Prevalence and risk factors of kidney stone disease in population aged 40-70 years old in Kharameh cohort study: a cross-sectional population-based study in southern Iran

Kidney stone and risk of cardiovascular diseases: a cross-sectional study in the southeast of Iran

BACKGROUND

Since the prevalence of kidney stones and cardiovascular diseases (CVD) is increasing globally and also in Iran, it is vital to assess the associations between both disorders. The current study aimed to investigate the association between kidney stones and the risk of CVD.

METHODS

This study was cross-sectional in design, which used the data of the Rafsanjan cohort study (RCS), a population-based Prospective epidemiological research study in Iran (PERSIAN) that recruited 10,000 participants of both genders aged 35-70 years from four urban and suburban areas of Rafsanjan. Demographic factors, medical history, personal habits, biochemical parameters including Fasting blood sugar (FBS), glomerular filtration rate (GFR), creatine (Cr), Blood urea nitrogen (BUN), urine specific gravity (USG), and lipids of the participants were collected according to standard protocols.

RESULTS

The results showed that the risk of CVD was higher in men (51.02%) than in women (48.98%). Also, the results showed the highest risk of CVD development for age ≥ 56 years old. The results were presented in about 31% of patients with kidney stones, 19.5% of patients with abnormal urine tests, 9.84% with Proteinuria, more than 33% with abnormal USG, and more than 94% of patients with abnormal GFR had CVD. The odds of CVD were increased in patients with kidney stones (22%), female (25%), and age ≥ 56 years old (24%).

CONCLUSIONS

There was a high prevalence of kidney stones and CVD risk factors, such as gender, age, and kidney stones that increased the risk of cardiovascular disease.

Metabolic dysfunction associated steatotic liver and kidney stones: what is going on?

PURPOSE OF REVIEW

Metabolic dysfunction associated steatotic liver disease (MASLD) is increasing throughout the world, affecting nearly one in three individuals. Kidney stone disease, which is also increasing, is associated with MASLD. Common risk factors for both, including obesity, diabetes, dyslipidemia, hypertension, and metabolic syndrome, are likely drivers of this association. We present here a review of the associations and possible interconnections between these two common disease processes.

RECENT FINDINGS

Epidemiological studies are discordant regarding the impact of sex on this association and on the impact of MASLD on incident stone risk. The nature of kidney stones is rarely taken into account.A favorable milieu for uric acid kidney stone formation may be created by a lower urine pH resulting from defective ammonium production associated with insulin resistance, common in MASLD.Endogenous oxalate synthesis, a major risk factor for calcium oxalate kidney stones, may be increased in MASLD via decline in the activity of enzymes involved in the detoxification of glyoxylate, the immediate precursor of oxalate.

SUMMARY

The nature of kidney stones associated with MASLD and factors driving this association remain to be elucidated. Potential mechanisms identified underlying this include an increase in the risk factors for both uric acid and calcium oxalate kidney stones.

Plasma proteome fingerprint in kidney diseases

Introduction

Kidney diseases pose a serious healthcare problem because of their high prevalence, worsening of patients' quality of life, and high mortality. Patients with kidney diseases are often asymptomatic until disease progression starts. Expensive renal replacement therapy options, such as dialysis or kidney transplant, are required for end-stage kidney disease. Early diagnosis of kidney pathology is crucial for slowing down or curbing further damage. This study aimed to analyze the features of the protein composition of blood plasma in patients with the most common kidney pathologies: kidney calculus, kidney cyst, and kidney cancer.

Methods

The study involved 75 subjects. Proteins associated with kidney pathologies (CFB, SERPINA3, HPX, HRG, SERPING1, HBB, ORM2, and CP) were proposed. These proteins are important participants of complement and coagulation cascade activation and lipid metabolism.

Results

The revealed phosphorylated proteoforms (CFB, C4A/C4B, F2, APOB, TTR, and NRAP) were identified. For them, modification sites were mapped on 3D protein models, and the potential role in formation of complexes with native partner proteins was assessed.

Discussion

The study demonstrates that the selected kidney pathologies have a similar proteomic profile, and patients can be classified into kidney pathology groups with an accuracy of (70-80)%.

Association between the Fatty Liver Index, Metabolic Dysfunction-Associated Steatotic Liver Disease, and the Risk of Kidney Stones

INTRODUCTION

This study aimed to investigate the potential association between the fatty liver index (FLI), metabolic dysfunction-associated steatotic liver disease (MASLD), and the risk of kidney stones using large-scale population-based data.

METHODS

This study employed a cross-sectional design, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES) database. A total of 24,342 participants were enrolled in the study, and fatty liver status was assessed by calculating the FLI. MASLD was diagnosed by FLI in conjunction with cardiometabolic criteria. Data on the history of kidney stones were obtained by self-report. We employed logistic regression models to analyze the association between FLI, MASLD, and kidney stone risk and constructed multivariable adjustment models to control for potential confounders. Furthermore, we used restricted cubic spline curve models to investigate the dose-response relationship between FLI and kidney stone risk and conducted subgroup and interaction analyses.

RESULTS

The study's results indicate a strong correlation between increasing FLI quartiles and a notable rise in the prevalence of kidney stones. Specifically, the risk of developing kidney stones was 1.68 times higher among participants in the highest FLI quartile compared to those in the lowest. Furthermore, patients with MASLD exhibited a 1.35-fold increased risk of developing kidney stones compared to those with non-MASLD. Subgroup analyses demonstrated that the correlation between MASLD and kidney stone risk was consistent across multiple subgroups. However, a significant interaction was observed in the subgroups of smoking status, physical activity level, and hypertension (interaction p < 0.05). The restricted cubic spline analysis did not yield a statistically significant nonlinear association between FLI and kidney stone risk. However, the study did identify inflection point values for FLI.

CONCLUSION

This study demonstrated an association between FLI and MASLD and the risk of kidney stones. This suggests that these conditions may be pivotal risk factors for kidney stones. Further investigation is required to elucidate these associations' underlying mechanisms and develop efficacious interventions to reduce the risk of kidney stones. Also, formulating personalized prevention and treatment strategies for different population subgroups is paramount.

Intelligent Ureteral Stent Placeable via Standard Procedure for Kidney Pressure Telemetry: An Ex-Vivo Study

This paper reports the first telemetric ureteral stent compatible with common placement procedure, enabling wireless sensing and detection of ureteral obstruction and resultant kidney swelling known as hydronephrosis at an early stage. This sensor-integrated "intelligent" ureteral stent is prototyped via the design and fabrication approaches that raise the practicality of the device and tested in a harvested swine kidney-ureter model ex vivo. Leveraging a polymeric double-J stent and micro-electro-mechanical systems technology, the intelligent stent is built by embedding micro pressure sensors and a radiofrequency antenna, forming a resonant circuit that enables wireless kidney pressure monitoring in an operating frequency of 40-50 MHz. The stent device is entirely packaged with Parylene-C for both biocompatibility and electrical insulation of the device in order to function in the real environment including urine, an electrically conductive liquid. A comparison between the results measured in in-vitro and ex-vivo settings show a good match in the sensitivity to applied pressure. In particular, the ex-vivo test in the kidney-ureter model pressurized with artificial urine in a cycled manner demonstrates wireless pressure tracking with a response of 1.3 kHz/mmHg, over pressures up to 37 mmHg that well covers a range of pressure increase known for chronic obstruction. This testing is enabled by the prototype placement into the ex-vivo model using the standard stenting technique and tools without noticeable functional degradation or failures, showing potential compatibility of the device with today's clinical need as a ureteral stent.

Prevalence of Urinary Stones and Their Associated Risk Factors in the Jazan Region of Saudi Arabia

BACKGROUND

 Kidney stones, commonly calcium-based, form due to urine supersaturation and are influenced by factors such as pH, diet, and comorbidities. Symptoms include pain, hematuria, and infections. Studies indicate a higher prevalence in men and obese individuals. Risk factors include gender, climate, low fluid intake, and metabolic syndrome. Limited research has been conducted in Saudi Arabia. This study aimed to evaluate the prevalence and associated risk factors of kidney stones among participants in the Jazan Region, Saudi Arabia.

METHODOLOGY

 This cross-sectional study included 386 participants from the Jazan region of Saudi Arabia. Data on kidney stone prevalence and risk factors were collected using structured questionnaires. Associations were analyzed using univariate and multivariate analyses, with statistical significance set at p < 0.05.  Results: The study assessed the prevalence of kidney stones and associated risk factors among 386 participants in Jazan, Saudi Arabia. More than half of the participants (n = 214, 55.4%) reported kidney stones, with male participants (n = 141, 65.9%) significantly more affected than female participants (n = 73, 42.4%; p < 0.001). Older age groups, particularly 51-60 years (n = 29, 78.4%) and >60 years (n = 5, 83.3%), showed higher prevalence (p < 0.001). Smoking (n = 87, 73.1%; p < 0.001), high blood pressure (n = 77, 81.9%; p < 0.001), and family history (n = 93, 77.5%; p < 0.001) were significant risk factors. The adjusted analysis identified smoking (odds ratio (OR) 1.776; p = 0.033), hypertension (OR 3.439; p = 0.001), and family history (OR 3.085; p < 0.001) as strong predictors. Higher education was protective (OR 0.563; p < 0.001), while BMI and other comorbidities showed no significant associations.

CONCLUSION

 This study highlights a high prevalence of kidney stones in Jazan, Saudi Arabia, with significant predictors including male gender, older age, smoking, hypertension, and family history. Higher education was found to be protective. These findings underscore the importance of targeted prevention strategies addressing modifiable risk factors and promoting public health awareness.

Evaluating the lipid accumulation product index as a predictor for kidney stone prevalence: insights from NHANES 2007-2018

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.

SGLT2 Inhibitors and Their Effect on Urolithiasis: Current Evidence and Future Directions

Urolithiasis (UL) is increasingly prevalent due to rising cardiorenometabolic diseases, posing significant management challenges despite advances in urological techniques. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, primarily used for type 2 diabetes mellitus, chronic kidney disease, and heart failure, have emerged as a potential novel approach for UL treatment. These inhibitors may help reduce the risk of urolithiasis, particularly in patients with diabetes, by improving glycemic control and altering urinary chemistry, which are crucial factors in stone formation. However, the changes in urinary composition induced by SGLT2 inhibitors might also increase the risk of uric acid stone formation. This review evaluates the potential of SGLT2 inhibitors in managing UL, highlighting both the benefits and the risks. While these inhibitors show promise in reducing new and recurrent urinary stones in patients with diabetes, data on their effects in patients without diabetes who form stones are limited. Current human evidence largely comes from post hoc analyses of randomized controlled trials (RCTs) and large-scale database studies, with only one study providing detailed stone composition data. Experimental studies in animal models and cell lines have focused on calcium oxalate (CaOx) stones, showing that SGLT2 inhibitors specifically target CaOx stone formation and related renal inflammation. Although primarily studied for CaOx stones, their potential impact on other calcium-containing stones, such as calcium phosphate, remains promising. Further research is needed to explore their therapeutic potential and optimize treatment strategies.

Relation between Urine Cytological Findings and Renal Function in Patients with Kidney Stones in Taif, Saudi Arabia

Background and Objectives: Urine serves as a vital diagnostic fluid, and urine cytology analysis plays a crucial role in identifying urinary system illnesses such as bladder cancer and kidney stones. The Paris System for Reporting Urinary Cytology establishes a uniform method for diagnosing urinary tract cancer. This study aimed to provide valuable insights that can inform diagnostic strategies related to kidney stones and ultimately improve patient outcomes via the early detection of the cellular changes associated with kidney stones and their relation to kidney function tests. Materials and Methods: A comparative study was conducted and comprised two groups: group 1, consisting of 50 patients diagnosed with kidney stones, and group 2, comprising 50 patients diagnosed with other kidney diseases. Renal function tests and urinalysis (via the PAP staining of urine cellular deposits to detect nuclear changes) were performed, and the results were analyzed. Results: There was a statistically significant increase in urinary red blood cells, white blood cells, and nuclear reactive atypical changes in urinary sediments of kidney stone patients compared to the patients without stones, while there was a decrease in the estimated glomerular filtration rate (eGFR). eGFR showed a 96.7% specificity in detecting cases with nuclear reactive atypia. Conclusions: eGFR emerges as a reliable diagnostic marker for the comprehensive assessment of kidney stones, particularly when associated with nuclear atypia. The significant correlation between the indicators of chronic kidney disease, such as decreased eGFR, and the presence of kidney stones emphasizes the urgent need for efficient diagnostic practices.

Decoding Urinary Stones: Compositional Insights and Recurrence Patterns from a Tertiary Care Hospital in Eastern India

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence.

Association between metabolic dysfunction-associated steatotic liver disease and risk of urolithiasis: an updated systematic review and meta-analysis

Epidemiological studies have reported an association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of urolithiasis. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta-analysis of observational studies to quantify the magnitude of the association between MASLD and urolithiasis. We systematically searched PubMed, Scopus, and Web of Science from database inception to March 31, 2024, using predefined keywords to identify relevant observational studies in which imaging methods or survey questionnaires diagnosed MASLD and urolithiasis. Meta-analysis was performed using random-effects modelling. We identified seven cross-sectional studies and one prospective cohort study with aggregate data on 248,936 adults from different countries. MASLD was significantly associated with an increased risk of prevalent urolithiasis (pooled random-effects odds ratio 1.87, 95% CI 1.34-2.60; I2 = 91%). This association remained significant in those studies whose results were adjusted for age, sex, ethnicity, obesity, diabetes, and other potential confounders. There was a positive graded association between the ultrasonographic severity of MASLD and urolithiasis. Meta-analysis of the single prospective cohort study showed that MAFLD was not associated with risk of developing incident urolithiasis (pooled random-effects hazard ratio 1.08, 95% CI 0.90-1.30), although a significant association was reported in men. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias. This updated meta-analysis provides evidence for a significant association between MASLD and the presence of urolithiasis. Whether MASLD is associated with a higher risk of developing incident urolithiasis remains to be established.

Exploring the incidence and characteristics of urolithiasis in the central region of Saudi Arabia: Insights from a prominent medical center

Introduction

Urolithiasis is a common and recurrent condition with a rising global incidence. Stones typically develop in the upper urinary tract, primarily the kidneys. Various factors such as age, gender, diet, fluid intake, climate, occupation, genetics, and metabolic diseases influence stone formation. Stones can vary in size and location, causing obstruction, urine stasis, and complications such as infection. The prevalence of urolithiasis in Saudi Arabia has significantly increased in recent decades, and the study aims to determine the current prevalence and composition trends of urolithiasis, guide treatment and prevention strategies, as well as understand predictors of occurrence and recurrence.

Materials and Methods

It is a retrospective cohort study where the data was collected in the time frame of 2015-2021. The study was conducted in the Department of Surgery and the Division of Urology at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia.

Results

The study reveals significant trends in the sociodemographic profile and clinical aspects of urolithiasis patients. With a higher incidence among males (68.5%). Stone compositions predominantly consist of calcium oxalate (67.8%) and uric acid (19.7%), while site distribution shows the left kidney as the most common location (36.5%). Notably, hypertensive patients exhibit a significant association with stone site (P = 0.014). Encouragingly, the majority of patients do not experience reoccurrence (91.6%), and the study demonstrates an increasing recurrence rate with subsequent visits. The relatively shorter hospital stays (55.9% with 1-day stays) indicate efficient management, and this knowledge can aid in optimizing patient care.

Conclusion

This study sheds light on the multifaceted nature of urolithiasis by examining various facets. Low recurrence rate of kidney stones offers positive prospects for effective initial management. The shorter hospital stays, suggest advancements in medical practices, enhancing patient convenience and healthcare resource optimization. Investigating the underlying causes behind the observed stone compositions yield insights into potential preventive strategies. Furthermore, extended studies examining the impact of lifestyle modifications and medical interventions on stone recurrence could contribute to refined treatment protocols. These findings can guide healthcare professionals in optimizing patient care, preventive strategies, and future research endeavors.

A cross-sectional analysis of the relationship between the non-high density to high density lipoprotein cholesterol ratio (NHHR) and kidney stone risk in American adults

BACKGROUND

Recent interest in the Non-High Density to High Density Lipoprotein Cholesterol ratio (NHHR) has emerged due to its potential role in metabolic disorders. However, the connection between NHHR and the development of kidney stones still lacks clarity. The primary goal of this research is to explore how NHHR correlates with kidney stone incidence.

METHODS

An analysis was conducted on the data collected by the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, focusing on adults over 20 years diagnosed with kidney stones and those with available NHHR values. Employing weighted logistic regression and Restricted Cubic Spline (RCS) models, NHHR levels' correlation with kidney stone risk was examined. Extensive subgroup analyses were conducted for enhanced reliability of the findings.

RESULTS

The findings indicate a heightened kidney stone risk for those at the highest NHHR levels relative to those at the lowest (reference group). A notable non-linear correlation of NHHR with kidney stone incidence has been observed, with a significant P-value (< 0.001), consistent across various subgroups.

CONCLUSION

A clear link exists between high NHHR levels and increased kidney stone risk in the American adult population. This study highlights NHHR's significance as a potential indicator in kidney stone formation.

Knowledge, attitudes, and practices towards urinary system stones among the Chengdu population

This cross-sectional study aimed to explore the knowledge, attitudes, and practices (KAP) regarding urinary system stones among the general public in Chengdu, China. Conducted between January and June 2023, this research targeted individuals undergoing physical examinations at the Health Management Center of Sichuan Provincial People's Hospital. Structured questionnaires were administered to collect demographic information and assess KAP related to urinary system stones. Following meticulous scrutiny, 1014 valid questionnaires were retained for analysis. The computed scores for knowledge, attitude, and practice were 9.36 ± 4.23 (possible score range 0-17), 37.75 ± 7.20 (possible score range 11-55), and 30.77 ± 4.00 (possible score range 10-50), respectively. These outcomes suggested insufficient knowledge and moderately positive attitudes and practices among the participants. Structural Equation Modeling (SEM) analysis revealed a direct impact of knowledge on attitude (β = 0.967, P < 0.001), with attitude subsequently exerting a direct influence on practice (β = 0.167, P < 0.001). This indicated an indirect impact of knowledge on practice. Additionally, there was a direct effect of knowledge on practice (β = 0.167, P < 0.001). In conclusion, the general populace in Chengdu exhibited insufficient knowledge and moderate attitudes and practices concerning urinary stones. These findings underscore the imperative for targeted educational interventions aimed at enhancing public awareness and fostering positive attitudes and practices toward urinary stone prevention and management.

Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study

PURPOSE

Oxidative balance stress (OBS) was an important indicator for assessing exposure to oxidative stress related to diet and lifestyle. The purpose of this study was to explore the relationship between OBS and kidney stone disease (KSD).

METHODS

Secondary dataset analysis was performed by the study from six survey cycles (2007-2018) in the National Health and Nutrition Examination Survey (NHANES). OBS was the exposure factor and ever had kidney stone (yes or no) was the outcome. Weighted univariate or multivariate logistic regression models were used to estimate the associations.

RESULTS

The prevalence of KSD among participants was 8.6%. OBS showed a significant negative correlation with KSD (OR: 0.98, 95% CI 0.96-0.999), 35% reduction in KSD in the highest OBS quartile compared to the lowest OBS quartile. Dietary OBS was significantly negatively correlated with KSD (OR: 0.98, 95% CI 0.96-0.9998), but not with lifestyle OBS. In addition, OBS had a negative correlation with KSD in females (OR: 0.97, 95% CI 0.94-0.996), non-diabetic participants (OR: 0.98, 95% CI 0.96-0.99), and hypertensive participants (OR: 0.96, 95% CI 0.93-0.99), but OBS was not observed to be associated with KSD in gout participants. Interestingly, this relationship existed in participants aged 30-60 years and a ratio of family income to poverty (PIR) of 1.3-3.5 (all P value < 0.05).

CONCLUSION

Our study revealed that OBS was negative associated with KSD, and high OBS might be a protective factor in KSD. Targeting one of the components of OBS might be beneficial.

Tight junction and kidney stone disease

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.

Management of nephrolithiasis in the Middle East over a recent decade: A systematic review

Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis.

Incidence and risk factors of cardiovascular disease among population aged 40-70 years: a population-based cohort study in the South of Iran

BACKGROUND

Cardiovascular diseases are the main cause of mortality in the world. This study aimed to estimate the incidence and identify the risk factors of these diseases.

METHODS

This prospective cohort study was performed on 9442 individuals aged 40-70 years in Kharameh, a city in the South of Iran, in 2015-2022. The subjects were followed up for 4 years. The demographic information, behavioral habits, biological parameters, and history of some diseases were examined. The density incidence of cardiovascular disease was calculated. The log-rank test was calculated to assess the cardiovascular incidence difference between men and women. Simple and multiple Cox regression with Firth's bias reduction method were used to identify the predictors of cardiovascular disease.

RESULTS

The mean ± SD age of the participants was 51.4 ± 8.04 years, and the density incidence was estimated at 1.9 cases per 100,000 person-day. The log-rank test showed that men had a higher risk of cardiovascular disease than women. The Fisher's exact test showed a statistically significant difference between the incidence of cardiovascular diseases in different age groups, education levels, diabetes, and hypertension in men and women. The results of multiple Cox regression revealed that with increasing age, the risk of developing CVDs increased. In addition, the risk of cardiovascular disease is higher in people with kidney disease (HR_adj = 3.4, 95% CI 1.3 to 8.7), men (HR_adj = 2.3, 95% CI 1.7 to 3.2), individuals with hypertension (HR_adj = 1.6, 95% CI 1.3 to 2.1), diabetics (HR_adj = 2.3, 95%c CI 1.8 to 2.9), and alcohol consumption (HR_adj = 1.5, 95% CI 1.09 to 2.2).

CONCLUSIONS

In the present study, diabetes, hypertension, age, male gender, and alcohol consumption were identified as the risk factors for cardiovascular diseases; three variables of diabetes, hypertension and alcohol consumption were among the modifiable risk factors, so if they were removed, the incidence of cardiovascular disease could greatly reduce. Therefore, it is necessary to develop strategies for appropriate interventions to remove these risk factors.

Analysis of Nephrolithiasis Treatment in Highest Reference Hospital-Occurrence of Acromegaly in the Study Group

BACKGROUND

Urolithiasis is one of the most common diseases of the urinary system, the incidence of which is assumed to be up to 100,000 cases per million (10% of the population). The cause of it is dysregulation of renal urine excretion. Acromegaly is a very rare endocrine disorder that causes a somatotropic pituitary adenoma producing higher amounts of growth hormone. It occurs approximately in 80 cases per million (about 0.008% of the population). One of the acromegaly complications may be urolithiasis.

METHODS

Clinical and laboratory results of 2289 patients hospitalized for nephrolithiasis in the highest reference hospital were retrospectively analyzed, distinguishing a subgroup of patients with acromegaly. Statistical analysis was performed to compare the prevalence of the disease in the analyzed subgroup with the epidemiological results available in up-to-date literature.

RESULTS

The distribution of nephrolithiasis treatment was definitely in favor of non-invasive and minimally invasive treatment. The methods used were as follows: ESWL (61.82%), USRL (30.62%), RIRS (4.15%), PCNL (3.1%), and pyelolithotomy (0.31%). Such a distribution limited the potential complications of the procedures while maintaining the high effectiveness of the treatment. Among two thousand two hundred and eighty-nine patients with urolithiasis, two were diagnosed with acromegaly before the nephrological and urological treatment, and seven were diagnosed de novo. Patients with acromegaly required a higher percentage of open surgeries (including nephrectomy) and also had a higher rate of kidney stones recurrence. The concentration of IGF-1 in patients with newly diagnosed acromegaly was similar to those treated with somatostatin analogs (SSA) due to incomplete transsphenoidal pituitary surgery.

CONCLUSIONS

In the population of patients with urolithiasis requiring hospitalization and interventional treatment compared to the general population, the prevalence of acromegaly was almost 50-fold higher (p = 0.025). Acromegaly itself increases the risk of urolithiasis.

The effect of prehypertension and hypertension on the incidence of cardiovascular disease: A population-based cohort study in Kharameh, a city in the South of Iran

Background and Aim

Prehypertension and hypertension are important risk factors for cardiovascular diseases. This study was carried out to evaluate the effect of prehypertension and hypertension on the development of cardiovascular diseases.

Methods

This prospective cohort study was performed on 9442 people aged 40-70 in Kharameh, southern Iran. Individuals were divided into three groups: normal blood pressure (N = 5009), prehypertension (N = 2166), and hypertension (N = 2267). In this study, demographic data, disease histories, behavioral habits, and biological parameters were studied. At first, the incidence density was calculated. Then Firth's Cox regression models were used to investigate the association between prehypertension and hypertension with the incidence of cardiovascular diseases.

Results

The incidence density in the three groups of individuals with normal blood pressure, prehypertension, and hypertension was 1.33, 2.02, and 3.29 cases per 100,000 person-days, respectively. The results of multiple Firth's Cox regression by controlling all factors showed that the risk of occurrence of cardiovascular disease in people with prehypertension was 1.33 times (hazard ratio [HR] = 1.32, 95% confidence interval [CI]: 1.01-1.73, p = 0.03) and those with hypertension were 1.85 times higher (HR = 1.77, 95% CI: 1.38-2.29, p < 0.0001) than the individuals with normal blood.

Conclusion

Prehypertension and hypertension have played an independent role in the risk for developing cardiovascular diseases. Therefore, early detection of individuals with these factors and control of other risk factors in them can contribute to reducing the occurrence of cardiovascular diseases.

Epidemiology of Kidney Stones

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.