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Zeng H, Liu Z, He Y, Chen H, He J, Liu M, Wu S, He H, Huang C, Xu R. Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04021-9. [PMID: 38564076 DOI: 10.1007/s11255-024-04021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi. METHODS We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins. RESULTS The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)]. CONCLUSIONS Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.
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Affiliation(s)
- Hongbo Zeng
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziyi Liu
- Department of Emergency Medicine, The Second Xiangya Hospital of Central-South University, Emergency and Difficult Diseases Institute of Central South University, Changsha, China
| | - Yunhui He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huixiang Chen
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingke Liu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuiqing Wu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiqing He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Changkun Huang
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Zhang J, Tang Z, Lu Z, Lin X, Liao H, Li Z, Chen W, Hu C, He Z, Tang F. The Association between Dietary Sugar Intake and Nephrolithiasis: Results from National Health and Nutrition Examination Survey 2007-2018. J Nutr 2023; 153:2968-2978. [PMID: 37648110 DOI: 10.1016/j.tjnut.2023.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Dietary sugar intake is gradually considered a risk factor for many diseases. A sugary diet was positively associated with risk of nephrolithiasis, but the specific relationships remain undefined. OBJECTIVES To determine associations between risk of nephrolithiasis and dietary sugar intake. METHODS This cross-sectional study involved 21,590 participants based on the National Health and Nutrition Examination Survey from 2007 to 2018. Amounts of dietary sugar intake (g/d) were the main exposure, including total sugar intake, added sugar intake, and food sources. Associations were analyzed by logistic regression models and restricted cubic splines using complex weighted designs. RESULTS Weighted mean intake [standard error] of total sugar and added sugar were 111.2 [2.0] g/d and 73.7 [1.9] g/d in participants with nephrolithiasis, respectively. In the fully adjusted regression model, compared to those in quartile 1, the population in quartile 4 of total sugar intake showed a significant risk of nephrolithiasis [odds ratio (OR): 1.23; 95% confidence interval (CI): 1.00-1.51]; OR for added sugar intake was 1.56 (95% CI: 1.25-1.94). The risks of nephrolithiasis increased steadily when total sugar and added sugar intake exceeded ∼150 g/d and 63 g/d in restricted cubic spline analyses, respectively. The highest sugar intake from beverages was associated with an increased risk of nephrolithiasis (OR for total sugar: 1.36; 95% CI: 1.07-1.72; OR for added sugar: 1.37; 95% CI: 1.09-1.73). Added sugar intake from meat, egg, and oil was significantly associated with risk of nephrolithiasis (quartile 4, OR: 1.22; 95% CI: 1.02-1.47), whereas total sugar intake from dairy products was in reverse (quartile 4, OR: 0.67; 95% CI: 0.54-0.82). CONCLUSIONS Total and added sugar intake, sugar intake from beverages, and added sugar intake from meat, egg, and oil were associated with an increased risk of nephrolithiasis, whereas total sugar intake from dairy products was negatively associated.
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Affiliation(s)
- Jiahao Zhang
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Zhicheng Tang
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Zechao Lu
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Xuqing Lin
- The Second Clinical College of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Haiqin Liao
- The Second Clinical College of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhibiao Li
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Wanru Chen
- The Third Clinical College of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chuxian Hu
- The Sixth Clinical College of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhaohui He
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Fucai Tang
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
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Medical and Interventional Management of Upper Urinary Tract Uroliths. Vet Clin North Am Small Anim Pract 2019; 49:157-174. [DOI: 10.1016/j.cvsm.2018.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
PURPOSE OF REVIEW In this article, we aim to review the data regarding associations between obesity and nephrolithiasis to assist with workup and treatment of these intersecting disorders. As obesity has a multifactorial influence on the risk for urinary stone disease, the complicated mechanisms will be discussed to improve diagnosis and management. RECENT FINDINGS Obesity and metabolic syndrome interact with nephrolithiasis risk factors to produce a myriad of bodily responses that induce stone formation. For this reason, many societies recommend prompt metabolic workup to evaluate the precise causes of stone formation. Data have shown that dietary and directed medical therapies can produce an excellent therapeutic response in this patient population, although the response may be blunted compared with nonobese patients. SUMMARY Given the increasing number of obese and overweight patients, the urologist should be familiar with the pathophysiology, workup, and treatment of metabolic stone disease in this population, which are outlined here.
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Shin RH, Cabrera FJ, Nguyen G, Wang C, Youssef RF, Scales CD, Ferrandino MN, Preminger GM, Yoshizumi TT, Lipkin ME. Radiation Dosimetry for Ureteroscopy Patients: A Phantom Study Comparing the Standard and Obese Patient Models. J Endourol 2016; 30:57-62. [DOI: 10.1089/end.2015.0419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Richard H. Shin
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
| | - Fernando J. Cabrera
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
| | - Giao Nguyen
- Radiation Safety Division, Duke University Medical Center, Durham, North Carolina
- Department of Radiology, Duke University, Durham, North Carolina
| | - Chu Wang
- Radiation Safety Division, Duke University Medical Center, Durham, North Carolina
- Graduate Program of Medical Physics, Duke University, Durham, North Carolina
| | - Ramy F. Youssef
- Urology Department, University of California, Irvine, Orange, California
| | - Charles D. Scales
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
- Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Michael N. Ferrandino
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
| | - Glenn M. Preminger
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
| | - Terry T. Yoshizumi
- Radiation Safety Division, Duke University Medical Center, Durham, North Carolina
- Department of Radiology, Duke University, Durham, North Carolina
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Michael E. Lipkin
- Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina
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Torricelli FCM, De S, Li I, Sarkissian C, Monga M. Can Obese Stone Formers Follow Dietary Recommendations? J Endourol 2014; 28:248-51. [DOI: 10.1089/end.2013.0536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fabio Cesar Miranda Torricelli
- Stevan B. Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Shubha De
- Stevan B. Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Ina Li
- Stevan B. Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Carl Sarkissian
- Stevan B. Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Manoj Monga
- Stevan B. Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, Ohio
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Ahmed MH, Ahmed HT, Khalil AA. Renal stone disease and obesity: what is important for urologists and nephrologists? Ren Fail 2012; 34:1348-54. [PMID: 23013150 DOI: 10.3109/0886022x.2012.723777] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Currently, obesity has reached an epidemic stage and represents a challenge for health authorities across the globe. Certainly, with emergence of obesity epidemic, we started to see an increase in the prevalence of chronic kidney disease (CKD) and nephrolithiasis. Interestingly, epidemiologic studies have shown that the incident stone risk increases with body mass index (BMI), and no further increase in risk is noticed when the BMI > 30 kg/m(2). Furthermore, metabolic syndrome and diabetes are also associated with an increase in the incidence of renal stones disease. The shared links between these metabolic disorders are insulin resistance. Furthermore, insulin resistance is thought to alter renal acid-base metabolism, resulting in a lower urine pH and increased risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances such as refined sugars, low fluid intake, calcium, oxalate, and purine-rich foods. Obesity is also associated with an increase in incidence of urinary tract infection. Recent reports suggested that renal stone disease carries risk of myocardial infarction, progression of CKD, and diabetes. Alarmingly, orlistat (obesity medication) and bariatric surgery are associated with hyperoxaluria and associated stone formation and even oxalate nephropathy. Certainly, the many health risks of obesity, including nephrolithiasis, will add more burden on urologists and nephrologists. Shockwave lithotripsy, percutaneous nephrolithotomy, and ureteroscopy are all safe procedures in obese individuals. Further research is urgently needed to address the pathophysiology and management of obesity-induced renal stones disease.
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Affiliation(s)
- Mohamed H Ahmed
- Department of Medicine, Wexham Park Hospital, Slough, Berkshire, UK.
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Inci M, Demirtas A, Sarli B, Akinsal E, Baydilli N. Association between body mass index, lipid profiles, and types of urinary stones. Ren Fail 2012; 34:1140-3. [PMID: 22889148 DOI: 10.3109/0886022x.2012.713298] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine the differences in body mass index (BMI), levels of cholesterol, and levels of triglycerides (TGs) among urolithiasis patients with different stone compositions. MATERIALS AND METHODS Forty-nine patients who had a diagnosis of nephrolithiasis and had undergone open surgery or percutaneous surgery were included, and patients without urolithiasis were randomly selected as controls. Urinary stones were collected and analyzed using infrared spectroscopy. Data relating to patient's age, BMI at diagnosis, serum total cholesterol (TC), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) were collected. The stone groups including calcium oxalate monohydrate-calcium oxalate dihydrate (COM-COD), COM, and uric acid were compared with one another and with the control group. In addition, the stone formers group (COM-COD, COM, uric acid, calcium phosphate, and mixed-type stones) was compared to the control group. RESULTS BMI, TC, and TG levels were significantly higher in stone formers compared with the control group; this association of BMI and TC with stone formation was more prominent in uric acid and COM-COD stone formers, but there was no such prominence for COM stones. LDL-C levels in COM-COD stone formers were significantly higher when compared with COM stone formers. CONCLUSION Elevated BMI, hypercholesterolemia, and hyperlipidemia, which are leading components of metabolic syndrome, may be associated with different types of urinary stone formation.
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Affiliation(s)
- Mehmet Inci
- Department of Urology, Mustafa Kemal University School of Medicine, Antakya, Turkey.
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Abstract
Fructose consumption has markedly increased over the past decades. This intake may increase the urinary excretion of calcium, oxalate, uric acid, and other factors associated with kidney stone risk. We prospectively examined the relationship between fructose intake and incident kidney stones in the Nurses' Health Study I (NHS I) (93,730 older women), the Nurses' Health Study II (NHS II) (101,824 younger women), and the Health Professionals Follow-up Study (45,984 men). Food frequency questionnaires were used to assess free fructose and sucrose intake every 4 years. Total-fructose intake was calculated as free fructose plus half the intake of sucrose, and expressed as percentage of total energy. Cox proportional hazard regressions were adjusted for age, body mass index (BMI), thiazide use, caloric intake, and other dietary factors. We documented 4902 incident kidney stones during a combined 48 years of follow-up. The multivariate relative risks of kidney stones significantly increased for participants in the highest compared to the lowest quintile of total-fructose intake for all three study groups. Free-fructose intake was also associated with increased risk. Non-fructose carbohydrates were not associated with increased risk in any cohort. Our study suggests that fructose intake is independently associated with an increased risk of incident kidney stones.
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Khan ZA, Assiri AM, Al-Afghani HM, Maghrabi TM. Inhibition of oxalate nephrolithiasis with Ammi visnaga (AI-Khillah). Int Urol Nephrol 2002; 33:605-8. [PMID: 12452606 DOI: 10.1023/a:1020526517097] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigated the effect of Ammi visnaga seeds on experimentally - induced kidney stones - in male Wistar albino rats. Oxalate nephrolithiasis was experimentally induced by 3% glycolic acid (added in their diet) given for the period of four weeks. A highly significant amount of deposits were found in the kidneys, which were analyzed quantitatively. These deposits were mainly of calcium oxalate in composition. Daily oral (gavage) treatment with Ammi visnaga (500 mg/kg) highly reduced the incidence of nephrolithiasis (calcium oxalate deposition in the kidneys). Ammi visnaga seeds extract showed highly potent diuretic activity. The reduction in body weight, increase in kidneys weight, increase in water intake, decrease in urine output found in glycolic acid control group were prevented to various extent on Ammi visnaga treatment; and the values became to insignificant difference with control group. The changes in weights of liver, heart and lungs of the three groups were insignificant. Uraemia and hyperbilirubinaemia observed in glycolic acid control group were found to be ameliorated by Ammi visnaga seed extract treatment.
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Affiliation(s)
- Z A Khan
- Department of Biochemistry, Faculty of Medicine and Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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Martin A, Rambal C, Berger V, Perier S, Louisot P. Availability of specific sugars for glycoconjugate biosynthesis: a need for further investigations in man. Biochimie 1998; 80:75-86. [PMID: 9587665 DOI: 10.1016/s0300-9084(98)80059-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We review the metabolism of specific sugars used for protein glycosylation, focusing on the fate of exogenously provided sugars. Theoretically, all glycoprotein sugars can derive from glucose, but previous studies show that other exogenous sugars can be incorporated into glycoproteins. From data obtained in congenital galactosemia, exogenous galactose may be important for correct glycosylation. Contrary to galactose, the metabolism of other sugars seems to depend on insulin regulation: stimulation of their endogenous production in diabetic subjects might participate in some diabetic complications, precluding the need for an exogenous supply. The metabolic fate of these sugars is different according to the administration route and exogenous supply may be important either in enteral nutrition or in some clinical situations as has been suggested for sialic acid in the newborn. Data in man are too sparse to reach firm conclusions, implying a need for further investigations. Our preliminary results in animals and man demonstrate that stable isotope methodology allows one to trace glycoprotein sugar metabolism in nutritionally relevant conditions with accuracy and sensitivity, using doses of specific sugars well below toxic levels.
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Affiliation(s)
- A Martin
- INSERM-CNRS U189, Lyon-Sub Medical School, Oullins, France
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