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Farooq K, Hameed N, Zaib Z, Hameed MB, Ausaf H, Shakil F, Afzaal Nawaz M. Comparison of STONE Score, Guy's Stone Score, CROES Nomogram, and Seoul National University Renal Stone Complexity Score in Prognosticating Outcomes of Multiple-Tract Mini-Percutaneous Nephrolithotomy: A Retrospective Study. Cureus 2024; 16:e54790. [PMID: 38529424 PMCID: PMC10961480 DOI: 10.7759/cureus.54790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
Objective The objective of this study was to compare the STONE score (Size of the stone, Topography or location, degree of Obstruction of the urinary system, Number of stones, and Evaluation of Hounsfield units), Guy's stone score (GSS), Clinical Research Office of the Endourological Society (CROES) nomogram, and Seoul National University Renal Stone Complexity Score (RSCS) in prognosticating multiple tract mini-percutaneous nephrolithotomy (mPCNL) outcome. Methodology This descriptive retrospective analysis was carried out at the Urology Department, Lady Reading Hospital, Peshawar, Pakistan. Male and female patients in the age range of 18-70 years who underwent multiple tract mPCNL for renal stones from July 1, 2021, to June 30, 2023, were included in the analysis. Results A total of 110 patients were registered. Stone-free status (SFS) was achieved in 78.2% (n=86), and complications were observed in 13.6% (n=15) patients. The odds ratio for STONE score, GSS, CROES scoring system, and RSCS for predicting the SFS was 7.093 (95%CI 2.40-20.89), 9.333 (95%CI 2.92-29.81), 11.70 (95%CI 2.56-53.38) and 3.450 (95%CI 1.25-9.53), respectively. Conclusion Multiple tract mPCNL is a safe and effective technique for the management of renal stones, producing a high stone-free rate. This study demonstrated adequate efficacy and dependability of the four scoring systems in predicting SFS.
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Affiliation(s)
| | - Najma Hameed
- Radiology, Northwest General Hospital, Peshawar, PAK
| | - Zainab Zaib
- Obstetrics and Gynecology, Lady Reading Hospital, Peshawar, PAK
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2
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Sierra A, Castillo C, Carbonell E, Muní M, Martinez C, López JM, Peri L, Alcaraz A, Luque MP, Musquera M. Living donor-gifted allograft lithiasis: surgical experience after bench surgery stone removal and follow-up. Urolithiasis 2023; 51:91. [PMID: 37358636 PMCID: PMC10293412 DOI: 10.1007/s00240-023-01463-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/04/2023] [Indexed: 06/27/2023]
Abstract
This study presents the surgical experience and long-term outcomes of living donor kidney transplantations involving asymptomatic kidney stones, using ex vivo flexible ureterorenoscopy (f-URS) during bench surgery for stone removal. Out of 1743 living kidney donors assessed between January 2012 and October 2022, 18 (1%) were diagnosed with urolithiasis. Among them, 12 donors were rejected, and 6 were accepted for kidney donation. Stone removal was successfully performed using f-URS during bench surgery, with no immediate complications or acute rejections observed. The study analyzed six living kidney transplants, of which 4 (67%) donors and three recipients were female, and 4 (67%) donors were blood-related to the recipient. The median age for donors and recipients was 57.5 and 51.5 years, respectively. The stones, primarily located in the lower calyx, had a median size of 6 mm. The median cold ischemia time during surgery was 41.6 min, and ex vivo f-URS ensured complete stone removal in all cases. After a median follow-up of 120 months, the remaining grafts were functioning well, and no urinary stone recurrence was observed in either the recipients or living donors. The findings suggest that bench f-URS is a safe approach for managing urinary stones in kidney grafts, providing good functional outcomes without stone recurrence in selected cases.
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Affiliation(s)
- Alba Sierra
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Carlos Castillo
- Division of Transplant Surgery, Department of General Surgery, Hospital General Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Enric Carbonell
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Maria Muní
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Carmen Martinez
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Juan Manuel López
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Lluís Peri
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
| | - Antonio Alcaraz
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Maria Pilar Luque
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Mireia Musquera
- Division of Kidney Transplant, Department of Urology, Hospital Clinic, Barcelona, Spain.
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.
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Mohim M, Kachkoul R, El Habbani R, Lahrichi A, Sqalli Houssaini T. In vitro effect of Sidi Hrazem mineral water on the dissolution of calcium oxalate monohydrate calculi (Whewellite). SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Alelign T, Tessema TS, Debella A, Petros B. Evaluations of the curative efficacy of G. fruticosus solvent extracts in experimentally induced nephrolithiatic Wistar male rats. BMC Complement Med Ther 2021; 21:145. [PMID: 34011326 PMCID: PMC8136233 DOI: 10.1186/s12906-021-03320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopian folk medicine, there is a claim that medicinal plants can treat urolithiasis although there is insufficient scientific evidence. The objective of this study was to evaluate the curative efficacy of Gomphocarpus fruticosus extracts in experimentally induced nephrolithiatic rats. METHODS Urolithiasis was induced in male Wistar rats by feeding ethylene glycol in drinking water for 28 days. The curative effects were evaluated after oral administrations of 200 mg/kg of the extracts from 15 to 28 days. Urine samples were collected 1 day before sacrificing the rats. Blood, liver and kidney samples were gathered under anaesthetic condition at day 28. Crystals in the urine were also analyzed by light microscopy. RESULTS G. fruticosus EtOAc extract reduced significantly the level of sodium (P < 0.001), whereas it was significantly elevated the levels of magnesium and citrate (P < 0.01) compared to lithiatic control. G. fruticosus BuOH extract lowered the levels of potassium (P < 0.01), calcium and phosphate in urolithiatic rats. It was also observed that G. fruticosus EtOAc extract decreased the level of oxalate in the urine (P < 0.001), whereas it was increased the levels of magnesium (P < 0.05) and citrate (P < 0.01) in serum analysis after exposure to BuOH extract. In the kidneys, CaOx crystal deposits were reduced significantly by G. fruticosus EtOAc extract (P < 0.01). CONCLUSION It has been noted that G. fruticosus EtOAc extract was potent in treating urolithiasis. However, further study is required to assess the efficacy of the active compounds against urolithiasis.
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Affiliation(s)
- Tilahun Alelign
- Department of Microbial, Cellular, and Molecular Biology, College of Natural and Computational Sciences Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. .,Department of Biology, Debre Birhan University, P.O. Box 445, Debre Birhan, Ethiopia.
| | - Tesfaye Sisay Tessema
- Institute of Biotechnology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Asfaw Debella
- Ethiopian Public Health Institute, Traditional and Modern Medicine Directorate, Addis Ababa, Ethiopia
| | - Beyene Petros
- Department of Microbial, Cellular, and Molecular Biology, College of Natural and Computational Sciences Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
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5
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Runova GE, Golounina OO, Glinkina IV, Sych YP, Fadeev VV. [Differential diagnosis of normocalcemic hyperparathyroidism and idiopathic hypercalciuria on the example of clinical case]. PROBLEMY ENDOKRINOLOGII 2020; 66:13-17. [PMID: 33481363 DOI: 10.14341/probl12677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
Idiopathic hypercalciuria is a heterogeneous generalized disorder caused by various defects in calcium transport and increased urinary calcium excretion. The main etiopathogenetic factors are violations of vitamin D metabolism, changes in the sensitivity of calcitriol receptors and violations of the processes of calcium reabsorption in the proximal tubules and in the ascending knee of the Henle loop. This article presents a clinical observation of patient with idiopathic hypercalciuria, initially high levels of parathyroid hormone (PTH) in the absence of hyperparathyroidism. Therapy with thiazide diuretics allowed to achieve normalization of daily urinary calcium excretion and reducing PTH. Despite the low prevalence of idiopathic hypercalciuria, differential diagnosis of this metabolic disorder should be carried out with mandatory consideration of clinical and laboratory data, as well as with diseases that may cause increased PTH production.
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Affiliation(s)
- G E Runova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - O O Golounina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - I V Glinkina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - Yu P Sych
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - V V Fadeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Nimesh S, Ashwlayan VD, Rani R, Prakash O. Advantages of Herbal Over Allopathic Medicine in the Management of Kidney and Urinary Stones Disease. BORNEO JOURNAL OF PHARMACY 2020. [DOI: 10.33084/bjop.v3i3.1415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Kidney and urinary stone disease (Nephrolithiasis and urolithiasis) are the condition where urinary stones or calculi are formed in the urinary tract. The problem of urinary stones is very ancient; these stones are found in all parts of the urinary tract, kidney, ureters, and the urinary bladder and may vary considerably in size. It is a common disease estimated to occur in approximately 12% of the population, with a recurrence rate of 70-81% in males and 47-60% in females. The treatment of kidney and urinary stone diseases such as a western (allopathy) medicine and surgery is now in trends. However, most people preferred plant-based (herbal) therapy because of the overuse of allopathic drugs, which results in a higher incidence rate of adverse or severe side effects. Therefore, people every year turn to herbal therapy because they believe plant-based medicine is free from undesirable side effects, although herbal medicines are generally considered to be safe and effective. In the present article, an attempt has been made to emphasize an herbal therapy is better than allopathic therapy for the management of the kidney and urinary stone disease.
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Affiliation(s)
| | | | - Rubi Rani
- NKBR College of Pharmacy and Research Centre
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Robinson TE, Hughes EAB, Wiseman OJ, Stapley SA, Cox SC, Grover LM. Hexametaphosphate as a potential therapy for the dissolution and prevention of kidney stones. J Mater Chem B 2020; 8:5215-5224. [PMID: 32436557 DOI: 10.1039/d0tb00343c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The incidence of kidney stones is increasing worldwide, and recurrence is common (50% within 5 years). Citrate, the current gold standard therapy, which is usually given as potassium or sodium salts, is used because it raises urine pH and chelates calcium, the primary component of up to 94% of stones. In this study hexametaphosphate (HMP), a potent calcium chelator, was found to be 12 times more effective at dissolving calcium oxalate, the primary component of kidney stones, than citrate. HMP was also observed to be effective against other common kidney stone components, namely calcium phosphate and struvite (magnesium ammonium phosphate). Interestingly, HMP was capable of raising the zeta potential of calcium oxalate particles from -15.4 to -34.6 mV, which may prevent stone growth by aggregation, the most rapid growth mechanism, and thus avert occlusion. Notably, HMP was shown to be up to 16 times as effective as citrate at dissolving human kidney stones under simulated physiological conditions. It may thus be concluded that HMP is a promising potential therapy for calcium and struvite kidney stones.
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Affiliation(s)
- Thomas E Robinson
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT, UK. and Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston, B15 2SQ, UK
| | - Erik A B Hughes
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT, UK.
| | - Oliver J Wiseman
- Department of Urology, Cambridge University Hospital, Cambridge, CB2 0QQ, UK
| | - Sarah A Stapley
- Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston, B15 2SQ, UK
| | - Sophie C Cox
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT, UK.
| | - Liam M Grover
- School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT, UK.
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Abstract
Urolithiasis, which is the presence of stones in the urinary tract, has long been linked with a
higher risk of causing chronic kidney diseases and associated illnesses, such as diabetes-affecting 12%
of the world population. This clinical condition arises due to the supersaturation of urine and alterations
in the expression of cellular and urinary proteins. The renal stone mineral composition has been
well understood and incorporated as a routine part of stone removal, however, the protein composition,
an essential fraction of the stone matrix has been inadequately understood and not adeptly established.
Stone proteomics consists of a number of techniques including crystal analysis using X-ray diffractometry
and IR spectroscopy, sample purification, identification and characterization of proteins using
high throughput mass spectrometric methods. However, not many studies have utilized the data obtained
from these experiments to assign functional significance to associated identified proteins. Protein
network analysis using bioinformatic tools such as STRING to study protein-protein interactions
will enable researchers to get better insight into stone formation mechanics. Hence, a comprehensive
proteomic study of kidney stone matrix will help in deciphering protein-crystal pathways generating
novel information useful for clinical application.
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Affiliation(s)
- Manavi Jain
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
| | - Paramveer Yadav
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
| | - Priyadarshini
- Department of Biotechnology, Jaypee Institute of Information Technology, Noida, India
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9
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Hureaux M, Ashton E, Dahan K, Houillier P, Blanchard A, Cormier C, Koumakis E, Iancu D, Belge H, Hilbert P, Rotthier A, Del Favero J, Schaefer F, Kleta R, Bockenhauer D, Jeunemaitre X, Devuyst O, Walsh SB, Vargas-Poussou R. High-throughput sequencing contributes to the diagnosis of tubulopathies and familial hypercalcemia hypocalciuria in adults. Kidney Int 2019; 96:1408-1416. [PMID: 31672324 DOI: 10.1016/j.kint.2019.08.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/07/2019] [Accepted: 08/22/2019] [Indexed: 12/15/2022]
Abstract
Hereditary tubulopathies are rare diseases with unknown prevalence in adults. Often diagnosed in childhood, hereditary tubulopathies can nevertheless be evoked in adults. Precise diagnosis can be difficult or delayed due to insidious development of symptoms, comorbidities and polypharmacy. Here we evaluated the diagnostic value of a specific panel of known genes implicated in tubulopathies in adult patients and compared to our data obtained in children. To do this we analyzed 1033 non-related adult patients of which 744 had a clinical diagnosis of tubulopathy and 289 had a diagnosis of familial hypercalcemia with hypocalciuria recruited by three European reference centers. Three-quarters of our tubulopathies cohort included individuals with clinical suspicion of Gitelman syndrome, kidney hypophosphatemia and kidney tubular acidosis. We detected pathogenic variants in 26 different genes confirming a genetic diagnosis of tubulopathy in 29% of cases. In 16 cases (2.1%) the genetic testing changed the clinical diagnosis. The diagnosis of familial hypercalcemia with hypocalciuria was confirmed in 12% of cases. Thus, our work demonstrates the genetic origin of tubulopathies in one out of three adult patients, half of the rate observed in children. Hence, establishing a precise diagnosis is crucial for patients, in order to guide care, to survey and prevent chronic complications, and for genetic counselling. At the same time, this work enhances our understanding of complex phenotypes and enriches the database with the causal variants described.
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Affiliation(s)
- Marguerite Hureaux
- Department of Genetics, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France; Paris Descartes Université, Sorbonne Paris Cité, Paris, France
| | - Emma Ashton
- North East Thames Regional Genetics Service Laboratories, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, UK
| | - Karin Dahan
- Center of Human Genetics, Institut de Pathologie et Génétique, Gosselies, Belgium; Division of Nephrology, Université Catholique de Louvain Medical School, Brussels, Belgium
| | - Pascal Houillier
- Paris Descartes Université, Sorbonne Paris Cité, Paris, France; Department of Physiological Functional Investigations, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- Paris Descartes Université, Sorbonne Paris Cité, Paris, France; Assistance Publique Hôpitaux des Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Centre d'Investigation Clinique 1418, Paris, France
| | - Catherine Cormier
- Rheumatology Department, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Reference Center for Rare Calcium and Phosphate Diseases, Paris, France
| | - Eugenie Koumakis
- Rheumatology Department, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Reference Center for Rare Calcium and Phosphate Diseases, Paris, France
| | - Daniela Iancu
- Department of Renal Medicine, University College London, London, UK
| | - Hendrica Belge
- Center of Human Genetics, Institut de Pathologie et Génétique, Gosselies, Belgium
| | - Pascale Hilbert
- Center of Human Genetics, Institut de Pathologie et Génétique, Gosselies, Belgium
| | | | | | - Franz Schaefer
- Paediatric Nephrology, Heidelberg University Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany
| | - Robert Kleta
- Department of Renal Medicine, University College London, London, UK; Department of Pediatric Nephrology, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, UK
| | - Detlef Bockenhauer
- Department of Renal Medicine, University College London, London, UK; Department of Pediatric Nephrology, Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, UK
| | - Xavier Jeunemaitre
- Department of Genetics, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France; Paris Descartes Université, Sorbonne Paris Cité, Paris, France
| | - Olivier Devuyst
- Division of Nephrology, Université Catholique de Louvain Medical School, Brussels, Belgium; Institute of Physiology, Zurich Center for Integrative Human Physiology (ZIHP), Mechanisms of Inherited Kidney Disorders Group, University of Zurich, Zurich, Switzerland.
| | - Stephen B Walsh
- Department of Renal Medicine, University College London, London, UK.
| | - Rosa Vargas-Poussou
- Department of Genetics, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France.
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Abstract
Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall's plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches.
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