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Mifsud S, Montanaro G, Craus S, Mifsud EL, Gruppetta M. Thiazide diuretics and primary hyperparathyroidism. Br J Hosp Med (Lond) 2023; 84:1-8. [PMID: 38153014 DOI: 10.12968/hmed.2023.0228] [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] [Indexed: 12/29/2023]
Abstract
Thiazide diuretics exert a natriuretic and diuretic effect by inhibiting sodium reabsorption in the distal convoluted tubule. Furthermore, thiazide diuretics affect renal calcium handling by increasing calcium reabsorption, leading to hypocalciuria. The effect that thiazide diuretics exert on parathyroid hormone secretion is controversial. Some studies found parathyroid hormone levels were suppressed with the use of thiazide diuretics, while others found that thiazides were associated with initial parathyroid hormone suppression followed by raised parathyroid hormone levels. This makes the relationship between thiazide diuretics and primary hyperparathyroidism interesting. If a patient is taking thiazide diuretics, this may make it harder to establish the aetiology of hypercalcaemia and may unmask normocalcaemic or mild primary hyperparathyroidism. Thiazide diuretics may have a beneficial role in the diagnosis of patients with concomitant hyperparathyroidism and hypercalciuria by distinguishing secondary hyperparathyroidism caused by hypercalciuria from normocalcaemic primary hyperparathyroidism. In addition, thiazide diuretics may have a role in managing patients with primary hyperparathyroidism who have an indication for parathyroidectomy in view of significant hypercalciuria, but are unfit for surgery.
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Affiliation(s)
- Simon Mifsud
- Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
| | | | - Sarah Craus
- Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
| | - Emma L Mifsud
- Department of Medicine, Mater Dei Hospital, Msida, Malta
| | - Mark Gruppetta
- Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
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Chmiel JA, Stuivenberg GA, Al KF, Akouris PP, Razvi H, Burton JP, Bjazevic J. Vitamins as regulators of calcium-containing kidney stones - new perspectives on the role of the gut microbiome. Nat Rev Urol 2023; 20:615-637. [PMID: 37161031 PMCID: PMC10169205 DOI: 10.1038/s41585-023-00768-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 05/11/2023]
Abstract
Calcium-based kidney stone disease is a highly prevalent and morbid condition, with an often complicated and multifactorial aetiology. An abundance of research on the role of specific vitamins (B6, C and D) in stone formation exists, but no consensus has been reached on how these vitamins influence stone disease. As a consequence of emerging research on the role of the gut microbiota in urolithiasis, previous notions on the contribution of these vitamins to urolithiasis are being reconsidered in the field, and investigation into previously overlooked vitamins (A, E and K) was expanded. Understanding how the microbiota influences host vitamin regulation could help to determine the role of vitamins in stone disease.
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Affiliation(s)
- John A Chmiel
- Department of Microbiology & Immunology, Western University, London, Ontario, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Ontario, Canada
| | - Gerrit A Stuivenberg
- Department of Microbiology & Immunology, Western University, London, Ontario, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Ontario, Canada
| | - Kait F Al
- Department of Microbiology & Immunology, Western University, London, Ontario, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Ontario, Canada
| | - Polycronis P Akouris
- Department of Microbiology & Immunology, Western University, London, Ontario, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Ontario, Canada
| | - Hassan Razvi
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada
| | - Jeremy P Burton
- Department of Microbiology & Immunology, Western University, London, Ontario, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Ontario, Canada
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada.
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3
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Lombardi G, Ferraro PM, Gambaro G. The Optimal Length of Pharmacological Prophylaxis in Calcium Kidney Stone Formers. KIDNEY360 2023; 4:e1318-e1321. [PMID: 37424064 PMCID: PMC10550000 DOI: 10.34067/kid.0000000000000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Gianmarco Lombardi
- Division of Nephrology, Department of Medicine, University of Verona, Verona, Italy
| | - Pietro Manuel Ferraro
- Università Cattolica del Sacro Cuore, Roma, Italia
- U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Giovanni Gambaro
- Division of Nephrology, Department of Medicine, University of Verona, Verona, Italy
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Guo X, Wang W, Ma Y, Liang Y, Zhou Y, Cai G. 24-h Urinary Calcium Excretion and Renal Outcomes in Hospitalized Patients with and without Chronic Kidney Disease. J Clin Med 2023; 12:4600. [PMID: 37510715 PMCID: PMC10380443 DOI: 10.3390/jcm12144600] [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: 05/17/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
This study investigated the impact of 24-h urinary calcium excretion (UCaE) on renal function decline in hospitalized patients with and without chronic kidney disease (CKD). This study enrolled 3815 CKD patients in stages 1-4 and 1133 non-CKD patients admitted to the First Center of the Chinese PLA General Hospital between January 2014 and July 2022. The primary outcome for CKD patients was a composite of CKD progression, defined as a 40% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease. Annual eGFR change was the secondary outcome. For non-CKD patients, the primary outcome was an eGFR decline of ≥20% or CKD incidence, while annual eGFR change was the secondary outcome. The association between UCaE and kidney function decline was assessed using Cox proportional hazards and generalized linear models. Primary outcomes were observed in 813 CKD patients and 109 non-CKD patients over a median follow-up of 3.0 and 4.1 years, respectively. For CKD patients, every 1-mmol/d increase in UCaE was associated with a 15% decreased risk of CKD progression. The hazard ratio (HR) was 0.85, with a 95% confidence interval (CI) of 0.77-0.93. For non-CKD patients, the risk of renal function decline decreased by 11%. The multivariate models indicated that there was an annual decrease in eGFR in both CKD and non-CKD patients, with a reduction of 0.122 mL/min/1.73 m2/year (p < 0.001) and 0.046 mL/min/1.73 m2/year (p = 0.004), respectively, for every 1-mmol/d increase in UCaE. CKD experiences a decrease in 24-h UCaE as early as stage 1, with a significant decline in stage 4. CKD and non-CKD patients with lower UCaE levels are at an increased risk of renal decline, regardless of other variables.
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Affiliation(s)
- Xinru Guo
- School of Medicine, Nankai University, Tianjin 300071, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing 100853, China
| | - Wanling Wang
- National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, China
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing 100853, China
| | - Yangyang Ma
- Department of Information, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yanjun Liang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing 100853, China
| | - Yena Zhou
- School of Medicine, Nankai University, Tianjin 300071, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing 100853, China
| | - Guangyan Cai
- School of Medicine, Nankai University, Tianjin 300071, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing 100853, China
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Li Z, Li L, Zheng J, Li M, Wu S, Xin K, Li R, Bai S, Chen X. Associations between lumbar bone mineral density, serum 25-hydroxyvitamin D and history of kidney stones in adults aged 30-69 years in the USA (NHANES 2011-2018). BMJ Open 2023; 13:e070555. [PMID: 37221021 DOI: 10.1136/bmjopen-2022-070555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES Most kidney stones contain calcium, which is closely associated with human bone health. Therefore, we aimed to determine the relationship between the history of kidney stones and human bone health. This study examined the associations between lumbar bone mineral density (BMD), serum 25-hydroxyvitamin D (25-OHD) and a history of kidney stones in individuals aged between 30 years and 69 years. DESIGN AND DATA ANALYSIS A multivariate logistic regression model was used to estimate the relationship between lumbar BMD, serum 25-OHD levels and kidney stones in this cross-sectional study. All models incorporated survey sample weights and were adjusted for covariates. SETTING National Health and Nutrition Examination Survey (NHANES) 2011-2018. The exposure and outcomes of this study included the lumbar BMD and presence of kidney stones. PARTICIPANTS All the 7500 participants for this cross-sectional survey were selected from the NHANES between 2011 and 2018. MAIN OUTCOME MEASURES The main outcome of this study was the presence of kidney stones. The interviewers asked the questions on kidney stones while the respondents were at home, using a computer-assisted personal interview system. RESULTS Lumbar BMD was negatively correlated with a history of kidney stones in all three multivariate linear regression models; the negative association existed in all genders after adjusting for all confounding factors. In the multiple regression analysis, there was an interaction between serum 25-OHD and lumbar BMD (p<0.05) regarding the influence on kidney stones; the negative association between lumbar BMD and kidney stones was more obvious in the higher 25-OHD group (≥50 nmol/L). CONCLUSION The study results suggest that maintaining a high lumbar BMD may reduce the incidence of kidney stone formation. Simultaneously, maintaining a high serum 25-OHD level may be more beneficial in preventing the occurrence or recurrence of stones while ensuring a high lumbar BMD.
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Affiliation(s)
- Zeyu Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lei Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jianyi Zheng
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mingyang Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Siyu Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kerong Xin
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rong Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
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Tang TY, Lee JI, Shen JT, Lee YC, Wang HS, Tsao YH, Wu YH, Huang SP, Chen SC, Jhan JH, Geng JH. The association between menopause, postmenopausal hormone therapy, and kidney stone disease in Taiwanese women. Ann Epidemiol 2023; 78:13-18. [PMID: 36494042 DOI: 10.1016/j.annepidem.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The association between menopause, postmenopausal hormone therapy, and kidney stone disease has long been a topic of discussion and is still unclear. Moreover, most previous research has focused on Caucasians. Therefore, we aimed to explore this issue in an Asian population. METHODS In this cross-sectional study, we enrolled female participants aged between 30 and 70 years from the Taiwan Biobank. The presence of kidney stone disease (KSD) was defined through a self-reported questionnaire. The participants were divided into two groups according to the presence of menopause; premenopausal and postmenopausal groups. The associations among menopause, postmenopausal hormone therapy, and KSD were examined using binary logistic regression models. RESULTS A total of 17,460 women with available information were recruited, including 5976 in the premenopausal group and 11,484 in the postmenopausal group. Compared to the premenopausal group, the postmenopausal group had a significantly higher prevalence of KSD (3% vs. 6%). The odds ratio for KSD was higher in the postmenopausal group than in the premenopausal group (odds ratio = 1.50; 95% confidence interval = 1.17-1.92) after adjusting for confounders. We also examined associations between the type of menopause (natural and surgical) and KSD, and found that both types of menopause were associated with KSD in age-adjusted and multivariable models. Compared with those who had never received postmenopausal hormone therapy, those who had received postmenopausal hormone therapy were not associated with a higher risk of KSD. CONCLUSIONS Our study suggests that natural and surgical menopause were associated with KSD. However, we found no association between the postmenopausal hormone therapy and KSD in the postmenopausal women.
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Affiliation(s)
- Tsz-Yi Tang
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jung-Tsung Shen
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsun-Shuan Wang
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Hsuan Tsao
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsuan Wu
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jhen-Hao Jhan
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Ferre N, Parada E, Balaguer A, Feliu A, Roqué-Figuls M, Franco JVA, Escribano J. Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review. Nefrologia 2022; 42:506-518. [PMID: 36792305 DOI: 10.1016/j.nefroe.2021.04.014] [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: 01/07/2021] [Accepted: 04/03/2021] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVE To assess the effects of pharmacological interventions in patients with idiopathic hypercalciuria. METHODS We performed a search of multiple databases, trial registries, grey literature and conference proceedings up to October 2019. We included randomized and quasi-randomized controlled trials that examined any pharmacological intervention for preventing complications of idiopathic hypercalciuria (given for at least four months and six of follow-up). The primary outcomes were stone-free patients, urinary symptoms and severe adverse events. RESULTS We included five RCTs (n=446 patients, all adults, 4 in individuals with kidney stones and 1 in postmenopausal women with osteoporosis). Diuretics were likely to increase the number of stone-free patients (RR 1.61, 95% CI 1.33-1.96, moderate quality of evidence (QoE)); 274 more stone-free patients/1000 patients treated (95% CI: 148-432) and produced a slight decrease in the stone formation rate (mean difference -0.18, 95% CI -0.30 to -0.06, low QoE); 180 fewer stones/year/1000 patients treated (95% CI: 300 r to 60). No data on urinary symptoms were reported. The association between diuretic use and severe adverse events was uncertain (RR 5.00, 95% CI 0.60-41.88, very low QoE); 4 more severe adverse events/1000 patients treated (95% CI: 0 fewer to 39 more). CONCLUSIONS The addition of diuretics to a normal or modified diet probably reduces the number of stone recurrences and may decrease the stone formation rate. It is uncertain whether diuretics increase the occurrence of severe adverse events. There were no studies investigating other outcomes or in children.
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Affiliation(s)
- Natalia Ferre
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain
| | - Ester Parada
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari de Tarragona Joan XXIII, Dr. Mallafré Guasch 4, 43005 Tarragona, Spain
| | - Albert Balaguer
- Department of Pediatrics, Hospital Universitari General de Catalunya, Pere i Pons 1, 08195 Sant Cugat del Vallés, Barcelona, Spain; Universitat Internacional de Catalunya, Carrer de la Immaculada 22, 08017 Barcelona, Spain
| | - Albert Feliu
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, Spain
| | - Marta Roqué-Figuls
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Sant Quintí 77-79, 08041 Barcelona, Spain
| | - Juan Victor A Franco
- Argentine Cochrane Centre, Instituto Universitario Hospital Italiano, Potosí 4265, C1199 CABA Buenos Aires, Argentina
| | - Joaquín Escribano
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, Spain.
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Huang T, Redline S, Gordon CM, Schernhammer E, Curhan GC, Paik JM. Self-reported sleep characteristics and risk for incident vertebral and hip fracture in women. Sleep Health 2022; 8:234-241. [PMID: 35241403 PMCID: PMC8995338 DOI: 10.1016/j.sleh.2021.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the relationships between self-reported sleep characteristics and risk of incident vertebral fracture and hip fracture in women. DESIGN Longitudinal cohort study. SETTING Nurses' Health Studies (NHS: 2002-2014, NHSII: 2001-2015). PARTICIPANTS Total 122,254 female registered nurses (46,129 NHS, 76,125 NHSII) without prior history of fracture. EXPOSURE Sleep was characterized by 4 sleep-related domains-sleep duration, sleep difficulty, snoring, and excessive daytime sleepiness-assessed by self-reported questionnaires. OUTCOMES Self-reports of vertebral fracture were confirmed by medical record review and hip fracture was assessed by biennial questionnaires. RESULTS Over 12-14 years of follow-up, 569 incident vertebral fracture cases (408 in NHS, 161 in NHSII) and 1,881 hip fracture cases (1,490 in NHS, 391 in NHSII) were documented. In the pooled analysis, the multivariable-adjusted HR (95% CI) for vertebral fracture was 1.20 (0.86, 1.66) for sleep duration ≤5 hours vs. 7 hours and 0.82 (0.60, 1.12) for ≥9 vs. 7 hours; 1.63 (0.93, 2.87) for sleep difficulties all-the-time vs. none/little-of-the-time (p-trend = 0.005); 1.47 (1.05, 2.05) for snoring every night/week vs. never/occasionally (p-trend = 0.03), and 2.20 (1.49, 3.25) for excessive daytime sleepiness daily vs. never (p-trend < 0.001). In contrast, associations were not observed with hip fracture risk. CONCLUSION Poorer sleep characteristics were associated with risk of vertebral fracture. Our study highlights the importance of multiple dimensions of sleep in the development of vertebral fractures. Further research is warranted to understand the role of sleep in bone health that may differ by fracture site, as well as sleep interventions that may reduce the risk of fracture.
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Catherine M Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Eva Schernhammer
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Gary C Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Julie M Paik
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
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Numerical characterization of astronaut CaOx renal stone incidence rates to quantify in-flight and post-flight relative risk. NPJ Microgravity 2022; 8:2. [PMID: 35091560 PMCID: PMC8799707 DOI: 10.1038/s41526-021-00187-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Changes in urine chemistry potentially alter the risk of renal stone formation in astronauts. Quantifying spaceflight renal stone incidence risk compared to pre-flight levels remains a significant challenge for assessing the appropriate vehicle, mission, and countermeasure design. A computational biochemistry model representing CaOx crystal precipitation, growth, and agglomeration is combined with a probabilistic analysis to predict the in- and post-flight CaOx renal stone incidence risk ratio (IRR) relative to pre-flight values using 1517 astronaut 24-h urine chemistries. Our simulations predict that in-flight fluid intake alone would need to increase from current prescriptions of 2.0–2.5 L/day to ~3.2 L/day to approach the CaOx IRR of the pre-flight population. Bone protective interventions would reduce CaOx risk to pre-flight levels if Ca excretion alone is reduced to <150 mg/day or if current levels are diminished to 190 mg/day in combination with increasing fluid intake to 2.5–2.7 L/day. This analysis provides a quantitative risk assessment that can influence the critical balance between engineering and astronaut health requirements.
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10
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Ferre N, Parada E, Balaguer A, Feliu A, Roqué-Figuls M, Franco JVA, Escribano J. Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review. Nefrologia 2021; 42:S0211-6995(21)00150-8. [PMID: 34393000 DOI: 10.1016/j.nefro.2021.04.007] [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: 01/07/2021] [Revised: 03/23/2021] [Accepted: 04/03/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the effects of pharmacological interventions in patients with idiopathic hypercalciuria. METHODS We performed a search of multiple databases, trial registries, grey literature and conference proceedings up to October 2019. We included randomized and quasi-randomized controlled trials that examined any pharmacological intervention for preventing complications of idiopathic hypercalciuria (given for at least four months and six of follow-up). The primary outcomes were stone-free patients, urinary symptoms and severe adverse events. RESULTS We included five RCTs (n=446 patients, all adults, 4 in individuals with kidney stones and 1 in postmenopausal women with osteoporosis). Diuretics were likely to increase the number of stone-free patients (RR 1.61, 95% CI 1.33-1.96, moderate quality of evidence (QoE)); 274 more stone-free patients/1000 patients treated (95% CI: 148-432) and produced a slight decrease in the stone formation rate (mean difference -0.18, 95% CI -0.30 to -0.06, low QoE); 180 fewer stones/year/1000 patients treated (95% CI: 300 r to 60). No data on urinary symptoms were reported. The association between diuretic use and severe adverse events was uncertain (RR 5.00, 95% CI 0.60-41.88, very low QoE); 4 more severe adverse events/1000 patients treated (95% CI: 0 fewer to 39 more). CONCLUSIONS The addition of diuretics to a normal or modified diet probably reduces the number of stone recurrences and may decrease the stone formation rate. It is uncertain whether diuretics increase the occurrence of severe adverse events. There were no studies investigating other outcomes or in children.
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Affiliation(s)
- Natalia Ferre
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain
| | - Ester Parada
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari de Tarragona Joan XXIII, Dr. Mallafré Guasch 4, 43005 Tarragona, Spain
| | - Albert Balaguer
- Department of Pediatrics, Hospital Universitari General de Catalunya, Pere i Pons 1, 08195 Sant Cugat del Vallés, Barcelona, Spain; Universitat Internacional de Catalunya, Carrer de la Immaculada 22, 08017 Barcelona, Spain
| | - Albert Feliu
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, Spain
| | - Marta Roqué-Figuls
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Sant Quintí 77-79, 08041 Barcelona, Spain
| | - Juan Victor A Franco
- Argentine Cochrane Centre, Instituto Universitario Hospital Italiano, Potosí 4265, C1199 CABA Buenos Aires, Argentina
| | - Joaquín Escribano
- Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, Spain.
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11
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Curhan SG, Stankovic K, Halpin C, Wang M, Eavey RD, Paik JM, Curhan GC. Osteoporosis, bisphosphonate use, and risk of moderate or worse hearing loss in women. J Am Geriatr Soc 2021; 69:3103-3113. [PMID: 34028002 DOI: 10.1111/jgs.17275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Osteoporosis and low bone density (LBD) may be associated with higher risk of hearing loss, but findings are inconsistent and longitudinal data are scarce. Bisphosphonates may influence risk, but the relation has not been studied in humans. We longitudinally investigated associations of osteoporosis and LBD, bisphosphonate use, vertebral fracture (VF), hip fracture (HF), and risk of self-reported moderate or worse hearing loss. DESIGN Longitudinal cohort study. SETTING The Nurses' Health Study (NHS) (1982-2016) and Nurses' Health Study II (NHS II) (1995-2017). PARTICIPANTS Participants included 60,821 NHS women, aged 36-61 years at baseline, and 83,078 NHS II women, aged 31-48 years at baseline (total n = 143,899). MEASUREMENTS Information on osteoporosis, LBD, bisphosphonate use, VF, HF, and hearing status was obtained from validated biennial questionnaires. In a subcohort (n = 3749), objective hearing thresholds were obtained by audiometry. Multivariable-adjusted Cox proportional hazards models were used to examine independent associations between osteoporosis (NHS), osteoporosis/LBD (NHS II), and risk of hearing loss. RESULTS The multivariable-adjusted relative risk (MVRR, 95% confidence interval) of moderate or worse hearing loss was higher among women with osteoporosis or LBD in both cohorts. In NHS, compared with women without osteoporosis, the MVRR was 1.14 (1.09, 1.19) among women with osteoporosis; in NHS II, the MVRR was 1.30 (1.21, 1.40) among women with osteoporosis/LBD. The magnitude of the elevated risk was similar among women who did and did not use bisphosphonates. VF was associated with higher risk (NHS: 1.31 [1.16, 1.49]; NHS II: 1.39 [1.13, 1.71]), but HF was not (NHS: 1.00 [0.86, 1.16];NHS II: 1.15 [0.75,1.74]). Among participants with audiometric measurements, compared with women without osteoporosis/LBD, the mean multivariable-adjusted hearing thresholds were higher (i.e., worse) among those with osteoporosis/LBD who used bisphosphonates. CONCLUSION Osteoporosis and LBD may be important contributors to aging-related hearing loss. Among women with osteoporosis, the risk of hearing loss was not influenced by bisphosphonate use.
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Affiliation(s)
- Sharon G Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Konstantina Stankovic
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Christopher Halpin
- Department of Otolaryngology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Molin Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Roland D Eavey
- Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Julie M Paik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.,Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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12
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Abstract
PURPOSE OF REVIEW Kidney stones are strongly associated with low bone density and bone fracture. Clinical management focuses on prevention of kidney stones and bone fracture. We reviewed literature of kidney stones and bone disease with a special focus on updates in therapeutic strategies. We will review the literature regarding dietary management, supplements, and medications and emphasize the recent studies on bisphosphonates and kidney stone management. RECENT FINDINGS Bisphosphonate medications are commonly used in management of low bone density. Previous studies showed that they reduce urinary calcium. A recent large prospective study found that bisphosphonates may reduce the risk of kidney stones in individuals who have low bone density. In addition to lowering urinary calcium, a recent study found that bisphosphonates may act as an inhibitor in the urinary space. SUMMARY There are multiple dietary and pharmacologic strategies that can be considered for kidney stones and bone disease, such as low salt and normal calcium diet, as well as thiazides, alkali, and bisphosphonate medications. Bisphosphonates may have an important role in reducing bone resorption and reducing overall risk of kidney stone and bone disease.
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13
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Rendina D, D'Elia L, Evangelista M, De Filippo G, Giaquinto A, Barone B, Piccinocchi G, Prezioso D, Strazzullo P. Osteoporosis is a Predictive Factor for Nephrolithiasis in an Adult Free-Living Caucasian Population From Southern Italy: A Longitudinal Retrospective Study Based on a General Practice Database. Calcif Tissue Int 2020; 107:446-452. [PMID: 32740693 PMCID: PMC7546977 DOI: 10.1007/s00223-020-00737-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/23/2020] [Indexed: 12/12/2022]
Abstract
Osteoporosis and nephrolithiasis are common multifactorial disorders with high incidence and prevalence in the adult population worldwide. Both are associated with high morbidity and mortality if not correctly diagnosed and accurately treated. Nephrolithiasis is considered a risk factor for reduced bone mineral density. Aim of this retrospective longitudinal study was to evaluate if osteoporosis is a predictive factor for the nephrolithiasis occurrence. Free-living subjects referring to "COMEGEN" general practitioners cooperative operating in Naples, Southern Italy. Twelve thousand seven hundred ninety-four Caucasian subjects (12,165 female) who performed bone mineral density by dual-energy X-ray absorptiometry and have a negative personal history for nephrolithiasis. Subjects aged less than 40 years or with signs or symptoms suggestive of secondary osteoporosis were excluded from the study. In a mean lapse of time of 19.5 months, 516 subjects had an incident episode of nephrolithiasis. Subjects with osteoporosis had an increased risk of nephrolithiasis than subjects without osteoporosis (Hazard Ratio = 1.33, 95% Confidence Interval 1.01-1.74, p = 0.04). Free-living adult subjects over the age of 40 with idiopathic osteoporosis have an increased risk of incident nephrolithiasis, suggesting the advisability of appropriate investigation and treatment of the metabolic alterations predisposing to nephrolithiasis in patients with osteoporosis. The study protocol was approved by the ASL Napoli 1 Ethical Committee, protocol number 0018508/2018.
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Affiliation(s)
- Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Lanfranco D'Elia
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Marco Evangelista
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | - Alfonso Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Biagio Barone
- Department of Neuroscience Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | | | - Domenico Prezioso
- Department of Neuroscience Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
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14
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Huang T, Tworoger SS, Redline S, Curhan GC, Paik JM. Obstructive Sleep Apnea and Risk for Incident Vertebral and Hip Fracture in Women. J Bone Miner Res 2020; 35:2143-2150. [PMID: 32909307 PMCID: PMC7719618 DOI: 10.1002/jbmr.4127] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/09/2020] [Accepted: 07/02/2020] [Indexed: 12/11/2022]
Abstract
Recent studies suggest a positive association between obstructive sleep apnea (OSA), a disorder associated with intermittent hypoxia and sleep fragmentation, and derangements in bone metabolism. However, no prospective study to date has investigated the association between OSA and fracture risk in women. We conducted a prospective study examining the relation between OSA and risk of incident vertebral fracture (VF) and hip fracture (HF) in the Nurses' Health Study. History of physician-diagnosed OSA was assessed by self-reported questionnaires. A previous validation study demonstrated high concordance between self-reports and medical record identification of OSA. OSA severity was further categorized according to the presence or absence of self-reported sleepiness. Self-reports of VF were confirmed by medical record review. Self-reported HF was assessed by biennial questionnaires. Cox proportional-hazards models estimated the hazard ratio for fracture according to OSA status, adjusted for potential confounders, including BMI, physical activity, calcium intake, history of osteoporosis, and falls, and use of sleep medications. Among 55,264 women without prior history of fracture, physician-diagnosed OSA was self-reported in 1.3% in 2002 and increased to 3.3% by 2012. Between 2002 and 2014, 461 incident VF cases and 921 incident HF cases were documented. The multivariable-adjusted hazard ratio (HR) for confirmed VF for women with history of OSA was 2.00 (95% CI, 1.29-3.12) compared with no OSA history, with the strongest association observed for OSA with daytime sleepiness (HR 2.86; 95% CI, 1.31-6.21). No association was observed between OSA history and self-reported HF risk (HR 0.83; 95% CI, 0.49-1.43). History of OSA is independently associated with higher risk of confirmed VF but did not have a statistically significant association with self-reported HF in women. Further research is warranted in understanding the role of OSA and intermittent hypoxia in bone metabolism and health that may differ by fracture site. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Julie M Paik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
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15
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Rendina D, De Filippo G, Iannuzzo G, Abate V, Strazzullo P, Falchetti A. Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin? Int J Mol Sci 2020; 21:ijms21218183. [PMID: 33142950 PMCID: PMC7662860 DOI: 10.3390/ijms21218183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022] Open
Abstract
Idiopathic osteoporosis and nephrolithiasis are formidable health problems showing a progressive increase in their incidence and prevalence in the last decades. These temporal trends were observed in both pediatric and adult populations worldwide. Epidemiological and experimental studies indicate that both disorders show several common pathogenic environmental and genetic factors. In this review, we analyzed the clinical characteristics common to the two disorders and the state-of-the-art knowledge regarding the genetic predisposition and the environmental factors recognized as triggers in adult and pediatric ages. As a result of this work, we propose to consider idiopathic nephrolithiasis and osteoporosis as two possible expressions of a unique clinical syndrome. Accordingly, the clinical approach to both disorders should be modified in order to program an efficient primary and secondary prevention strategy.
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Affiliation(s)
- Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie et Diabétologie Pédiatrique, 75019 Paris, France;
- French Clinical Research Group in Adolescent Medicine and Health, 75014 Paris, France
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Alberto Falchetti
- Unit of Bone and Mineral Metabolic Diseases, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy
- Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, 20145 Milan, Italy
- Correspondence: ; Tel.: +39-33-1689-2204
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16
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Taguchi K, Hamamoto S, Okada A, Tanaka Y, Sugino T, Unno R, Kato T, Ando R, Tozawa K, Yasui T. Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: a single-center retrospective cohort study. BMC Urol 2020; 20:174. [PMID: 33121459 PMCID: PMC7596945 DOI: 10.1186/s12894-020-00749-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022] Open
Abstract
Background Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-h urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio = 0.44, p = 0.007), whereas a T-score < − 2.5 and hyperoxaluria were associated with symptoms (odds ratio = 2.59, p = 0.037; odds ratio = 0.45, p = 0.01; respectively). Conclusion These results revealed that low T-scores might cause symptoms in patients with urolithiasis, suggesting the importance of BMD examination for high-risk Japanese patients with urolithiasis having hypocitraturia.
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Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan.
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Yutaro Tanaka
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Teruaki Sugino
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Rei Unno
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Taiki Kato
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Keiichi Tozawa
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 4678601, Japan
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17
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Kovacevic L, Lu H, Kovacevic N, Lakshmanan Y. Effect of bisphosphonates on the crystallization of stone-forming salts in synthetic urine. Investig Clin Urol 2020; 61:310-315. [PMID: 32377608 PMCID: PMC7189110 DOI: 10.4111/icu.2020.61.3.310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/01/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose We investigated the inhibitory effect of bisphosphonates (BPs) on the crystallization of calcium oxalate monohydrate (COM), calcium phosphate (CaP), and magnesium ammonium phosphate (MAP) in synthetic urine, aiming to see 1) which specific BPs work best on a particular type of crystal and 2) what is the lowest concentration of BPs that inhibits crystal formation. Materials and Methods Crystals from synthetic urine were exposed to different concentrations of BPs. Urinary turbidity was used as a marker of crystallization and was measured by spectrophotometry by use of a validated method in our laboratory. The percent inhibitory activity (IA) was calculated by using the formula: (a−b )/a×100, where a is baseline maximal turbidity and b is maximal turbidity with various concentrations of medication. Potassium citrate and magnesium citrate were used as positive controls. Results At the lowest dose of 0.001 mg/mL, risedronate induced the highest IA of 37% on CaP, whereas ibandronate had the strongest IA on COM (24%). To initiate the inhibition of MAP crystallization, risedronate required a two-fold higher concentration (0.002 mg/mL) to reach 30% IA, whereas etidronate required a four-fold higher concentration (0.004 mg/mL) to reach 42% IA. Conclusions BPs are good inhibitors of crystallization in synthetic urine, with risedronate and ibandronate being the most potent. At a low clinically acceptable dose, their highest inhibitory action was on CaP and COM crystals. Higher doses were needed to prevent MAP crystallization. Further investigation of the use of BPs in kidney stone prevention is warranted.
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Affiliation(s)
- Larisa Kovacevic
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
| | - Hong Lu
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
| | - Natalija Kovacevic
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA.,Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Yegappan Lakshmanan
- Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
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18
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19
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Schulster ML, Goldfarb DS. Vitamin D and Kidney Stones. Urology 2020; 139:1-7. [PMID: 32032687 DOI: 10.1016/j.urology.2020.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/11/2020] [Accepted: 01/21/2020] [Indexed: 12/31/2022]
Abstract
This review explores the relationship between vitamin D supplementation and lithogenesis. A causal relationship has been assumed despite myriad studies demonstrating that therapeutic doses of vitamin D do not increase lithogenic risk. Select stone formers may be at increased risk for recurrence with vitamin D supplementation, possibly from CYP24A1 gene mutations. Additionally, the evidence for who is vitamin D deficient, and the benefits of supplementation in those not at risk for rickets, is sparse. Concerns may be avoidable as vitamin D screening appears unnecessary in most patients, and superior pharmacology is available which increases bone density, while decreasing stone formation.
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Affiliation(s)
- Michael L Schulster
- Department of Urology, NYU Langone Health, NYU School of Medicine, and New York Harbor VA Healthcare System, New York, NY
| | - David S Goldfarb
- Nephrology Division, NYU Langone Health, NYU School of Medicine, and New York Harbor VA Healthcare System, New York, NY.
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20
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Paik JM, Rosen HN, Katz JN, Rosner BA, Rimm EB, Gordon CM, Curhan GC. BMI, Waist Circumference, and Risk of Incident Vertebral Fracture in Women. Obesity (Silver Spring) 2019; 27:1513-1519. [PMID: 31318497 PMCID: PMC6707901 DOI: 10.1002/oby.22555] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/10/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The study aimed to investigate the association between BMI, waist circumference, and vertebral fracture (VF) risk in women. METHODS This prospective study was conducted in 54,934 Nurses' Health Study participants. BMI was assessed biennially, and waist circumference was assessed in the year 2000. Self-reports of VF were confirmed by record review. BMI reflects lean body mass, and waist circumference reflects abdominal adiposity when included in the same regression model. RESULTS This study included 536 VF cases (2002 to 2014). Compared with women with BMI of 21.0 to 24.9 kg/m2 , the multivariable-adjusted relative risk (RR) of VF for women with BMI ≥ 32.0 was 0.84 (95% CI: 0.61-1.14; Ptrend = 0.08). After further adjustment for waist circumference, the multivariable-adjusted RR of VF for women with BMI ≥ 32.0 was 0.70 (95% CI: 0.49-0.98; Ptrend = 0.003). Compared with women with waist circumference < 71.0 cm, the multivariable-adjusted RR of VF for women with waist circumference ≥ 108.0 cm was 1.76 (95% CI: 1.06-2.92; Ptrend = 0.01), and after further adjustment for BMI, the multivariable-adjusted RR of VF was 2.49 (95% CI: 1.44-4.33; Ptrend < 0.001). CONCLUSIONS Greater lean body mass was independently associated with lower VF risk. Larger waist circumference was independently associated with higher VF risk. These findings suggest that fat distribution is an important predictor of VF and that avoiding central adiposity, as well as maintaining muscle mass, may potentially confer reduced risk of VF in older women.
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Affiliation(s)
- Julie M Paik
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Harold N Rosen
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Endocrinology Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jeffrey N Katz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Rheumatology Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Eric B Rimm
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Catherine M Gordon
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
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21
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Karami H, Maleki H, Baghbeheshti M, Hashemi M, Rouzbeh M, Afkhami Ardakani M. A Short Review on the Relationships Between Nephrolithiasis and Myocardial Infarction. Galen Med J 2019; 8:e1289. [PMID: 34466485 PMCID: PMC8343981 DOI: 10.31661/gmj.v8i0.1289] [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: 07/16/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 11/16/2022] Open
Abstract
The interaction between organs is a crucial part of modern medicine. As a very prerequisite to manage a disease, practitioners should have a full awareness of the related organs. Kidney and heart are two vital organs that are closely interconnected in various fields. These two organs have a lot of common risk factors for making a person unhealthy; therefore, if you prevent the disease in one of them, the other's morbidity might be alleviated as well. Among them, nephrolithiasis and myocardial infarction (MI) have more risk factors in common, and both could be fatal. Also, these two diseases are important regarding the prevalence, incidence, and burden of disease. Some studies confirm the relationship between MI and nephrolithiasis; however, further researches are needed to discover the exact direction of their relationship. The present review aims to explain the mechanism of MI and nephrolithiasis; clarify the relationship between these two disease based on physiological, pathological, and clinical studies; and propose some solutions for the prevention and treatment of such diseases.
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Affiliation(s)
- Hormoz Karami
- Department of Urology, Shahid Doctor Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hadi Maleki
- Department of Urology, Shahid Doctor Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Baghbeheshti
- Student Research Committee, Yazd Cardiovascular research center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mostafa Hashemi
- Department of Urology, Shahid Doctor Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehrdad Rouzbeh
- School of medicine, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Goldfarb DS. Empiric therapy for kidney stones. Urolithiasis 2018; 47:107-113. [PMID: 30478476 DOI: 10.1007/s00240-018-1090-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023]
Abstract
Careful phenotyping of patients to classify those with kidney stones has a long and important history in revealing the chemical basis for stone formation. Advances in our genetic understanding of kidney stones will lead to incredible insights regarding the pathophysiology of this common disorder. At this time, both evaluation of urine chemistry and genotyping of patients are extremely useful in the setting of a university and research-based kidney stone clinic. For much of the world, in a more clinically focused setting, these techniques are neither available nor absolutely necessary. Careful implementation of an empiric prescription based on stone composition would have an important effect to reduce stone recurrence in the world's many stone formers. Increased fluid intake, generic dietary manipulations, and prescription of potassium citrate and thiazides are all appropriate empiric therapies for people with calcium and uric acid kidney stones.
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Affiliation(s)
- David S Goldfarb
- Nephrology Division, NYU Langone Health, New York, NY, USA. .,NYU School of Medicine, Nephrology Section/111G, New York DVAMC, 423 E. 23 St., New York, NY, 10010, USA.
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