low and high intake may not be beneficial in CKD.
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Affiliation(s)
- Sandra Wagner
- Université de Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN INI-CRCT, Nancy, France
| | - Thomas Merkling
- Université de Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, FCRIN INI-CRCT, Nancy, France
| | - Marie Metzger
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Université Paris-Saclay, Université Versailles Saint Quentin, Villejuif, France
| | - Lise Bankir
- Sorbonne Université, INSERM, Centre de Recherche des Cordeliers, Paris, France
| | - Maurice Laville
- Département de Néphrologie, Centre Hospitalier Lyon-Sud, Université de Lyon, UCBL, Carmen, Pierre-Bénite, France
| | - Luc Frimat
- EA4360 Apemac, Université de Lorraine, Université Paris-Descartes, Nancy, France
- Département de Néphrologie, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Christian Combe
- Service de Néphrologie-Transplantation-Dialyse-Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- INSERM, U1026, Université Bordeaux Segalen, Bordeaux, France
| | - Christian Jacquelinet
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Université Paris-Saclay, Université Versailles Saint Quentin, Villejuif, France
- Agence de Biomédecine, Saint Denis la Plaine, France
| | - Denis Fouque
- Département de Néphrologie, Centre Hospitalier Lyon-Sud, Université de Lyon, UCBL, Carmen, Pierre-Bénite, France
| | - Ziad A Massy
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Université Paris-Saclay, Université Versailles Saint Quentin, Villejuif, France
- Service de Néphrologie, Hôpital Ambroise Paré, AP-HP, Paris, France
| | - Bénédicte Stengel
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Université Paris-Saclay, Université Versailles Saint Quentin, Villejuif, France
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Perrier ET, Armstrong LE, Bottin JH, Clark WF, Dolci A, Guelinckx I, Iroz A, Kavouras SA, Lang F, Lieberman HR, Melander O, Morin C, Seksek I, Stookey JD, Tack I, Vanhaecke T, Vecchio M, Péronnet F. Hydration for health hypothesis: a narrative review of supporting evidence. Eur J Nutr 2020; 60:1167-1180. [PMID: 32632658 PMCID: PMC7987589 DOI: 10.1007/s00394-020-02296-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/28/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE An increasing body of evidence suggests that excreting a generous volume of diluted urine is associated with short- and long-term beneficial health effects, especially for kidney and metabolic function. However, water intake and hydration remain under-investigated and optimal hydration is poorly and inconsistently defined. This review tests the hypothesis that optimal chronic water intake positively impacts various aspects of health and proposes an evidence-based definition of optimal hydration. METHODS Search strategy included PubMed and Google Scholar using relevant keywords for each health outcome, complemented by manual search of article reference lists and the expertise of relevant practitioners for each area studied. RESULTS The available literature suggest the effects of increased water intake on health may be direct, due to increased urine flow or urine dilution, or indirect, mediated by a reduction in osmotically -stimulated vasopressin (AVP). Urine flow affects the formation of kidney stones and recurrence of urinary tract infection, while increased circulating AVP is implicated in metabolic disease, chronic kidney disease, and autosomal dominant polycystic kidney disease. CONCLUSION In order to ensure optimal hydration, it is proposed that optimal total water intake should approach 2.5 to 3.5 L day-1 to allow for the daily excretion of 2 to 3 L of dilute (< 500 mOsm kg-1) urine. Simple urinary markers of hydration such as urine color or void frequency may be used to monitor and adjust intake.
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Affiliation(s)
- Erica T Perrier
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France.
| | - Lawrence E Armstrong
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.,Hydration & Nutrition, LLC, Newport News, VA, USA
| | - Jeanne H Bottin
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - William F Clark
- London Health Sciences Centre and Western University, London, ON, Canada
| | - Alberto Dolci
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Isabelle Guelinckx
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Alison Iroz
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Stavros A Kavouras
- College of Health Solutions and Hydration Science Lab, Arizona State University, Phoenix, AZ, USA
| | - Florian Lang
- Department of Physiology, Eberhard Karls University, Tübingen, Germany
| | | | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Clementine Morin
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Isabelle Seksek
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Jodi D Stookey
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | - Ivan Tack
- Explorations Fonctionnelles Physiologiques, Hôpital Rangueil, Toulouse, France
| | - Tiphaine Vanhaecke
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - Mariacristina Vecchio
- Health, Hydration & Nutrition Science, Danone Research, Route Départementale 128, 91767, Palaiseau cedex, France
| | - François Péronnet
- École de Kinésiologie et des Sciences de l'activité Physique, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
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Abstract
BACKGROUND Urinary stone disease is a common condition characterised by increasing prevalence and high rates of recurrence. Observational studies have reported that increased water intake played a role in the prevention of urinary stone formation but with limited strength of evidence. OBJECTIVES To compare the effects of increased water intake with standard water intake for the prevention of urinary stone formation in participants with or without a history of urinary stones. SEARCH METHODS We performed a systematic search of PubMed (MEDLINE), EMBASE (Ovid) and the Cochrane Library to 15 October 2019. We handsearched review articles, clinical trial registries, and reference lists of retrieved articles. We did not apply any restrictions to publication language or publication status. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs looking at the benefits and harms of increased water intake versus standard water intake for the prevention of urinary stone formation in participants with or without a history of urinary stones. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed the risk of bias of included studies. We pooled dichotomous outcomes (e.g. incidence/recurrence rate of urinary stones; adverse events) using risk ratios (RRs) with 95% confidence intervals (CIs). We calculated hazard ratio (HRs) and corresponding 95% CIs to assess the intervention effect for time-to-event outcomes. We assessed the certainty of the evidence by using the GRADE criteria. MAIN RESULTS Our search identified no RCTs investigating the role of increased water intake for the prevention of urinary stone formation in participants with no history of urinary stones (primary prevention). We found one RCT assessing the effects of increased water intake versus standard water intake for the prevention of urinary stone formation in people with a history of urinary stones (secondary prevention). This trial randomised 220 participants (110 participants in the intervention group with increased water intake and 110 in the control group with standard water intake). Increased water intake was defined as achieving a urine volume of at least 2.0 L per day by drinking water. Based on this study, increased water intake may decrease stone recurrences (RR 0.45, 95% CI 0.24 to 0.84; 199 participants; low-certainty evidence); this corresponds to 149 fewer (43 fewer to 205 fewer) stone recurrences per 1000 participants with 270 stone recurrence per 1000 participants over five years in the control group. Increased water intake may also prolong the time to urinary stone recurrence compared to standard water intake (HR 0.40, 95% CI 0.20 to 0.79; 199 participants; low-certainty evidence); based on a stone recurrence rate of 270 per 1000 participants over five years, this corresponds to 152 fewer (209 fewer to 50 fewer) recurrences per 1000 participants. For both outcomes we downgraded the certainty of evidence for study limitations and imprecision. We found no evidence for the outcome of adverse events AUTHORS' CONCLUSIONS: We found no RCT evidence on the role of increased water intake for primary prevention of urinary stones. For secondary prevention, increased water intake achieving a urine volume of at least 2.0 L/day may reduce urinary stone recurrence and prolong time to recurrence for people with a history of urinary stone disease. However, our confidence in these findings is limited. We did not find evidence for adverse events.
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Affiliation(s)
- Yige Bao
- West China Hospital, Sichuan UniversityDepartment of UrologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Xiang Tu
- Sichuan UniversityWest China School of Clinical MedicineChengduChina
| | - Qiang Wei
- West China Hospital, Sichuan UniversityDepartment of UrologyNo. 37, Guo Xue XiangChengduSichuanChina610041
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Which Type of Water Is Recommended for Patients with Stone Disease (Hard or Soft Water, Tap or Bottled Water): Evidence from a Systematic Review over the Last 3 Decades. Curr Urol Rep 2020; 21:6. [DOI: 10.1007/s11934-020-0968-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Association Between Daily Water Intake and 24-hour Urine Volume Among Adolescents With Kidney Stones. Urology 2020; 140:150-154. [PMID: 32004558 DOI: 10.1016/j.urology.2020.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the association between daily water intake and 24-hour urine volume among adolescents with nephrolithiasis in order to estimate a "fluid prescription," the additional water intake needed to increase urine volume to a target goal. METHODS We conducted a secondary analysis of an ecological momentary assessment study that prospectively measured daily water intake of 25 adolescents with nephrolithiasis over 7 days. We identified 24-hour urine volumes obtained for clinical care within 12 months of water intake assessment. A linear regression model was fit to estimate the magnitude of the association between daily water intake and 24-hour urine volume, adjusting for age, sex, race, and daily temperature. RESULTS Twenty-two participants completed fifty-seven 24-hour urine collections within 12 months of the study period. Median daily water intake was 1.4 L (IQR 0.67-1.94). Median 24-hour urine volume was 2.01 L (IQR 1.20-2.73). A 1 L increase in daily water intake was associated with a 710 mL increase in 24-hour urine output (95%CI 0.55-0.87). Using the model output, the equation was generated to estimate the additional fluid intake needed fluid prescription (FP) to produce the desired increase in urine output (dUOP): FP = dUOP/0.71. CONCLUSION The FP equation (FP = dUOP)/0.71), which reflects the relationship between water intake and urine volume, could be used to help adolescents with nephrolithiasis achieve urine output goals to decrease stone recurrence.
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Streeper NM, Dubnansky A, Sanders AB, Lehman K, Thomaz E, Conroy DE. Improving Fluid Intake Behavior Among Patients With Kidney Stones: Understanding Patients’ Experiences and Acceptability of Digital Health Technology. Urology 2019; 133:57-66. [DOI: 10.1016/j.urology.2019.05.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/24/2019] [Accepted: 05/16/2019] [Indexed: 01/08/2023]
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Becker B, Gadzhiev N, Popiolek M, Gross AJ, Netsch C. [A mobile app for patients suffering from kidney stones]. Urologe A 2019; 57:577-582. [PMID: 29713752 DOI: 10.1007/s00120-018-0652-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Kidney stone disease has become an important worldwide socioeconomic issue. However, metaphylaxis fails due to low compliance rates. Therefore, we developed a mobile app (StoneMD: Kidney Stones) for patients with kidney stones to increase compliance in stone metaphylaxis. MATERIALS AND METHODS To identify the most appropriate design of the app, we searched through the App Store and the Google Play Store and integrated the clinical recommendations of the European Association of Urology (EAU) and the American Urological Association (AUA). To test the value of this app, a questionnaire was developed in which the patient should answer questions about the drinking behavior and the subjective use of the app in the field of metaphylaxis. RESULTS StoneMD: Kidney Stones offers the opportunity to calculate the individual risk of a new stone episode. In addition, the app offers several features to raise awareness of lifestyle modification, including hydration as metaphylaxis of urolithiasis, reminder of inserted ureteral stents and document the self-measured urine pH. A total of 49 patients participated in the questionnaire: 89.8% (n = 46) of these patients had a smartphone, 73.9% reported a daily intake of <2.5 l, 76.5% of these patients believe that their drinking behavior is positively influenced by the app, 71.7% stated that the app for relapse prevention is more suitable than traditional information brochures, 56.5% want to continue to use the app. CONCLUSIONS StoneMD: Kidney Stones is the first mobile app for stone metaphylaxis. StoneMD might help to improve patient compliance and might lower the risk of stone formation.
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Affiliation(s)
- B Becker
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - N Gadzhiev
- Urology, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russland
| | - M Popiolek
- Department of Urology, University Hospital Örebro, Örebro, Schweden
| | - A J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
| | - C Netsch
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
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PREZIOSO D, DI DOMENICO D, PANE M, CICCARELLI D, D’ERRICO G. Ion specificity in determining physico-chemical properties of drinking water. FOOD SCIENCE AND TECHNOLOGY 2019. [DOI: 10.1590/fst.34717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Manuela PANE
- Università degli Studi di Napoli “Federico II”, Italia
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13
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Paz-Graniel I, Babio N, Serra-Majem L, Vioque J, Zomeño MD, Corella D, Díaz-López A, Pintó X, Bueno-Cavanillas A, Tur JA, Daimiel L, Martínez JA, Becerra-Tomás N, Navarrete-Muñoz EM, Schröder H, Fernández-Carrión R, Ortiz-Andrellucchi A, Corbella E, Riquelme-Gallego B, Gallardo-Alfaro L, Micó V, Zulet M, Barrubés L, Fitó M, Ruiz-Canela M, Salas-Salvadó J. Fluid and total water intake in a senior mediterranean population at high cardiovascular risk: demographic and lifestyle determinants in the PREDIMED-Plus study. Eur J Nutr 2019; 59:1595-1606. [PMID: 31154492 DOI: 10.1007/s00394-019-02015-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/28/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to evaluate associations between compliance with recommendations for total water intake (TWI) and total water intake from fluids (TWIF), and some socio-demographic and lifestyle factors of a senior Mediterranean population at high cardiovascular risk. METHODS Cross-sectional analysis with data of 1902 participants from the PREDIMED-Plus study. A validated 32-item Spanish fluid-intake questionnaire was used to assess beverage consumption and water intake. Multivariable logistic regression models were used to assess the odds ratio (OR) and the 95% confidence interval (CI) for complying with European Food Safety Agency recommendations for TWI and TWIF according to various socio-demographic and lifestyle factors, and for the joint associations of Mediterranean diet (MedDiet) adherence and moderate-vigorous physical activity (MVPA). RESULTS The mean total volume of fluid intake in the population studied was 1934 ± 617 mL/day. Water was the most frequently consumed beverage. Significant differences between sex were only observed in alcoholic and hot beverage consumption. Compliance with TWIF was associated with being women (OR 3.02; 2.40, 3.80), high adherence to MedDiet (OR 1.07; 1.02, 1.12), and participants who were more engaged in physical activity (PA) (OR 1.07; 1.02, 1.13). Age was inversely associated (OR 0.96; 0.94, 0.98). Similar results for TWI recommendations compliance were observed in relation to being women (OR 5.34; 3.85, 7.42), adherence to MedDiet (OR 1.16; 1.02, 1.31) and PA (OR 1.07; 1.00, 1.15). The joint association of PA and MedDiet, showed that participants with higher adherence to MedDiet and meeting WHO recommendations for MVPA complied better with the TWI recommendations (OR 1.66; 1.19, 2.32). CONCLUSIONS High compliance with recommendations for TWI was associated with being a woman, and a healthy lifestyle characterized by high adherence to the MedDiet and PA.
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Affiliation(s)
- Indira Paz-Graniel
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain
| | - Nancy Babio
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain. .,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
| | - Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, University of Las Palmas de Gran Canaria, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Dolores Zomeño
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Blanquerna, School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Andrés Díaz-López
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain.,Department of Nutrition, Food Science and Physiology, University of Navarra, IDISNA, Pamplona, Spain
| | - Nerea Becerra-Tomás
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Eva Mª Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Rebeca Fernández-Carrión
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Adriana Ortiz-Andrellucchi
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, University of Las Palmas de Gran Canaria, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Emili Corbella
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Blanca Riquelme-Gallego
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Laura Gallardo-Alfaro
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Víctor Micó
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Marian Zulet
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Nutrition, Food Science and Physiology, University of Navarra, IDISNA, Pamplona, Spain
| | - Laura Barrubés
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
| | - Jordi Salas-Salvadó
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, University Hospital of Sant Joan de Reus, IISPV, Reus, Spain. .,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
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Kang HW, Seo SP, Ha YS, Kim WT, Kim YJ, Yun SJ, Kim WJ, Lee SC. Twenty-four-hour urine osmolality as a representative index of adequate hydration and a predictor of recurrence in patients with urolithiasis. Int Urol Nephrol 2019; 51:1129-1135. [PMID: 31089946 DOI: 10.1007/s11255-019-02108-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/16/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE To determine the value of 24-h urine osmolality (UOsm) as a representative index of adequate hydration and predictor of stone recurrence in patients with urolithiasis. METHODS Medical records of consecutive patients presenting with renal or ureteric stones between 1994 and 2017 were retrospectively reviewed. Patients were grouped according to the results of 24-h UOsm (low ≤ 564 mOsm/kg H2O, high > 564 mOsm/kg H2O). Metabolic parameters and risk of stone recurrence were compared between the two groups. RESULTS The low urine concentration group were more likely to be older, to be female, and to have a lower body mass index and higher glomerular filtration rate than the high concentration group (each P < 0.005). A positive correlation was seen between 24-h UOsm and urinary calcium, sodium, uric acid, and magnesium excretion and 24-h specific gravity; a negative correlation was seen with 24-h urine volume. Stone-forming constituents, such as calcium and uric acid, were significantly higher in the high urine concentration group. Kaplan-Meier estimates showed that the low urine concentration group had a significantly longer stone recurrence-free period than the high urine concentration group (log-rank test, P < 0.001). In multivariate Cox regression analyses, 24-h UOsm was seen to be an independent risk factor for stone recurrence. CONCLUSIONS UOsm is a promising approach to assessing hydration and predicting stone recurrence in patients with urolithiasis. Maintaining UOsm < 564 mOsm/kg H2O may reduce the risk of stone recurrence.
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Affiliation(s)
- Ho Won Kang
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Sung Pil Seo
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Yun-Sok Ha
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Won Tae Kim
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Yong-June Kim
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Seok-Joong Yun
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Wun-Jae Kim
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Sang-Cheol Lee
- Department of Urology, College of Medicine and Institute for Tumor Research, Chungbuk National University, 776 1sunhwan-ro, Seowon-gu, Cheonju, 28644, Korea. .,Department of Urology, Chungbuk National University Hospital, Cheongju, Korea.
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Perceptions of dietary factors promoting and preventing nephrolithiasis: a cross-sectional survey. World J Urol 2018; 37:1723-1731. [PMID: 30554273 DOI: 10.1007/s00345-018-2562-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/03/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To assess knowledge of both promoting and preventive dietary factors on nephrolithiasis in a diverse patient population. Precipitating factors of kidney stone disease include diet, lifestyle, socioeconomic status, and race/ethnicity. However, patient awareness of these influences is poorly described. MATERIALS AND METHODS A 24-question survey, assessing intake-related risk factors for stone disease, was administered prospectively to 1018 patients. Responses were summarized with frequency and percent. Statistical comparisons were made using a propensity scoring method in order to account for potential confounding variables. Propensity scores were stratified into quintiles. Further analysis with multiple imputation was performed to account for any missing data in the survey. The results of the propensity-adjusted log-binomial regression model are presented as prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS Respondents demonstrated limited knowledge of nutrient factors that influence stone development. However, most study participants (70.3%) reported a willingness to make lifestyle changes aimed at lowering their risk for stone disease. Respondents reporting previous nephrolithiasis education were less likely to report that diet had no effect on kidney stone formation (PR = 0.795, 95% CI 0.65, 0.96, p = 0.01) The type of physician who counseled the respondent had no association with patient knowledge for stone disease (PR = 0.83, 95% CI 0.63, 1.10, p = 0.2). CONCLUSIONS Knowledge of diet-related risk factors for nephrolithiasis is limited among this population. Respondents who received prior education appeared to maintain the knowledge of dietary risk for nephrolithiasis. Participants also expressed a willingness to make requisite dietary changes if that information is provided. Given that most stone formers experience a recurrence, these findings highlight the need for more comprehensive patient education strategies on the modifiable risk factors for nephrolithiasis.
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Hoy NY, Dean NS, Wu J, Wollin TA, De SK. Impact of LUTS on urine volume in stone formers The impact of lower urinary tract symptomatology on urine volumes in stone formers. Can Urol Assoc J 2018; 13:256-259. [PMID: 30526800 DOI: 10.5489/cuaj.5530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to determine if there is a correlation between International Prostate Symptom scores (IPSS) and 24-hour urine collection volumes, as patients experiencing lower urinary tract symptoms (LUTS) may have impaired ability to increase fluid intake for stone prevention. METHODS We conducted a single-centre, retrospective review was performed of stone-formers presenting from 2014-2016. Inclusion criteria were completion of an IPSS questionnaire and a 24-hour urine collection. Exclusion criteria included symptomatic stone or urinary tract infection at time of IPSS completion, inadequate 24-hour collection, or incomplete IPSS questionnaire. RESULTS A total of 131 patients met inclusion criteria. Stratification by IPSS severity into mild (0-7), moderate (8-19), and severe (20-35) yielded groups of n=96, 28, and 7, respectively. Linear regression modelling did not reveal a correlation between IPSS score and volume (p=0.10). When compared to those with adequate urine volumes (>2 L/day, n=65), low-volume patients (<1 L/day, n=10) had a significantly higher total IPSS (11.7 vs. 6.1; p=0.036). These groups showed significant differences in their responses to questions about incomplete emptying (p=0.031), intermittency (p=0.011), and stranguria (p=0.0020), with higher scores noted in the low urine output group. CONCLUSIONS This study is the first to examine the correlation between IPSS and 24-hour urine volume. Though our data does not show a linear relationship between urine output and IPSS, those with lower urine volumes appear to have worse self-reported voiding symptoms when compared to those with adequate volumes (>2 L/day) for stone prevention. The overall number of patients in our study is relatively small, which may account for the lack of a relationship between IPSS and 24-hour urine volumes.
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Affiliation(s)
- Nathan Y Hoy
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Nick S Dean
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Jeremy Wu
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Timothy A Wollin
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Shubha K De
- Division of Urology, University of Alberta, Edmonton, AB, Canada
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Sorokin I, Pearle MS. Medical therapy for nephrolithiasis: State of the art. Asian J Urol 2018; 5:243-255. [PMID: 30364650 PMCID: PMC6197179 DOI: 10.1016/j.ajur.2018.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/08/2018] [Accepted: 07/11/2018] [Indexed: 12/13/2022] Open
Abstract
The prevalence of nephrolithiasis is increasing worldwide. Understanding and implementing medical therapies for kidney stone prevention are critical to prevent recurrences and decrease the economic burden of this condition. Dietary and pharmacologic therapies require understanding on the part of the patient and the prescribing practitioner in order to promote compliance. Insights into occupational exposures and antibiotic use may help uncover individual risk factors. Follow-up is essential to assess response to treatment and to modify treatment plans to maximize therapeutic benefit.
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Affiliation(s)
- Igor Sorokin
- Department of Urology, University of Massachusetts, Worcester, MA, USA
| | - Margaret S Pearle
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.,Charles and Jane Pak Center for Mineral Metabolism and Bone Research, UT Southwestern Medical Center, Dallas, TX, USA
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Streeper NM, Lehman K, Conroy DE. Acceptability of Mobile Health Technology for Promoting Fluid Consumption in Patients With Nephrolithiasis. Urology 2018; 122:64-69. [PMID: 30171920 DOI: 10.1016/j.urology.2018.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/28/2018] [Accepted: 08/06/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate kidney stone patients' interest in lifestyle behavior modification and a variety of mobile health (mHealth) technologies to improve adherence to fluid consumption recommendations for the prevention of nephrolithiasis. Of particular interest was the acceptability of various intervention components for the design of a stone-specific mHealth technology. MATERIALS AND METHODS Using a cross-sectional design, adult patients with a diagnosis of kidney stones (n = 94) were recruited from outpatient clinics to complete a three-part questionnaire. RESULTS Patients reported being willing to make lifestyle changes to prevent kidney stones (97%). The majority of the patients recalled the recommendation to increase fluid intake (93%) but few monitored their daily fluid intake (30%). Most patients had never installed an app (95%) or owned a device (100%) to help with increasing fluid consumption, but believed an app or device could improve their adherence (72%) and would be interested in using an app or device (86%). The mHealth intervention components most widely perceived as useful included automated lapse detection with notifications, educational materials, self-monitoring tools, scheduler with prompts and/or reminders and/or notifications, connected water bottles and text message reminders to drink. CONCLUSION Patients are interested in lifestyle behavior change to prevent stones but technology has not been widely adopted to improve adherence to fluid intake recommendations for stone prevention. This study identified a number of viable mHealth intervention components that should be considered when designing a stone-specific mHealth technology to support adherence to increased fluid consumption recommendations.
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Affiliation(s)
- Necole M Streeper
- Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
| | - Kathleen Lehman
- Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA; Department of Preventive Medicine, Northwestern University, Chicago, IL
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Ali L, Ali S, Hussain SA, Haider F, Ali S. Role of Spiritual Sentiments in Improving the Compliance of Water Intake in Patients with Urolithiasis. JOURNAL OF RELIGION AND HEALTH 2018; 57:26-32. [PMID: 27342410 DOI: 10.1007/s10943-016-0272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of this study was to compare the compliance for water intake and rate of recurrence between spiritually motivated and non-motivated patients of renal tract stone disease. It is a multi centric prospective cohort study, conducted in Department of Urology, Institute of Kidney Diseases and Peshawar Medical College, from January 10, 2009 to December 2012. A total of 180 patients with comparable demographic, IQ, EQ and BMI after achieving complete stone clearance were divided into two equal groups. Both groups were instructed to increase the water intake timetable according to AUA guidelines. Group 'A' comprising of 90 patients who were identified as spiritually motivated patients based on questioner of FICA 12 is also instructed that increasing the water intake is mentioned in contemporary Islamic medicine. No spiritual instruction was given to Group B. The instructed guidelines and practice for amount and timing of water intake were recalled from participants at the end of 6 and 12 months. The data were recorded on structured proforma and was analyzed using SPSS version 17. The mean age of the patient in Group A was 37.5 years (18-70 years), while in Group B it was 34 years (18-65 years). Urolithiasis affected predominantly male gender in both groups. Sixty-five patients (72.2 %) in Group A have significant compliance (p < 0.001) for water intake over Group B (46 %). The spiritually motivated Group A has significantly reduced rate of recurrence of stones in 23 patients versus 37 in Group B. The spiritually motivated patients had significantly better compliance for water intake and reduced rate of recurrence versus non-motivated individuals in urolithiasis.
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Affiliation(s)
- Liaqat Ali
- Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, Pakistan.
| | - Saima Ali
- Peshawar Medical College, Warsak Road, Peshawar, 25160, Pakistan
| | | | - Fayyaz Haider
- Quide Azam International Hospital, Islamabad, Pakistan
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Porowski T, Kirejczyk JK, Mrozek P, Protas P, Kozerska A, Łabieniec Ł, Szymański K, Wasilewska A. Upper metastable limit osmolality of urine as a predictor of kidney stone formation in children. Urolithiasis 2018; 47:155-163. [PMID: 29356875 PMCID: PMC6420897 DOI: 10.1007/s00240-018-1041-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 01/10/2018] [Indexed: 12/01/2022]
Abstract
High fluid intake has been universally recommended for kidney stone prophylaxis. We evaluated 24-h urine osmolality regarded as the best biomarker of optimal hydration and upper metastable limit osmolality after water evaporation from urine sample to the onset of spontaneous crystallization and its usefulness as a new risk index that would describe an individual lithogenic potential. We collected 24-h urine from 257 pediatric patients with kidney stones and 270 controls. After volume and osmolality assessment, the urine samples were subjected to volume reduction in vacuum rotavapor continued to the onset of an induced urinary crystallization. The upper metastable limit osmolality of urine sample was calculated based on its initial osmolality value and the amount of water reduction. Pediatric stone formers presented with higher urine volume and lower urine osmolality than healthy controls. Despite that, their urine samples required much lower volume reduction to induce the spontaneous crystallization than those of controls. The ROC analysis revealed an AUC for the upper metastable limit osmolality of 0.9300 (95% CI 0.9104-0.9496) for distinguishing between stone formers and healthy subjects. At the cutoff of 2696 mOsm/kg, the test provided sensitivity and specificity of 0.8638 and 0.8189, respectively. 24-h urine osmolality provided the information about current hydration status, whereas evaporation test estimated the urinary potential to crystalize dependent on urine composition. Upper metastable limit osmolality may estimate the individual lithogenic capability and identify people at risk to stone formation when exposed to dehydration.
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Affiliation(s)
- Tadeusz Porowski
- Department of Paediatric Nephrology, Children's Clinical Hospital, Medical University of Bialystok, Bialystok, Poland.
| | - Jan K Kirejczyk
- Faculty of Health Sciences, Lomza State University of Applied Sciences, Lomza, Poland
| | - Piotr Mrozek
- Faculty of Mechanical Engineering, Bialystok University of Technology, Bialystok, Poland
| | - Piotr Protas
- Department of Paediatric Nephrology, Children's Clinical Hospital, Medical University of Bialystok, Bialystok, Poland
| | - Agata Kozerska
- Department of Paediatric Nephrology, Children's Clinical Hospital, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Anna Wasilewska
- Department of Paediatric Nephrology, Children's Clinical Hospital, Medical University of Bialystok, Bialystok, Poland
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Otto BJ, Bozorgmehri S, Kuo J, Canales M, Bird VG, Canales B. Age, Body Mass Index, and Gender Predict 24-Hour Urine Parameters in Recurrent Idiopathic Calcium Oxalate Stone Formers. J Endourol 2017; 31:1335-1341. [DOI: 10.1089/end.2017.0352] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brandon J. Otto
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida
| | - Shahab Bozorgmehri
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida
- Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida
| | - Jennifer Kuo
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida
| | - Muna Canales
- Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida
| | - Vincent G. Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida
| | - Benjamin Canales
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida
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22
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Abstract
Nephrolithiasis is highly prevalent across all demographic groups in the Western world and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Across the majority of stone types, increased fluid intake and targeted dietary modifications are mainstays of therapy. Specific dietary interventions associated with reduced calcium stone risk include adequate dietary calcium intake and restriction of sodium, protein, and oxalate intake, among others. Pharmaceutical therapy may be required if lifestyle changes are insufficient to minimize risk of stone recurrence, and must be targeted to the specific metabolic abnormalities portending risk for a given patient. Therapeutic options for idiopathic calcium stone disease include thiazides, citrate salts, and uric acid-lowering agents. Alkali salts are also the treatment of choice for uric acid stone disease. Management of struvite stone disease is largely surgical, but acetohydroxamic acid is a proven second line therapy. Cystinuria requires lifestyle modifications and may call for thiol-binding agents. Significant heterogeneity of the clinical population with stone disease has previously limited opportunities for large randomized controlled trials. However, as clinical phenotypes and genotypes are increasingly clarified, there are mounting opportunities for targeted randomized controlled trials in stone prevention. In the meantime, the currently available evidence for both lifestyle and pharmacologic interventions is reviewed herein.
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Affiliation(s)
- Anna L Zisman
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois
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Accuracy of daily fluid intake measurements using a "smart" water bottle. Urolithiasis 2017; 46:343-348. [PMID: 28980082 DOI: 10.1007/s00240-017-1006-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/15/2017] [Indexed: 12/25/2022]
Abstract
High fluid intake is an effective preventative strategy against recurrent kidney stones but is known to be challenging to achieve. Recently, a smart water bottle (Hidrate Spark™, Minneapolis, MN) was developed as a non-invasive fluid intake monitoring system. This device could help patients who form stones from low urine volume achieve sustainable improvements in hydration, but has yet to be validated in a clinical setting. Hidrate Spark™ uses capacitive touch sensing via an internal sensor. It calculates volume measurements by detecting changes in water level and sends data wirelessly to users' smartphones through an application. A pilot study was conducted to assess accuracy of measured fluid intake over 24 h periods when used in a real life setting. Subjects were provided smart bottles and given short tutorials on their use. Accuracy was determined by comparing 24-h fluid intake measurements calculated through the smart bottle via sensor to standard volume measurements calculated by the patient from hand over the same 24 h period. Eight subjects performed sixty-two 24-h measurements (range 4-14). Mean hand measurement was 57.2 oz/1692 mL (21-96 oz/621-2839 mL). Corresponding mean smart bottle measurement underestimated true fluid intake by 0.5 ozs. (95% CI -1.9, 0.9). Percent difference between hand and smart bottle measurements was 0.0% (95% CI - 3%, 3%). Intraclass correlation coefficient (ICC), calculated to assess consistency between hand measures and bottle measures, was 0.97 (0.95, 0.98) indicating an extremely high consistency between measures. 24-h fluid intake measurements from a novel fluid monitoring system (Hidrate Spark™) are accurate to within 3%. Such technology may be useful as a behavioral aide and/or research tool particularly among recurrent stone formers with low urinary volume.
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24
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Ticinesi A, Nouvenne A, Borghi L, Meschi T. Water and other fluids in nephrolithiasis: State of the art and future challenges. Crit Rev Food Sci Nutr 2017; 57:963-974. [PMID: 25975220 DOI: 10.1080/10408398.2014.964355] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Adequate hydration, as to maintain urinary volume over 2 L/day, has long been considered as the cornerstone medical prescription for preventing nephrolithiasis. However, scientific evidence about what kind of water stone formers should drink and about the effects of other beverages on urinary stone risk factors is sometimes unclear. Moreover, the recommendation that water therapy prevents kidney stone recurrence relies on only one randomized controlled trial, even if more epidemiologic and basic science studies seem to support this assumption. Therefore, in this review we analyze current evidence that support water therapy in nephrolithiasis and we highlight the possible effects of different types of water and other beverages on lithogenic risk, giving some practical recommendations for what stone formers should be advised to prevent recurrence.
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Affiliation(s)
- Andrea Ticinesi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Antonio Nouvenne
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Loris Borghi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Tiziana Meschi
- a Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
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25
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Epidemiology of stone disease across the world. World J Urol 2017; 35:1301-1320. [PMID: 28213860 DOI: 10.1007/s00345-017-2008-6] [Citation(s) in RCA: 430] [Impact Index Per Article: 61.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/24/2017] [Indexed: 01/20/2023] Open
Abstract
Nephrolithiasis is a highly prevalent disease worldwide with rates ranging from 7 to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Due to high rates of new and recurrent stones, management of stones is expensive and the disease has a high level of acute and chronic morbidity. The goal of this study is to review the epidemiology of stone disease in order to improve patient care. A review of the literature was conducted through a search on Pubmed®, Medline®, and Google Scholar®. This review was presented and peer-reviewed at the 3rd International Consultation on Stone Disease during the 2014 Société Internationale d'Urologie Congress in Glasgow. It represents an update of the 2008 consensus document based on expert opinion of the most relevant studies. There has been a rising incidence in stone disease throughout the world with a narrowing of the gender gap. Increased stone prevalence has been attributed to population growth and increases in obesity and diabetes. General dietary recommendations of increased fluid, decreased salt, and moderate intake of protein have not changed. However, specific recommended values have either changed or are more frequently reported. Geography and environment influenced the likelihood of stone disease and more information is needed regarding stone disease in a large portion of the world including Asia and Africa. Randomized controlled studies are lacking but are necessary to improve recommendations regarding diet and fluid intake. Understanding the impact of associated conditions that are rapidly increasing will improve the prevention of stone disease.
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26
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Canvasser NE, Alken P, Lipkin M, Nakada SY, Sodha HS, Tepeler A, Lotan Y. The economics of stone disease. World J Urol 2017; 35:1321-1329. [PMID: 28108799 DOI: 10.1007/s00345-017-2003-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/06/2017] [Indexed: 11/28/2022] Open
Abstract
The rising prevalence of kidney stone disease is associated with significant costs to healthcare systems worldwide. This is in part due to direct procedural and medical management costs, as well as indirect costs to health systems, patients, and families. A number of manuscripts evaulating the economics of stone disease have been published since the 2008s International Consultation on Stone Disease. These highlight costs associated with stone disease, including acute management, surgical management, and medical management. This work hopes to highlight optimization in care by reducing inefficient treatments and maximizing cost-efficient preventative strategies.
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Affiliation(s)
- Noah E Canvasser
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA
| | - Peter Alken
- Department of Urology, Mannheim University Hospital, Mannheim, Germany
| | | | - Stephen Y Nakada
- Department of Urology, University of Wisconsin, Madison, WI, USA
| | - Hiren S Sodha
- Department of Urology, RG Stone Urology and Laparoscopy Hospital, Andheri, Mumbai, India
| | - Abdulkadir Tepeler
- Department of Urology, Sen Jorj Austria Hospital, Beyoglu, Istanbul, Turkey
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA.
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27
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McCotter L, Douglas P, Laur C, Gandy J, Fitzpatrick L, Rajput-Ray M, Ray S. Hydration education: developing, piloting and evaluating a hydration education package for general practitioners. BMJ Open 2016; 6:e012004. [PMID: 27927656 PMCID: PMC5168638 DOI: 10.1136/bmjopen-2016-012004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To (1) assess the hydration knowledge, attitudes and practices (KAP) of doctors; (2) develop an evidence-based training package; and (3) evaluate the impact of the training package. DESIGN Educational intervention with impact evaluation. SETTING Cambridgeshire, UK. PARTICIPANTS General practitioners (GPs (primary care physicians)). INTERVENTIONS Hydration and healthcare training. MAIN OUTCOME MEASURES Hydration KAP score before and immediately after the training session. RESULTS Knowledge gaps of doctors identified before the teaching were the definition of dehydration, European Food Safety Authority water intake recommendations, water content of the human body and proportion of water from food and drink. A face-to-face teaching package was developed on findings from the KAP survey and literature search. 54 questionnaires were completed before and immediately after two training sessions with GPs. Following the training, total hydration KAP scores increased significantly (p<0.001; median (25th, 75th centiles); 32 (29, 34)). Attendees rated the session as excellent or good (90%) and reported the training was likely to influence their professional practice (100%). CONCLUSIONS The training package will continue to be developed and adapted, with increased focus on follow-up strategies as well as integration into medical curricula and standards of practice. However, further research is required in the area of hydration care to allow policymakers to incorporate hydration awareness and care with greater precision in local and national policies.
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Affiliation(s)
- L McCotter
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - P Douglas
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - C Laur
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Department of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - J Gandy
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Nutrition and Dietetics, University of Hertfordshire, Hatfield Hertfordshire, UK
| | - L Fitzpatrick
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
| | - M Rajput-Ray
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
| | - S Ray
- UK Need for Nutrition Education/Innovation Programme in Partnership with the Medical Research Council's Elsie Widdowson Laboratory in Cambridge, and the British Dietetic Association, Cambridge, UK
- Cambridge University Hospitals and School of Clinical Medicine, Cambridge, UK
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28
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Doré B, Meria P. A great contributor to the French urological science: Michel Daudon. CR CHIM 2016. [DOI: 10.1016/j.crci.2014.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Scales CD, Tasian GE, Schwaderer AL, Goldfarb DS, Star RA, Kirkali Z. Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health. Clin J Am Soc Nephrol 2016; 11:1305-1312. [PMID: 26964844 PMCID: PMC4934851 DOI: 10.2215/cjn.13251215] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment.
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Affiliation(s)
- Charles D. Scales
- Duke Clinical Research Institute and Division of Urologic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Gregory E. Tasian
- Children’s Hospital of Philadelphia and Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrew L. Schwaderer
- Department of Pediatrics, Section of Nephrology, Nationwide Children’s Hospital, Columbus, Ohio
| | - David S. Goldfarb
- Division of Nephrology, New York University School of Medicine, New York, New York; and
| | - Robert A. Star
- Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Ziya Kirkali
- Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
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30
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Thornton SN. Increased Hydration Can Be Associated with Weight Loss. Front Nutr 2016; 3:18. [PMID: 27376070 PMCID: PMC4901052 DOI: 10.3389/fnut.2016.00018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/30/2016] [Indexed: 12/25/2022] Open
Abstract
This mini-review develops the hypothesis that increased hydration leads to body weight loss, mainly through a decrease in feeding, and a loss of fat, through increased lipolysis. The publications cited come from animal, mainly rodent, studies where manipulations of the central and/or the peripheral renin–angiotensin system lead to an increased drinking response and a decrease in body weight. This hypothesis derives from a broader association between chronic hypohydration (extracellular dehydration) and raised levels of the hormone angiotensin II (AngII) associated with many chronic diseases, such as obesity, diabetes, cancer, and cardiovascular disease. Proposed mechanisms to explain these effects involve an increase in metabolism due to hydration expanding cell volume. The results of these animal studies often can be applied to the humans. Human studies are consistent with this hypothesis for weight loss and for reducing the risk factors in the development of obesity and type 2 diabetes.
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Affiliation(s)
- Simon N Thornton
- INSERM U_1116, Université de Lorraine , Vandoeuvre les Nancy , France
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31
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Feehally J, Khosravi M. Effects of acute and chronic hypohydration on kidney health and function. Nutr Rev 2016; 73 Suppl 2:110-9. [PMID: 26290296 DOI: 10.1093/nutrit/nuv046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The kidneys play a critical role in the homeostasis of body fluid tonicity and effective circulating volume. Renal homeostatic mechanisms are frequently challenged in acutely ill people. Fluid depletion causing hypovolemia may result in renal hypoperfusion that, if left untreated, may lead to acute kidney failure. Some populations, notably older people and neonates, are less tolerant of extremes in fluid loading and deprivation, similar to those with established chronic kidney disease. Risk of kidney injury during fluid depletion is increased by medications including diuretics, nonsteroidal antiinflammatory drugs, and renin-angiotensin system blockers. There is no consistent evidence indicating that lower-than-average fluid intake can cause chronic kidney disease, nor accelerate progression of established kidney disease. Increasing consumption of sugar-containing beverages is, however, a major concern for kidney health as a precursor of obesity and diabetes. There is no evidence that high dietary protein intake can cause chronic kidney disease, nor accelerate progression of established kidney disease. Idiosyncratic, adverse renal responses have been described with creatine supplements. There are only a few clinical conditions for which high fluid intake should be considered. These include recurrent kidney stones or urinary tract infections and, possibly, polycystic kidney disease.
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Affiliation(s)
- John Feehally
- J. Feehally is with the John Walls Renal Unit, Leicester General Hospital and Department of Infection, Immunity & Inflammation, University of Leicester, United Kingdom. M. Khosravi is with the Royal Free & University College London Centre for Nephrology, London, United Kingdom.
| | - Maryam Khosravi
- J. Feehally is with the John Walls Renal Unit, Leicester General Hospital and Department of Infection, Immunity & Inflammation, University of Leicester, United Kingdom. M. Khosravi is with the Royal Free & University College London Centre for Nephrology, London, United Kingdom
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32
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Tarplin S, Monga M, Stern KL, McCauley LR, Sarkissian C, Nguyen MM. Predictors of Reporting Success With Increased Fluid Intake Among Kidney Stone Patients. Urology 2016; 88:49-56. [DOI: 10.1016/j.urology.2015.10.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/26/2015] [Accepted: 10/26/2015] [Indexed: 12/27/2022]
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33
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The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease? Urolithiasis 2015; 44:83-90. [PMID: 26667826 PMCID: PMC4724361 DOI: 10.1007/s00240-015-0842-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/05/2015] [Indexed: 01/27/2023]
Abstract
Whether prevention of Urolithiasis is worthwhile is the outcome of the balance between efficacy of prevention and costs and efforts related of respectively prevention and treatment of a new stone. Well controlled trials demonstrate that effective prevention of new stone formation is possible using medical treatment and lifestyle interventions. In long-term general practice the results obtained with preventive interventions is disappointing. Low and diminishing long-term compliance to the intervention is a major cause for this. Both the long-term aspect and the natural resistance to lifestyle changes contribute to this low compliance. From an analysis of the existing data on trials of preventive interventions and from experiences obtained in other patient groups where lifestyle changes are applied I will make the case that self-empowerment of the patient using m-health lifestyle coaching (a smart phone application) can considerably enhance the level of prevention that is obtained in general practice. In conclusion, I will describe what features will improve usage and efficacy of such an app.
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34
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Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease. Urolithiasis 2015; 44:9-26. [PMID: 26645870 DOI: 10.1007/s00240-015-0849-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
Abstract
This review describes the various dietary regimens that have been used to advise patients on how to prevent the recurrence of their calcium-containing kidney stones. The conclusion is that although there is some general advice that may be useful to many patients, it is more efficacious to screen each patient individually to identify his/her main urinary, metabolic, nutritional, environmental, and lifestyle risk factors for stone-formation and then tailor specific advice for that particular patient based on the findings from these investigations. If the patient can be motivated to adhere strictly to this conservative approach to the prophylactic management of their stone problem over a long time period, then it is possible to prevent them from forming further stones. This approach to stone management is considerably less expensive than any of the procedures currently available for stone removal or disintegration. In the UK, for each new stone episode prevented by this conservative approach to prophylaxis it is calculated to save the Health Authority concerned around £2000 for every patient treated successfully. In the long term, this accumulates to a major saving within each hospital budget if most stone patients can be prevented from forming further stones and when the savings are totalled up country-wide saves the National Exchequer considerable sums in unclaimed Sick Pay and industry a significant number of manpower days which would otherwise be lost from work. It is also of immense relief and benefit to the patients not to have to suffer the discomfort and inconvenience of further stone episodes.
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35
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Abstract
Aim. The aim of this study was to investigate dietitians’ knowledge, attitudes, and practices (KAP) regarding hydration and patient care. Methods. A cross-sectional online survey was administered to UK dietitians via the British Dietetic Association monthly newsletter and included 18 items on hydration knowledge (n=8), attitudes (n=4), and practices (n=6). KAP scores were calculated by adding the total number of correct knowledge responses and by ranking attitude and practice responses on a Likert scale. Results. 97 dietitians completed the online survey and displayed varying levels of KAP regarding hydration and patient care. The mean unweighted scores were knowledge 5.0 (±1.3) out of 8; attitude 13.9 (±1.3) out of 16; practice 14.9 (±2.6) out of 24. Dietitians appeared to be guided by clinical reasoning and priorities for nutrition care. Conclusions. There may be scope to further assess and potentially enhance the KAP of dietitians regarding hydration and patient care. Innovative approaches to hydration promotion are warranted and may include focusing on dietitians’ personal hydration status, increasing communication with other healthcare professionals, and partnering with patients to take a proactive role in hydration monitoring.
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36
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Twenty-four-hour urine osmolality as a physiological index of adequate water intake. DISEASE MARKERS 2015; 2015:231063. [PMID: 25866433 PMCID: PMC4381985 DOI: 10.1155/2015/231063] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/06/2015] [Indexed: 12/05/2022]
Abstract
While associations exist between water, hydration, and disease risk, research quantifying the dose-response effect of water on health is limited. Thus, the water intake necessary to maintain optimal hydration from a physiological and health standpoint remains unclear. The aim of this analysis was to derive a 24 h urine osmolality (UOsm) threshold that would provide an index of “optimal hydration,” sufficient to compensate water losses and also be biologically significant relative to the risk of disease. Ninety-five adults (31.5 ± 4.3 years, 23.2 ± 2.7 kg·m−2) collected 24 h urine, provided morning blood samples, and completed food and fluid intake diaries over 3 consecutive weekdays. A UOsm threshold was derived using 3 approaches, taking into account European dietary reference values for water; total fluid intake, and urine volumes associated with reduced risk for lithiasis and chronic kidney disease and plasma vasopressin concentration. The aggregate of these approaches suggest that a 24 h urine osmolality ≤500 mOsm·kg−1 may be a simple indicator of optimal hydration, representing a total daily fluid intake adequate to compensate for daily losses, ensure urinary output sufficient to reduce the risk of urolithiasis and renal function decline, and avoid elevated plasma vasopressin concentrations mediating the increased antidiuretic effort.
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37
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Johnson EC, Muñoz CX, Le Bellego L, Klein A, Casa DJ, Maresh CM, Armstrong LE. Markers of the hydration process during fluid volume modification in women with habitual high or low daily fluid intakes. Eur J Appl Physiol 2015; 115:1067-74. [PMID: 25564016 DOI: 10.1007/s00421-014-3088-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/17/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Human daily total water intake (TWI) has a large inter-individual range. Recently, water supplementation has been suggested as a potential preventative and therapeutic modality. Thus, we aimed to measure hydration biomarkers in women with high (HIGH) versus low (LOW) daily TWI to determine baseline differences, and the efficacy of these markers during a systematic alteration in TWI. METHODS This cohort study identified 14 HIGH [3.34 (0.56) L day(-1)] and 14 LOW [1.62 (0.48) L day(-1)] from 120 women. Next, fluid intake was decreased in HIGH [2.00 (0.21) L day(-1)] while LOW increased [3.50 (0.13) L day(-1)] across 4 days. Body mass, fluid intake, serum osmolality (S osmo), total plasma protein (TPP), 24 h urine osmolality, and 24 h urine volume, were measured on each day of modified TWI. Estimated plasma volume (E pv) was calculated using measured body mass and hematocrit values. RESULTS At baseline, urinary markers and TPP differentiated HIGH from LOW [7.0 (0.3) versus 7.3 (0.3) mg dL(-1), respectively]. Upon TWI intervention, (1) body mass decreased in HIGH [-0.7 (1.1) kg, p = 0.010)] but did not increase in LOW [+0.0 (0.6) kg, p = 0.110], (2) E pv decreased 2.1 (2.4) %, p = 0.004, (3) urine osmolality increased in HIGH [397 (144)-605 (230) mOsm kg(-1), p < 0.001] and decreased in LOW [726 (248)-265 (97) mOsm kg(-1) p < 0.001], and (4) no changes of serum osmolality occurred in either HIGH or LOW (all p > 0.05). CONCLUSIONS Urinary markers and TPP are sensitive measures to habitual high and low TWI and to changes in TWI. Both groups through urinary and some hematological responses following TWI manipulation achieved regulation of hemoconcentration.
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Affiliation(s)
- Evan C Johnson
- Department of Health, Human Performance, and Recreation, University of Arkansas, 155 Stadium Dr, Fayetteville, AR, 72701, USA,
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38
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Castiglione V, Jouret F, Bruyère O, Dubois B, Thomas A, Waltregny D, Bekaert AC, Cavalier É, Gadisseur R. [Epidemiology of urolithiasis in Belgium on the basis of a morpho-constitutional classification]. Nephrol Ther 2014; 11:42-9. [PMID: 25488796 DOI: 10.1016/j.nephro.2014.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 12/13/2022]
Abstract
Urolithiasis is a common condition, with a prevalence of ∼10% and a male/female ratio above 1 according to large national series. Various types of urinary stones have been described upon their mineral content and/or their morphology. Hence, a combined morpho-constitutional (M-C) classification has been proposed. In order to detail the prevalence of urolithiasis in general and of each M-C type in particular upon age and gender in Belgium, we retrospectively studied the database of a reference center for urolithiasis analysis. Between 2010 and 2013, 2195 stones were characterized. We excluded 45 non-biological stones and 281 stones, which originated from outside the study zone. Among 1869 stones, 1293 (69.2%) affected men. Prevalence peak of urolithiasis was observed between 50-60 years of age in both genders. The M-C analysis was available for 1854 stones (99.2%): multiple morphological types were concomitantly identified in 49.3%. In the whole population, the main mineral constituent was whewellite (54.4%), mainly organized as type Ia (94%). Weddellite was found in 19.8%, with an equal distribution between types IIa and IIb. Uric acid was the 3rd most frequent constituent in man, with a similar distribution between IIIa and IIIb. Phosphate was uncommon in man (8.2%), but frequent in woman (26.6%) with a type IVa1 organization. Prevalence of M-C types changes with aging, i.e. decrease of weddellite and increase of whewellite and uric acid in both genders. This retrospective analysis of a single-center database of urinary stones helps characterize the M-C epidemiology of urolithiasis in Belgium.
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Affiliation(s)
- Vincent Castiglione
- Département de biologie clinique, service de chimie clinique, centre hospitalier universitaire de Liège (ULg CHU), Liège, Belgique
| | - François Jouret
- Département de médecine interne, service de néphrologie, ULg CHU, Liège, Belgique
| | - Olivier Bruyère
- Unité de soutien méthodologique en épidémiologie et en biostatistiques, service de santé publique, épidémiologie et économie de la santé, université de Liège, Liège, Belgique
| | - Bernard Dubois
- Département de médecine interne, service de néphrologie, ULg CHU, Liège, Belgique
| | - Alexandre Thomas
- Département de chirurgie, service d'urologie, ULg CHU, Liège, Belgique
| | - David Waltregny
- Département de chirurgie, service d'urologie, ULg CHU, Liège, Belgique
| | - Anne-Catherine Bekaert
- Département de biologie clinique, service de chimie clinique, centre hospitalier universitaire de Liège (ULg CHU), Liège, Belgique
| | - Étienne Cavalier
- Département de biologie clinique, service de chimie clinique, centre hospitalier universitaire de Liège (ULg CHU), Liège, Belgique
| | - Romy Gadisseur
- Département de biologie clinique, service de chimie clinique, centre hospitalier universitaire de Liège (ULg CHU), Liège, Belgique.
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Chertin B. A 24 h urine collection is essential in nephrolithiasis evaluation. Nat Rev Urol 2014; 11:552-3. [DOI: 10.1038/nrurol.2014.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- Max Lafontan
- *Prof. Dr. Max Lafontan, Inserm/UPS UMR 1048 — Institut des Maladies Métaboliques et Cardiovasculaires, BP84225, 31432 Toulouse Cedex 4 (France),
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Schoen T, Blum J, Paccaud F, Burnier M, Bochud M, Conen D. Factors associated with 24-hour urinary volume: the Swiss salt survey. BMC Nephrol 2013; 14:246. [PMID: 24199987 PMCID: PMC4226251 DOI: 10.1186/1471-2369-14-246] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/29/2013] [Indexed: 01/05/2023] Open
Abstract
Background Low 24-hour urine volume (24UV) may be a significant risk factor for decline in kidney function. We therefore aimed to study associated markers and possible determinants of 24UV in a sample of the Swiss population. Methods The cross-sectional Swiss Salt Study included a population-based sample of 1535 (746 men and 789 women) individuals from three linguistic regions of Switzerland. Data from 1300 subjects were available for the present analysis. 24UV was measured using 24-hour urine collection. Determinants of 24UV were identified using multivariable linear regression models. Results In bivariate analysis, 24UV was higher in women compared to men (2000 ml/24 h [interquartile range (IQR): 1354, 2562] versus 1780 ml/24 h [IQR: 1244, 2360], p = 0.002). In multivariable regression analyses, independent associated markers of 24UV were female sex (β = 280, 95% confidence interval [CI]: 174, 386, p < 0.0001), fluid intake (β = 604, 95% CI: 539, 670, p < 0.0001), sodium excretion (β = 4.2, 95% CI: 3.4, 4.9, p < 0.0001) age (β = 6.6, CI: 3.4, 9.7, p < .0001), creatinine clearance (β = 2.4, CI: 0.2, 4.6, p = 0.04), living in the German-speaking part of Switzerland (β = 124, CI: 29, 219, p = 0.01), alcohol consumption (β = 41, CI: 9, 73, p = 0.01 for increasing categories of alcohol consumption), body mass index (β = −32, CI: -45, -18, p < 0.0001), current smoking (β = −146, CI: -265, -26, p = 0.02), and consumption of meat and cold cut (β = −56, CI: -108, -5, p = 0.03). Conclusion In this large population-based, cross-sectional study, we found several strong and independent correlates for 24UV. These findings may be important to improve our understanding in the development of chronic kidney disease.
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Affiliation(s)
| | | | | | | | | | - David Conen
- Department of Medicine, University Hospital, Basel, Switzerland.
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Re: Primary Prevention of Nephrolithiasis is Cost-Effective for a National Healthcare System. J Urol 2013; 190:902. [DOI: 10.1016/j.juro.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2013] [Indexed: 11/23/2022]
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Abstract
Office management of stone disease is an important component of a urologist's practice. Evaluation should include analysis of stone composition, 24-hour urine studies, identification of modifiable risk factors, and targeted dietary, lifestyle, and/or medical therapy. A sizeable portion of investigated etiologies and risk factors for stone disease have centered on the complex interplay between obesity, diabetes, and other disease states that comprise the metabolic syndrome. Alternatives to traditional preventive therapy, such as probiotics and various fruit juices, are still being studied but may prove useful adjuncts to traditional preventive therapy, where the mainstays remain increased fluid intake, dietary modification, and pharmacologic therapy. Future studies on preventive therapy of urolithiasis are likely to focus on strategies to increase compliance, cost-effectiveness, and systems-based implementation.
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