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Qi Q, Hu Y, Chen Y, Xu Y, Hao Z. Dietary Selenium Intake and Kidney Stones in Old Adults: an Analysis from NHANES 2011 to 2018. Biol Trace Elem Res 2023; 201:1588-1595. [PMID: 35687296 PMCID: PMC9931801 DOI: 10.1007/s12011-022-03282-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
The association between dietary selenium intake and kidney stones remains unclear. The purpose of this study was to explore the correlation between dietary selenium intake and kidney stones in older adults. A total of 6669 adults aged ≥ 60 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during 2011-2018 were enrolled in the current study. The correlation between dietary selenium intake and kidney stones was assessed by the logistic regression analysis. Smooth curve fitting was used to explore the potential non-linear relationship and subgroup analyses were further adopted. After adjustment for multiple confounding factors, the odds ratio (OR) with 95% confidence interval (CI) of kidney stones for per standard deviation increment in dietary selenium intake was 0.92 (0.85, 1.00) overall. Compared with the lowest quartile, the ORs (95% CIs) with increasing quartiles were 0.88 (0.71, 1.08), 0.82 (0.66, 1.02), and 0.79 (0.64, 0.97). In addition, smooth curve fitting and stratified analyses showed that there was a non-linear and stable correlation between dietary selenium intake and the occurrence of kidney stones respectively. For adults aged over 60, dietary selenium intake was inversely correlated with kidney stones, and this relationship remained after adjusting for other confounding variables. Further researches are needed to explore the potential mechanism between dietary selenium intake and kidney stones.
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Affiliation(s)
- Qiao Qi
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, 218th Jixi Road, Hefei, 230022, China
| | - Yongtao Hu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, 218th Jixi Road, Hefei, 230022, China
| | - Yang Chen
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, 218th Jixi Road, Hefei, 230022, China
| | - Yuexian Xu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, 218th Jixi Road, Hefei, 230022, China
| | - Zongyao Hao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.
- Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, 218th Jixi Road, Hefei, 230022, China.
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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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Kim JY, Yu JH, Kang SH, Lee JG, Cheon J, Kang SG. The effect of metabolic risk factors on urinary stone composition: An observational study. Medicine (Baltimore) 2022; 101:e29622. [PMID: 35838990 PMCID: PMC11132329 DOI: 10.1097/md.0000000000029622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
To investigate how the risk factors of metabolic diseases affect urinary stone composition, particularly uric acid (UA) stones. Overall, 583 patients with data on urinary stone composition were retrospectively analyzed and classified into UA and nonUA stone formers according to the presence of the UA component. Various factors were compared between both groups. Participants were categorized according to age, glucose level, HbA1c level, and estimated glomerular filtration rate (eGFR) into subgroups, and the incidence of UA stone was compared. Overall, 137 UA stone formers (23.5%) and 446 nonUA stone formers (76.5%) were included. Mean age and male-to-female ratio were higher in the UA group than in the nonUA group. The rates of diabetes mellitus (DM), hypertension, chronic kidney disease, and coronary artery disease, all of which were associated with differences in urinary stone composition, were higher in the UA group than in the nonUA group. The UA group exhibited lower mean eGFR and higher glucose and HbA1c levels. Similarly, the UA group had higher mean UA levels and predictably lower urinary pH. In subgroup analysis, higher age, glucose level, HbA1c level, and lower eGFR were associated with an increased risk of UA stone formation. In the multivariate logistic regression analysis, the UA group showed a significantly higher age (P < .001), DM frequency (P = .049), and HbA1c level (P = .032), but significantly lower eGFR than the nonUA group (P < .001). Age and DM were independent risk factors for UA urolithiasis, implying a relationship between urinary stone composition and metabolic diseases. Additionally, renal function and HbA1c level were risk factors for UA stones.
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Affiliation(s)
- Jae Yoon Kim
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Ji Hyeong Yu
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
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Yuan S, Larsson SC. Assessing causal associations of obesity and diabetes with kidney stones using Mendelian randomization analysis. Mol Genet Metab 2021; 134:212-215. [PMID: 34454843 DOI: 10.1016/j.ymgme.2021.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity and type 2 diabetes have been associated with an increased risk of kidney stones in observational studies, but the causality of these associations remains unestablished. We conducted a Mendelian randomization study to determine these associations. METHODS Independent single nucleotide polymorphisms at the genome-wide significance threshold (p < 5 × 10-8) were selected as instrumental variables and were identified from meta-analyses of genome-wide association studies on body mass index (up to 806,834 individuals) and type 2 diabetes (228,499 cases and 1,178,783 non-cases). Summary-level data for the associations of exposure-associated SNPs with kidney stones were obtained from the UK Biobank study (3540 cases and 357,654 non-cases) and the FinnGen consortium (3856 cases and 172,757 non-cases). Causal estimates from two sources were combined using the meta-analysis method. RESULTS Higher genetically predicted body mass index and genetic liability to type 2 diabetes were associated with an increased risk of kidney stones in both the UK Biobank study and FinnGen consortium. In the meta-analysis of results from the two data sources, the odds ratios of kidney stones were 1.33 (95% confidence interval, 1.17, 1.51; p < 0.001) per one standard deviation increase in genetically predicted body mass index (~4.8 kg/m2) and 1.15 (95% confidence interval, 1.10, 1.20; p < 0.001) for one unit increase in genetically predicted log-transformed odds of type 2 diabetes. INTERPRETATION This study based on genetic data suggests that a high body mass index and type 2 diabetes may be causal risk factors for kidney stone formation.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Wu B, Xie J, Guo J, Wang J, Lang H. Association between metabolic syndrome and calcium oxalate stone risk in Chinese individuals: a nomogram prediction model. J Int Med Res 2021; 49:300060520986726. [PMID: 33596688 PMCID: PMC7897830 DOI: 10.1177/0300060520986726] [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] [Indexed: 11/16/2022] Open
Abstract
Objective This retrospective study explored the association between calcium oxalate (CaOx) stones and metabolic syndrome. It also developed and validated a nomogram to aid in the prediction of CaOx stones. Methods This case-control study enrolled 150 patients with CaOx stones and 635 individuals without urolithiasis from October 2016 to October 2018. Student’s t-test, the chi-squared test, and logistic univariate and multivariate regression analyses were used. A nomogram for prediction of CaOx stones was established based on independent associated factors. The concordance index and calibration curves were plotted to determine nomogram accuracy. Results Female sex, age ≥66 years, blood pressure (systolic pressure ≥130 mmHg and/or diastolic pressure ≥85 mmHg), and blood uric acid level independently influenced the risk of CaOx stones, according to multivariate logistic regression analysis; these factors were included in the nomogram. The concordance index was 0.701 (95% confidence interval: 0.658–0.737). The standard curve showed a robust fit with the calibrated predictive curve. Conclusions Female sex, age ≥66 years, elevated blood pressure, and blood uric acid level independently influenced the risk of CaOx stones. Our nomogram for the prediction of CaOx stones may provide a clinical basis for the assessment of CaOx stone and facilitate early prevention efforts.
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Affiliation(s)
- Baisuo Wu
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Junhao Xie
- Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Junyi Guo
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Jinbo Wang
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Hongjuan Lang
- Department of Nursing, The Fourth Military Medical University, Xi'an, China
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Feng X, Wu W, Zhao F, Xu F, Han D, Guo X, Lyu J. Association between physical activity and kidney stones based on dose-response analyses using restricted cubic splines. Eur J Public Health 2020; 30:1206-1211. [PMID: 32879977 DOI: 10.1093/eurpub/ckaa162] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to determine whether there is a dose-response relationship between physical activity and the self-reported prevalence of kidney stone, based on a restricted cubic splines (RCS) method. METHODS This study analyzed 8931 adults aged ≥20 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during 2013-16. Kidney stones and physical activity were defined using a standard questionnaire, and metabolic equivalents (MET) were used to quantify the physical activity level. Logistic regression was used to assess the association between physical activity and the risk of kidney stones, and the dose-response relationship was explored using RCS. RESULTS Kidney stones were present in 10.3% of the analyzed individuals: 11.5% of males and 9.2% of females. After adjusting for potential confounders, compared with the first quartile (Q1) of MET, the odds ratios (ORs) of kidney stones for those with Q2, Q3 and Q4 of MET were 0.72 [95% confidence interval (CI)=0.59-0.87], 0.77 (95% CI = 0.63-0.93) and 0.63 (95% CI = 0.51-0.78), respectively (all P < 0.01). The RCS regression showed that physical activity was related to kidney stones in a non-linear manner (P for non-linearity = 0.0100). The prevalence of kidney stones decreasing as physical activity increased, reaching a plateau for physical activity at approximately 2480 MET-min week-1 (OR = 0.75, 95% CI = 0.63-0.91). CONCLUSIONS Physical activity is inversely associated with the prevalence of kidney stones, and the dose-response relationship has a plateau, after which the prevalence of kidney stones does not change with the increase of physical activity.
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Affiliation(s)
- Xiaojie Feng
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fanfan Zhao
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Fengshuo Xu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Didi Han
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Xiaojuan Guo
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jun Lyu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
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Prasanchaimontri P, Monga M. Predictive Factors for Kidney Stone Recurrence in Type 2 Diabetes Mellitus. Urology 2020; 143:85-90. [PMID: 32343997 DOI: 10.1016/j.urology.2020.04.067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/05/2020] [Accepted: 04/12/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the predictive factors for kidney stone recurrence in type 2 diabetic patients. METHODS A retrospective cohort study was conducted from 2013 to 2019 by using the database of diabetic patients diagnosed with kidney stone disease. The patients were divided into 2 groups according to stone disease status: recurrent stone and nonrecurrent stone. Baseline characteristics were compared and logistic regression was done to assess which variables could predict a stone recurrence. RESULTS There were 1617 type 2 diabetic patients with kidney stone disease, 1244 (77%) did not have a stone recurrence and 373 (23%) had a stone recurrence. Of these patients with recurrent stone, 40% had asymptomatic stones, 43% visited emergency department, and 45% required a surgical intervention. Median time to recurrence was 64 months. Multivariable analysis revealed that body mass index (odds ratios [OR] 1.032, 95% confidence interval [CI] 1.016-1.047), urine pH (OR 0.500, CI 0.043-0.581), HbA1c (OR 1.186, CI 1.012-1.277), diabetic neuropathy (OR 1.839, CI 1.413-2.392), diabetic retinopathy (OR 1.690, CI 1.122-2.546), insulin as well as potassium citrate therapy (OR 0.611, CI 0.426-0.87), and stone with calcium oxalate and uric acid composition (OR 1.955, CI 1.420-2.691 and OR 2.221, CI 1.249-3.949, respectively) are significant predictors for stone recurrence. CONCLUSION The severity of diabetes and stone composition are strong predictors for stone recurrence in type 2 diabetic patients, while HbA1c and urine pH are important modifiable factors.
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Affiliation(s)
- Phornphen Prasanchaimontri
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Department of Surgery, Ratchaburi Hospital, Ratchaburi, Thailand
| | - Manoj Monga
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Department of Urology, UCSD, San Diego, CA.
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Liu CJ, Wu JS, Huang HS. Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis. J Clin Med 2019; 8:jcm8101536. [PMID: 31557790 PMCID: PMC6832126 DOI: 10.3390/jcm8101536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 12/04/2022] Open
Abstract
Uric acid urolithiasis constitutes approximately 7–10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, p < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.
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Affiliation(s)
- Chan Jung Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Jin Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
| | - Ho Shang Huang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
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Maalouf NM, Poindexter JR, Adams-Huet B, Moe OW, Sakhaee K. Increased production and reduced urinary buffering of acid in uric acid stone formers is ameliorated by pioglitazone. Kidney Int 2019; 95:1262-1268. [PMID: 30795852 DOI: 10.1016/j.kint.2018.11.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/08/2018] [Accepted: 11/16/2018] [Indexed: 02/08/2023]
Abstract
Idiopathic uric acid nephrolithiasis is characterized by an overly acidic urine pH caused by the combination of increased acid production and inadequate buffering of urinary protons by ammonia. A large proportion of uric acid stone formers exhibit features of the metabolic syndrome. We previously demonstrated that thiazolidinediones improved the urinary biochemical profile in an animal model of the metabolic syndrome. In this proof-of-concept study, we examined whether the thiazolidinedione pioglitazone can also ameliorate the overly acidic urine in uric acid stone formers. Thirty-six adults with idiopathic uric acid nephrolithiasis were randomized to pioglitazone 30 mg/day or matching placebo for 24 weeks. At baseline and study end, participants underwent collection of blood and 24-hour urine in an inpatient research unit while consuming a fixed metabolic diet, followed by assessment of the ammoniagenic response to an acute oral acid load. Twenty-eight participants completed the study. Pioglitazone treatment improved features of the metabolic syndrome. Pioglitazone also reduced net acid excretion and increased urine pH (5.37 to 5.59), the proportion of net acid excreted as ammonium, and ammonium excretion in response to an acute acid load, whereas these parameters were unchanged with placebo. Treatment of patients with idiopathic uric acid nephrolithiasis with pioglitazone for 24 weeks led to a reduction in the acid load presented to the kidney and a more robust ammoniagenesis and ammonium excretion, resulting in significantly higher urine pH. Future studies should consider the impact of this targeted therapy on uric acid stone formation.
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Affiliation(s)
- Naim M Maalouf
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John R Poindexter
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Beverley Adams-Huet
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Orson W Moe
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Khashayar Sakhaee
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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Maciolek KA, Penniston KL, Jhagroo RA, Best SL. Successful Diabetic Control as Measured by Hemoglobin A1c Is Associated with Lower Urine Risk Factors for Uric Acid Calculi. J Endourol 2018; 32:771-776. [PMID: 29896970 DOI: 10.1089/end.2018.0376] [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] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES To examine the association of glycemic control, including strict glycemic control, with 24-hour urine risk factors for uric acid and calcium calculi. MATERIALS AND METHODS With institutional review board (IRB) approval, we identified 183 stone formers (SFs) with 459 twenty-four-hour urine collections. Hemoglobin A1c (HgbA1c) measures were obtained within 3 months of the urine collection. Collections were categorized into normoglycemic (NG, HgbA1c < 6.5) and hyperglycemic (HG, HgbA1c ≥ 6.5) cohorts; 24-hour urine parameters were compared. The NG cohort was further divided into patients with and without a history of diabetes mellitus (DM) type 2. Variables were analyzed using chi-square, Welch's t-test and multivariate linear regression to adjust for clustering, body mass index (BMI), age, gender, thiazide use, and potassium citrate use. RESULTS Patients in the HG group were older with higher BMI. Multivariate analysis of the total study population revealed that hyperglycemia correlated with lower pH, higher uric acid relative saturation (RS), lower brushite RS, and higher citrate. NG SFs with and without a history of DM had similar risk factors for uric acid stone formation. Among NG SFs, those with DM had higher urine calcium and calcium oxalate RS than those without DM. However, this difference may be related to other factors since neither parameter correlated with DM on multivariate regression (p > 0.05). CONCLUSIONS Successful glycemic control may be associated with reduced urinary risk factors for uric acid stone formation. Patients with well-controlled DM had equivalent risk factors to those without DM. Glycemic control should be considered a target of the multidisciplinary medical management of stone disease.
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Affiliation(s)
- Kimberly A Maciolek
- 1 Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
| | - Kristina L Penniston
- 1 Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
| | - Roy Allan Jhagroo
- 2 Department of Medicine, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
| | - Sara L Best
- 1 Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.,3 Department of Urology, William S. Middleton Memorial Veterans Hospital , Madison, Wisconsin
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Boyd C, Wood K, Whitaker D, Assimos DG. The influence of metabolic syndrome and its components on the development of nephrolithiasis. Asian J Urol 2018; 5:215-222. [PMID: 30364536 PMCID: PMC6197366 DOI: 10.1016/j.ajur.2018.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/28/2018] [Accepted: 04/18/2018] [Indexed: 02/07/2023] Open
Abstract
The prevalence of kidney stone disease is increasing, afflicting 7%–11% of the United States population. Multiple systemic conditions, including obesity and diabetes, are also on the rise. Further, the literature has demonstrated a strong association between metabolic syndrome, its components, and kidney stone disease. In this article, we aim to review the associations of metabolic syndrome and nephrolithiasis, discussing the pathophysiology, urinary parameters, and clinical presentations. With this knowledge, urologists will have a more comprehensive understanding of this complex population of metabolic stone formers enabling improved patient management and treatment of stone disease.
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Affiliation(s)
- Carter Boyd
- University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA
| | - Kyle Wood
- Department of Urology, University of Alabama-Birmingham, Birmingham, AL, USA
| | - Dustin Whitaker
- University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA
| | - Dean G Assimos
- Department of Urology, University of Alabama-Birmingham, Birmingham, AL, USA
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Davidson MA, Mattison DR, Azoulay L, Krewski D. Thiazolidinedione drugs in the treatment of type 2 diabetes mellitus: past, present and future. Crit Rev Toxicol 2017; 48:52-108. [PMID: 28816105 DOI: 10.1080/10408444.2017.1351420] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Thiazolidinedione (TZD) drugs used in the treatment of type 2 diabetes mellitus (T2DM) have proven effective in improving insulin sensitivity, hyperglycemia, and lipid metabolism. Though well tolerated by some patients, their mechanism of action as ligands of peroxisome proliferator-activated receptors (PPARs) results in the activation of several pathways in addition to those responsible for glycemic control and lipid homeostasis. These pathways, which include those related to inflammation, bone formation, and cell proliferation, may lead to adverse health outcomes. As treatment with TZDs has been associated with adverse hepatic, cardiovascular, osteological, and carcinogenic events in some studies, the role of TZDs in the treatment of T2DM continues to be debated. At the same time, new therapeutic roles for TZDs are being investigated, with new forms and isoforms currently in the pre-clinical phase for use in the prevention and treatment of some cancers, inflammatory diseases, and other conditions. The aims of this review are to provide an overview of the mechanism(s) of action of TZDs, a review of their safety for use in the treatment of T2DM, and a perspective on their current and future therapeutic roles.
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Affiliation(s)
- Melissa A Davidson
- a Faculty of Health Sciences , University of Ottawa , Ottawa , Canada.,b McLaughlin Centre for Population Health Risk Assessment , Ottawa , Canada
| | - Donald R Mattison
- b McLaughlin Centre for Population Health Risk Assessment , Ottawa , Canada.,c Risk Sciences International , Ottawa , Canada
| | - Laurent Azoulay
- d Center for Clinical Epidemiology , Lady Davis Research Institute, Jewish General Hospital , Montreal , Canada.,e Department of Oncology , McGill University , Montreal , Canada
| | - Daniel Krewski
- a Faculty of Health Sciences , University of Ottawa , Ottawa , Canada.,b McLaughlin Centre for Population Health Risk Assessment , Ottawa , Canada.,c Risk Sciences International , Ottawa , Canada.,f Faculty of Medicine , University of Ottawa , Ottawa , Canada
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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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Yang AW, Johnson JD, Fronczak CM, LaGrange CA. Lunar Phases and Emergency Department Visits for Renal Colic Due to Ureteral Calculus. PLoS One 2016; 11:e0157589. [PMID: 27299307 PMCID: PMC4907477 DOI: 10.1371/journal.pone.0157589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/01/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Urolithiasis affects an estimated 5% of the population and the lifetime risk of passing a stone in the urinary tract is estimated to be 8-10%. Urinary calculus formation is highly variable and while certain risk factors such as age, gender, seasonality, anatomic abnormality, and metabolic diseases have been identified, not much is known regarding the association of environmental factors such as lunar phases on renal colic. We conducted a retrospective study to test the hypothesis that full moon phase is an environmental factor associated for increased emergency department (ED) visits for renal colic due to ureteral calculus. METHODS We analyzed 559 renal colic diagnoses by the ED at the University of Nebraska Medical Center in a 24-month period and compared them with corresponding lunar phases as well as supermoon events. The lunar phases were defined as full moon ± two days, new moon ± two days, and the days in-between as normal days according to the lunar calendar. Supermoon event dates were obtained from NASA. RESULTS 90 cases (16.1%) were diagnosed during full moon phase, 89 cases (15.9%) were diagnosed during new moon phase, and 380 cases (68.0%) were diagnosed during normal days. The incidence of renal colic showed no statistically significant association with lunar phases or supermoon events. CONCLUSION In this retrospective longitudinal study with adequate power, neither full moon phase nor supermoon event exhibited an association with increased renal colic diagnoses due to ureteral calculus by the ED at the University of Nebraska Medical Center.
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Affiliation(s)
- Andy W. Yang
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Justin D. Johnson
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Carolyn M. Fronczak
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Chad A. LaGrange
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
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Sayyid RK, Fleshner NE. Diabetes Mellitus Type 2: A Driving Force for Urological Complications. Trends Endocrinol Metab 2016; 27:249-261. [PMID: 26969242 DOI: 10.1016/j.tem.2016.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/12/2016] [Accepted: 02/17/2016] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a growing epidemic associated with many adverse complications. Urological complications of diabetes mellitus in men are gaining recognition. Previously unknown associations between T2DM and risk for prostate cancer, bladder cancer, renal cell carcinomas, urinary tract infections, nephrolithiasis, penile lesions, androgen deficiency, and erectile dysfunction have been discovered. Significantly, metformin could play a role in the management of urological malignancies, and therapies used for management of these cancers could in return lead to increased risk for diabetes. In this review, we aim to bridge the gap between T2DM and urological complications by discussing the latest findings in these fields, with the ultimate goal being improved patient care on both fronts.
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Affiliation(s)
- Rashid K Sayyid
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, M5G 2M9, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, M5G 2M9, Toronto, Ontario, Canada.
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Zhu W, Mai Z, Qin J, Duan X, Liu Y, Zhao Z, Yuan J, Wan SP, Zeng G. Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis. PLoS One 2016; 11:e0150006. [PMID: 26906900 PMCID: PMC4764372 DOI: 10.1371/journal.pone.0150006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 02/07/2016] [Indexed: 02/03/2023] Open
Abstract
Background Diabetic patients are more likely to develop kidney stones than the general population. The underlying mechanisms for this disparity remain to be elucidated. Little is known about the relationship between urine composition and diabetes mellitus in non-stone-forming individuals. We sought to examine the differences in the 24-hour (24-h) urine composition between diabetic and non-diabetic adults who were not stone formers. Methods A convenience sample of 538 individuals without a history of nephrolithiasis, gout, hyperparathyroidism, or gastroenteric diseases participated in this study. The 24-h urine profiles of 115 diabetic adults were compared with those of 423 non-diabetic adults. Diabetes was defined by self-reported physician diagnosis or medication use. All participants were non-stone formers confirmed by urinary tract ultrasonography. Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Student’s t-test was used to compare mean urinary values. Linear regression models were adjusted for age, gender, body mass index, hypertension, fasting serum glucose, serum total cholesterol, estimated creatinine clearance rate and urinary factors. Results Univariable analysis showed that the diabetic participants had significantly higher 24-h urine volumes and lower urine calcium and magnesium excretions than non-diabetic participants (all P < 0.05). After multivariate adjustment, no significant differences in 24-h urine composition were observed between diabetic and non-diabetic participants except for a slightly increased 24-h urine volume in diabetic participants (all P > 0.05). The main limitation of this study is that the convenience samples and self-reported data may have been sources of bias. Conclusion Our data showed that there were no differences in 24-h urine composition between diabetic and non-diabetic adults who are not stone formers. The reason for it might be the improved glycemic control in diabetic individuals in our study. Therefore, a tighter glycemic control might reduce stone formation in diabetic adults.
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Affiliation(s)
- Wei Zhu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Zanlin Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Jing Qin
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Yang Liu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Zhijian Zhao
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Jian Yuan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Shaw P. Wan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China
- * E-mail:
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Fram EB, Moazami S, Stern JM. The Effect of Disease Severity on 24-Hour Urine Parameters in Kidney Stone Patients With Type 2 Diabetes. Urology 2016; 87:52-9. [DOI: 10.1016/j.urology.2015.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/09/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
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Diabetes mellitus and the risk of urolithiasis: a meta-analysis of observational studies. Urolithiasis 2015; 43:293-301. [DOI: 10.1007/s00240-015-0773-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/08/2015] [Indexed: 01/14/2023]
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