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Guimerà J, Martínez A, Quetglas JLB, Sanchis P, Costa-Bauzá A, Pieras E, Grases F. Phytate Effects on Incomplete Distal Renal Tubular Acidosis. J Clin Med 2024; 13:5059. [PMID: 39274272 PMCID: PMC11395708 DOI: 10.3390/jcm13175059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Adults who have incomplete distal renal tubular acidosis (dRTA) may present with recurrent urolithiasis due to metabolic acidosis, leading to bone resorption, which in turn causes hypercalciuria and urine alkalinization (pH > 6.0). Oral potassium citrate is the most commonly used treatment for dRTA, but some patients cannot tolerate this treatment. The objective of this single-arm study was to evaluate the effect of phytate, an inhibitor of bone resorption, on calciuria of patients with incomplete dRTA. Methods: The calciuria levels of 16 patients who had incomplete dRTA with urolithiasis and could not tolerate potassium citrate treatment were recorded before (baseline) and after 6 months of treatment with oral calcium magnesium phytate (380 mg every 12 h). There were no dietary modifications or other treatments. Results: The baseline calciuria was 317 ± 81 mg/24 h and the level after 6 months was 221 ± 38 mg/24 h (p < 0.005). Conclusions: Our results suggest that calcium magnesium phytate should be considered as an alternative or adjunctive treatment for hypercalciuria in patients with incomplete dRTA.
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Affiliation(s)
- Jordi Guimerà
- Urology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain
| | - Ana Martínez
- Urology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain
| | - José Luis Bauzá Quetglas
- Urology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain
| | - Pilar Sanchis
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Antonia Costa-Bauzá
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Enrique Pieras
- Urology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain
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Almeras C, Assoun J, Baboudjian M, Touzani A, Pradere B. Correlation analysis between renal papillae Hounsfield density (PHD) and endoscopic papillary description in stone formers. Sci Rep 2024; 14:18582. [PMID: 39127767 PMCID: PMC11316768 DOI: 10.1038/s41598-024-69390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024] Open
Abstract
We aimed to evaluate the correlation between endoscopic papillary abnormalities (PA) and high renal papilla Hounsfield density (PHD) on CT scan in patients who underwent flexible ureteroscopic treatment (fURS) for renal stones. We retrospectively assessed patients from a prospectively collected database who were treated with fURS for renal stones between May 2016 and October 2020. PHD was measured on preoperative CT-scan by a radiologist blinded from the intraoperative aspect of the papillae. Correlation was examined between high PHD (≥ 43 HU) and PA described in fURS, stone composition, metabolic abnormalities, … Out of 159 consecutive cases, 131 were eligible for analysis with available preoperative CT-scan. Median age was 55 years (IQR 43-67) and median PHD was 40 (IQR 36-45). Eighty patients (61%) had PHD < 43, and 51 patients (39%) had PHD ≥ 43. In univariate and multivariate analysis, only young age (p-value = 0.017) and insufficient diuresis (p-value = 0.008) were correlated with high PHD. No significant correlation was found with PA described during endoscopy, including the intensity of Randall's plaques. In this study, high PHD appears to be only a sign of insufficient diuresis, with no significant correlation with potential PA.
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Affiliation(s)
- Christophe Almeras
- Department of Urology UROSUD, Ramsay Santé, La Croix du Sud Hospital, Quint Fonsegrives, France.
| | - Jacques Assoun
- Department of Radiology, Ramsay Santé La Croix du Sud Hospital, Quint Fonsegrives, France
| | | | - Alae Touzani
- Department of Urology UROSUD, Ramsay Santé, La Croix du Sud Hospital, Quint Fonsegrives, France
| | - Benjamin Pradere
- Department of Urology UROSUD, Ramsay Santé, La Croix du Sud Hospital, Quint Fonsegrives, France
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3
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De Coninck V, Skolarikos A, Juliebø-Jones P, Joris M, Traxer O, Keller EX. Advancements in stone classification: unveiling the beauty of urolithiasis. World J Urol 2024; 42:46. [PMID: 38244083 DOI: 10.1007/s00345-023-04746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/02/2023] [Indexed: 01/22/2024] Open
Abstract
PURPOSE Urolithiasis has become increasingly prevalent, leading to higher disability-adjusted life years and deaths. Various stone classification systems have been developed to enhance the understanding of lithogenesis, aid urologists in treatment decisions, and predict recurrence risk. The aim of this manuscript is to provide an overview of different stone classification criteria. METHODS Two authors conducted a review of literature on studies relating to the classification of urolithiasis. A narrative synthesis for analysis of the studies was used. RESULTS Stones can be categorized based on anatomical position, size, medical imaging features, risk of recurrence, etiology, composition, and morphoconstitutional analysis. The first three mentioned offer a straightforward approach to stone classification, directly influencing treatment recommendations. With the routine use of CT imaging before treatment, precise details like anatomical location, stone dimensions, and Hounsfield Units can be easily determined, aiding treatment planning. In contrast, classifying stones based on risk of recurrence and etiology is more complex due to dependencies on multiple variables, including stone composition and morphology. A classification system based on morphoconstitutional analysis, which combines morphological stone appearance and chemical composition, has demonstrated its value. It allows for the rapid identification of crystalline phase principles, the detection of crystalline conversion processes, the determination of etiopathogenesis, the recognition of lithogenic processes, the assessment of crystal formation speed, related recurrence rates, and guidance for selecting appropriate treatment modalities. CONCLUSIONS Recognizing that no single classification system can comprehensively cover all aspects, the integration of all classification approaches is essential for tailoring urolithiasis patient-specific management.
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Affiliation(s)
- Vincent De Coninck
- Department of Urology, Augustijnslei 100, Klina, 2930, Brasschaat, AZ, Belgium.
- Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands.
| | - Andreas Skolarikos
- Department of Urology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Manu Joris
- Faculty of Medicine, University Hospitals Leuven, Louvain, Belgium
| | - Olivier Traxer
- GRC N°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Arnhem, The Netherlands
- Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, Arnhem, The Netherlands
| | - Etienne Xavier Keller
- Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, The Netherlands
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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4
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Zhang Q, Wei H, Huang G, Jin L. CCL7 and olfactory transduction pathway activation play an important role in the formation of CaOx and CaP kidney stones. Front Genet 2024; 14:1267545. [PMID: 38235001 PMCID: PMC10791818 DOI: 10.3389/fgene.2023.1267545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
Background: The deposition of calcium oxalate (CaOx) and calcium phosphate (CaP) is the most common cause of kidney stone disease (KSD). Whether KSDs caused by CaOx and CaP have common genetic targets or signaling pathways remained unclear. Methods: The present study utilized public data GSE73680 to analyze differentially expressed genes between CaOx or CaP tissues and normal tissues, respectively. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of co-DEGs were performed. The protein-protein interaction (PPI) network was constructed to identify hub genes, and the top hub gene was selected for gene set enrichment analysis (GSEA). Finally, real-time PCR of patients' urine was performed to validate the bioinformatic results. Results: In total, 155 significantly co-upregulated DEGs and 64 co-downregulated DEGs were obtained from the datasets. The Gene Ontology analysis showed that DEGs were significantly enriched in chemical stimulus in sensory perception, detection of chemical stimulus in sensory perception of smell, and olfactory receptor activity. The KEGG analysis showed that the olfactory transduction pathway was significantly enriched. According to protein-protein interaction, 10 genes were identified as the hub genes, and CCL7 was the top hub gene. The olfactory transduction, maturity-onset diabetes of the young, linoleic acid metabolism, and fat digestion and absorption were significantly enriched in the high-CCL7 subgroup by GSEA. In total, 9 patients who had primarily CaOx mixed with some CaP stones and 9 healthy subjects were enrolled. The RT-PCR results showed that CCL7 level in the stone group was significantly higher than that in the control group (p < 0.05). For the olfactory transduction pathway, the expression of OR10A5, OR9A2, and OR1L3 was significantly upregulated in the stone group compared with the control group (p < 0.05). Conclusion: CCL7 may play a key role in the development of both CaOx and CaP, and this process may depend on olfactory transduction pathway activation.
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Affiliation(s)
- Qiankun Zhang
- Division of Nephrology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, China
| | - Hhuiling Wei
- Division of Nephrology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, China
| | - Gang Huang
- Division of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, China
| | - Lie Jin
- Division of Nephrology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, China
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Almeras C, Estrade V, Meria P. 2022 Recommendations of the AFU Lithiasis Committee: Endoscopic description of renal papillae and stones. Prog Urol 2023; 33:766-781. [PMID: 37918978 DOI: 10.1016/j.purol.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
Endoscopic observation is performed during treatments by flexible ureteroscopy to differentiate in situ between renal papillary abnormalities and stones based on their concordance with Daudon's morphological/composition descriptions adapted to endoscopy. These intraoperative visual analyses are now an integral part of the urinary stone disease diagnostic approach in addition to the morphological/structural and spectrophotometric analysis that remains the reference exam, but that loses information on the stone component representativeness due to the development of in situ laser lithotripsy. These are the first practical recommendations on the endoscopic description of renal papillae and stones. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendations (CPR) and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis [EAU Guidelines on urolithiasis. 2022]) and their adaptability to the French context.
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Affiliation(s)
- C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
| | - V Estrade
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France
| | - P Meria
- Service d'urologie, Hôpital Saint-Louis, AP-HP-Centre université Paris cité, Paris, France
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Daudon M, Haymann JP, Estrade V, Meria P, Almeras C. 2022 Recommendations of the AFU Lithiasis Committee: Epidemiology, stone analysis and composition. Prog Urol 2023; 33:737-765. [PMID: 37918977 DOI: 10.1016/j.purol.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
The incidence of urinary lithiasis is rising steadily in industrialized countries, and its prevalence in the general population of France is estimated at 10%. Renal colic accounts for 1-2% of emergency department consultations. At a time when the new LASER stone fragmentation techniques available to urologists will lead to ever finer in situ pulverization of stones, the exact identification of the compounds that form the stone is essential for etiological diagnosis. Constitutional analysis by infrared spectrophotometry or X-ray diffraction is therefore recommended, to be complemented by morphological typing of the calculi. METHODOLOGY: These recommendations have been drawn up using two methods: the Recommendation for Clinical Practice (RPC) method and the ADAPTE method, depending on whether or not the issue was considered in the EAU recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context.
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Affiliation(s)
- M Daudon
- CRISTAL Laboratory, Tenon Hospital, SFBC, Paris, France; Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France
| | - J-P Haymann
- Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France; Service d'Explorations Fonctionnelles Multidisciplinaires, Tenon Hospital, SP, Paris, France
| | - V Estrade
- Department of Urology, CHU Pellegrin, Bordeaux, France
| | - P Meria
- Service d'Urologie, Hôpital Saint-Louis, AP-HP-Centre Université Paris Cité, Paris, France
| | - C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
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7
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Wagner CA, Unwin R, Lopez-Garcia SC, Kleta R, Bockenhauer D, Walsh S. The pathophysiology of distal renal tubular acidosis. Nat Rev Nephrol 2023; 19:384-400. [PMID: 37016093 DOI: 10.1038/s41581-023-00699-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/06/2023]
Abstract
The kidneys have a central role in the control of acid-base homeostasis owing to bicarbonate reabsorption and production of ammonia and ammonium in the proximal tubule and active acid secretion along the collecting duct. Impaired acid excretion by the collecting duct system causes distal renal tubular acidosis (dRTA), which is characterized by the failure to acidify urine below pH 5.5. This defect originates from reduced function of acid-secretory type A intercalated cells. Inherited forms of dRTA are caused by variants in SLC4A1, ATP6V1B1, ATP6V0A4, FOXI1, WDR72 and probably in other genes that are yet to be discovered. Inheritance of dRTA follows autosomal-dominant and -recessive patterns. Acquired forms of dRTA are caused by various types of autoimmune diseases or adverse effects of some drugs. Incomplete dRTA is frequently found in patients with and without kidney stone disease. These patients fail to appropriately acidify their urine when challenged, suggesting that incomplete dRTA may represent an intermediate state in the spectrum of the ability to excrete acids. Unrecognized or insufficiently treated dRTA can cause rickets and failure to thrive in children, osteomalacia in adults, nephrolithiasis and nephrocalcinosis. Electrolyte disorders are also often present and poorly controlled dRTA can increase the risk of developing chronic kidney disease.
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Affiliation(s)
- Carsten A Wagner
- Institute of Physiology, University of Zurich, Zurich, Switzerland.
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK.
| | - Robert Unwin
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Sergio C Lopez-Garcia
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Robert Kleta
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Detlef Bockenhauer
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Stephen Walsh
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
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8
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Description of Stone Morphology and Crystalluria Improve Diagnosis and Care of Kidney Stone Formers. Healthcare (Basel) 2022; 11:healthcare11010002. [PMID: 36611462 PMCID: PMC9818792 DOI: 10.3390/healthcare11010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Stone analysis by physical methods is critical to determine their chemical nature and to diagnose the underlying conditions affecting kidney stone formers. This analysis should be completed by a morphologic examination of stone surface and section, leading to the diagnosis of anatomical or metabolic disorders and of specific diseases. Crystalluria study, the analysis of urine crystals, provides complementary information and is extremely useful for both diagnosis and patient follow-up. This review describes briefly how these techniques may be used and in which conditions stone morphology and urine crystal description are particularly relevant for patients medical care.
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The characterization of in vivo urinary phospate stones by spectral CT. Urolithiasis 2022; 51:10. [DOI: 10.1007/s00240-022-01388-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
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10
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Lithiase urinaire de type IVa2 et pathologies associées : à propos de 3 cas. Nephrol Ther 2022; 18:570-574. [DOI: 10.1016/j.nephro.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 11/11/2022]
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Bazin D. Nanomaterials in medicine: a concise review of nanomaterials intended to treat pathology, nanomaterials induced by pathology, and pathology provoked by nanomaterials. CR CHIM 2022. [DOI: 10.5802/crchim.194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Bazin D, Rabant M, Mathurin J, Petay M, Deniset-Besseau A, Dazzi A, Su Y, Hessou EP, Tielens F, Borondics F, Livrozet M, Bouderlique E, Haymann JP, Letavernier E, Frochot V, Daudon M. Cystinuria and cystinosis are usually related to L-cystine: is this really the case for cystinosis? A physicochemical investigation at micrometre and nanometre scale. CR CHIM 2022. [DOI: 10.5802/crchim.135] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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13
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Colboc H, Moguelet P, Letavernier E, Frochot V, Bernaudin JF, Weil R, Rouzière S, Senet P, Bachmeyer C, Laporte N, Lucas I, Descamps V, Amode R, Brunet-Possenti F, Kluger N, Deschamps L, Dubois A, Reguer S, Somogyi A, Medjoubi K, Refregiers M, Daudon M, Bazin D. Pathologies related to abnormal deposits in dermatology: a physico-chemical approach. CR CHIM 2022. [DOI: 10.5802/crchim.153] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bazin D, Daudon M, Frochot V, Haymann JP, Letavernier E. Foreword to microcrystalline pathologies: combining clinical activity and fundamental research at the nanoscale. CR CHIM 2022. [DOI: 10.5802/crchim.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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15
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Bazin D, Lucas IT, Rouzière S, Elkaim E, Mocuta C, Réguer S, Reid DG, Mathurin J, Dazzi A, Deniset-Besseau A, Petay M, Frochot V, Haymann JP, Letavernier E, Verpont MC, Foy E, Bouderlique E, Colboc H, Daudon M. Profile of an “at cutting edge” pathology laboratory for pathological human deposits: from nanometer to in vivo scale analysis on large scale facilities. CR CHIM 2022. [DOI: 10.5802/crchim.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Pozdzik A, Hamade A, Racapé J, Roumeguère T, Wolff F, Cotton F. The epidemiology of kidney stones in Belgium based on Daudon’s morpho-constitutional classification: a retrospective, single-center study. CR CHIM 2022. [DOI: 10.5802/crchim.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Bazin D, Bouderlique E, Daudon M, Frochot V, Haymann JP, Letavernier E, Tielens F, Weil R. Scanning electron microscopy—a powerful imaging technique for the clinician. CR CHIM 2022. [DOI: 10.5802/crchim.101] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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18
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Daudon M, Frochot V, Bazin D, Haymann JP, Letavernier E. Medullary sponge kidney: what kind of stones? CR CHIM 2022. [DOI: 10.5802/crchim.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Almeras C, Pradere B, Estrade V, Meria P, French Urological Association OBOTLCOT. Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review. J Clin Med 2021; 10:jcm10132888. [PMID: 34209668 PMCID: PMC8267668 DOI: 10.3390/jcm10132888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic-RGDS, UroSud, 52 bis Chemin de Ribaute, Boite 301, 31130 Quint Fonsegrives, France
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Correspondence: ; Tel.: +33-53-202-7202; Fax: +33-53-202-7203
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
| | - Vincent Estrade
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, CHU Pellegrin, 33300 Bordeaux, France
| | - Paul Meria
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, Saint Louis Hospital, Denis Diderot University, 75010 Paris, France
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20
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Trepiccione F, Walsh SB, Ariceta G, Boyer O, Emma F, Camilla R, Ferraro PM, Haffner D, Konrad M, Levtchenko E, Lopez-Garcia SC, Santos F, Stabouli S, Szczepanska M, Tasic V, Topaloglu R, Vargas-Poussou R, Wlodkowski T, Bockenhauer D. Distal Renal Tubular Acidosis: ERKNet/ESPN Clinical Practice Points. Nephrol Dial Transplant 2021; 36:1585-1596. [PMID: 33914889 DOI: 10.1093/ndt/gfab171] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
Distal renal tubular acidosis (dRTA) is characterised by an impaired ability of the distal tubule to excrete acid, leading to metabolic acidosis. Associated complications include bone disease, growth failure, urolithiasis and hypokalaemia. Due to its rarity, there is a limited evidence to guide diagnosis and management, however, available data strongly suggest that metabolic control of the acidosis by alkali supplementation can halt or revert almost all complications. Despite this, cohort studies show that adequate metabolic control is present in only about half of patients, highlighting problems with treatment provision or adherence. With these clinical practice points the authors, part of the working groups tubulopathies in the European Rare Kidney Disease Reference network (ERKnet) and inherited kidney diseases of the European Society for Paediatric Nephrology (ESPN) aim to provide guidance for the management of patients with dRTA to facilitate adequate treatment and establish an initial best practice standard against which treatment of patients can be audited.
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Affiliation(s)
- Francesco Trepiccione
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Steven B Walsh
- Department of Renal Medicine, University College London, UK
| | - Gema Ariceta
- Division of Pediatric Nephrology. Hospital Universitario Vall d' Hebron. Universitat Autonoma de Barcelona. Barcelona, Spain
| | - Olivia Boyer
- Pediatric Nephrology, Necker Hospital, APHP, MARHEA, Imagine Institute, Paris University, Paris, France
| | - Francesco Emma
- Division of Nephrology, Bambino Gesu Children's Hospital - IRCCS, Rome, Italy
| | - Roberta Camilla
- Nephrology, Dialysis, Transplantation, Regina Margherita University Hospital, Turin, Italy
| | - Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School Children's Hospital, Hannover, Germany
| | - Martin Konrad
- Department of General Pediatrics, University Children's Hospital, Muenster, Germany
| | - Elena Levtchenko
- Division of Pediatric Nephrology, University Hospitals Leuven; Department of Development & Regeneration, Katholieke Universiteit Leuven, Belgium
| | - Sergio Camilo Lopez-Garcia
- Department of Renal Medicine, University College London, UK.,Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Fernando Santos
- Department of Pediatrics, Hospital Universitario Central de Asturias and Área de Pediatría, Dpto. de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Stella Stabouli
- 1st Department of Pediatrics, Aristotle University, Thessaloniki, Greece
| | | | - Velibor Tasic
- University Children's Hospital, Medical School, Skopje, Macedonia
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rosa Vargas-Poussou
- Department of Genetics, Centre de Références MARHEA, Hôpital Européen Georges Pompidou Assistance Publique Hôpitaux de Paris, Paris France
| | - Tanja Wlodkowski
- Department of Paediatric Nephrology, University Children's Hospital, Heidelberg, Germany
| | - Detlef Bockenhauer
- Department of General Pediatrics, University Children's Hospital, Muenster, Germany.,Division of Pediatric Nephrology, University Hospitals Leuven; Department of Development & Regeneration, Katholieke Universiteit Leuven, Belgium
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21
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Vidavsky N, Kunitake JAMR, Estroff LA. Multiple Pathways for Pathological Calcification in the Human Body. Adv Healthc Mater 2021; 10:e2001271. [PMID: 33274854 PMCID: PMC8724004 DOI: 10.1002/adhm.202001271] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/16/2020] [Indexed: 12/12/2022]
Abstract
Biomineralization of skeletal components (e.g., bone and teeth) is generally accepted to occur under strict cellular regulation, leading to mineral-organic composites with hierarchical structures and properties optimized for their designated function. Such cellular regulation includes promoting mineralization at desired sites as well as inhibiting mineralization in soft tissues and other undesirable locations. In contrast, pathological mineralization, with potentially harmful health effects, can occur as a result of tissue or metabolic abnormalities, disease, or implantation of certain biomaterials. This progress report defines mineralization pathway components and identifies the commonalities (and differences) between physiological (e.g., bone remodeling) and pathological calcification formation pathways, based, in part, upon the extent of cellular control within the system. These concepts are discussed in representative examples of calcium phosphate-based pathological mineralization in cancer (breast, thyroid, ovarian, and meningioma) and in cardiovascular disease. In-depth mechanistic understanding of pathological mineralization requires utilizing state-of-the-art materials science imaging and characterization techniques, focusing not only on the final deposits, but also on the earlier stages of crystal nucleation, growth, and aggregation. Such mechanistic understanding will further enable the use of pathological calcifications in diagnosis and prognosis, as well as possibly provide insights into preventative treatments for detrimental mineralization in disease.
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Affiliation(s)
- Netta Vidavsky
- Department of Chemical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel
| | - Jennie A M R Kunitake
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, 14853, USA
| | - Lara A Estroff
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, 14853, USA
- Kavli Institute at Cornell for Nanoscale Science, Ithaca, NY, 14853, USA
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22
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Corrales M, Doizi S, Barghouthy Y, Traxer O, Daudon M. Classification of Stones According to Michel Daudon: A Narrative Review. Eur Urol Focus 2020; 7:13-21. [PMID: 33288482 DOI: 10.1016/j.euf.2020.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
CONTEXT Morphoconstitutional analysis of urinary stones is perhaps the most important examination in the evaluation of a patient with urolithiasis. OBJECTIVE A comprehensive stone classification system was developed in the early 1990s by Michel Daudon, which included the main types of stones and their possible physiopathogenic origin. EVIDENCE ACQUISITION A narrative review of the articles published about this classification was conducted, without time limit. EVIDENCE SYNTHESIS Two analytical steps are needed for the classification process: the microscopic examination, which gives the stone morphology, and the physical analysis, which provides the stone constitution. Upon completion of a full analysis, knowledge of the principal crystal species of the stone is acquired. In addition, this analysis highlights the possible causes of the lithogenic process, taking in account less frequent, but severe, pathologies. CONCLUSIONS The aim of this report is to summarize the principal etiological causes for urinary stone formation thanks to the morphoconstitutional analysis and to present its contribution in the field of urinary stones. PATIENT SUMMARY We looked at all types of stones and found that their origin varies according to the underlying pathology of the patient.
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Affiliation(s)
- Mariela Corrales
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France; Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France.
| | - Steeve Doizi
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France; Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Yazeed Barghouthy
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France; Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Olivier Traxer
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France; Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Michel Daudon
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France; Department of Multidisciplinary Functional Explorations, AP-HP, Tenon Hospital, Sorbonne University, Paris, France
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23
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The surgeon's role on chemical investigations of the composition of urinary stones. Urolithiasis 2020; 48:435-441. [PMID: 32436004 DOI: 10.1007/s00240-020-01195-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/08/2020] [Indexed: 10/24/2022]
Abstract
The chemical analysis of an urolith is often interpreted as "stone's composition". However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of "stone composition". Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model "grown" under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith's more resistant parts remain intact while ESWL or laser-based stone fragmentation ("dusting"), the weak parts became fully disintegrated and removed from the body as fine-grained sludge-the stone's fine fraction is lost although its composition may carry important information on the stone's pathogenesis. Consequently, a "stone analysis" only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested.
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24
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Almeras C, Daudon M, Estrade V, Gautier JR, Traxer O, Meria P. Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update. World J Urol 2020; 39:177-185. [PMID: 32193654 PMCID: PMC7858204 DOI: 10.1007/s00345-020-03149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction To assess the use of the 2016 proposed classification of the renal papillary abnormalities during flexible ureteroscopy that aims to standardize their description. Patients and methods We performed a prospective monocentric single operator collection of the data using this classification during 88 consecutive flexible ureteroscopies required for renal stones treatment. Outcome measurements and statistical analysis: data of stones analysis (microscopy and infrared spectrophotometry) and of serum and urines biochemical samples have been compared with the results of the classified endoscopic descriptions. Results Mean duration of description was 81.4 s. We reported that 83% of the patients had Randall plaques (RP), as only 4.5% of the patients had no abnormality. Concerning the papillary stones and anchored stones were observed in 30.7% and aspect of intraductal crystallization (Sc) in 15.9%. Erosions were present in 55.7% and extrophic papillae in 8%. Sa1 and Pa2 were significantly correlated to RP, anchored stones (Sa) to papillary erosions and calcium phosphate stones to intraductal crystallization. Hypercalciuria was significantly higher in Sa2 than Sa1 stones. Conclusions The different descriptions in the 2016 classification were confirmed by the results of this study. Papillary abnormalities are consequences of stones development. Their descriptions could also improve the follow-up and the diagnosis of a metabolic lithogenesis. We recommend their systematic description during ureteroscopy. Some improvements are proposed to update this classification.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France.
| | - Michel Daudon
- Unit of Functional Explorations, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | | | - Jean Romain Gautier
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | - Paul Meria
- Department of Urology, Saint-Louis Hospital, Denis Diderot University, Paris, France
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25
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Wang S, Zhang Y, Zhang X, Tang Y, Li J. Upper urinary tract stone compositions: the role of age and gender. Int Braz J Urol 2020; 46:70-80. [PMID: 31851461 PMCID: PMC6968895 DOI: 10.1590/s1677-5538.ibju.2019.0278] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/31/2019] [Indexed: 02/08/2023] Open
Abstract
Objective: To analyze the compositions of upper urinary tract stones and investigate their distributions in different gender and age groups. Materials and Methods: Patients diagnosed with upper urinary tract stone disease between December 2014 and March 2018 were retrospectively reviewed. Patient's age, gender, BMI, comorbidities, stone event characteristics, and compositions were collected, and proportions of stone components in different gender and age groups were analyzed. Results: A total of 1532 stone analyses were performed (992 from males and 540 from females). The mean age was younger in males (p <0.001). Males included more cases with larger BMI, hyperuricemia, and obesity, while females had more urinary tract infections. Multiple components were present in 61.8% of stones. Calcium oxalate (CaOx) (67.0%) was the most common component, followed by uric acid (UA) (11.8%), infection stone (11.4%), calcium phosphate (CaP) (8.0%), cystine (1.1%), brushite (0.4%), and 2, 8-dihydroxyadenine (0.2%). Men contributed with more CaOx stones than women at age 30-49 years (all p <0.01) and more UA stones at 30-59 years (all p <0.05). Women contributed with more infection stones than men in age groups 30-49 and 60-69 years (all p <0.05), and more CaP stones at 30-49 years. The prevalence peak was 50-59 years in men and 60-69 years in women. Both genders had the lowest prevalence in adolescence. Prevalence of UA stones increased while that of infection stones decreased with aging in both genders. Conclusions: Age and sex had a strong association with distribution of stone compositions in this Chinese cohort.
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Affiliation(s)
- Shu Wang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China.,Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Yitian Zhang
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Xin Zhang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Yuzhe Tang
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jianxing Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
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26
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Guerlain J, Perie S, Lefevre M, Perez J, Vandermeersch S, Jouanneau C, Huguet L, Frochot V, Letavernier E, Weil R, Rouziere S, Bazin D, Daudon M, Haymann JP. Localization and characterization of thyroid microcalcifications: A histopathological study. PLoS One 2019; 14:e0224138. [PMID: 31648281 PMCID: PMC6812851 DOI: 10.1371/journal.pone.0224138] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 10/07/2019] [Indexed: 11/19/2022] Open
Abstract
Thyroid calcification is frequent in thyroid nodules. The aim of our study was to evaluate the prevalence of calcifications in thyroid tissue samples of patients with various thyroid diseases, and to identify their composition according to their localization. Among 50 thyroid samples included, 56% were malignant (papillary carcinoma) and 44% were benign (adenoma, multinodular goiter, Graves' disease, sarcoidosis). Calcifications were found in 95% of samples using polarised light microscopy, whereas only 12% were described in initial pathological reports. Three types were individualised and analyzed by infrared spectrometry (μFTIR): colloid calcifications composed of calcium oxalate, capsular calcifications and psammoma bodies, both composed of calcium phosphate. Of notice, psammoma bodies characterized by FE-SEM were composed of concentric structure suggesting a slow process for crystal deposition. Calcium phosphates were found only in malignant samples whereas calcium oxalate was not associated with a define pathology. Proliferation assessed by KI67 staining was high (33% of positive follicles), and RUNX2, OPN, and CD44 positive staining were detected in thyrocytes with a broad variation between samples. However, thyrocyte proliferation and differentiation markers were not associated with the number of crystals. TRPV5 and CaSR expression was also detected in thyrocytes. mRNA transcripts expression was confirmed in a subgroup of 10 patients, altogether with other calcium transporters such as PMCA1 or Cav1.3. Interestingly, TRPV5 mRNA expression was significantly associated with number of colloid calcifications (rho = -0.72; p = 0.02). The high prevalence of calcium oxalate crystals within colloid gel raises intriguing issues upon follicle physiology for calcium and oxalate transport.
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Affiliation(s)
- Joanne Guerlain
- Sorbonne Université, INSERM, UMR_S 1155, AP-HP, Hôpital Tenon, Paris, France
- * E-mail:
| | - Sophie Perie
- Service d’Oto-rhino-laryngologie et de Chirurgie Cervico-Faciale, Hôpital Tenon, Paris, France
| | - Marine Lefevre
- Service d’Anatomopathologie, Hôpital Tenon, Paris, France
| | - Joëlle Perez
- Sorbonne Université, INSERM, UMR_S 1155, AP-HP, Hôpital Tenon, Paris, France
| | | | | | - Léa Huguet
- Sorbonne Université, INSERM, UMR_S 1155, AP-HP, Hôpital Tenon, Paris, France
| | - Vincent Frochot
- Service d’Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpital Tenon, Paris, France
| | - Emmanuel Letavernier
- Sorbonne Université, INSERM, UMR_S 1155, AP-HP, Hôpital Tenon, Paris, France
- Service d’Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpital Tenon, Paris, France
| | - Raphael Weil
- Laboratoire de Physique des Solides, UMR CNRS 8502, Université Paris Sud, Université Paris Saclay, Orsay Cedex, France
| | - Stéphan Rouziere
- Laboratoire de Physique des Solides, UMR CNRS 8502, Université Paris Sud, Université Paris Saclay, Orsay Cedex, France
| | - Dominique Bazin
- Laboratoire de Chimie Physique, Université Paris Sud, Orsay, France
| | - Michel Daudon
- Service d’Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpital Tenon, Paris, France
| | - Jean-Philippe Haymann
- Sorbonne Université, INSERM, UMR_S 1155, AP-HP, Hôpital Tenon, Paris, France
- Service d’Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpital Tenon, Paris, France
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27
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Dong W, Hu R, Wu Q. A New Discovery of Calcium Phosphate Urinary Stones Formation Induced by Melamine: Nanocrystalline Assembly Mechanism. CHINESE J CHEM 2019. [DOI: 10.1002/cjoc.201900124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Wenya Dong
- School of Chemical Science and Engineering, Shanghai Key Laboratory of Chemical Assessment and SustainabilityTongji University Shanghai 200092 China
| | - Ruiming Hu
- Huashan HospitalFudan University Shanghai 200040 China
| | - Qingsheng Wu
- School of Chemical Science and Engineering, Shanghai Key Laboratory of Chemical Assessment and SustainabilityTongji University Shanghai 200092 China
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28
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Prevalence of distal renal tubular acidosis in patients with calcium phosphate stones. World J Urol 2019; 38:789-794. [PMID: 31079188 DOI: 10.1007/s00345-019-02804-9] [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: 01/25/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION AND PURPOSE Distal renal tubular acidosis (DRTA) is a metabolic disorder that associates urolithiasis and urinary pH > 6. The prevalence of DRTA in patients with calcium phosphate stones is not well known. The objective is to determine the prevalence of DRTA in patients with calcium phosphate stones and urinary pH above 6 based on the furosemide test. METHODS A total of 54 patients with calcium phosphate stones and urinary pH above 6.0 were submitted to the furosemide test. The association of DRTA with age, sex, type of stone, stone recurrence, stone bilaterality, 24-h urine biochemistry, and adverse effects of the furosemide test were examined. RESULTS The furosemide test indicated that 19 of 54 patients (35.2%) had DRTA. The sex ratio was similar in the two groups (p < 0.776). The DRTA group was significantly younger (p < 0.001), and had a higher prevalence of bilateral stones (p < 0.001), a higher prevalence of recurrent stones (p < 0.04), a lower plasma potassium level (p < 0.001), a higher urinary Ca level (p ≤ 0.05), and a lower urinary citrate level (p < 0.001). None of the patients reported adverse effects from the furosemide test. CONCLUSIONS There was a high prevalence of DTRA in patients with urinary pH above 6 and calcium phosphate stones. Young age, bilateral stones, stone recurrence, hypercalciuria, hypocitraturia, and plasma hypokalemia were associated with DRTA. None of the patients reported adverse effects of the furosemide test.
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29
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Nephrolithiasis secondary to inherited defects in the thick ascending loop of henle and connecting tubules. Urolithiasis 2018; 47:43-56. [PMID: 30460527 DOI: 10.1007/s00240-018-1097-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/08/2018] [Indexed: 12/19/2022]
Abstract
Twin and genealogy studies suggest a strong genetic component of nephrolithiasis. Likewise, urinary traits associated with renal stone formation were found to be highly heritable, even after adjustment for demographic, anthropometric and dietary covariates. Recent high-throughput sequencing projects of phenotypically well-defined cohorts of stone formers and large genome-wide association studies led to the discovery of many new genes associated with kidney stones. The spectrum ranges from infrequent but highly penetrant variants (mutations) causing mendelian forms of nephrolithiasis (monogenic traits) to common but phenotypically mild variants associated with nephrolithiasis (polygenic traits). About two-thirds of the genes currently known to be associated with nephrolithiasis code for membrane proteins or enzymes involved in renal tubular transport. The thick ascending limb of Henle and connecting tubules are of paramount importance for renal water and electrolyte handling, urinary concentration and maintenance of acid-base homeostasis. In most instances, pathogenic variants in genes involved in thick ascending limb of Henle and connecting tubule function result in phenotypically severe disease, frequently accompanied by nephrocalcinosis with progressive CKD and to a variable degree by nephrolithiasis. The aim of this article is to review the current knowledge on kidney stone disease associated with inherited defects in the thick ascending loop of Henle and the connecting tubules. We also highlight recent advances in the field of kidney stone genetics that have implications beyond rare disease, offering new insights into the most common type of kidney stone disease, i.e., idiopathic calcium stone disease.
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30
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Daudon M, Jungers P, Bazin D, Williams JC. Recurrence rates of urinary calculi according to stone composition and morphology. Urolithiasis 2018; 46:459-470. [PMID: 29392338 PMCID: PMC6711148 DOI: 10.1007/s00240-018-1043-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/24/2018] [Indexed: 12/13/2022]
Abstract
Few studies have examined the relative risk of recurrence of different stone types. The object of the present study was to evaluate the tendency for stone recurrence as a function of major mineral composition of the stones and morphological characteristics of the stones. This study was carried out using 38,274 stones for which we had data available to specify if the stone was from the first or a subsequent urinary stone episode. Stones were analyzed for morphology by stereomicroscope and for composition by infrared spectroscopy. Overall, 42.7% of stones were from patients who had had a previous stone event, with these being more frequent in men (44.4%) than in women (38.9%, p < 0.0001). Age of first stone occurrence was lowest for dihydroxyadenine (15.7 ± 16.6 years) and highest for anhydrous uric acid (62.5 ± 14.9 years), with the average age of first stones of calcium oxalate falling in the middle (40.7 ± 14.6 years for calcium oxalate dihydrate, and 48.4 ± 15.1 years for calcium oxalate monohydrate, COM). By composition alone, COM was among the least recurrent of stones, with only 38.0% of COM stones coming from patients who had had a previous episode; however, when the different morphological types of COM were considered, type Ic-which displays a light color, budding surface and unorganized section-had a significantly greater rate of recurrence, at 82.4% (p < 0.0001), than did other morphologies of COM. Similarly, for stones composed of apatite, morphological type IVa2-a unique form with cracks visible beneath a glossy surface-had a higher rate of recurrence than other apatite morphologies (78.8 vs. 39-42%, p < 0.0001). Stone mineral type alone is insufficient for identifying the potential of recurrence of the stones. Instead, the addition of stone morphology may allow the diagnosis of highly recurrent stones, even among common mineral types (e.g., COM) that in general are less recurrent.
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Affiliation(s)
- Michel Daudon
- Laboratoire des Lithiases, Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, APHP, 4, rue de la Chine, 75970, Paris Cedex 20, France.
- Unité INSERM UMRS 1155, UPMC, Hôpital Tenon, Paris, France.
| | - Paul Jungers
- Département de Néphrologie, Hôpital Necker, APHP, Paris, France
| | - Dominique Bazin
- LCMCP, UPMC, CNRS, Collège de France, Paris, France
- Laboratoire de Physique des Solides, Université Paris Sud, Orsay, France
| | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University, Indianapolis, IN, USA
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31
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Castiglione V, Sacré PY, Cavalier E, Hubert P, Gadisseur R, Ziemons E. Raman chemical imaging, a new tool in kidney stone structure analysis: Case-study and comparison to Fourier Transform Infrared spectroscopy. PLoS One 2018; 13:e0201460. [PMID: 30075002 PMCID: PMC6075768 DOI: 10.1371/journal.pone.0201460] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/15/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The kidney stone's structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two-dimension maps of the constituents' distribution in samples. We aimed at determining the use of Raman chemical imaging in urinary stone analysis. MATERIAL AND METHODS Fourteen calculi were analyzed by Raman chemical imaging using a confocal Raman microspectrophotometer. They were selected according to their heterogeneous composition and morphology. Raman chemical imaging was performed on the whole section of stones. Once acquired, the data were baseline corrected and analyzed by MCR-ALS. Results were then compared to the spectra obtained by Fourier Transform Infrared spectroscopy. RESULTS Raman chemical imaging succeeded in identifying almost all the chemical components of each sample, including monohydrate and dihydrate calcium oxalate, anhydrous and dihydrate uric acid, apatite, struvite, brushite, and rare chemicals like whitlockite, ammonium urate and drugs. However, proteins couldn't be detected because of the huge autofluorescence background and the small concentration of these poor Raman scatterers. Carbapatite and calcium oxalate were correctly detected even when they represented less than 5 percent of the whole stones. Moreover, Raman chemical imaging provided the distribution of components within the stones: nuclei were accurately identified, as well as thin layers of other components. Conversion of dihydrate to monohydrate calcium oxalate was correctly observed in the centre of one sample. The calcium oxalate monohydrate had different Raman spectra according to its localization. CONCLUSION Raman chemical imaging showed a good accuracy in comparison with infrared spectroscopy in identifying components of kidney stones. This analysis was also useful in determining the organization of components within stones, which help locating constituents in low quantity, such as nuclei. However, this analysis is time-consuming, making it more suitable for research studies rather than routine analysis.
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Affiliation(s)
- Vincent Castiglione
- Department of Clinical Chemistry, CHU of Liège, University of Liège, Liège, Belgium
| | - Pierre-Yves Sacré
- University of Liege (ULiege), CIRM, VibraSante Hub, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU of Liège, University of Liège, Liège, Belgium
| | - Philippe Hubert
- University of Liege (ULiege), CIRM, VibraSante Hub, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium
| | - Romy Gadisseur
- Department of Clinical Chemistry, CHU of Liège, University of Liège, Liège, Belgium
| | - Eric Ziemons
- University of Liege (ULiege), CIRM, VibraSante Hub, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium
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Abstract
Renal tubular acidosis (RTA) is comprised of a diverse group of congenital or acquired diseases with the common denominator of defective renal acid excretion with protean manifestation, but in adults, recurrent kidney stones and nephrocalcinosis are mainly found in presentation. Calcium phosphate (CaP) stones and nephrocalcinosis are frequently encountered in distal hypokalemic RTA type I. Alkaline urinary pH, hypocitraturia, and, less frequently, hypercalciuria are the tripartite lithogenic factors in distal RTA (dRTA) predisposing to CaP stone formation; the latter 2 are also commonly encountered in other causes of urolithiasis. Although the full blown syndrome is easily diagnosed by conventional clinical criteria, an attenuated forme fruste called incomplete dRTA typically evades clinical testing and is only uncovered by provocative acid-loading challenges. Stone formers (SFs) that cannot acidify urine of pH < 5.3 during acid loading are considered to have incomplete dRTA. However, urinary acidification capacity is not a dichotomous but rather a continuous trait, so incomplete dRTA is not a distinct entity but may be one end of a spectrum. Recent findings suggest that incomplete dRTA can be attributed to heterozygous carriers of hypofunctional V-ATPase. The value of incomplete dRTA diagnosis by provocative testing and genotyping candidate genes is a valuable research tool, but it remains unclear at the moment whether they alter clinical practice and needs further clarification. No randomized controlled trials have been performed in SFs with dRTA or CaP stones, and until such data are available, treatment of CaP stones are centered on reversing the biochemical abnormalities encountered in the metabolic workup. SFs with type I dRTA should receive alkali therapy, preferentially in the form of K-citrate delivered judiciously to treat the chronic acid retention that drives both stone formation and bone disease.
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Improvement of Urinary Stones Analysis Combining Morphological Analysis and Infrared Spectroscopy. J CHEM-NY 2018. [DOI: 10.1155/2018/4621256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Daudon et al. have developed a complex morphoconstitutional classification of renal stone in six different morphological types and several subtypes. According to this classification, a precise correspondence exists between causes of renal stones and subtypes with a great clinical relevance and can be considering a sort of shortcut for the metabolic diagnosis in renal stone patients. Now the diagnosis of causes of renal stones generally requires repeated biochemical investigations on urine and blood samples and usually remains presumptive. We analyzed 150 urinary stones both by stereoscopic microscopy and Fourier transform infrared spectroscopy. The comparison of 150 stones did not reveal any disagreement. We have only 20 partial agreement, and clinicians agreed that the imprecise information obtained with morphological analysis alone would have missed an important clinical finding only in 3 cases. In conclusion, in our opinion, the analysis of urinary stone must combine two different analytical techniques: morphological analysis by stereomicroscope and biochemical analysis with the FT-IR.
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Dhayat NA, Gradwell MW, Pathare G, Anderegg M, Schneider L, Luethi D, Mattmann C, Moe OW, Vogt B, Fuster DG. Furosemide/Fludrocortisone Test and Clinical Parameters to Diagnose Incomplete Distal Renal Tubular Acidosis in Kidney Stone Formers. Clin J Am Soc Nephrol 2017; 12:1507-1517. [PMID: 28775126 PMCID: PMC5586565 DOI: 10.2215/cjn.01320217] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 05/12/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Incomplete distal renal tubular acidosis is a well known cause of calcareous nephrolithiasis but the prevalence is unknown, mostly due to lack of accepted diagnostic tests and criteria. The ammonium chloride test is considered as gold standard for the diagnosis of incomplete distal renal tubular acidosis, but the furosemide/fludrocortisone test was recently proposed as an alternative. Because of the lack of rigorous comparative studies, the validity of the furosemide/fludrocortisone test in stone formers remains unknown. In addition, the performance of conventional, nonprovocative parameters in predicting incomplete distal renal tubular acidosis has not been studied. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a prospective study in an unselected cohort of 170 stone formers that underwent sequential ammonium chloride and furosemide/fludrocortisone testing. RESULTS Using the ammonium chloride test as gold standard, the prevalence of incomplete distal renal tubular acidosis was 8%. Sensitivity and specificity of the furosemide/fludrocortisone test were 77% and 85%, respectively, yielding a positive predictive value of 30% and a negative predictive value of 98%. Testing of several nonprovocative clinical parameters in the prediction of incomplete distal renal tubular acidosis revealed fasting morning urinary pH and plasma potassium as the most discriminative parameters. The combination of a fasting morning urinary threshold pH <5.3 with a plasma potassium threshold >3.8 mEq/L yielded a negative predictive value of 98% with a sensitivity of 85% and a specificity of 77% for the diagnosis of incomplete distal renal tubular acidosis. CONCLUSIONS The furosemide/fludrocortisone test can be used for incomplete distal renal tubular acidosis screening in stone formers, but an abnormal furosemide/fludrocortisone test result needs confirmation by ammonium chloride testing. Our data furthermore indicate that incomplete distal renal tubular acidosis can reliably be excluded in stone formers by use of nonprovocative clinical parameters.
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Affiliation(s)
- Nasser A. Dhayat
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - Michael W. Gradwell
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - Ganesh Pathare
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
- Swiss National Centre of Competence in Research TransCure, University of Bern, Bern, Switzerland
| | - Manuel Anderegg
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
- Swiss National Centre of Competence in Research TransCure, University of Bern, Bern, Switzerland
| | - Lisa Schneider
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - David Luethi
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - Cedric Mattmann
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - Orson W. Moe
- Departments of Internal Medicine and Physiology, and the Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Bruno Vogt
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
| | - Daniel G. Fuster
- Division of Nephrology and Hypertension, Bern University Hospital, Bern, Switzerland
- Swiss National Centre of Competence in Research TransCure, University of Bern, Bern, Switzerland
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Gambaro G, Croppi E, Coe F, Lingeman J, Moe O, Worcester E, Buchholz N, Bushinsky D, Curhan GC, Ferraro PM, Fuster D, Goldfarb DS, Heilberg IP, Hess B, Lieske J, Marangella M, Milliner D, Preminger GM, Reis Santos JM, Sakhaee K, Sarica K, Siener R, Strazzullo P, Williams JC. Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement. J Nephrol 2016; 29:715-734. [PMID: 27456839 PMCID: PMC5080344 DOI: 10.1007/s40620-016-0329-y] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/20/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research. DESIGN A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved. RESULTS Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients. CONCLUSIONS This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified.
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Affiliation(s)
- Giovanni Gambaro
- Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Fredric Coe
- Department of Nephrology, University of Chicago Medicine, Chicago, USA
| | - James Lingeman
- Department of Urology, Indiana University School of Medicine, Indianapolis, USA
| | - Orson Moe
- Department of Internal Medicine, Southwestern Medical Center, University of Texas, Dallas, USA
| | - Elen Worcester
- Department of Nephrology, University of Chicago Medicine, Chicago, USA
| | - Noor Buchholz
- Department of Urological Surgery, Sobeh's Vascular and Medical Center, Dubai, UAE
| | - David Bushinsky
- Department of Nephrology, Medical Center, University of Rochester, Rochester, USA
| | - Gary C Curhan
- Renal Division, Brigham and Women's Hospital, Boston, USA
| | - Pietro Manuel Ferraro
- Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniel Fuster
- Department of Nephrology, University of Bern, Bern, Switzerland
| | - David S Goldfarb
- Department of Nephrology, New York Harbor VA Health Care System, New York, USA
| | | | - Bernard Hess
- Department of Internal Medicine and Nephrology, Klinik Im Park Hospital, Zurich, Switzerland
| | - John Lieske
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | - Martino Marangella
- Department of Nephrology, A.S.O Ordine Mauriziano Hospital, Turin, Italy
| | - Dawn Milliner
- Department of Nephrology, Mayo Clinic, Rochester, USA
| | - Glen M Preminger
- Department of Urology, Duke University Medical Center, Durham, USA
| | | | - Khashayar Sakhaee
- Southwestern Medical Center, Mineral Metabolism Research, University of Texas, Dallas, USA
| | - Kemal Sarica
- Department of Urology, Dr. Lutfi KIRDAR Kartal Research and Training Hospital, Istanbul, Turkey
| | | | | | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indiana, USA
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Shedding light on the morphology of calcium oxalate monohydrate crystallites present in kidney biopsies in the case of hyperoxaluria. CR CHIM 2016. [DOI: 10.1016/j.crci.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Combining field effect scanning electron microscopy, deep UV fluorescence, Raman, classical and synchrotron radiation Fourier transform Infra-Red Spectroscopy in the study of crystal-containing kidney biopsies. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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38
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Rouzière S, Bazin D, Daudon M. In-lab X-ray fluorescence and diffraction techniques for pathological calcifications. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.05.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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39
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Vibrational spectroscopies to investigate concretions and ectopic calcifications for medical diagnosis. CR CHIM 2016. [DOI: 10.1016/j.crci.2016.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Daudon M, Letavernier E, Weil R, Véron E, Matzen G, André G, Bazin D. Type 2 diabetes and uric acid stones: A powder neutron diffraction investigation. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Daudon M, Dessombz A, Frochot V, Letavernier E, Haymann JP, Jungers P, Bazin D. Comprehensive morpho-constitutional analysis of urinary stones improves etiological diagnosis and therapeutic strategy of nephrolithiasis. CR CHIM 2016. [DOI: 10.1016/j.crci.2016.05.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dessombz A, Bazin D, Daudon M. Reply. Urology 2016; 86:1096. [PMID: 26719111 DOI: 10.1016/j.urology.2015.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Arnaud Dessombz
- CNRS, Laboratoire de Physique des Solides, Université Paris XI, 91405 Orsay, France; INSERM, UMR 1138, Centre de Recherche des Cordeliers, Laboratoire de Physiopathologie Orale Moléculaire, Equipe Berdal, Université Paris-5, Université Paris-6, Université Paris-7, Paris, France
| | - Dominique Bazin
- CNRS, Laboratoire de Chimie de la Matière Condensée de Paris, UPMC Paris-6, Collège de France, Paris, France
| | - Michel Daudon
- APHP, Service des Explorations Fonctionnelles, Hôpital Tenon, Paris, France; INSERM, UMR S 1155, Hôpital Tenon, Paris, France
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Grases F, Costa-Bauzá A. Simplified methods for the evaluation of the risk of forming renal stones and the follow-up of stone-forming propensity during the preventive treatment of stone-formation. Urolithiasis 2015; 44:77-82. [PMID: 26614111 DOI: 10.1007/s00240-015-0838-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 11/05/2015] [Indexed: 11/27/2022]
Abstract
Renal lithiasis is a complex multifactorial disease in which recurrence is common. Thus, simple and reliable procedures are needed to evaluate patients with previous kidney stones to determine the risk of recurrence. In this paper we review simple biochemical procedures that can be used to determine the risk for renal stone formation when the stone is available or unavailable for analysis. Our present knowledge of renal lithiasis indicates that renal stones form due to several well-defined factors. Analysis of the renal stone itself can provide important information about clinical factors that require further investigation. When the stone is unavailable, it is necessary to perform a general evaluation of main urinary risk factors associated to renal stone formation, but this study should be complemented considering information related to direct familial antecedents, recidivant degree, radiological images, medical history, and life style habits. Finally, tools for patient follow-up of stone-forming propensity during the preventive treatment are discussed .
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Affiliation(s)
- Fèlix Grases
- Laboratory of Renal Lithiasis Research, Faculty of Sciences, Universitary Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122, Palma de Mallorca, Spain.
| | - Antonia Costa-Bauzá
- Laboratory of Renal Lithiasis Research, Faculty of Sciences, Universitary Institute of Health Sciences Research (IUNICS), University of Balearic Islands, 07122, Palma de Mallorca, Spain
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