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Oswal M, Varghese R, Zagade T, Dhatrak C, Sharma R, Kumar D. Dietary supplements and medicinal plants in urolithiasis: diet, prevention, and cure. J Pharm Pharmacol 2023:7148056. [PMID: 37130140 DOI: 10.1093/jpp/rgac092] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/16/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND Urolithiasis has been a major health concern for centuries, primarily owing to the limited treatment options in the physician's armamentarium. However, various studies have underscored a lesser incidence of urolithiasis in cohorts predominantly consuming fruits and vegetables. This article aims to review various dietary plants, medicinal herbs and phytochemicals in the prevention and management of urolithiasis. METHODS To provide context and evidence, relevant publications were identified on Google Scholar, PubMed and Science-Direct using keywords such as urolithiasis, nephrolithiasis, urolithiasis, renal stones, phytochemicals and dietary plants. RESULTS Growing bodies of evidence suggest the incorporation of plant-based foods, medicinal and herbal supplements, and crude drugs containing phytochemicals into the staple diet of people. The anti-urolithiatic activity of these plant bioactives can be attributed to their antioxidant, antispasmodic, diuretic, and inhibitory effect on the crystallization, nucleation and crystal aggregation effects. These mechanisms would help alleviate the events and symptoms that aid in the development and progression of renal calculi. In addition, it will also avoid the exacerbation of secondary disorders like inflammation and injury, which can initiate a vicious circle in turn worsening the disease progression. CONCLUSION In conclusion, the results presented in the review demonstrate the promising role of various dietary plants, medicinal and herbal supplements, and phytochemicals in preventing and managing the precipitation of uroliths. However, more conclusive and cogent evidence from preclinical and clinical studies is required to substantiate their safety, efficacy and toxicity profiles in humans.
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Affiliation(s)
- Mitul Oswal
- Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be) University, Pune Maharashtra, 411038, India
| | - Ryan Varghese
- Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be) University, Pune Maharashtra, 411038, India
| | - Tanmay Zagade
- Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be) University, Pune Maharashtra, 411038, India
| | - Chetan Dhatrak
- Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be) University, Pune Maharashtra, 411038, India
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Dileep Kumar
- Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be) University, Pune Maharashtra, 411038, India
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Oral chemolysis is an effective, non-invasive therapy for urinary stones suspected of uric acid content. Urolithiasis 2020; 48:501-507. [PMID: 32770255 PMCID: PMC7666279 DOI: 10.1007/s00240-020-01204-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Despite the possible benefit from avoiding stone surgery with all its possible complications, oral chemolysis is rarely performed in patients with urinary stones suspected of uric acid content. Among the reasons for its limited use is the sparse and low-quality data on its efficacy and the lack of reliable factors predicting its outcome. We thus performed a retrospective single-center cohort study of 216 patients (median patient age 63 years) with 272 renal (48%) and/or ureteral (52%) stones treated with oral chemolysis from 01/2010 to 12/2019. Patients with low urine pH (< 6), low stone density upon non-contrast enhanced computed tomography (NCCT), radiolucent urinary stones on plain radiography, and/or a history of uric acid urolithiasis were included. Potassium citrate and/or sodium/magnesium bicarbonate were used for alkalization (target urine pH 6.5–7.2). Median stone size was 9 mm, median stone density 430 Hounsfield Units. Patients with ureteral stones < 6 mm were excluded since stones this small are very likely to pass spontaneously. The stone-free status of each patient was evaluated after 3 months using NCCT. Oral chemolysis was effective with a complete and partial response rate of stones at 3 months of 61% and 14%, respectively; 25% of stones could not be dissolved. Lower stone density (OR = 0.997 [CI 0.994–0.999]; p = 0.008) and smaller stone size (OR = 0.959 [CI 0.924–0.995]; p = 0.025) significantly increased the success rate of oral chemolysis in multivariate logistic regression analysis. More precise stone diagnostics to exclude non-uric-acid stones could further improve outcome.
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Golomb D, Nevo A, Goldberg H, Ehrlich Y, Margel D, Lifshitz D. Long-Term Adherence to Medications in Secondary Prevention of Urinary Tract Stones. J Endourol 2019; 33:469-474. [DOI: 10.1089/end.2019.0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Dor Golomb
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amihay Nevo
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hanan Goldberg
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron Ehrlich
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Margel
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Lifshitz
- Department of Urology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Medical dissolution therapy for the treatment of uric acid nephrolithiasis. World J Urol 2019; 37:2509-2515. [PMID: 30810833 DOI: 10.1007/s00345-019-02688-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/18/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Uric acid (UA) nephrolithiasis represents 10% of kidney stones in the US with low urine pH and high saturation of UA as the main risk factors for stone development. Dissolution therapy for UA kidney stones via urinary alkalization has been described as a treatment option. We present our experience in treating UA nephrolithiasis with medical dissolution therapy. METHODS A retrospective review was performed of UA stone patients referred for surgery but treated with dissolution therapy between July 2007 and July 2016. Patients were identified using ICD-9 codes. Patients were treated with potassium citrate alone or in combination with allopurinol. Serial imaging and urine pH were obtained at follow-up. Demographics, aggregate stone size, time to stone clearance, urine pH (office dip), and complications were recorded. RESULTS OBTAINED Twenty-four patients (14 men and 10 women) were identified that started medical dissolution therapy for UA nephrolithiasis after initial referral for surgical management. Three patients (13%) did not tolerate the initiation of dissolution therapy and discontinued this treatment. Of the 21 patients that were maintained on dissolution therapy, 14 patients (67%) showed complete resolution of nephrolithiasis and 7 patients (33%) showed partial reduction. Patients with partial response had a mean reduction in stone burden of 68%. There were 3 recorded complications (UTI, GI upset with therapy, and throat irritation) and 4 recorded stone recurrences among these 21 patients. CONCLUSION Based on our study population, medical dissolution therapy is a well-tolerated, non-invasive option for UA nephrolithiasis.
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Guha M, Banerjee H, Mitra P, Das M. The Demographic Diversity of Food Intake and Prevalence of Kidney Stone Diseases in the Indian Continent. Foods 2019; 8:E37. [PMID: 30669549 PMCID: PMC6352122 DOI: 10.3390/foods8010037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 01/14/2023] Open
Abstract
Food intake plays a pivotal role in human growth, constituting 45% of the global economy and wellbeing in general. The consumption of a balanced diet is essential for overall good health, and a lack of equilibrium can lead to malnutrition, prenatal death, obesity, osteoporosis and bone fractures, coronary heart diseases (CHD), idiopathic hypercalciuria, diabetes, and many other conditions. CHD, osteoporosis, malnutrition, and obesity are extensively discussed in the literature, although there are fragmented findings in the realm of kidney stone diseases (KSD) and their correlation with food intake. KSD associated with hematuria and renal failure poses an increasing threat to healthcare infrastructures and the global economy, and its emergence in the Indian population is being linked to multi-factorial urological disorder resulting from several factors. In this realm, epidemiological, biochemical, and macroeconomic situations have been the focus of research, even though food intake is also of paramount importance. Hence, in this article, we review the corollary associations with the consumption of diverse foods and the role that these play in KSD in an Indian context.
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Affiliation(s)
- Manalee Guha
- Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700019, India.
| | - Hritwick Banerjee
- Department of Biomedical Engineering, Faculty of Engineering, 4 Engineering Drive 3, National University of Singapore, Singapore 117583, Singapore.
| | - Pubali Mitra
- Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700019, India.
| | - Madhusudan Das
- Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700019, India.
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Salem SM, Sultan MF, Badawy A. Oral dissolution therapy for renal radiolucent stones, outcome, and factors affecting response: A prospective study. Urol Ann 2019; 11:369-373. [PMID: 31649455 PMCID: PMC6798288 DOI: 10.4103/ua.ua_20_19] [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] [Indexed: 11/16/2022] Open
Abstract
Background: Urolithiasis is a widespread problem, that affects up to 10% of population. Uric acid stones come second to calcium stones in prevalence (around 10% of urolithiasis). Potassium citrate is currently the treatment of choice for urine alkalization with minimal side effects and high tolerability. Aims and Objectives: This study is trying to present the outcome of oral dissolution therapy (ODT) for treating radiolucent renal stones and evaluating factors affecting its success in a prospective manner. Materials and Methods: Between 2015 and 2018, 147 patients with solitary radiolucent renal stones were offered ODT using potassium sodium hydrogen citrate (K citrate). The study included patients diagnosed by noncontrast computed tomography (NCCT) with stone size of 5–30 mm in the longest dimension and attenuation less than 600 Hounsfield units (HU). Patient compliance, blood pressure, creatinine level, K level, and tolerance to side effects were followed up at days 3, 7, and 15 and then monthly for 3 months. Follow-up renal ultrasound at 6-week intervals and a final NCCT at the end of treatment. Successful dissolution was defined as complete stone dissolution or residual that measures up to 2 mm in maximum length. Data were collected, tabulated, and analyzed using Stata 12.0 software (Stata Corporation, College Station, TX, USA). Results: One hundred and thirty-nine patients were included in the analyses. The age was 45.1 ± 10.5 years. DJ stent was used in 47 (33.8%) patients. Overall response rate was 64.8%. The stone location within the kidney (pelvic or calyceal) showed no difference between responders and non-responders. Stone longest diameter was smaller in responders (17 ± 5.7 mm) versus 19.2 ± 6.1 mm in nonresponders (P value = 0.039). The mean stone attenuation value (HU) was also lower in responders (347.4 ± 68.5 HU) versus (428.9 ± 84.0 HU) in nonresponders with P < 0.001. DJ insertions seemed to have marginal effect on stone dissolution on univariate analysis but found insignificant in multivariate analysis. Conclusion: ODT is safe and effective in the treatment of radiolucent renal stones. The efficacy was affected by stone density and stone size with more tendencies to failure with bigger stones and denser stones. Double J stent insertion may facilitate dissolution rate. There was no effect of the baseline urinarypH, hyperuricemia, or stone location on the dissolution rate of the stones.
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Affiliation(s)
- Shady Mohammed Salem
- Department of Urology, Faculty of Midicine, Menoufia University, Shibin Elkom, Egypt
| | - Mohammed Farag Sultan
- Department of Urology, Faculty of Midicine, Menoufia University, Shibin Elkom, Egypt
| | - Atef Badawy
- Department of Urology, Faculty of Midicine, Menoufia University, Shibin Elkom, Egypt
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Wu SY, Chen HY, Tsai KS, Chiang JH, Muo CH, Sung FC, Chen YH, Chen WC. Long-Term Therapy With Wu-Ling-San, a Popular Antilithic Chinese Herbal Formula, Did Not Prevent Subsequent Stone Surgery: A Nationwide Population-Based Cohort Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2016; 53:53/0/0046958016681148. [PMID: 27932514 PMCID: PMC5798738 DOI: 10.1177/0046958016681148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/16/2016] [Accepted: 10/22/2016] [Indexed: 12/17/2022]
Abstract
Traditional Chinese herbal medicine (CHM), which is widely used to treat pain and urolithiasis, is a promising therapy for urinary stone prevention. This study investigated the clinical efficacy of a popular CHM, Wu-Ling-San (WLS), in Taiwan for the prophylaxis of recurrent nephrolithiasis as assessed by surgical stone treatment via a nationwide population-based cohort study. The National Health Insurance Research Database, 2000–2010, which included one million patient records. All patients diagnosed with stone disease at the beginning of the study. The matched controls (4-fold the number of WLS patients) were stone patients who did not take WLS. Data analysis included the stone surgeries following the first treatment. We enrolled 11 900 patients with stone disease, and the incidence of stone patients in this database was 1.19%. The prevalence of comorbidities such as benign prostate hyperplasia, chronic kidney disease, diabetes mellitus, and urinary tract infection, but not hypertension, was significantly higher in WLS users. Several patients in both groups were prescribed potassium citrate. The stone treatment rate was significantly higher in WLS users (17.85%) than in the non-WLS users (14.47%). WLS users with an associated comorbidity had a higher treatment rate than the non-WLS users: 21.05% versus 16.70%, respectively. The surgery rate for upper urinary tract stones was higher in WLS users than in the non-WLS users (adjusted hazard ratio, 1.28; 95% confidence interval, 1.08-1.52; P < .05). The stone treatment rate (52.79%) was significantly higher in patients who used a very high amount of WLS (adjusted hazard ratio, 3.02; 95% confidence interval, 2.30-3.98). Stone patients using a high amount of WLS use had a high stone surgical rate. Long-term therapy with WLS did not have a preventive effect on stone surgical treatment. Long-term potassium citrate therapy as a preventive measure appeared to be underutilized in this study.
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Affiliation(s)
| | | | - Kao-Sung Tsai
- China Medical University, Taichung, Taiwan.,Hungkuang University, Taichung, Taiwan
| | | | | | | | - Yung-Hsiang Chen
- China Medical University, Taichung, Taiwan.,Asia University, Taichung, Taiwan
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Kc HB, Shrestha A, Acharya GB, Basnet RB, Shah AK, Shrestha PM. Tamsulosin versus tadalafil as a medical expulsive therapy for distal ureteral stones: A prospective randomized study. Investig Clin Urol 2016; 57:351-6. [PMID: 27617317 PMCID: PMC5017565 DOI: 10.4111/icu.2016.57.5.351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/22/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to compare the safety and efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteral stones. MATERIALS AND METHODS This prospective randomized study was conducted at the Department of Urology of Bir Hospital over a period of 12 months in patients with distal ureteral stones sized 5 to 10 mm. Patients were randomly divided into 2 groups: group A received tamsulosin 0.4 mg and group B received tadalafil 10 mg at bedtime for 2 weeks. Stone expulsion rate, number of ureteric colic episodes and pain score, analgesic requirements, and adverse drug effects were noted in both groups. Statistical analyses were performed by using Student t-test and chi-square test. RESULTS Altogether 85 patients, 41 in group A and 44 in group B, were enrolled in the study. The patients' average age was 31.72±12.63 years, and the male-to-female ratio was 1.5:1. Demographic profiles, stone size, and baseline investigations were comparable between the 2 groups. The stone expulsion rate was significantly higher in the tadalafil group than in the tamsulosin group (84.1% vs. 61.0%, p=0.017). Although the occurrence of side effects was higher with tadalafil, this difference was not significant (p=0.099). There were no serious adverse effects. CONCLUSIONS Tadalafil has a significantly higher stone expulsion rate than tamsulosin when used as a medical expulsive therapy for distal ureteral stones sized 5-10 mm. Both drugs are safe, effective, and well tolerated with minor side effects.
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Affiliation(s)
- Hari Bahadur Kc
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Anil Shrestha
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Ganesh Bhakta Acharya
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Robin Bahadur Basnet
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Arvind Kumar Shah
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Parash Mani Shrestha
- Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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Aykan S, Tuken M, Gunes S, Akin Y, Ozturk M, Seyhan S, Yuruk E, Temiz MZ, Yılmaz AF, Nguyen DP. ApaL1 urokinase and Taq1 vitamin D receptor gene polymorphisms in first-stone formers, recurrent stone formers, and controls in a Caucasian population. Urolithiasis 2016; 44:109-15. [PMID: 26275878 DOI: 10.1007/s00240-015-0813-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 08/04/2015] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to determine differences in genotype distribution and allele frequency of urokinase and vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) between first-stone formers, recurrent stone formers, and controls in a Caucasian population. A total of 86 first-stone formers, 78 recurrent stone formers, and 167 controls were included. Urokinase and VDR SNPs were tested by gene amplification followed by ApaL1 and Taq1 endonuclease digestion, respectively. Baseline variables, genotype, and allele frequencies were compared between the three groups, using descriptive statistics. Adjusted odds ratios were calculated to estimate the risk for recurrent urolithiasis associated with genotypes. We found that differences in the distribution of ApaL1 SNP and Taq1 SNP genotypes were statistically different between recurrent stone formers and first-stone formers, and between recurrent stone formers and controls. Allele frequency analysis showed that the T allele for ApaL1 SNP and the C allele for Taq1 SNP were significantly associated with recurrent urolithiasis. For Taq1 SNP, logistic regression analysis showed that the C/C genotype was associated with a more than threefold higher risk for recurrent urolithiasis. We conclude that ApaL1 and Taq1 SNPs of the urokinase and VDR genes are associated with recurrent urolithiasis in a Caucasian population.
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Affiliation(s)
- Serdar Aykan
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Murat Tuken
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Sezgin Gunes
- Department of Medical Biology, Ondokuz Mayis University, Samsun, Turkey
| | - Yigit Akin
- Department of Urology, Erzincan University, Erzincan, Turkey
| | - Murat Ozturk
- Bursa Training and Research Hospital, Istanbul, Turkey
| | - Serkan Seyhan
- Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Emrah Yuruk
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Zafer Temiz
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ali Faik Yılmaz
- Department of Urology, Ondokuz Mayis University, Samsun, Turkey
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Zhou L, Wang Q, Zhang L, Ning B, Zhang Y, Chen X. Determination of components in traditional Chinese medicines associated with promoting or inhibiting urinary stone formation. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2015. [DOI: 10.1016/j.jtcms.2016.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Reichard C, Gill BC, Sarkissian C, De S, Monga M. 100% uric acid stone formers: what makes them different? Urology 2014; 85:296-8. [PMID: 25623669 DOI: 10.1016/j.urology.2014.10.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/22/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify what risk factors on 24-hour urinalysis, if any, predispose patients to have higher percentages of uric acid (UA) stone composition in their stones, with specific emphasis on patients with pure UA stones. METHODS We retrospectively identified 308 patients from review of a kidney stone analysis database. Patients were grouped according to the percentage UA composition: 10%-20%, 30%-50%, 60%-90%, and 100% UA. Data were extracted from 24-hour urine collections and serum chemistries. Patients taking allopurinol, citrates, or thiazide diuretics were excluded. RESULTS The percentage UA stone composition increased as patients became older (P = .05) or heavier (P <.001). Gender did not impact the percentage of UA in stones. Although a higher serum UA level was associated with higher UA stone composition (P <.0006), urinary UA levels did not correlate (P = .1). In contrast, urinary pH correlated significantly with higher UA stone composition (P = .03). CONCLUSION Older and heavier patients with higher serum UA levels are more likely to have a pure UA stone. This information combined with traditional predictors (urine pH, radiopacity of stone, and Hounsfield units) may help identify those most likely to respond to dissolution therapy.
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Effect of Flos carthami Extract and α 1-Adrenergic Antagonists on the Porcine Proximal Ureteral Peristalsis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:437803. [PMID: 25170340 PMCID: PMC4120800 DOI: 10.1155/2014/437803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/08/2014] [Accepted: 05/08/2014] [Indexed: 11/20/2022]
Abstract
Traditional Chinese medicine (TCM) has been proposed to prevent urolithiasis. In China, Flos carthami (FC, also known as Carthamus tinctorius) (Safflower; Chinese name: Hong Hua/紅花) has been used to treat urological diseases for centuries. We previously performed a screening and confirmed the in vivo antilithic effect of FC extract. Here, ex vivo organ bath experiment was further performed to study the effect of FC extract on the inhibition of phenylepinephrine (PE) (10−4 and 10−3 M) ureteral peristalsis of porcine ureters with several α1-adrenergic antagonists (doxazosin, tamsulosin, and terazosin) as experimental controls. The results showed that doxazosin, tamsulosin, and terazosin dose (approximately 4.5 × 10−6 − 4.5 × 10−1
μg/mL) dependently inhibited both 10−4 and 10−3 M PE-induced ureteral peristalsis. FC extract achieved 6.2% ± 10.1%, 21.8% ± 6.8%, and 24.0% ± 5.6% inhibitions of 10−4 M PE-induced peristalsis at doses of 5 × 103, 1 × 104, and 2 × 104
μg/mL, respectively, since FC extract was unable to completely inhibit PE-induced ureteral peristalsis, suggesting the antilithic effect of FC extract is related to mechanisms other than modulation of ureteral peristalsis.
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Torricelli FCM, Marchini GS, De S, Yamaçake KGR, Mazzucchi E, Monga M. Predicting urinary stone composition based on single-energy noncontrast computed tomography: the challenge of cystine. Urology 2014; 83:1258-63. [PMID: 24726314 DOI: 10.1016/j.urology.2013.12.066] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/02/2013] [Accepted: 12/24/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To study several measurements from a single-energy noncontrast computed tomography (NCCT) that may distinguish calcium oxalate, uric acid, and cystine stones. METHODS Patients with pure urinary stones who had at least 1 single-energy NCCT before the stone composition analysis from January 2008 to December 2012 were enrolled in this study. The analyzed data comprised stone size, volume, core Hounsfield unit (HU), periphery HU, absolute and relative HU differences between core and periphery, and HU density. After these measurements, an NCCT bone window was subjectively evaluated to study the homogeneity of each stone from core to periphery. The Spearman correlation test was used to determine the correlation between HU values and stone size and volume for each group. RESULTS A total of 113 patients were found with pure urinary stones who also had a corresponding NCCT. There were 36, 47, and 30 patients in the calcium oxalate, uric acid, and cystine groups, respectively. The core HU, periphery HU, absolute and relative HU differences, and HU density were significantly different among the 3 groups (P<.001). Stone size and volume had a positive correlation with core and periphery HUs only for calcium oxalate and cystine stones. The subjective evaluation of the urinary calculi revealed a different pattern for each stone composition. CONCLUSION Single-energy NCCT may predict calcium oxalate stones with a high degree of accuracy. There is an overlap in radiographic profiles of cystine and uric acid stones, making a definitive differentiation more challenging.
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Affiliation(s)
- Fabio Cesar Miranda Torricelli
- Stevan B. Streem Center for Endourology and Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, OH; Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Giovanni Scala Marchini
- Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Shubha De
- Stevan B. Streem Center for Endourology and Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, OH
| | - Kleiton G R Yamaçake
- Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Eduardo Mazzucchi
- Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Manoj Monga
- Stevan B. Streem Center for Endourology and Stone Disease, Glickman Urological & Kidney Institute, The Cleveland Clinic, Cleveland, OH.
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Kumar S, Jayant K, Agrawal S, Singh SK. Comparative efficacy of tamsulosin versus tamsulosin with tadalafil in combination with prednisolone for the medical expulsive therapy of lower ureteric stones: a randomized trial. Korean J Urol 2014; 55:196-200. [PMID: 24648875 PMCID: PMC3956949 DOI: 10.4111/kju.2014.55.3.196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/09/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare the safety and efficacy of tamsulosin and tamsulosin with the phosphodiesterase-5 inhibitor tadalafil in combination with prednisolone as medical expulsive therapies for lower ureteric stones. MATERIALS AND METHODS Between July 2011 and December 2012, 62 adult patients presenting with distal ureteric stones sized 5 to 10 mm were randomized equally to treatment with tamsulosin (group A) or tamsulosin with tadalafil (group B). Therapy was given for a maximum of 6 weeks. In addition, patients in groups A and B were given 5-mg prednisolone once daily (maximum 1 week). The stone expulsion rate, time to stone expulsion, analgesic use, number of hospital visits for pain, follow-up and endoscopic treatment, and adverse effects of the drugs were noted. Statistical analyses were done by using Student t-test and chi-square test. RESULTS There was a higher expulsion rate (83.9% in group B and 74.2% in group A) and a lower time to expulsion in both treatment groups than in historical controls used in earlier studies. However, these results were not statistically significant (p=0.349, p=0.074, respectively). Statistically significant differences were noted in hospitalization for colic and analgesic requirement, which were less in group B than in group A. There were no serious adverse events. Another important finding was improvement in erectile function in group B. CONCLUSIONS Medical expulsive therapy for distal ureteric stones using tamsulosin and tadalafil with prednisolone is safe and efficacious. Also, the prescription of tadalafil in cases of erectile dysfunction with the development of lower ureteric stones may provide additional advantages.
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Affiliation(s)
- Santosh Kumar
- Department of Urology, PGIMER (Postgraduate Institute of Medical Education and Research), Chandigarh, India
| | - Kumar Jayant
- Department of Surgery, PGIMER (Postgraduate Institute of Medical Education and Research), Chandigarh, India
| | | | - Shrawan Kumar Singh
- Department of Urology, PGIMER (Postgraduate Institute of Medical Education and Research), Chandigarh, India
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Ho CY, Chen YH, Wu PY, Chang CH, Chen HY, Man KM, Shen JL, Tsai FJ, Lin WY, Lee YJ, Chen WC. Effects of commercial citrate-containing juices on urolithiasis in a Drosophila model. Kaohsiung J Med Sci 2013; 29:488-93. [DOI: 10.1016/j.kjms.2013.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 08/10/2012] [Indexed: 11/28/2022] Open
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Rosa M, Usai P, Miano R, Kim FJ, Agrò EF, Bove P, Micali S. Recent finding and new technologies in nephrolitiasis: a review of the recent literature. BMC Urol 2013; 13:10. [PMID: 23413950 PMCID: PMC3599704 DOI: 10.1186/1471-2490-13-10] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 02/06/2013] [Indexed: 11/24/2022] Open
Abstract
This review summarizes recent literature on advances regarding renal and ureteral calculi, with particular focus in areas of recent advances in the overall field of urolithiasis. Clinical management in everyday practice requires a complete understanding of the issues regarding metabolic evaluation and subgrouping of stone-forming patients, diagnostic procedures, effective treatment regime in acute stone colic, medical expulsive therapy, and active stone removal. In this review we focus on new perspectives in managing nephrolitihiasis and discuss recentadvances, including medical expulsive therapy, new technologies, and refinements of classical therapy such as shock wave lithotripsy, give a fundamental modification of nephrolithiasis management. Overall, this field appears to be the most promising, capable of new developments in ureterorenoscopy and percutaneous approaches. Further improvements are expected from robotic-assisted procedures, such as flexible robotics in ureterorenoscopy.
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Affiliation(s)
- Marco Rosa
- Department of Urology, University of Modena, Via del Pozzo, 71-41124, Modena, Italy
| | - Paolo Usai
- Department of Urology, University of Cagliari, Via Aurelio Nicolodi, 1 09123, Cagliari, Italy
| | - Roberto Miano
- Department of Urology, University “Tor Vergata”, Rome, Italy
| | - Fernando J Kim
- Department of Urology, Denver Health Care Center, 777 Bannock Street, Denver, CO, 80204-4597, USA
| | | | - Pierluigi Bove
- Department of Urology, University “Tor Vergata”, Rome, Italy
| | - Salvatore Micali
- Department of Urology, Denver Health Care Center, 777 Bannock Street, Denver, CO, 80204-4597, USA
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Perk OY, Şeşen M, Gozuacik D, Koşar A. Kidney Stone Erosion by Micro Scale Hydrodynamic Cavitation and Consequent Kidney Stone Treatment. Ann Biomed Eng 2012; 40:1895-902. [DOI: 10.1007/s10439-012-0559-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/22/2012] [Indexed: 12/25/2022]
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Guo Y, Zhang D, Lu H, Luo S, Shen X. Association between calcifying nanoparticles and placental calcification. Int J Nanomedicine 2012; 7:1679-86. [PMID: 22615531 PMCID: PMC3357051 DOI: 10.2147/ijn.s29786] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the possible contribution of calcifying nanoparticles to the pathogenesis of placental calcification. METHODS Calcified placental tissues and distal tissue samples were collected from 36 confirmed placental calcification cases. In addition, 20 normal placental tissue samples were obtained as a control group. All the tissue samples were cultured using special nanobacterial culture methods. The cultured calcifying nanoparticles were examined by transmission electron microscopy (TEM), and their growth was monitored by optical density (OD) at a wavelength of 650 nm. 16S rRNA gene expression of the cultured calcifying nanoparticles was also isolated and sequenced. RESULTS Novel calcifying nanoparticles wrapped with electron-dense shells between 50 nm to 500 nm in diameter were observed in the extracellular matrix of calcified placental tissues. They were detected in placental villi and hydroxyapatite crystals, and contained "nucleic acid-like materials". After isolation and four weeks of culture, 28 of 36 calcified placental tissue samples showed white granular precipitates attached to the bottom of the culture tubes. OD(650) measurements indicated that the precipitates from the calcified placental tissues were able to grow in culture, whereas no such precipitates from the control tissues were observed. The 16S rRNA genes were isolated from the cultured calcifying nanoparticles and calcified placental tissues, and their gene sequencing results implied that calcifying nanoparticles were novel nanobacteria (GenBank JF823648). CONCLUSION Our results suggest that these novel calcifying nanoparticles may play a role in placental calcification.
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Affiliation(s)
- Yanan Guo
- Molecular Medicine and Tumor Research Center, Chongqing Medical University, Yuzhong District, Chongqing, People's Republic of China
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Rajekar H, Singh SK. Primary Hyperoxaluria: The Role and Timing of Liver and Kidney Transplantation. Urolithiasis 2012. [DOI: 10.1007/978-1-4471-4387-1_77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kallidonis P, Liourdi D, Liatsikos E. Medical Treatment for Renal Colic and Stone Expulsion. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.eursup.2011.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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