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Stamatelou K, Goldfarb DS. Epidemiology of Kidney Stones. Healthcare (Basel) 2023; 11:healthcare11030424. [PMID: 36766999 PMCID: PMC9914194 DOI: 10.3390/healthcare11030424] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
In the past two decades, major breakthroughs that improve our understanding of the pathophysiology and therapy of kidney stones (KS) have been lacking. The disease continues to be challenging for patients, physicians, and healthcare systems alike. In this context, epidemiological studies are striving to elucidate the worldwide changes in the patterns and the burden of the disease and identify modifiable risk factors that contribute to the development of kidney stones. Our expanding knowledge of the epidemiology of kidney stones is of paramount importance and largely upgrades the modern management of the disease. In this paper, we review the variables affecting prevalence and incidence, including age, gender, race, ethnicity, occupation, climate, geography, systemic diseases, diabetes, vascular disease, chronic kidney disease, and dietary risk factors relevant to kidney stones.
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Affiliation(s)
- Kyriaki Stamatelou
- “MESOGEIOS” Nephrology Center, Haidari and Nephros.eu Private Clinic, 11527 Athens, Greece
| | - David S. Goldfarb
- Nephrology Division, NYU Langone Health and NYU Grossman School of Medicine, NY Nephrology Section, NY Harbor VA Healthcare System, New York, NY 10016, USA
- Correspondence: ; Tel.: +1-212-686-7500 (ext. 3877); Fax: +1-212-951-6842
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Metabolic risk factors and the role of prophylaxis in pediatric urolithiasis. J Pediatr Urol 2021; 17:215.e1-215.e6. [PMID: 33342680 DOI: 10.1016/j.jpurol.2020.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/13/2020] [Accepted: 12/02/2020] [Indexed: 01/05/2023]
Abstract
Suppose that the recurrence in pediatric urolithiasis has a close relationship with metabolic abnormalities and is affected by residual burden and prophylaxis. If so, the recurrence rates could be reduced with effective surgery and appropriate prophylaxis. Here we retrospectively evaluate the metabolic risk factors data of 148 children who were operated on between January 2005 and March 2013 due to kidney stones. All patients underwent percutaneous nephrolithotomy (PCNL), and all were children. Thirteen children had a history of surgery performed to treat urological anomalies. Twenty-four-hour urine analysis, the residual status of surgery, BMI levels, and the number of metabolic abnormalities were noted. Only 18 (15%) of 122 patients without residual stones after PCNL had recurrence at follow-up whereas; nine (26%) of 26 patients with residual stones developed recurrence (p = 0.017). Recurrence was observed in 14 (16%) of 89 patients with a metabolic abnormality, and 13 (30%) of 44 patients with two or more metabolic abnormalities had recurrence at follow-up (p = 0.024). Those patients with no metabolic abnormalities did not develop recurrence. Stone recurrence was seen in six (8%) of 78 children who were given metabolic prophylaxis, compared to 21 (30%) of 70 patients who did not receive metabolic prophylaxis (p = 0.02). No stone recurrence was seen in nine children who were given Shohl's, whereas four (67%) of six patients who did not take Shohl's had recurrence (p = 0.022). Complete removal of stones by a suitable surgical method is essential to avoid recurrences. Detailed clinical and laboratory evaluations should be performed in children with urolithiasis. Appropriate specific prophylactic treatment (e.g., potassium citrate and Shohl's) and non-specific prophylactic treatment (e.g., avoiding animal proteins, salt, simple sugars, and increased water intake) should be given to prevent reformation of stones in patients with pediatric urolithiasis.
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Patel PM, Kandabarow AM, Aiwerioghene E, Blanco-Martinez E, Hart S, Leehey DJ, Farooq A, Baldea KG, Turk TMT. Proton-pump inhibitors associated with decreased urinary citrate excretion. Int Urol Nephrol 2020; 53:679-683. [PMID: 33206338 DOI: 10.1007/s11255-020-02719-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/07/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Proton-pump inhibitors (PPIs) may increase the risk of kidney stone formation, but the mechanism has not been elucidated. There is a paucity of literature evaluating the effects of PPIs on urinary metabolites and urine pH. METHODS We performed a retrospective review of nephrolithiasis patients treated at our institution and compared patients who were taking PPIs to those who were not at the time of their 24-h urine collections. Hierarchical multivariate linear regression was used to evaluate the independent relationship between PPI use and urinary mineral composition. RESULTS We identified 301 consecutive patients, 88 (29%) of whom were taking PPIs at the time of their 24-h urine collections. Patients taking PPIs were older and more likely to have medical comorbidities associated with metabolic syndrome such as hypertension, diabetes, and dyslipidemia (p < 0.01). Controlling for these factors, patients taking PPIs were found to have 12% lower 24-h urine citrate excretion (β = - 0.12, ΔF = 4.24, p = 0.04). There were no other differences in urinary mineral composition between the groups. CONCLUSION Our findings suggest that patients who take PPIs regularly may be at risk for decreased urinary citrate excretion. The consequent decrease in urinary citrate may become clinically significant for patients with other predisposing factors for hypocitraturia.
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Affiliation(s)
- Parth M Patel
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA.
| | - Alexander M Kandabarow
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA
| | | | | | - Spencer Hart
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA
| | - David J Leehey
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Ahmer Farooq
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA
| | - Kristin G Baldea
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA
| | - Thomas M T Turk
- Department of Urology, Loyola University Medical Center, 2160 S. 1st Ave., Fahey Building, 2nd Floor, Maywood, IL, 60153, USA
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Udomsilp P, Saepoo S, Ittiwut R, Shotelersuk V, Dissayabutra T, Boonla C, Tosukhowong P. rs11567842 SNP in SLC13A2 gene associates with hypocitraturia in Thai patients with nephrolithiasis. Genes Genomics 2018; 40:965-972. [DOI: 10.1007/s13258-018-0702-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
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Qi Z, Yu J, Shen L, Yu Z, Yu M, Du Y, Zhang R, Song T, Yin X, Zhou Y, Li H, Wei Q, Liu Y. Enhanced resistance to rice blast and sheath blight in rice (oryza sativa L.) by expressing the oxalate decarboxylase protein Bacisubin from Bacillus subtilis. PLANT SCIENCE : AN INTERNATIONAL JOURNAL OF EXPERIMENTAL PLANT BIOLOGY 2017; 265:51-60. [PMID: 29223342 DOI: 10.1016/j.plantsci.2017.09.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 05/05/2023]
Abstract
Oxalate decarboxylase (OxDC), catalyzing the degradation of oxalic acid, is widely distributed in varieties of organisms. In this study, an oxalate decarboxylase gene from Bacillus subtilis strain BS-916, Bacisubin, was transformed into rice variety Nipponbare to generate transgenic rice with increased OxDC activity. Pathogenicity test revealed that the transgenic rice showed enhanced resistance to rice blast and sheath blight. Further RNA-seq analysis between Nipponbare WT (wild type) and transgenic rice identified 1764 DEGs (Differentially expressed genes) including 723 up-regulated unigenes and 1041 down-regulated unigenes. Five GO terms including single-organism process and oxidation-reduction process were significantly enriched in the up-regulated genes. Interestingly, five genes encoding glutaredoxin and one gene encoding MADS box were up- and down-regulated in the transgenic rice, respectively. Collectively, our study advances the understanding of OxDC in resistance to rice disease and its possible mechanisms. Our results also suggest that OxDC would be an effective antifungal protein preventing fungal infection in transgenic rice.
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Affiliation(s)
- Zhongqiang Qi
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Junjie Yu
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Lerong Shen
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Zhenxian Yu
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Mina Yu
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Yan Du
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Rongsheng Zhang
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Tianqiao Song
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Xiaole Yin
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Yuxin Zhou
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Huanhuan Li
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Qian Wei
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China
| | - Yongfeng Liu
- Institute of Plant Protection, Jiangsu Academy of Agricultural Science, Nanjing 210014, Jiangsu Province, People's Republic of China.
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Lieske JC, Turner ST, Edeh SN, Smith JA, Kardia SLR. Heritability of urinary traits that contribute to nephrolithiasis. Clin J Am Soc Nephrol 2014; 9:943-50. [PMID: 24578335 DOI: 10.2215/cjn.08210813] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Kidney stones and their risk factors aggregate in families, yet few studies have systematically estimated heritabilities and genetic correlations of the numerous urinary traits associated with risk of kidney stones. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Twenty-four-hour urine samples were collected from the Genetic Epidemiology Network of Arteriopathy cohort of families in Rochester, Minnesota, to measure urinary determinants of supersaturation. Diet was assessed using the Viocare food frequency questionnaire. Heritabilities and genetic correlations among the urinary traits were estimated using variance components methods. RESULTS Samples were available from 811 individuals (344 men, 467 women; mean age 66 ± 9 years). Age, sex, and weight were significantly correlated with the majority of urinary traits. Many urine excretions (calcium, magnesium, citrate excretion) had strong evidence for heritability (P<0.01) both before and after adjusting for the identified covariates. Among significantly heritable urinary traits, genetic factors explained 20%-36% of interindividual variation after adjustment for covariates. Urinary calcium excretion was significantly genetically correlated with urinary magnesium and with urinary citrate excretion (P<0.05). Although eGFR influenced many urinary traits, controlling for eGFR did not greatly affect estimated heritabilities. CONCLUSIONS Evidence from this cohort suggests a strong heritable component to many urinary nephrolithiasis risk factors. Further study of genetic influences on urinary traits relevant for kidney stone pathogenesis is warranted.
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Affiliation(s)
- John C Lieske
- Division of Nephrology and Hypertension, and, †Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, ‡Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Theka T, Rodgers AL, Webber D, O'Ryan C. Variability in kidney stone incidence between black and white South Africans: AGT Pro11Leu polymorphism is not a factor. J Endourol 2014; 28:577-81. [PMID: 24344980 DOI: 10.1089/end.2013.0617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Kidney stone disease is rare in the South African black (B) population and more prevalent in the white (W) population. Genetic studies have not previously examined this anomaly. The AGT Pro11Leu polymorphism in the alanine:glyoxylate aminotransferase (AGT) enzyme has been suggested as possibly playing a role in the pathogenesis of idiopathic calcium oxalate kidney stones. The present study was undertaken to investigate whether differences occur in the frequency of this polymorphism in subjects of both race groups. MATERIALS AND METHODS Healthy B (n=60) and W (n=60) male subjects each provided early morning spot urine, blood, and buccal cell samples. The AGT Pro11Leu locus was amplified using the polymerase chain reaction and polymorphism was genotyped using a restriction fragment length polymorphism. RESULTS There was no difference in the frequency of the AGT Pro11Leu polymorphism, and the major allele (C) was present at a frequency of 0.82 in B and 0.83 in W. Thus, the most common genotype homozygous normal CC genotype was observed at similar frequencies in both groups (0.68 and 0.65 in B and W, respectively), as were the heterozygous CT genotype (CT) and the homozygous variant TT genotype (TT) genotypes (0.33 & 0.02 and 0.28 & 0.03 in B and W, respectively). Neither urinary oxalate nor any other component in the two groups was correlated with the frequency of the AGT Pro11Leu polymorphism. CONCLUSIONS Our data imply that the AGT Pro11Leu polymorphism is not directly responsible for the low incidence of stone formation in B. We conclude that other factors must be instrumental in protecting the B population from urolithiasis.
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Affiliation(s)
- Takalani Theka
- 1 Department of Chemistry, University of Cape Town , Cape Town, South Africa
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Abstract
Nephrolithiasis is a prevalent and costly condition with high recurrence rate. A medical evaluation to identify abnormalities responsible for nephrolithiasis and guide subsequent therapy has been advocated to reduce the risk of stone recurrence. The evaluation of kidney stone formers generally comprises an extensive medical history to identify metabolic, environmental, dietary and/or genetic factors contributing to stone formation. Imaging studies are utilized to evaluate and follow stone burden. Laboratory studies including stone composition analysis and serum and urinary chemistries are commonly obtained to further assess for any underlying systemic disorders, to detect environmental and metabolic processes contributing to stone disease, and to guide initial and follow-up dietary and pharmacological therapy. The nature and extent of such an evaluation is discussed in this review article.
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Affiliation(s)
- Naim Maalouf
- Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism, University of Texas Southwestern Medical Center Dallas, TX, U.S.A
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Attanasio M. The genetic components of idiopathic nephrolithiasis. Pediatr Nephrol 2011; 26:337-46. [PMID: 20563734 DOI: 10.1007/s00467-010-1562-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 05/03/2010] [Accepted: 05/07/2010] [Indexed: 02/04/2023]
Abstract
Nephrolithiasis is a cause of significant morbidity and medical care expenses worldwide. Its prevalence has increased steadily during the last three decades among both adults and children. This trend suggests that changing environmental factors play a significant role in the risk of developing kidney stones although, conversely, there are many indications that genes play an important role in this condition as well. A limited number of monogenic forms have been identified, but the majority of nephrolithiasis cases are the result of complex, multi-factorial interactions between genetic inheritance and environmental exposure. Scientific evidence indicates that inheritance accounts for about half of the risk of common forms, making these forms suitable for investigation by genetic analysis. Here, we review the numerous studies that have been conducted to establish the role of genes in determining the risk of nephrolithiasis, the differential contribution of genes to this risk, and the confounding influence that environmental variables have on genetic studies.
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Affiliation(s)
- Massimo Attanasio
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, G5.100, Dallas, TX 75390, USA.
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Evaluación metabólica y nutricional en litiasis renal. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Genetic basis of renal cellular dysfunction and the formation of kidney stones. ACTA ACUST UNITED AC 2009; 37:169-80. [PMID: 19517103 DOI: 10.1007/s00240-009-0201-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Accepted: 05/27/2009] [Indexed: 12/18/2022]
Abstract
Nephrolithiasis is a result of formation and retention of crystals within the kidneys. The driving force behind crystal formation is urinary supersaturation with respect to the stone-forming salts, which means that crystals form when the concentrations of participating ions are higher than the thermodynamic solubility for that salt. Levels of supersaturation are kept low and under control by proper functioning of a variety of cells including those that line the renal tubules. It is our hypothesis that crystal deposition, i.e., formation and retention in the kidneys, is a result of impaired cellular function, which may be intrinsic and inherent or triggered by external stimuli and challenges. Cellular impairment or dysfunction affects the supersaturation, by influencing the excretion of participating ions such as calcium, oxalate and citrate and causing hypercalciuria, hyperoxaluria or hypocitraturia. The production and excretion of macromolecular promoters and inhibitors of crystallization is also dependent upon proper functioning of the renal epithelial cells. Insufficient or ineffective crystallization modulators such as osteopontin, Tamm-Horsfall protein, bikunin, etc. are most likely produced by the impaired cells.
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Kutyshenko VP, Stepanov AA, Suslikov AV, Chailakhyan LM. High-resolution NMR spectroscopy as a method of studying human biological fluids in normal state and pathology. DOKL BIOCHEM BIOPHYS 2007; 410:300-3. [PMID: 17286108 DOI: 10.1134/s1607672906050139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- V P Kutyshenko
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow oblast, 142290 Russia
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