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Yin S, Tang Y, Zhu M, Zeng J, Li X, Wu L, Wang X, Song T, Lin T. Ex Vivo Surgical Removal Versus Conservative Management of Small Asymptomatic Kidney Stones in Living Donors and Long-term Kidney Transplant Outcomes. Transplantation 2024:00007890-990000000-00831. [PMID: 39049114 DOI: 10.1097/tp.0000000000005146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND Donors with small asymptomatic kidney stones have been increasingly accepted because of organ shortages and advances in endoscopic urology. This study aims to evaluate and compare long-term living-donor kidney transplant outcomes following ex vivo surgical removal versus conservative management of donors' gifted asymptomatic stones. METHODS Between January 2007 and December 2021, 119 kidney transplant recipients received stone-bearing kidneys, divided into the removal group (N = 63) and observation group (N = 56). We evaluated posttransplant stone events, urinary infections, kidney function, delayed graft function, length of hospital stay, and survival outcomes. RESULTS After a median follow-up of 75.5 mo, the removal group had a 10.9% lower absolute incidence of stone events (7/56 [12.5%] versus 1/63 [1.6%]; hazard ratio, 0.08; 95% confidence interval, 0.01-0.77) and a 14.3% lower absolute incidence of urinary infections (16/56 [28.6%] versus 9/63 [14.3%]; hazard ratio, 0.42; 95% confidence interval, 0.19-0.95) than the observation group. The removal group also showed superior kidney graft function. The 2 groups had comparable length of hospital stay (11.0 versus 12.0 d; P = 0.297) and exhibited similar delayed graft function incidence (1/56 [1.8%] versus 2/63 [3.2%]; P = 1.000) and urinary stricture incidence (1/56 [1.8%] versus 3/63 [4.8%]; P = 0.621). Graft survival (P = 0.350) and patient survival (P = 0.260) were comparable between 2 groups. Subgroup analyses in recipients who received kidneys with stones <4 mm also reported similar results. CONCLUSIONS Ex vivo surgical removal might outperform conservative management for donors' gifted asymptomatic kidney stones, improving long-term transplant outcomes and reducing stone events without increasing perioperative complications, even for stones <4 mm.
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Affiliation(s)
- Saifu Yin
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yangming Tang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mengli Zhu
- Core Facilities of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jun Zeng
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingxing Li
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lijuan Wu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xianding Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Turun Song
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tao Lin
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Jiang Q, Dong C, He Z, Wang Y, Jiang R, Liao W, Yang S. Research landscape and pharmacological mechanisms of traditional Chinese medicines in treating and preventing urolithiasis: Unearthing an anti-urolithic treasure trove. JOURNAL OF ETHNOPHARMACOLOGY 2024; 334:118502. [PMID: 38950794 DOI: 10.1016/j.jep.2024.118502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/13/2024] [Accepted: 06/25/2024] [Indexed: 07/03/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Urolithiasis represents a predominant concern within urology due to its high recurrence rate and consequential surgical complications. Traditional Chinese Medicine (TCM), with a history spanning over 2000 years in treating kidney diseases, not only offers a less invasive and cost-effective option for treating and preventing urolithiasis, but also serves as a pharmacological treasure trove for the development of anti-urolithic drugs. AIM OF THE STUDY With the continuous deepening of research on the anti-urolithic effects of Chinese medicines, the pharmacological mechanisms of TCMs against urolithiasis are continuously evolving. Therefore, it is essential to summarize the current research status, clinical effectiveness, and mechanisms of TCM in treating and preventing urolithiasis, to ascertain its potential in anti-urolithic treatments, and to provide a reference for future anti-urolithiasis drug research. METHODS The electronic databases such as PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) have been utilized to retrieve relevant literature spanning from 2000 to September 2023, using keywords "Traditional Chinese Medicine" and "Urolithiasis". Then we conducted a visual analysis of the current status of related research, as well as a systematic organization of the therapeutic effects and underlying mechanisms of anti-urolithic TCMs. RESULTS Through the organization of research models, therapeutic effects, and active ingredients of 31 potential anti-urolithic TCMs, we have systematically summarized the underlying mechanisms of TCMs in management of urolithiasis. Mechanistically, Chinese herbs facilitate stone expulsion by enhancing diuresis, instigating anti-spasmodic effects, and promoting ureteral peristalsis when addressing calculi. They also harbor the potential to dissolve pre-existing stones. In terms of stone recurrence prevention, TCM compounds obstruct stone formation through targeting the sequence of crystal adhesion, nucleation, growth, and aggregation to inhibit stone formation. Additionally, TCM's significant roles include stifling oxidative stress, augmenting urinary stone inhibitors, and harmonizing oxalate metabolism, all of which are critical actions in stone prevention. CONCLUSION The anti-urolithic mechanism of TCM is multifaceted. Investigating the anti-urolithiasis mechanisms of TCM not only illuminates the potential of Chinese medicine in treating and preventing urolithiasis, but also uncovers active molecules and targets for drug treatment against calculus formation.
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Affiliation(s)
- Qinhong Jiang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Caitao Dong
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Ziqi He
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Yunhan Wang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Rong Jiang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Wenbiao Liao
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China.
| | - Sixing Yang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China.
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Yan J, Li S. Evaluating the lipid accumulation product index as a predictor for kidney stone prevalence: insights from NHANES 2007-2018. Int Urol Nephrol 2024:10.1007/s11255-024-04112-7. [PMID: 38869668 DOI: 10.1007/s11255-024-04112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE This study aimed to explore the relationship between the lipid accumulation product (LAP) index and kidney stone prevalence, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. METHODS An observational study was executed employing the NHANES dataset from 2007 to 2018. Analytical methods encompassed multivariate logistic regression, restricted cubic splines (RCS), subgroup analysis, and interaction tests. Predictions were made using the receiver operating characteristic (ROC) curve and the area under the curve (AUC) values. RESULTS The analysis included 9744 adults aged 20 years and older. Multivariate logistic regression identified a significant positive association between log2-transformed LAP (treated as a continuous variable) and kidney stone risk across all models, with odds ratios (ORs) exceeding 1 and p values less than 0.001. Categorically, ORs escalated with increasing LAP levels, indicating a dose-response relationship. The RCS analysis confirmed a linear positive correlation between log2-transformed LAP and kidney stone risk. Subgroup analyses revealed that the log2-transformed LAP-kidney stones relationship was consistent, unaffected by stratification across the examined variables. In addition, LAP index (AUC = 0.600) proved to be a more effective predictor of kidney stones compared to body mass index (AUC = 0.584). CONCLUSION Elevated LAP levels are positively correlated with a higher incidence of kidney stones, signifying its potential as a risk marker for this condition. Future research should investigate the mechanisms underlying this relationship. LAP can be used as a new anthropometric index to predict kidney stones, and its predictive ability is stronger than body mass index.
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Affiliation(s)
- Ji Yan
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Sen Li
- School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
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Xie J, Zhang XQ, Guo JN, Yuan Q, Xiao KF, Yuan YQ. The urinary microbiota composition and functionality of calcium oxalate stone formers. Front Cell Infect Microbiol 2024; 14:1394955. [PMID: 38912208 PMCID: PMC11190077 DOI: 10.3389/fcimb.2024.1394955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/29/2024] [Indexed: 06/25/2024] Open
Abstract
Background Accumulated evidences indicate that dysbiosis of the urinary microbiota is associated with kidney stone formation. In the present study, we aimed to investigate the urinary microbiota composition and functionality of patients with calcium oxalate stones and compare it with those of healthy individuals. Method We collected bladder urine samples from 68 adult patients with calcium oxalate stones and 54 age-matched healthy controls by transurethral catheterization. 16S rRNA gene and shotgun sequencing were utilized to characterize the urinary microbiota and functionality associated with calcium oxalate stones. Results After further exclusion, a total of 100 subjects was finally included and analyzed. The diversity of the urinary microbiota in calcium oxalate stone patients was not significantly different from that of healthy controls. However, the urinary microbiota structure of calcium oxalate stone formers significantly differed from that of healthy controls (PERMANOVA, r = 0.026, P = 0.019). Differential representation of bacteria (e.g., Bifidobacterium) and several enriched functional pathways (e.g., threonine biosynthesis) were identified in the urine of calcium oxalate stone patients. Conclusion Our results showed significantly different urinary microbiota structure and several enriched functional pathways in calcium oxalate stone patients, which provide new insight into the pathogenesis of calcium oxalate stones.
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Affiliation(s)
- Jing Xie
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Xue-qi Zhang
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Ji-nan Guo
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Qian Yuan
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Ke-feng Xiao
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Ye-qing Yuan
- Department of Urology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Shenzhen Engineering and Technology Center of Minimally Invasive Urology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
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Li Z, Fu C, Sun C, Suo Y, Li K, Qi S. Analysis of metabolic syndrome in bilateral upper urinary tract stones: A retrospective study of 3905 cases. Heliyon 2024; 10:e31180. [PMID: 38803979 PMCID: PMC11128924 DOI: 10.1016/j.heliyon.2024.e31180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 05/10/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
Bilateral upper urinary tract stones are significantly related to renal function damage. However, few studies characterized the risk factors of bilateral upper urinary tract stones. We retrospectively enrolled 3905 patients with urinary tract stones from March 2019 to March 2022 at the Second Hospital of Tianjin Medical University. Patients were divided into two groups according to the location of the stones, and the related data were evaluated. In this study, 2485 unilateral and 1420 bilateral stone patients were included. Multivariate logistic regression analysis showed that BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and metabolic syndrome (Mets) were independent risk factors for bilateral stone formation(P < 0.05). Based on these results, we construct a discrimination model. This model revealed good discrimination with an area under the receiver operating characteristic curves of 0.617, and the sensitivity and specificity were 0.592 and 0.586, respectively. Furthermore, the number of Mets components increased the risk of bilateral upper urinary tract stones. Hypertension, hyperglycemia, and low HDL level were strongly associated with bilateral upper urinary tract stones (P < 0.05). Patients with 5 components Mets had 1.89-fold higher risk of bilateral upper urinary tract stones than those with 1 component Mets (OR 3.381; 95 % CI 1.221-9.360; P = 0.013). Additionally, male patients with Mets had higher risk of bilateral upper urinary tract stones than female patients. Our analysis revealed that eight clinical factors were associated with the formation of bilateral upper urinary tract stones, namely BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and Mets. This study could help clinicians adjust treatment strategies for high-risk patients with bilateral upper urinary tract stones.
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Affiliation(s)
- Zhi Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Department of Urology, The 3(rd) Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Chong Fu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Chuangxin Sun
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yong Suo
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Department of Urology, Hebei Institute of Urology, Affiliated Hospital of Hebei University, Baoding, China
| | - Kai Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Department of Urology, Hebei Institute of Urology, Affiliated Hospital of Hebei University, Baoding, China
| | - Shiyong Qi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
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Pozdzik A, Grillo V, Sakhaee K. Gaps in kidney stone disease management: From clinical theory to patient reality. Urolithiasis 2024; 52:61. [PMID: 38592424 PMCID: PMC11004051 DOI: 10.1007/s00240-024-01563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024]
Abstract
With nephrolithiasis projected to affect 25% of the global population in the next three decades, there is an urgent call for innovative management strategies to prevent and reduce stone recurrence. This study aims to explore the evolving management needs in nephrolithiasis from both patient and healthcare provider perspectives. An expert-collaborative online survey comprising 10 targeted questions on kidney stone management was developed and disseminated. This survey was designed to gather comprehensive insights from patients, physicians and dietician and other person in the field of nephrolithiasis. Analysis of responses from 120 participants, including 45 nephrologists, 38 dieticians, 11 urologists, and 14 kidney stones patients followed in our hospital, revealed critical insights. A significant 97.5% emphasized the necessity of optimizing daily water intake, and 94.1% recognized the need for practical dietary modifications. Additionally, 88.3% of respondents found timely hydration reminders beneficial. Notably, monitoring urine color and pH was valued by 85% and 84.3% of the participants, respectively. A striking disparity emerged in the perception of fatigue and wellness monitoring, with 65% of patients prioritizing fatigue monitoring, a view less shared by healthcare professionals. Similarly, 71% of patients deemed wellness monitoring essential, highlighting a gap in understanding between patients and their caregivers. This study underscores the critical need for more tailored guidance on hydration strategies and the promise of remote urine parameters monitoring in nephrolithiasis management. The findings strongly advocate for a patient-centered approach, aligning medical recommendations with patient lifestyles and experiences, to enhance the effectiveness of nephrolithiasis management.
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Affiliation(s)
- Agnieszka Pozdzik
- Department of Nephrology and Dialysis, Kidney Stone Clinic, University Hospital Brugmann, Place A. Van Gehuchten 4, 1020, Brussels, Belgium.
- Faculty of Medecine, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.
| | - Viridiana Grillo
- MFP Haute Ecole de Vinci, Institut Paul Lambin, Place d'Alma 3, 1200, Brussels, Belgium
| | - Khashayar Sakhaee
- Department of Internal Medicine, and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Harry Hines Boulvards 5939, Dallas, TX, 75390, USA
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Siener R, Stein J, Ritter M. [Prevention of recurrence of urolithiasis]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:387-395. [PMID: 38466398 DOI: 10.1007/s00120-024-02312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
Urolithiasis is one of the most frequent urological diseases. Identifying the causes of stone formation forms the basis for successful prevention of recurrence. Metabolic diagnostics and measures for prevention of recurrence are based on the assignment of the patient to a low-risk or high-risk group. Analysis of the urinary calculi is an essential prerequisite for identifying patients at risk. The general recommendations on diet and lifestyle are considered to be the basis of treatment. Depending on the type of stone and the individual biochemical risk profile of a patient, these general measures should be supplemented by targeted medical nutrition therapy and pharmacological treatment. Mixed stones can pose a challenge for the treatment and prevention of recurrence. A personalized treatment decision that takes the various components of mixed stones into account could further improve the prevention of recurrence of urolithiasis.
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Affiliation(s)
- Roswitha Siener
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Johannes Stein
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Manuel Ritter
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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Basiri A, Kashi AH, Zahir M, Borumandnia N, Taheri M, Golshan S, Narouie B, Mombeini H. Predictors of Recurrent Urolithiasis in Iran: Findings from a Nationwide Study. ARCHIVES OF IRANIAN MEDICINE 2024; 27:200-205. [PMID: 38685846 PMCID: PMC11097307 DOI: 10.34172/aim.2024.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/24/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Prevention of urinary stone recurrence is the ultimate goal in urolithiasis patients. In this study, we aimed to investigate the national prevalence rate and possible determinants of increased urolithiasis recurrence risk in a nationwide study in Iran. METHODS All data regarding stone occurrence and recurrence episodes were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of recurrence were evaluated in the subset of 2913 patients who had a positive history of at least one episode of urolithiasis. RESULTS The national prevalence rate of recurrent urolithiasis was 2.6% (95% CI: 2.5, 2.8) in Iran. Moreover, the relative ratio of recurrent stone formers to all stone formers was 39.8% (95% CI: 38.0, 41.6). Our univariable truncated negative binomial regressions suggested that a positive history of urolithiasis in the patient's father (prevalence ratio [PR] [95% CI]=1.83 [1.39, 2.41], P<0.001), mother (PR [95% CI]=1.92 [1.39, 2.66], P<0.001) or brother (PR [95% CI]=1.32 [1.03, 1.69], P=0.026); and residence in urban areas (PR [95% CI]=1.27 [1.04, 1.55], P=0.016) were significant predictors of repetitive recurrence episodes. However, when incorporated into a multivariable truncated negative binomial regression model, the only significant predictors of more frequent recurrence episodes were a positive history in father (PR [95% CI]=1.66 [1.24, 2.22], P<0.001) and mother (PR [95% CI]=1.68 [1.20, 2.36], P=0.002); and urban residence (PR [95% CI]=1.24 [1.01, 1.51], P=0.031). CONCLUSION Our results indicate that a positive family history of urolithiasis in mother and father and residence in urban areas are the significant predictors of recurrence risk in urolithiasis patients in Iran.
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Affiliation(s)
- Abbas Basiri
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Kashi
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mazyar Zahir
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Taheri
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shabnam Golshan
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hayat Mombeini
- Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Tamborino F, Cicchetti R, Mascitti M, Litterio G, Orsini A, Ferretti S, Basconi M, De Palma A, Ferro M, Marchioni M, Schips L. Pathophysiology and Main Molecular Mechanisms of Urinary Stone Formation and Recurrence. Int J Mol Sci 2024; 25:3075. [PMID: 38474319 DOI: 10.3390/ijms25053075] [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: 12/22/2023] [Revised: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Kidney stone disease (KSD) is one of the most common urological diseases. The incidence of kidney stones has increased dramatically in the last few decades. Kidney stones are mineral deposits in the calyces or the pelvis, free or attached to the renal papillae. They contain crystals and organic components, and they are made when urine is supersaturated with minerals. Calcium-containing stones are the most common, with calcium oxalate as the main component of most stones. However, many of these form on a calcium phosphate matrix called Randall's plaque, which is found on the surface of the kidney papilla. The etiology is multifactorial, and the recurrence rate is as high as 50% within 5 years after the first stone onset. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more effective drugs. This review aims to understand the pathophysiology and the main molecular mechanisms known to date to prevent recurrences, which requires behavioral and nutritional interventions, as well as pharmacological treatments that are specific to the type of stone.
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Affiliation(s)
- Flavia Tamborino
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Rossella Cicchetti
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Marco Mascitti
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Giulio Litterio
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Angelo Orsini
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Simone Ferretti
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Martina Basconi
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Antonio De Palma
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy
| | - Michele Marchioni
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
| | - Luigi Schips
- Department of Medical Oral and Biotechnological Science, Università degli Studi "G. d'Annunzio" of Chieti, 66100 Chieti, Italy
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Alshubaili AM, Alotaibi AF, Alsaleh KA, Almogarri AI, Alanizi AA, Alsaif SS, Alghamdi AS, Alnazari NM, Almalki A. The Prevalence of Nephrolithiasis and Associated Risk Factors Among the Population of the Riyadh Province, Saudi Arabia. Cureus 2024; 16:e55870. [PMID: 38595876 PMCID: PMC11002709 DOI: 10.7759/cureus.55870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Background and objective Kidney stones, also referred to as nephrolithiasis or renal calculi, is a condition where crystal depositions are formed within the kidney and ideally excreted from the body via the urethra with no pain; however, larger calculi may cause significant pain and require further medical assistance. The vast majority of patients who develop renal calculi form calcium stones, which are either a composition of calcium oxalate or calcium phosphate. Other types include uric acid, struvite, and cysteine. While kidney stones are one of the most significant diseases among the Saudi population, which require an acute emergency intervention to prevent serious long-term complications, there are limited studies published regarding this condition in Saudi communities. In light of this, we performed this study to assess the prevalence, incidence, and risk factors of kidney stones among the population of Riyadh, Saudi Arabia. Methods This was a cross-sectional study conducted in Riyadh, Saudi Arabia between August and October 2023, aiming to estimate the prevalence and risk factors of nephrolithiasis among residents of the Riyadh province. Data were collected through an electronic questionnaire in both Arabic and English and distributed via social media in addition to barcode handouts in various selected venues in Riyadh. The questionnaire involved 12 questions categorized into three sections. The first section obtained demographical information while the second section collected data about the past medical history of the participants. Lastly, the third section aimed to assess the prevalence of nephrolithiasis among participants or any history of the condition among their families. Results A total of 1,043 participants were surveyed, of whom 533 were males (51.1%). The prevalence of kidney stones was reported in 98 individuals (9.4%) overall. Individuals in the age groups of 36-50, 51-60, and >60 years showed significantly more renal stone prevalence than those in younger age groups (p<0.001). The prevalence was found to be higher in participants who were smokers, diabetic, hypertensive, and those who suffered from inflammatory bowel disease (IBD), gout, chronic kidney disease (CKD), hyperthyroidism, and hyperparathyroidism. Participants who took calcium supplements or had a positive family history of renal stones were found to have a higher prevalence of renal stones as well. However, only hypertension, gout, and family history showed any statistical significance (p<0.05). Conclusions A direct correlation was observed between hypertension, gout, positive family history, and aging and an increased prevalence of kidney stones among the inhabitants of the Riyadh province. Therefore, we encourage the local authorities to raise awareness of kidney stones and their related risk factors among the general public. Moreover, further local studies need to be conducted to gain deeper insights into kidney stone prevalence, especially pertaining to associated comorbidities and the pattern of the disease itself.
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Affiliation(s)
- Abdullah M Alshubaili
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz F Alotaibi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Khalid A Alsaleh
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdulaziz I Almogarri
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdullah A Alanizi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Saif S Alsaif
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Ahmad S Alghamdi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Nasser M Alnazari
- Department of Hepatobiliary Sciences and Organ Transplant, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Amwaj Almalki
- Biostatistics and Epidemiology, King Abdullah International Medical Research Center, Riyadh, SAU
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Klein I, Pilosov Solomon I, Yasinov F, Zreik R, Friefeld Y, Dekel Y. "No stone should be left unturned": The next stone composition for recurrent stone formers is unpredictable, so all stones should be sent for analysis. World J Urol 2024; 42:107. [PMID: 38416250 DOI: 10.1007/s00345-024-04851-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Ilan Klein
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Ilona Pilosov Solomon
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel.
| | - Felix Yasinov
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel
| | - Rani Zreik
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Yuval Friefeld
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Yoram Dekel
- Department of Urology, Lady Davis Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel
- Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
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12
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Ni J, Lv L, Wu P, Xu C. Associations between the platelet/high-density lipoprotein cholesterol ratio and likelihood of nephrolithiasis: a cross-sectional analysis in United States adults. Front Endocrinol (Lausanne) 2024; 15:1289553. [PMID: 38449847 PMCID: PMC10914985 DOI: 10.3389/fendo.2024.1289553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
Aims The primary objective of this study was to investigate the relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR) and the prevalence of nephrolithiasis within the adult population of the United States. Methods The data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018. The analysis included a non-pregnant population aged 20 years or older, providing proper PHR index and nephrolithiasis data. The research utilized subgroup analyses and weighted univariate and multivariable logistic regression to evaluate the independent association between the PHR and the susceptibility to nephrolithiasis. Results The study comprised 30,899 participants with an average PHR value of 19.30 ± 0.11. The overall prevalence rate of nephrolithiasis was estimated at 9.98% with an increase in the higher PHR tertiles (T1, 8.49%; T2, 10.11%; T3, 11.38%, P < 0.0001). An elevated PHR level was closely linked with a higher susceptibility to nephrolithiasis. Compared with patients in T1, and after adjusting for potential confounders in model 2, the corresponding odds ratio for nephrolithiasis in T3 was 1.48 (95% CI: 1.06 to 2.08), with a P-value = 0.02. The results of the interaction tests revealed a significant impact of chronic kidney disease on the relationship between PHR and nephrolithiasis. Furthermore, the restricted cubic spline analyses exhibited a positive, non-linear correlation between PHR and the risk of nephrolithiasis. Conclusion A convenient biomarker, the PHR, was independently associated with nephrolithiasis and could be a novel biomarker in predicting occurrence in clinical decision.
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Affiliation(s)
- Junjie Ni
- Department of Breast and Thyroid Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Lin Lv
- Department of Breast and Thyroid Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Pu Wu
- Central Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Chaoyang Xu
- Department of Breast and Thyroid Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
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13
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Rungrasameviriya P, Santilinon A, Atichartsintop P, Hadpech S, Thongboonkerd V. Tight junction and kidney stone disease. Tissue Barriers 2024; 12:2210051. [PMID: 37162265 PMCID: PMC10832927 DOI: 10.1080/21688370.2023.2210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023] Open
Abstract
Defects of tight junction (TJ) are involved in many diseases related to epithelial cell functions, including kidney stone disease (KSD), which is a common disease affecting humans for over a thousand years. This review provides brief overviews of KSD and TJ, and summarizes the knowledge on crystal-induced defects of TJ in renal tubular epithelial cells (RTECs) in KSD. Calcium oxalate (CaOx) crystals, particularly COM, disrupt TJ via p38 MAPK and ROS/Akt/p38 MAPK signaling pathways, filamentous actin (F-actin) reorganization and α-tubulin relocalization. Stabilizing p38 MAPK signaling, reactive oxygen species (ROS) production, F-actin and α-tubulin by using SB239063, N-acetyl-L-cysteine (NAC), phalloidin and docetaxel, respectively, successfully prevent the COM-induced TJ disruption and malfunction. Additionally, genetic disorders of renal TJ, including mutations and single nucleotide polymorphisms (SNPs) of CLDN2, CLDN10b, CLDN14, CLDN16 and CLDN19, also affect KSD. Finally, the role of TJ as a potential target for KSD therapeutics and prevention is also discussed.
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Affiliation(s)
- Papart Rungrasameviriya
- Nawamethee Project, Doctor of Medicine Program, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aticha Santilinon
- Nawamethee Project, Doctor of Medicine Program, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Palita Atichartsintop
- Nawamethee Project, Doctor of Medicine Program, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sudarat Hadpech
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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14
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Ye Z, Wu C, Xiong Y, Zhang F, Luo J, Xu L, Wang J, Bai Y. Obesity, metabolic dysfunction, and risk of kidney stone disease: a national cross-sectional study. Aging Male 2023; 26:2195932. [PMID: 37038659 DOI: 10.1080/13685538.2023.2195932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association between different metabolic syndrome-body mass index (MetS-BMI) phenotypes and the risk of kidney stones. MATERIALS AND METHODS Participants aged 20-80 years from six consecutive cycles of the NHANES 2007-2018 were included in this study. According to their MetS status and BMI, the included participants were allocated into six mutually exclusive groups: metabolically healthy normal weight (MHN)/overweight (MHOW)/obesity (MHO) and metabolically unhealthy normal weight (MUN)/overweight (MUOW)/obesity (MUO). To explore the association between MetS-BMI phenotypes and the risk of kidney stones, binary logistic regression was used to determine the odds ratios (ORs). RESULTS A total of 13,589 participants were included. It was revealed that all the phenotypes with obesity displayed higher risks of kidney stones (OR = 1.38, p < 0.01 for MHO & OR = 1.80, p < 0.001 for MUO, in the fully adjusted model). The risk increased significantly when metabolic dysfunction coexisted with overweight and obesity (OR = 1.39, p < 0.05 for MUOW & OR = 1.80, p < 0.001 for MUO, in the fully adjusted model). Of note, the ORs for the MUO and MUOW groups were higher than those for the MHO and MHOW groups, respectively. CONCLUSIONS Obesity and unhealthy metabolic status can jointly increase the risk of kidney stones. Assessing the metabolic status of all individuals may be beneficial for preventing kidney stones.
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Affiliation(s)
- Zhenyang Ye
- Department of Urology, West China Xiamen Hospital of Sichuan University, Xiamen, P.R. China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Changjing Wu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Yang Xiong
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Fuxun Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jinyang Luo
- Department of Urology, West China Xiamen Hospital of Sichuan University, Xiamen, P.R. China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Lijing Xu
- Department of Urology, West China Xiamen Hospital of Sichuan University, Xiamen, P.R. China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jia Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Yunjin Bai
- Department of Urology, West China Hospital, Sichuan University, Chengdu, P.R. China
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15
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Zheng X, Chen Q, Wu Y, Xiong J. Association of body fat percentage with kidney stone Disease: a cross-sectional and longitudinal study among bus drivers. BMC Public Health 2023; 23:2174. [PMID: 37932777 PMCID: PMC10629027 DOI: 10.1186/s12889-023-17128-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The association between body fat percentage (BFP) and kidney stone disease (KSD) among bus drivers has not been explored in the existing literature. Thus, this study was conducted to explore the influence of BFP on the risk of KSD as well as KSD development for bus drivers to fill the research gap. METHODS A cross-sectional and longitudinal cohort study was designed. In total, 3433 bus drivers were included in the cross-sectional analyses, and 1864 bus drivers without KSD at baseline and with regular follow-up were included in the longitudinal cohort study. RESULTS During a median follow-up of 2.9 years, KSD occurred in 15.0% of bus drivers. Multivariate logistic analysis found that each 5% higher BFP was not only significantly related with higher odds of KSD (odds ratio [OR] = 1.48), but also associated with higher odds of developing KSD (OR = 1.27). The risk of prevalent KSD in obesity group based on BFP was 2.47 times of the normal group; and the corresponding risk of developing KSD was 1.61 times. For obesity bus drives with age < 40, the corresponding risk increased to 4.54 times. CONCLUSION Bus drivers were reported to have a high prevalence of KSD as well as development of KSD. As a significant predictive factor for KSD, BFP can be used to monitor and prevent bus drivers from kidney stone formation. Bus drivers in obesity group based on BFP, especially with age < 40 years should become priority subjects for targeted prevention.
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Affiliation(s)
- Xujuan Zheng
- Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, China
| | - Qianqian Chen
- Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, China
| | - Yanxia Wu
- Health Management Centre, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, China
| | - Juan Xiong
- Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, China.
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Xia K, Xu Y, Qi Q, Huang Q, Yao R, Zhang J, Hao Z. Establishment of a new predictive model for the recurrence of upper urinary tract stones. Int Urol Nephrol 2023; 55:2411-2420. [PMID: 37436572 DOI: 10.1007/s11255-023-03698-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE To construct a nomogram for evaluation of the recurrence risk of upper urinary tract stones in patients. METHODS We retrospectively reviewed the clinical data of 657 patients with upper urinary tract stones and divided them into stone recurrence group and non-recurrence group. Blood routine, urine routine, biochemical, and urological CT examinations were searched from the electronic medical record, relevant clinical data were collected, including age, BMI, stones number and location, maximum diameter, hyperglycemia, hypertension, and relevant blood and urine parameters. The Wilcoxon rank-sum test, independent sample t test, and Chi-square test were used to preliminarily analyze the data of the two groups, then LASSO and logistic regression analysis were used to find out the significant difference indicators. Finally, R software was used to draw a nomogram to construct the model, and ROC curve was drawn to evaluate the sensitivity and specificity. RESULTS The results showed that multiple stones (OR: 1.832, 95% CI 1.240-2.706), bilateral stones (OR: 1.779, 95% CI 1.226-2.582), kidney stones (OR: 3.268, 95% CI 1.638-6.518), and kidney ureteral stones (OR: 3.375, 95% CI 1.649-6.906) were high risk factors. And the stone recurrence risk was positively correlated with creatinine (OR: 1.012, 95% CI 1.006-1.018), urine pH (OR: 1.967, 95% CI 1.343-2.883), Apo B (OR: 4.189, 95% CI 1.985-8.841) and negatively correlated with serum phosphorus (OR: 0.282, 95% CI 0.109-0.728). In addition, the sensitivity and specificity of the prediction model were 73.08% and 61.25%, diagnosis values were greater than any single variable. CONCLUSION The nomogram model can effectively evaluate the recurrence risk of upper urinary stones, especially suitable for stone postoperative patients, to help reduce the possibility of postoperative stone recurrence.
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Affiliation(s)
- Kaiguo Xia
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yuexian Xu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Qiao Qi
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Qingfeng Huang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Rui Yao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Junzhi Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.
- Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China.
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17
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Xia K, Xu Y, Qi Q, Pan J, Yao R, Huang Q, Hao Z. Ae index is an independent predictor of kidney stone recurrence in overweight and obese patients. BMC Urol 2023; 23:151. [PMID: 37742017 PMCID: PMC10518111 DOI: 10.1186/s12894-023-01321-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Finding some convenient and economical indicators to initially screen overweight and obese patients at high risk of kidney stone recurrence can help them prevent stone recurrence with lower medical cost. The purpose of this article is to determine the clinical value of Ae index (Apo B × 1000/eGFR) as an independent predictor for kidney stone recurrence in overweight and obese populations. METHODS We queried the electronic medical records of patients with kidney stone operated at our hospital from March 2016 to March 2022, and selected BMI ≥ 25 kg/m2 as the study population and divided the patients into stone recurrence group and non-recurrence group. Relevant parameters of routine blood and biochemical test, glycated serum protein (GSP), and history of hypertension and hyperglycemia were collected. Then the Chi-square test, independent samples t-test or Wilcoxon rank-sum test were used to calculate the differences between the two groups of data. Next, we performed univariate and multivariate logistic regression analysis to screen out the most significant variables Apo B and eGFR, and then we calculated the Ae index using the formula Apo B × 1000/eGFR, and analyzed the relationship between Ae index and kidney stone recurrence. RESULTS Univariate analysis found that Apo B (OR:8.376,95%CI:3.093-22.680), Creatinine (OR:1.012,95%CI:1.003-1.021), Cystatin C(OR:2.747,95%CI:1.369-5.508), LDL-C (OR:1.588,95%CI:1.182-2.134), TC (OR:1.543,95%CI:1.198-1.988) were positively associated, eGFR (OR:0.980,95%CI:0.970-0.991) was negatively associated with kidney stone recurrence. And multivariate logistic regression analysis suggested that Apo B (OR:11.028, 95%CI:3.917-31.047) and eGFR (OR:0.976, 95%CI:0.965-0.988) were the most significant factors. Then we calculated Ae index and analyzed it, the sensitivity was 74.26% and the specificity was 60.00%, higher than either individual variable. Its smoothed curve revealed a non-linear relationship between them with the inflection point of 9.16. And the OR on the left side of the inflection point was 1.574 (95% CI: 1.228-2.018), whereas the OR on the right side of the inflection point was 1.088 (95% CI: 1.007-1.177). CONCLUSIONS Ae index is an easily calculated and obtained index that has some predictive value for kidney stone recurrence in overweight and obese patients, which is of interest.
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Affiliation(s)
- Kaiguo Xia
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Yuexian Xu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Qiao Qi
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Jiashan Pan
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Rui Yao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Qingfeng Huang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, 230022, China.
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18
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Peerapen P, Boonmark W, Thongboonkerd V. Characterizations of annexin A1-interacting proteins in apical membrane and cytosolic compartments of renal tubular epithelial cells. Comput Struct Biotechnol J 2023; 21:3796-3809. [PMID: 37560129 PMCID: PMC10407547 DOI: 10.1016/j.csbj.2023.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
Annexin A1 (ANXA1) is a multifunctional calcium-binding protein that can bind to membrane phospholipids. Under high-calcium condition, ANXA1 expression increases on renal epithelial cell surface, leading to enhanced adhesion of calcium oxalate (CaOx) crystal (stone material) onto the cells. To regulate various cellular processes, ANXA1 interacts with many other intracellular protein partners. However, components of the ANXA1-interacting protein complex remain unclear. Herein, we characterized the interacting complexes of apical membrane (ApANXA1) and cytosolic (cyANXA1) forms of ANXA1 in apical membrane and cytosolic compartments, respectively, of renal epithelial cells under high-calcium condition using proteomic and bioinformatic approaches. After fractionation, the ApANXA1- and CyANXA1-interacting partners were identified by immunoprecipitation followed by nanoLC‑ESI‑Qq-TOF tandem mass spectrometry (IP-MS/MS). The ANXA1-interacting partners that were common in both apical membrane and cytosolic compartments and those unique in each compartment were then analyzed for their physico-chemical properties (molecular weight, isoelectric point, amino acid contents, instability index, aliphatic index, and grand average of hydropathicity), secondary structure (α-helix, β-turn, random coil, and extended strand), molecular functions, biological processes, reactome pathways and KEGG pathways. The data demonstrated that each set of these interacting proteins exhibited common and unique characteristics and properties. The knowledge from this study may lead to better understanding of the ApANXA1 and CyAXNA1 biochemistry and functions as well as the pathophysiology of CaOx kidney stone formation induced by high-calcium condition.
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Affiliation(s)
- Paleerath Peerapen
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Wanida Boonmark
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Cao C, Jin X, Ding Q, Zhu J, Yang D, Fan B. The altered composition of gut microbiota and biochemical features as well as dietary patterns in a southern Chinese population with recurrent renal calcium oxalate stones. Urolithiasis 2023; 51:95. [PMID: 37458823 DOI: 10.1007/s00240-023-01467-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
The correlation among gut microbiota, biochemical features, and dietary patterns in recurrent stone formers has been inadequately investigated in the Chinese population. Forty-two patients with calcium oxalate stones (CaOxS group), including 34 recurrent stone formers (RS group), and 40 nonstone healthy subjects (NS group) from Changshu Hospital Affiliated with Soochow University, were prospectively recruited. Food frequency questionnaires were completed by participants, fasting vein blood was extracted, 24-h urine was collected for biochemical detection, and fecal samples were gathered for 16S ribosomal RNA (rRNA) gene sequencing. BMI; serum levels of triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), magnesium, and creatinine; and urine levels of magnesium in stone formers were significantly different from those of controls, and RS patients showed significantly low serum phosphate and high urine phosphate levels. Celery, bamboo shoots, and pickled food were the favored foods of local stone formers. Patients with recurrent stones had altered microbiota composition, with Escherichia, Fusobacterium, and Epulopiscium being the predominant pathogenic genera. The gut microbiota in RS patients had stronger functions in fatty acid and amino acid degradation but weaker functions in their biosynthesis. The pathogenic genera were positively correlated with BMI; serum levels of TGs and creatinine; urine levels of calcium, phosphate, and uric acid (UA); and celery, bamboo shoots, and pickled food intake. The abundance of Escherichia and Fusobacterium and the levels of serum magnesium and creatinine were the most relevant factors associated with stone recurrence and could be validated as biomarkers of recurrence. Our research provides a novel prevention strategy for the recurrence of renal calcium oxalate stones in the Han Chinese population of southern China.
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Affiliation(s)
- Cheng Cao
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Xiaohua Jin
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Qi Ding
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Jin Zhu
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Dongrong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Fan
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China.
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Alshehri M, Alsaeed H, Alrowili M, Alhoshan F, Abdel Raheem A, Hagras A. Evaluation of risk factors for recurrent renal stone formation among Saudi Arabian patients: Comparison with first renal stone episode. Arch Ital Urol Androl 2023; 95:11361. [PMID: 37401378 DOI: 10.4081/aiua.2023.11361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/28/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES We evaluated the baseline characteristics, and risk factors of renal stone recurrence among Saudi Arabian patients after successful primary stone treatment. MATERIALS AND METHODS In this cross-sectional comparative study, we reviewed the medical records of patients who presented consecutively with a first renal stone episode from 2015 to 2021 and were followed-up by mail questionnaire, telephone interviews, and/or outpatient clinic visit. We included patients who achieved stone-free status after primary treatment. Patients were divided into two groups: group I (patients with first episode renal stone) and group Ⅱ (patients who developed renal stone recurrence). The study outcomes were to compare the demographics of both groups and to evaluate the risk factors of renal stone recurrence after successful primary treatment. We used Student's t-test, Mann Whitney test or chi-square (x2) to compare variables between groups. Cox regression analyses were used to examine the predictors. RESULTS We investigated 1260 participants (820 males and 440 females). Of this number, 877 (69.6%) didn't develop renal stone recurrence and 383 (30.4%) had recurrence. Primary treatments were percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), extracorporeal shock wave lithotripsy (ESWL), surgery and medical treatment in 22.5%, 34.7%, 26.5%, 10.3%, and 6%, respectively. After primary treatment, 970 (77%) and 1011 (80.2%) of patients didn't have either stone chemical analysis or metabolic work-up, respectively. Multivariate logistic regression analysis revealed that male gender (OR: 1.686; 95% CI, 1.216-2.337), hypertension (OR: 2.342; 95% CI, 1.439-3.812), primary hyperparathyroidism (OR: 2.806; 95% CI, 1.510-5.215), low fluid intake (OR: 28.398; 95% CI, 18.158-44.403) and high daily protein intake (OR: 10.058; 95% CI, 6.400-15.807) were predictors of renal stone recurrence. CONCLUSIONS Male gender, hypertension, primary hyperparathyroidism, low fluid intake and high daily protein intake increase the risk of renal stone recurrence among Saudi Arabian patients.
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Affiliation(s)
- Mohammed Alshehri
- Department of Urology, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh.
| | - Hind Alsaeed
- Princess Nourah bint Abdulrahman University, Riyadh.
| | | | | | - Ali Abdel Raheem
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia; Department of Urology, Tanta University Hospital, Tanta.
| | - Ayman Hagras
- Department of Urology, Tanta University Hospital, Tanta, Egypt; Division of Urology, Surgery Department, Sharurah Armed Forces Hospital, Sharurah.
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Abate V, Vergatti A, Fiore A, Forte A, Attanasio A, Altavilla N, De Filippo G, Rendina D, D Elia L. Low Potassium Intake: A Common Risk Factor for Nephrolithiasis in Patients with High Blood Pressure. High Blood Press Cardiovasc Prev 2023:10.1007/s40292-023-00587-0. [PMID: 37330455 PMCID: PMC10403441 DOI: 10.1007/s40292-023-00587-0] [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: 03/21/2023] [Accepted: 05/29/2023] [Indexed: 06/19/2023] Open
Abstract
Hypertension (Htn) is a crucial cause of cardio-vascular and chronic kidney disease. Moreover, it is an independent risk factor for nephrolithiasis (NL). A diet rich in vegetables and fruits is indicated for both Htn and NL prevention, and the 24-h urinary potassium excretion can be used as a warning light for adherence. The aim of this study is to demonstrate the association between urinary potassium excretion and recurrent nephrolithiasis among patients affected by Htn. We have analyzed medical records of 119 patients affected by Htn and NL (SF-Hs) referring to Bone and Mineral Metabolism laboratory and 119 patients affected by Htn but without NL (nSF-Hs) referring to Hypertension and Organ Damage Hypertension related laboratory, both in Federico II University of Naples. The potassium 24-h urinary levels in SF-Hs were significantly lower compared to nSF-Hs. This difference was confirmed by the multivariable linear regression analysis in the unadjusted model and adjusted model for age, gender, metabolic syndrome, and body mass index. In conclusion, a higher potassium urinary excretion in 24-h is a protective factor against NL in patients affected by Htn and dietary interventions can be considered for kidney protection.
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Affiliation(s)
- Veronica Abate
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Anita Vergatti
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Antonella Fiore
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Angelo Forte
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Alessia Attanasio
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Nadia Altavilla
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d'Endocrinologie-Diabétologie, 75019, Paris, France
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy.
| | - Lanfranco D Elia
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Via Sergio Pansini, 80131, Naples, Italy
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Almaghlouth AK, Alqutayfi HM, Bohamad AH, Almarzooq AJ, Alamer MA, Alqattan DJ. Urolithiasis Symptoms and Risk Factors Among the General Population of Alahsa, Saudi Arabia. Cureus 2023; 15:e39645. [PMID: 37388587 PMCID: PMC10306256 DOI: 10.7759/cureus.39645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE This study aims to assess the awareness and attitudes about urolithiasis among the general population of Alahsa, Saudi Arabia. METHODOLOGY A cross-sectional study was conducted in September 2022 in Alahsa, Saudi Arabia, using a validated questionnaire that was distributed to the general population. Inclusion criteria include male and female citizens of Saudi Arabia who were living in Alahsa, older than 18 years old, and willing to participate in the study. Exclusion criteria include non-Saudi citizens or Saudi citizens who did not live in Alahsa. Data were analyzed using SPSS Statistics. RESULT The results showed there were 1023 participants. The results showed the awareness level of symptoms associated with kidney stones at 29%, complications at 34%, diagnosis at 51%, and treatment at 16%. The results showed there was a significant association between a history of kidney stones and having no complications (p-value = 0.002) or inflammation (p-value = 0.009). However, there was no significant association between kidney stone symptoms and the participants' comorbidities. CONCLUSION According to our findings, there was a low level of knowledge about the condition and the methods to prevent it, like dietary and lifestyle modifications. Regardless of the low level of general knowledge, there was some awareness of urolithiasis in some elements. Therefore, it is advised to increase health awareness campaigns.
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Song Y, Zhao C, Li D. Research progress on renal calculus associate with inborn error of metabolism. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:169-177. [PMID: 37283101 DOI: 10.3724/zdxbyxb-2022-0698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Renal calculus is a common disease with complex etiology and high recurrence rate. Recent studies have revealed that gene mutations may lead to metabolic defects which are associated with the formation of renal calculus, and single gene mutation is involved in relative high proportion of renal calculus. Gene mutations cause changes in enzyme function, metabolic pathway, ion transport, and receptor sensitivity, causing defects in oxalic acid metabolism, cystine metabolism, calcium ion metabolism, or purine metabolism, which may lead to the formation of renal calculus. The hereditary conditions associated with renal calculus include primary hyperoxaluria, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis, Bartter syndrome, primary distal renal tubular acidosis, infant hypercalcemia, hereditary hypophosphatemic rickets with hypercalciuria, adenine phosphoribosyltransferase deficiency, hypoxanthine-guanine phosphoribosyltransferase deficiency, and hereditary xanthinuria. This article reviews the research progress on renal calculus associated with inborn error of metabolism, to provide reference for early screening, diagnosis, treatment, prevention and recurrence of renal calculus.
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Affiliation(s)
- Yuanming Song
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.
| | - Changyong Zhao
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Daobing Li
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.
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Krampe NA, Oerline MK, Asplin JR, Hsi RS, Crivelli JJ, Shahinian VB, Hollingsworth JM. Potential for Urolithiasis-related Research Using the Novel Medicare-Litholink Database. UROLOGY PRACTICE 2023; 10:147-152. [PMID: 37103409 PMCID: PMC10140542 DOI: 10.1097/upj.0000000000000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/18/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION To overcome the data availability hurdle of observational studies on urolithiasis, we linked claims data with 24-hour urine results from a large cohort of adults with urolithiasis. This database contains the sample size, clinical granularity, and long-term follow-up needed to study urolithiasis on a broad level. METHODS We identified adults enrolled in Medicare with urolithiasis who had a 24-hour urine collection processed by Litholink (2011 to 2016). We created a linkage of their collections results and paid Medicare claims. We characterized them across a variety of sociodemographic and clinical factors. We measured frequencies of prescription fills for medications used to prevent stone recurrence, as well as frequencies of symptomatic stone events, among these patients. RESULTS In total, there were 11,460 patients who performed 18,922 urine collections in the Medicare-Litholink cohort. The majority were male (57%), White (93.2%), and lived in a metropolitan county (51.5%). Results from their initial urine collections revealed abnormal pH to be the most common abnormality (77.2%), followed by low volume (63.8%), hypocitraturia (45.6%), hyperoxaluria (31.1%), hypercalciuria (28.4%), and hyperuricosuria (11.8%). Seventeen percent had prescription fills for alkali monotherapy, and 7.6% had prescription fills for thiazide diuretic monotherapy. Symptomatic stone events occurred in 23.1% at 2 years of follow-up. CONCLUSIONS We successfully linked Medicare claims with results from 24-hour urine collections performed by adults that were processed by Litholink. The resulting database is a unique resource for future studies on the clinical effectiveness of stone prevention strategies and urolithiasis more broadly.
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Affiliation(s)
- Noah A. Krampe
- Dow Division of Health Services Research, Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Mary K. Oerline
- Dow Division of Health Services Research, Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - John R. Asplin
- Litholink Corporation, Laboratory Corporation of America Holdings, Itasca, Il
| | - Ryan S. Hsi
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Joseph J. Crivelli
- Department of Urology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
| | - Vahakn B. Shahinian
- Dow Division of Health Services Research, Department of Urology, University of Michigan Medical School, Ann Arbor, MI
- Division of Nephrology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - John M. Hollingsworth
- Dow Division of Health Services Research, Department of Urology, University of Michigan Medical School, Ann Arbor, MI
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25
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Yoodee S, Thongboonkerd V. Bioinformatics and computational analyses of kidney stone modulatory proteins lead to solid experimental evidence and therapeutic potential. Biomed Pharmacother 2023; 159:114217. [PMID: 36623450 DOI: 10.1016/j.biopha.2023.114217] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/26/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
In recent biomedical research, bioinformatics and computational analyses have played essential roles for examining experimental findings and database information. Several bioinformatic tools have been developed and made publicly available for analyzing protein sequence, structure, functional motif/domain, and interactions network. Such properties are very helpful to define biochemical and functional roles of the protein(s) of interest. During the past few decades, bioinformatics and computational biotechnology have been widely applied to kidney stone research. This review summarizes commonly used tools and evidence of bioinformatics and computational biotechnology applied to kidney stone disease (KSD) with special emphasis on analyses of the stone modulatory proteins that play critical roles in kidney stone formation. Such analyses lead to solid experimental evidence to demonstrate mechanisms underlying their stone modulatory activities. The findings obtained from such analyses may also lead to better understanding of KSD pathogenesis and to further development of new therapeutic and preventive strategies.
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Affiliation(s)
- Sunisa Yoodee
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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26
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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: 27] [Impact Index Per Article: 27.0] [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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27
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Lemberger U, Pjevac P, Hausmann B, Berry D, Moser D, Jahrreis V, Özsoy M, Shariat SF, Veser J. The microbiome of kidney stones and urine of patients with nephrolithiasis. Urolithiasis 2023; 51:27. [PMID: 36596939 PMCID: PMC9810570 DOI: 10.1007/s00240-022-01403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023]
Abstract
The incidence of nephrolithiasis is rising worldwide. Although it is a multifactorial disease, lifestyle plays a major role in its etiology. Another considerable factor could be an aberrant microbiome. In our observational single-center study, we aimed to investigate the composition of bacteria in kidney stones and urine focusing on patients with features of metabolic syndrome. Catheterized urine and kidney stones were collected prospectively from 100 consecutive patients undergoing endoscopic nephrolithotomy between 2020 and 2021 at our clinic. Microbiome composition was analyzed via 16S rRNA gene amplicon sequencing. Detection of bacteria was successful in 24% of the analyzed kidney stones. These patients had a prolonged length of stay compared to patients without verifiable bacteria in their stones (2.9 vs 1.5 days). Patients with features of metabolic syndrome were characterized by kidney stones colonized with classical gastrointestinal bacteria and displayed a significant enrichment of Enterococcaceae and Enterobacteriaceae. Stones of patients without features of metabolic syndrome characterized by Ureaplasma and Staphylococcaceae. Patients with bacteria in their kidney stones exhibit a longer length of stay, possibly due to more complex care. Patients presenting with features of metabolic syndrome displayed a distinct stone microbiome compared to metabolically fit patients. Understanding the role of bacteria in stone formation could enable targeted therapy, prevention of post-operative complications and new therapeutic strategies.
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Affiliation(s)
- Ursula Lemberger
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria.
| | - Petra Pjevac
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria
- Division of Microbial Ecology, Department of Microbiology and Ecosystem Science, Centre for Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Bela Hausmann
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - David Berry
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria
- Division of Microbial Ecology, Department of Microbiology and Ecosystem Science, Centre for Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Daniel Moser
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria
| | - Victoria Jahrreis
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria
| | - Mehmet Özsoy
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria
| | - Shahrokh F Shariat
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria
- Departments of Urology, Weill Cornell Medical College, New York, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute for Urology, University of Jordan, Amman, Jordan
| | - Julian Veser
- Research Laboratory, Department of Urology, Medical University of Vienna, Waeringerguertel 18-20, 1090, Vienna, Austria
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Siener R, Metzner C. Dietary weight loss strategies for kidney stone patients. World J Urol 2023; 41:1221-1228. [PMID: 36593299 DOI: 10.1007/s00345-022-04268-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Overweight has been associated with an increased risk of incident and recurrent kidney stone disease. Weight reduction is the therapeutic consequence to decrease the risk of stone formation. This review examines the effectiveness of different weight loss strategies on weight reduction and cardiometabolic risk profile, with a particular focus on risk factors for urolithiasis. METHODS A selective literature search was performed using PubMed and Cochrane library. RESULTS Clinical evidence for the potential benefits of dietary weight loss strategies for kidney stone disease is limited. A conventional, energy-restricted diet may significantly induce weight loss and reduce urinary supersaturation of calcium oxalate in overweight individuals with or without a history of stone formation. The current data indicate that an energy-restricted diet with partial meal replacement may additionally decrease the relative supersaturation of uric acid and further improve the cardiometabolic risk profile, and, thus, may be a favourable option for overweight kidney stone patients. Studies on the Mediterranean and DASH diets on the association between weight loss and the risk of urinary stone formation are lacking. CONCLUSION An energy-restricted diet with or without meal replacement could be a promising weight loss strategy for overweight kidney stone patients. Further studies are needed to evaluate the impact of different weight loss strategies on urinary risk factors and cardiometabolic risk profile in urolithiasis.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Christine Metzner
- Bonn Education Association for Dietetics r. A., Cologne, Germany.,Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), RWTH, Aachen, Germany
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29
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Muacevic A, Adler JR, Alzaidi MA, Asiri AF, Fatani MO, Alahmadi AH, Alnefaie Z, Hamoda TA. Influence of BMI on the Recurrence Rate of Nephrolithiasis in the Adult Population of Saudi Arabia: A Retrospective Study. Cureus 2023; 15:e33539. [PMID: 36779090 PMCID: PMC9907171 DOI: 10.7759/cureus.33539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
Objectives Nephrolithiasis is a common disease, and Saudi Arabia is among the countries with the highest prevalence of nephrolithiasis. Obesity is one of the risk factors associated with the increased formation of renal calculi. We aimed to assess whether obesity also increases the recurrence rate of nephrolithiasis. Methods We retrospectively identified and collected data of 283 adult patients with renal stones who were managed at our hospital from November 2018 to November 2021. The demographic information, comorbidities, stone burden, and treatment methods related to them were identified, collected, and analyzed. Moreover, we performed the chi-squared test (χ2) and multivariate logistic regression analysis in order to assess the risk factors (i.e., independent predictors) of recurrence among the studied patients. Additionally, the odds ratio (OR) was calculated at a confidence interval (CI) of 95%. A p-value of less than 0.05 was considered statistically significant. Results Of the 283 adult patients we analyzed, 35 did not meet the criteria of our study and, consequently, were excluded. Therefore, we ended up with 248 patients, of whom 179 (68.1%) were males, 131 (52.8%) had a previous history of renal stones, and 90 (36.3%) had chronic illnesses. Moreover, the mean age of the studied patients was 48.91 ± 14.51 years, and the mean BMI was 29.44 ± 6.1 kg/m2. It was found that most of the patients (35.5%) had only one stone, while 23.4% of them had more than 5 stones. Furthermore, the majority of the stones (35.9%) were medium size (with a stone diameter of 10-19 mm [1-1.9 cm]). We did not find a relationship between obesity and the recurrence rate of renal stones. However, there was a significant association (p < 0.05) between the recurrence rate and Saudi nationality, chronic diseases (more specifically, HTN), unilateral stones, and a stone diameter of 10-19 mm (1-1.9 cm). Additionally, we identified diabetes and the kidney as stone location factors that are associated with less recurrence. Conclusion Although obesity was reported to increase the risk of renal stone formation, we did not find it to be associated with an increased recurrent rate of the disease in the Saudi Arabian population, which is inconsistent with other studies conducted in this area in other countries. Therefore, larger studies are needed to prove this finding.
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30
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Sassanarakkit S, Hadpech S, Thongboonkerd V. Theranostic roles of machine learning in clinical management of kidney stone disease. Comput Struct Biotechnol J 2022; 21:260-266. [PMID: 36544469 PMCID: PMC9755239 DOI: 10.1016/j.csbj.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Kidney stone disease (KSD) is a common illness caused by deposition of solid minerals formed inside the kidney. The disease prevalence varies, based on sociodemographic, lifestyle, dietary, genetic, gender, age, environmental and climatic factors, but has been continuously increasing worldwide. KSD is a highly recurrent disease, and the recurrence rate is about 11% within two years after the stone removal. Recently, machine learning has been widely used for KSD detection, stone type prediction, determination of appropriate treatment modality and prediction of therapeutic outcome. This review provides a brief overview of KSD and discusses how machine learning can be applied to diagnostics, therapeutics and prognostics in clinical management of KSD for better therapeutic outcome.
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31
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Johnston SS, Chen BPH, Rai P, Grange P, Dwarakanathan HR, Amos T, Johnson BH, Ghosh SK, Buchholz N. Incremental Healthcare Cost Implications of Retreatment Following Ureteroscopy or Percutaneous Nephrolithotomy for Upper Urinary Tract Stones: A Population-Based Study of Commercially-Insured US Adults. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:371-384. [DOI: 10.2147/mder.s384823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022] Open
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