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Paik JM, Patorno E. Sodium-Glucose Cotransporter 2 Inhibitors and the Risk of Nephrolithiasis in Clinical Practice-Reply. JAMA Intern Med 2024; 184:852-853. [PMID: 38805217 DOI: 10.1001/jamainternmed.2024.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Affiliation(s)
- Julie M Paik
- Brigham and Women's Hospital, Boston, Massachusetts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Elisabetta Patorno
- Brigham and Women's Hospital, Boston, Massachusetts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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2
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Chmiel JA, Stuivenberg GA, Wong JFW, Nott L, Burton JP, Razvi H, Bjazevic J. Predictive Modeling of Urinary Stone Composition Using Machine Learning and Clinical Data: Implications for Treatment Strategies and Pathophysiological Insights. J Endourol 2024. [PMID: 37975292 DOI: 10.1089/end.2023.0446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Purpose: Preventative strategies and surgical treatments for urolithiasis depend on stone composition. However, stone composition is often unknown until the stone is passed or surgically managed. Given that stone composition likely reflects the physiological parameters during its formation, we used clinical data from stone formers to predict stone composition. Materials and Methods: Data on stone composition, 24-hour urine, serum biochemistry, patient demographics, and medical history were prospectively collected from 777 kidney stone patients. Data were used to train gradient boosted machine and logistic regression models to distinguish calcium vs noncalcium, calcium oxalate monohydrate vs dihydrate, and calcium oxalate vs calcium phosphate vs uric acid stone types. Model performance was evaluated using the kappa score, and the influence of each predictor variable was assessed. Results: The calcium vs noncalcium model differentiated stone types with a kappa of 0.5231. The most influential predictors were 24-hour urine calcium, blood urate, and phosphate. The calcium oxalate monohydrate vs dihydrate model is the first of its kind and could discriminate stone types with a kappa of 0.2042. The key predictors were 24-hour urine urea, calcium, and oxalate. The multiclass model had a kappa of 0.3023 and the top predictors were age and 24-hour urine calcium and creatinine. Conclusions: Clinical data can be leveraged with machine learning algorithms to predict stone composition, which may help urologists determine stone type and guide their management plan before stone treatment. Investigating the most influential predictors of each classifier may improve the understanding of key clinical features of urolithiasis and shed light on pathophysiology.
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Affiliation(s)
- John A Chmiel
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
| | - Gerrit A Stuivenberg
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
| | - Jennifer F W Wong
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Linda Nott
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Jeremy P Burton
- Department of Microbiology and Immunology, Western University, London, Canada
- Canadian Centre for Human Microbiome and Probiotic Research, London, Canada
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Hassan Razvi
- Division of Urology, Department of Surgery, Western University, London, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, Canada
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3
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Joubran P, Roux FA, Serino M, Deschamps JY. Gut and Urinary Microbiota in Cats with Kidney Stones. Microorganisms 2024; 12:1098. [PMID: 38930480 PMCID: PMC11205531 DOI: 10.3390/microorganisms12061098] [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: 04/23/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
Upper urinary tract urolithiasis is an emerging disease in cats, with 98% of kidney stones composed of calcium oxalate. In humans, disturbances in the intestinal and urinary microbiota are suspected to contribute to the formation of calcium oxalate stones. We hypothesized that similar mechanisms may be at play in cats. This study examines the intestinal and urinary microbiota of nine cats with kidney stones compared to nine healthy cats before, during, and after treatment with the antibiotic cefovecin, a cephalosporin. Initially, cats with kidney stones displayed a less diverse intestinal microbiota. Antibiotic treatment reduced microbiota diversity in both groups. The absence of specific intestinal bacteria could lead to a loss of the functions these bacteria perform, such as oxalate degradation, which may contribute to the formation of calcium oxalate stones. This study confirms the presence of a distinct urobiome in cats with kidney stones, characterized by greater richness and diversity compared to healthy cats. These findings highlight the potential of microbiota modulation as a strategy to prevent renal lithiasis in cats.
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Affiliation(s)
- Patrick Joubran
- Nutrition, PathoPhysiology and Pharmacology (NP3) Unit, Oniris VetAgro Bio, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, La Chantrerie, CEDEX 03, 44 307 Nantes, France; (P.J.); (F.A.R.)
| | - Françoise A. Roux
- Nutrition, PathoPhysiology and Pharmacology (NP3) Unit, Oniris VetAgro Bio, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, La Chantrerie, CEDEX 03, 44 307 Nantes, France; (P.J.); (F.A.R.)
- Emergency and Critical Care Unit, Oniris VetAgro Bio, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, La Chantrerie, CEDEX 03, 44 307 Nantes, France
| | - Matteo Serino
- IRSD, Institut de Recherche en Santé Digestive, Institut National de la Santé et de la Recherche Médicale (INSERM) U1220, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Ecole Nationale Vétérinaire de Toulouse (ENVT), Université de Toulouse III-Paul Sabatier (UPS), CS 60039, 31 024 Toulouse, France
| | - Jack-Yves Deschamps
- Nutrition, PathoPhysiology and Pharmacology (NP3) Unit, Oniris VetAgro Bio, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, La Chantrerie, CEDEX 03, 44 307 Nantes, France; (P.J.); (F.A.R.)
- Emergency and Critical Care Unit, Oniris VetAgro Bio, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, La Chantrerie, CEDEX 03, 44 307 Nantes, France
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4
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Grases F, Tomàs Nadal F, Julià Florit F, Costa-Bauza A. Cystine Renal Calculi: New Aspects Related to Their Formation and Development. J Clin Med 2024; 13:2837. [PMID: 38792383 PMCID: PMC11122214 DOI: 10.3390/jcm13102837] [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: 04/24/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Crystallization experiments of renal-calculi-forming compounds (calcium oxalate, calcium phosphates, uric acid) are normally performed by monitoring these processes during periods of time similar to the residence of urine inside the kidney. Nevertheless, cystine requires high supersaturation for its crystallization, and most experiments last for longer periods. It must be considered that at high supersaturation, the inhibitors of crystalline development have poor effects. Methods: The induction time of crystallization (ti) of cystine in experimental conditions similar to those of the formation of cystine renal calculi and the effect of different cystine-binding thiol agents was determined through turbidimetric measurements. We also studied the macro- and microstructure of 30 cystine kidney stones through stereoscopic microscopy and scanning electron microscopy. Results: Under the studied conditions, the ti in absence of crystallization inhibitors was 15 min, and the presence of 9 mM of penicillamine, tiopronin, or N-acetylcysteine totally inhibited crystallization, as their effects relate to the formation of complexes with cystine, although N-acetylcysteine also delayed cystine crystalline development and modified cystine crystal morphology. Cystine stones have traditionally been classified as smooth and rough. The study of their structure shows that all of them begin their formation from a few crystals that generate a compact radial structure. Their subsequent growth, depending on the renal cavity where they are located, gives rise to the rough structure in the form of large blocks of cystine crystals or the smooth structure with small crystals. Conclusions: To prevent the development of cystine renal stones, the formation of small crystals must be avoided by reducing urinary cystine supersaturation, with N-acetylcysteine being the most effective among the studied cystine-binding thiol agents. Also, the removal of cystine crystals through increased water intake and physical activity can be a very important preventive measure.
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Affiliation(s)
| | | | | | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (F.G.); (F.T.N.); (F.J.F.)
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5
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Awuah Boadi E, Shin S, Choi BE, Ly K, Raub CB, Bandyopadhyay BC. Sex-specific Stone-forming Phenotype in Mice During Hypercalciuria/Urine Alkalinization. J Transl Med 2024; 104:102047. [PMID: 38452902 PMCID: PMC11103239 DOI: 10.1016/j.labinv.2024.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024] Open
Abstract
Sex differences in kidney stone formation are well known. Females generally have slightly acidic blood and higher urine pH when compared with males, which makes them more vulnerable to calcium stone formation, yet the mechanism is still unclear. We aimed to examine the role of sex in stone formation during hypercalciuria and urine alkalinization through acetazolamide and calcium gluconate supplementation, respectively, for 4 weeks in wild-type (WT) and moderately hypercalciuric [TRPC3 knockout [KO](-/-)] male and female mice. Our goal was to develop calcium phosphate (CaP) and CaP+ calcium oxalate mixed stones in our animal model to understand the underlying sex-based mechanism of calcium nephrolithiasis. Our results from the analyses of mice urine, serum, and kidney tissues show that female mice (WT and KO) produce more urinary CaP crystals, higher [Ca2+], and pH in urine compared to their male counterparts. We identified a sex-based relationship of stone-forming phenotypes (types of stones) in our mice model following urine alkalization/calcium supplementation, and our findings suggest that female mice are more susceptible to CaP stones under those conditions. Calcification and fibrotic and inflammatory markers were elevated in treated female mice compared with their male counterparts, and more so in TRPC3 KO mice compared with their WT counterparts. Together these findings contribute to a mechanistic understanding of sex-influenced CaP and mixed stone formation that can be used as a basis for determining the factors in sex-related clinical studies.
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Affiliation(s)
- Eugenia Awuah Boadi
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, Washington, DC
| | - Samuel Shin
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, Washington, DC; Department of Biomedical Engineering, The Catholic University of America, Washington DC
| | - Bok-Eum Choi
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, Washington, DC
| | - Khanh Ly
- Department of Biomedical Engineering, The Catholic University of America, Washington DC
| | - Christopher B Raub
- Department of Biomedical Engineering, The Catholic University of America, Washington DC
| | - Bidhan C Bandyopadhyay
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, Washington, DC; Department of Biomedical Engineering, The Catholic University of America, Washington DC; Division of Renal Diseases and Hypertension, Department of Medicine, The George Washington University, Washington DC.
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6
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Cheraghian B, Meysam A, Hashemi SJ, Hosseini SA, Malehi AS, Khazaeli D, Rahimi Z. Kidney stones and dietary intake in adults: a population-based study in southwest Iran. BMC Public Health 2024; 24:955. [PMID: 38575950 PMCID: PMC10993538 DOI: 10.1186/s12889-024-18393-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The prevalence of kidney stones is on the rise globally. Several risk factors, including lifestyle, contribute to the formation of kidney stones. Nevertheless, there is a contentious debate about the relationship between diet and kidney stones. Therefore, our study aimed to assess the relationship between macronutrients and micronutrients and the formation of kidney stones. METHODS This population-based cross-sectional study was conducted in the baseline phase of the Hoveyzeh Cohort Study, focusing on adults aged 35-70 in southwest Iran. The information on demographic characteristics, anthropometrics, kidney stone history, and food frequency was collected. Chi-square and t-tests were utilized to assess the relationship between categorical and numerical variables with kidney stones. The ANCOVA and logistic regression models were used to evaluate the relationships while controlling for confounding factors. RESULTS Among 10,009 participants, the overall prevalence of kidney stones was 18.77% (95% CI: 17.99-19.53). A higher intake of carbohydrates [OR = 1.02 (95% CI:1.002-1.03), p = 0.026] and copper [OR = 1.04 (95% CI:1.01-1.09), p = 0.025] were found to be associated with kidney stones. No associations were found between the other assessed macronutrients or micronutrients and kidney stones (p-tvalues > 0.05). CONCLUSION Our study's findings indicate a correlation between diet and the formation of kidney stones. However, the relationship between dietary factors and kidney stones is complex, and further research is needed.
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Affiliation(s)
- Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alipour Meysam
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Clinical Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dinyar Khazaeli
- Department of Urology, School of Medicine, Chronic Renal Failure Research Center Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zeng H, Liu Z, He Y, Chen H, He J, Liu M, Wu S, He H, Huang C, Xu R. Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04021-9. [PMID: 38564076 DOI: 10.1007/s11255-024-04021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi. METHODS We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins. RESULTS The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)]. CONCLUSIONS Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.
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Affiliation(s)
- Hongbo Zeng
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziyi Liu
- Department of Emergency Medicine, The Second Xiangya Hospital of Central-South University, Emergency and Difficult Diseases Institute of Central South University, Changsha, China
| | - Yunhui He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huixiang Chen
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingke Liu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuiqing Wu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiqing He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Changkun Huang
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Paik JM, Tesfaye H, Curhan GC, Zakoul H, Wexler DJ, Patorno E. Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes. JAMA Intern Med 2024; 184:265-274. [PMID: 38285598 PMCID: PMC10825784 DOI: 10.1001/jamainternmed.2023.7660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/21/2023] [Indexed: 01/31/2024]
Abstract
Importance Type 2 diabetes (T2D) is associated with an increased risk of kidney stones. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) might lower the risk of nephrolithiasis by altering urine composition. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US. Objective To investigate the association between SGLT2i use and nephrolithiasis risk in clinical practice. Design, Setting, and Participants This new-user, active comparator cohort study used data from commercially insured adults (aged ≥18 years) with T2D who initiated treatment with SGLT2is, glucagon-like peptide 1 receptor agonists (GLP-1RAs), or dipeptidyl peptidase 4 inhibitors (DPP4is) between April 1, 2013, and December 31, 2020. The data were analyzed from July 2021 through June 2023. Exposure New initiation of an SGLT2i, GLP-1RA, or DPP4i. Main Outcomes and Measures The primary outcome was nephrolithiasis diagnosed by International Classification of Diseases codes in the inpatient or outpatient setting. New SGLT2i users were 1:1 propensity score matched to new users of a GLP-1RA or DPP4i in pairwise comparisons. Incidence rates, rate differences (RDs), and estimated hazard ratios (HRs) with 95% CIs were calculated. Results After 1:1 propensity score matching, a total of 716 406 adults with T2D (358 203 pairs) initiating an SGLT2i or a GLP-1RA (mean [SD] age, 61.4 [9.7] years for both groups; 51.4% vs 51.2% female; 48.6% vs 48.5% male) and 662 056 adults (331 028 pairs) initiating an SGLT2i or a DPP4i (mean [SD] age, 61.8 [9.3] vs 61.7 [10.1] years; 47.4% vs 47.3% female; 52.6% vs 52.7% male) were included. Over a median follow-up of 192 (IQR, 88-409) days, the risk of nephrolithiasis was lower in patients initiating an SGLT2i than among those initiating a GLP-1RA (14.9 vs 21.3 events per 1000 person-years; HR, 0.69 [95% CI, 0.67-0.72]; RD, -6.4 [95% CI, -7.1 to -5.7]) or a DPP4i (14.6 vs 19.9 events per 1000 person-years; HR, 0.74 [95% CI, 0.71-0.77]; RD, -5.3 [95% CI, -6.0 to -4.6]). The association between SGLT2i use and nephrolithiasis risk was similar by sex, race and ethnicity, history of chronic kidney disease, and obesity. The magnitude of the risk reduction with SGLT2i use was larger among adults aged younger than 70 years vs aged 70 years or older (HR, 0.85 [95% CI, 0.79-0.91]; RD, -3.46 [95% CI, -4.87 to -2.05] per 1000 person-years; P for interaction <.001). Conclusions and Relevance These findings suggest that in adults with T2D, SGLT2i use may lower the risk of nephrolithiasis compared with GLP-1RAs or DPP4is and could help to inform decision-making when prescribing glucose-lowering agents for patients who may be at risk for developing nephrolithiasis.
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Affiliation(s)
- Julie M. Paik
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Helen Tesfaye
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Gary C. Curhan
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Heidi Zakoul
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Deborah J. Wexler
- Harvard Medical School, Boston, Massachusetts
- Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Elisabetta Patorno
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Steely A, Worcester E, Prochaska M. Contrasting Response of Urine Stone Risk to Medical Treatment in Calcium Oxalate versus Calcium Phosphate Stone Formers. KIDNEY360 2024; 5:228-236. [PMID: 38251931 PMCID: PMC10914189 DOI: 10.34067/kid.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
Key Points Thiazide treatment successfully lowered urine calcium and both calcium oxalate and calcium phosphate supersaturations in both types of stone formers (SFs). Alkali therapy may not confer the same benefits on calcium phosphate SFs as it does on calcium oxalate SFs. Background Randomized controlled trials have shown that both thiazide diuretics and potassium citrate (K-Cit) can prevent calcium stone recurrence, but most participants formed calcium oxalate (CaOx) stones. While thiazides are expected to lower risk of calcium phosphate (CaP) stone formation, the effect of K-Cit on risk of CaP stone formation is unclear. Methods To study the effect of common calcium stone treatments, we analyzed the 24-hour urines of CaOx and CaP stone formers (SFs) by four treatment types: Lifestyle, K-Cit, Thiazide, or Both medications. Results Patients treated with thiazides reduced urine calcium in both CaOx (M =−74.4, SD =94.6 mg/d) and CaP (M =−102, SD =99.7 mg/d) SFs while those on K-Cit had no change in urine calcium. Among CaOx SFs, urine citrate rose in patients administered K-Cit with or without thiazide, but citrate did not rise significantly in CaP SFs. Urine pH rose in all CaOx SFs, but among CaP SFs, only rose in patients receiving K-Cit. CaOx supersaturation (SS) decreased in all patients who received Thiazide, and decreased among CaOx SFs treated with K-Cit. CaP SS decreased in both CaOx SFs (M =−0.46, SD =0.86) and CaP SFs (M =−0.76, SD =0.85) treated with Thiazide, except CaOx SFs who received Both. Patients treated with K-Cit alone increased CaP SS in CaOx SFs (M =0.25, SD =0.79). Conclusions Patients treated with Thiazide lowered urine calcium and SS in both stone groups. Patients treated with K-Cit had no significant changes in urine calcium and had a decrease in CaOx SS in CaOx SFs. The study raises questions about the best preventive treatment for patients with CaP stones and suggests that K-Cit may not confer the same benefits on CaP SFs as it does on CaOx SFs.
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Affiliation(s)
- Audrey Steely
- Department of Medicine, University of Chicago, Chicago, Illinois
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10
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Abbas SK, Al-Omary TSS, Fawzi HA. Ultrasound accuracy in evaluating renal calculi in Maysan province. J Med Life 2024; 17:226-232. [PMID: 38813369 PMCID: PMC11131636 DOI: 10.25122/jml-2023-0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/19/2024] [Indexed: 05/31/2024] Open
Abstract
Renal calculi are a common clinical presentation. While ultrasound (US) is a widely used imaging modality for kidney stone diagnosis due to its accessibility and lower cost, its accuracy compared to computerized tomography (CT), the gold standard, remains understudied. This cross-sectional study evaluated the diagnostic accuracy of ultrasound for detecting and characterizing kidney stones compared to computed tomography (CT). Fifty-six patients with suspected kidney stones based on flank pain underwent abdominal ultrasound to assess stone presence, size, location, and the severity of any hydronephrosis (kidney swelling). These findings were then confirmed with a subsequent non-contrast CT scan. There was a fair agreement between US and CT (Kappa = 0.368) for detecting the stone location. The US could not detect 7 (12.5%) stones, being less sensitive in the middle and upper calyx compared to CT. There was a fair agreement between the US and CT (Kappa = 0.394) for detecting the severity of hydronephrosis. The US was less sensitive to moderate and severe hydronephrosis compared to CT. The abdominal ultrasound demonstrated excellent reliability for stone size measurement (intraclass correlation = 0.924), with CT measurements only slightly larger on average (mean difference 0.9 mm). Although abdominal ultrasound provides reliable stone size assessment, its capacity to accurately localize stones and assess hydronephrosis severity is limited.
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Affiliation(s)
- Saud Kadhim Abbas
- Department of Surgery, College of Medicine, University of Misan, Misan, Iraq
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11
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Nguyen LD, Nguyen TT, Mai LV, Bui PV, Nguyen VT, Truong GT, Luu MT, Duong HT, Vu LD, Hoang TT. The first epidemiology of urolithiasis in Northern Vietnam: Urinary stone composition, age, gender, season, and clinical features study. Urologia 2024; 91:42-48. [PMID: 37916769 DOI: 10.1177/03915603231208090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVES The aim of this study is to analyze the compositions of urinary stones and investigate their distributions in different ages, genders, seasons, and clinical features of Northern Vietnamese patients. METHODS A total of 231 patients with urinary stones from Northern Vietnam were collected and analyzed composition from 1/2021-12/2022. For all patients, age, sex, stone location, stone side, urine pH, and hospitalized date (month) were collected. RESULTS Kidney stones are more frequently found in men than women with the male: female urinary stones ratio in this study being 1.96:1. The highest stone prevalence appeared between 60 and 69 years old. The most common stone composition was calcium oxalate, followed by calcium phosphate, uric acid, struvite, and cysteine. Mix stones of CaOx and CaP were more prevalent than pure stones. Males submitted more CaOx, CaP, and UA stones, whereas females were susceptible to infectious stones. Stones were more frequently found on the left side of the upper urinary tract (51.9%) than on the right side (27.3%) and lower urinary tract (7.8%). Cultural tendency leads to a smaller number of stones during the Lunar new year (February), and Ghost month (August).
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Affiliation(s)
- Lien D Nguyen
- E Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi-VNU, Hanoi, Vietnam
| | | | | | | | - Van Thi Nguyen
- Institute of Chemistry, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Giang Tb Truong
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- College of Education, Vinh University, Nghean, Vietnam
| | - Minh Tn Luu
- Institute of Chemistry, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Hung T Duong
- Institute of Chemistry, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Loi D Vu
- Institute of Chemistry, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- Vietnam - Korea Institute of Science and Technology, Hanoi, Vietnam
| | - Thao Th Hoang
- Institute of Chemistry, Vietnam Academy of Science and Technology, Hanoi, Vietnam
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12
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Liang D, Liu C, Yang M. The association between C-reactive protein levels and the risk of kidney stones: a population-based study. BMC Nephrol 2024; 25:39. [PMID: 38281018 PMCID: PMC10822160 DOI: 10.1186/s12882-024-03476-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/21/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVES The relationship between C-reactive protein (CRP) and the risk of developing kidney stones is unclear, and we aimed to assess the association between CRP and kidney stones in US adults. METHODS We used data from NHANES 2007-2010, and we excluded participants who were under 18 years of age and lacked data on CRP and kidney stones. Finally, we included a total of 11,033 participants and performed weighted multivariate regression analysis and subgroup analysis to assess the independent relationship between CRP and kidney stones. RESULTS The mean prevalence of kidney stones among the participants was 9.8%. Notably, as CRP levels increased, the prevalence of kidney stones exhibited a corresponding rise across quartiles (Kidney stones: Quartile 1: 7.59%; Quartile 2: 8.77%; Quartile 3: 9.64%; Quartile 4: 10.89%). CRP was positively associated with the risk of kidney stones (Model 1: OR = 1.09, 95% CI: 1.01-1.18, p = 0.03; Model 2: OR = 1.09, 95% CI: 1.00-1.18, p = 0.03, Model 3: OR = 1.14, 95%CI: 1.02-1.26, p = 0.04). Participants in the highest CRP quartile experienced a 69% increased risk of kidney stones compared to those in the lowest quartile (OR = 1.64, 95% CI: 1.04-2.59, p = 0.03). Notably, interaction tests revealed that gender, BMI, diabetes, hypertension, CKD and smoking or alcohol consumption status did not significantly influence the association between CRP and kidney stones. CONCLUSIONS Our findings reveal a significant association between higher CRP levels and an increased risk of kidney stones. In clinical practice, heightened awareness of CRP as a potential biomarker could aid in risk assessment and management strategies for kidney stone patients.
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Affiliation(s)
- Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China
| | - Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Mei Yang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China.
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13
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Paz DC, Gunther AC, Higham MC, Stephenson LG, Laporta AJ, Gubler KD, Ryznar RJ. Exploring the relationship of supernumerary recurrent renal calculi formation and tick-borne infections: a case report. Front Cell Infect Microbiol 2024; 14:1194307. [PMID: 38343886 PMCID: PMC10853403 DOI: 10.3389/fcimb.2024.1194307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
A 51-year-old male with a history of Cacchi-Ricci disease and long-standing infection with various species of Borrelia, Babesia, and Bartonella presented with recurrent symptoms of right-sided flank pain. Numerous renal calculi were identified on imaging. The etiology of the calculi had not been previously elucidated. Symptoms intermittently date back to 2002 when uric acid stones were identified. Subsequent calculi analysis revealed calcium oxalate stones. Despite the commonality of nephrolithiasis in patients with Cacchi-Ricci disease, the extreme number of calculi and recurrent presentation of symptoms persisted despite a plethora of medical evaluations, dietary changes, and hereditary testing. This case raises questions of etiology including possible immune deficiency and whether his uncommon microbial history contributes to recurrent stone formation.
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Affiliation(s)
- Dean C. Paz
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | - Abigael C. Gunther
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | - Michael C. Higham
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, United States
| | - Lynne G. Stephenson
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | - Anthony J. Laporta
- Department of Military Medicine, Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
| | - K. Dean Gubler
- Department of Military Medicine, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, United States
| | - Rebecca J. Ryznar
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States
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14
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Iqbal MS, Duan X, Ali H, Kaoqing P, Liu Z, Sardar N, Alsubki RA, Attia KA, Abushady AM, Gu D, Zeng G. Identification of TIMPs signatures in Randall plaque from single-cell RNA sequencing (scRNA-Seq) analysis. Funct Integr Genomics 2024; 24:11. [PMID: 38225514 DOI: 10.1007/s10142-024-01296-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Affiliation(s)
- Muhammad Sarfaraz Iqbal
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Habib Ali
- Khwaja Fareed University of Engineering and Information Technology, Rahim Yar Kahn, 64200, Pakistan.
| | - Peng Kaoqing
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zezehun Liu
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nimra Sardar
- Department of Microbiology and Molecular Genetics, School of Applied Biology, University of Okara, Okara, Pakistan
| | - Roua A Alsubki
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Kotb A Attia
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Asmaa M Abushady
- Biotechnology School, 26th of July Corridor, Nile University, Sheikh Zayed City, 12588, Giza, Egypt
- Department of Genetics, Agriculture College, Ain Shams University, Cairo, Egypt
| | - Di Gu
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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15
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Shim KH, Choi KB, Kim WB, Yang SW, Kim DK, Choo MS, Chung DY, Jung HD, Lee SW, Kim BS, Jeon SH, Kang SH, Paick S, Lee JY. Urolithiasis in Kidney Transplant Patients: A Multicenter KSER Research Series. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:132. [PMID: 38256393 PMCID: PMC10819323 DOI: 10.3390/medicina60010132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Urolithiasis occurrence is uncommon in kidney transplantation patients, though it has serious implications, including acute kidney injury in the transplanted kidney. This study investigates the leading causes of urolithiasis in kidney transplantation patients, the diagnostic process, and the outcomes of multimodal management. Materials and Methods: Data collection spanned from January 1997 to December 2021, involving kidney transplantation patients with urolithiasis from the database of the Korean Society of Endourology and Robotics (KSER) research committee. Analysis encompassed factors triggering urolithiasis, the diagnostic process, stone attributes, treatment methods, and outcomes. Results: Our analysis included 58 kidney transplantation patients with urolithiasis from eight medical centers. Of these patients, 37 were male and 4 had previous urolithiasis diagnoses. The mean age was 59.09 ± 10.70 years, with a mean duration from kidney transplantation to diagnosis of 76.26 ± 183.14 months. The most frequent method of stone detection was through asymptomatic routine check-ups (54.7%). Among the 58 patients, 51 underwent stone treatment. Notably, 95.3% of patients with ureter stones received treatment, a significantly higher rate than the 66.7% of patients with renal stones (p = 0.010). Success rates showed no significant differences between renal (70%) and ureter stone (78.0%) groups (p = 0.881). Conclusions: Urolithiasis in transplanted kidneys constitutes an acute condition requiring emergency intervention. Endo-urological interventions are effective for kidney transplantation patients with urolithiasis. To ensure prevention and early detection, diligent follow-up and routine imaging tests are necessary.
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Affiliation(s)
- Kang Hee Shim
- Department of Urology, Ajou University School of Medicine, Suwon 16499, Republic of Korea;
| | - Kwi Bok Choi
- Department of Urology, National Police Hospital, Seoul 05715, Republic of Korea;
| | - Woong Bin Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Republic of Korea;
| | - Seung Woo Yang
- Department of Urology, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea;
- Department of Urology, U-well Urology Clinic, Daejeon 35233, Republic of Korea
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Republic of Korea;
| | - Min Soo Choo
- Department of Urology, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea;
| | - Doo Yong Chung
- Department of Urology, Inha University College of Medicine, Incheon 22212, Republic of Korea;
| | - Hae Do Jung
- Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea;
| | - Sin Woo Lee
- Department of Urology, Seoul Medical Center, Seoul 02053, Republic of Korea;
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Seung Hyun Jeon
- Department of Urology, Kyung Hee University School of Medicine, Seoul 02447, Republic of Korea;
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul 02841, Republic of Korea;
| | - Sunghyun Paick
- Department of Urology, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
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16
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Siener R, Rüdy J, Herwig H, Schmitz MT, Schaefer RM, Lossin P, Hesse A. Mixed stones: urinary stone composition, frequency and distribution by gender and age. Urolithiasis 2024; 52:24. [PMID: 38189998 PMCID: PMC10774159 DOI: 10.1007/s00240-023-01521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
Proper analysis of urinary stone composition is a cornerstone for diagnosis, targeted treatment and recurrence prevention of urolithiasis. The aim of this study was to determine the composition, frequency and distribution of mixed stones according to gender and age of patients. A total of 42,519 urinary stones from 30,311 men and 12,208 women submitted between January 2007 and December 2020 were studied. Most urinary calculi consisted of two components (50.9%), followed by stones of a single constituent (27.1%) and three-component stones (21.9%), while four-component stones were only rarely identified (0.1%). Among all stones, 49.8% consisted of whewellite (COM), weddellite (COD), and mixtures of COM and COD, 33.8% were pure carbonate apatite (CA) and mixtures of CA with COM and/or COD, while 7.6% were composed of uric acid anhydrous (UAA), uric acid dihydrate (UAD), and mixed UAA and UAD. The remaining 8.8% of calculi were rare single-component stones and rare mixtures of various constituents. The number of stone components was inversely associated with age (p < 0.001). The proportion of men decreased significantly with the number of stone constituents, from 3.01:1 for single-component stones to 1.0:1 for four-component urinary calculi (p < 0.001). The vast majority of urinary calculi consisted of two or more components in varying proportions. While age was inversely associated with the number of stone constituents, the proportion of women increased significantly from single-component to four-component urinary calculi. A significant proportion of mixed stones could present a challenge for diagnosis and targeted recurrence prevention.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Jakob Rüdy
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Helena Herwig
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Marie-Therese Schmitz
- Department of Medical Biometry, Informatics and Epidemiology, Medical Faculty, Bonn, Germany
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17
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Rodríguez D, Gurevich E, Mohammadi Jouabadi S, Pastor Arroyo EM, Ritter A, Estoppey Younes S, Wagner CA, Imenez Silva PH, Seeger H, Mohebbi N. Serum sclerostin is associated with recurrent kidney stone formation independent of hypercalciuria. Clin Kidney J 2024; 17:sfad256. [PMID: 38186870 PMCID: PMC10768761 DOI: 10.1093/ckj/sfad256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 01/09/2024] Open
Abstract
Background Kidney stones are frequent in industrialized countries with a lifetime risk of 10 to 15%. A high percentage of individuals experience recurrence. Calcium-containing stones account for more than 80% of kidney stones. Diet, environmental factors, behavior, and genetic variants contribute to the development of kidney stones. Osteocytes excrete the 21 kDa glycoprotein sclerostin, which inhibits bone formation by osteoblasts. Animal data suggests that sclerostin might directly or indirectly regulate calcium excretion via the kidney. As hypercalciuria is one of the most relevant risk factors for kidney stones, sclerostin might possess pathogenic relevance in nephrolithiasis. Methods We performed a prospective cross-sectional observational controlled study in 150 recurrent kidney stone formers (rKSF) to analyse the association of sclerostin with known stone risk factors and important modulators of calcium-phosphate metabolism. Serum sclerostin levels were determined at the first visit. As controls, we used 388 non-stone formers from a large Swiss epidemiological cohort. Results Sclerostin was mildly increased in rKSF in comparison to controls. This finding was more pronounced in women compared to men. Logistic regression indicated an association of serum sclerostin with rKSF status. In hypercalciuric individuals, sclerostin levels were not different from normocalciuric patients. In Spearman correlation analysis we found a positive correlation between sclerostin, age, and BMI and a negative correlation with eGFR. There was a weak correlation with iPTH and intact FGF 23. In contrast, serum sclerostin levels were not associated with 25-OH Vitamin D3, 1,25-dihydroxy-Vitamin D3, urinary calcium and phosphate or other urinary lithogenic risk factors. Conclusion This is the first prospective controlled study investigating serum sclerostin in rKSF. Sclerostin levels were increased in rKSF independent of hypercalciuria and significantly associated with the status as rKSF. It appears that mechanisms other than hypercalciuria may be involved and thus further studies are required to elucidate underlying pathways.
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Affiliation(s)
- Daniel Rodríguez
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | | | - Soroush Mohammadi Jouabadi
- Department of Internal Medicine , Division of Vascular Medicine and Pharmacology, Erasmus Medical Center, University Medical Center Rotterdam, the Netherlands
| | | | - Alexander Ritter
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | | | - Carsten A Wagner
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Pedro Henrique Imenez Silva
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, the Netherlands
| | - Harald Seeger
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Nilufar Mohebbi
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
- Institute of Physiology, University of Zurich, Zurich, Switzerland
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18
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Sabhan AH. Comparison of immediate versus post-stenting ureteroscopy for ureteral stones treatment. J Med Life 2023; 16:1745-1749. [PMID: 38585524 PMCID: PMC10994621 DOI: 10.25122/jml-2023-0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/18/2023] [Indexed: 04/09/2024] Open
Abstract
Ureteroscopy is a highly effective treatment for ureteral stones, characterized by a high stone-free rate and a low need for re-treatment. Ureteral stent placement can improve the insertion of the ureteral access sheath and ureteroscope but may be associated with higher morbidity prior to and after ureteroscopy. The study aimed to compare immediate versus post-stenting ureteroscopy for ureteral stone treatment in terms of operative time, intra- and post-operative complications, length of hospital stay, and stone-free rate. This prospective study involved 126 patients with ureteral stones divided into two groups: the post-stenting ureteroscopy group (PS-URS), who underwent primary ureteral stenting by double J followed by delayed ureteroscopy, and the immediate ureteroscopy group (I-URS), who underwent immediate ureteroscopy without previous stenting. Sixty-six patients were included in the PS-URS group and 60 patients in the I-URS group. Results were comparable, with no significant differences between both groups. The mean operative time was 33.77±3.51 minutes for the PS-URS group and 34.60±2.01 minutes for the I-URS group. The average length of hospital stay was 0.84±2.55 days for PS-URS and 0.92±1.96 days for I-URS patients. The stone-free rate was 97% in the PS-URS group and 95% in the I-URS group. The overall complication rate was 4.5% versus 5% in the PS-URS and I-URS groups, respectively, with all complications being minor and managed effectively. Immediate ureteroscopy is a safe and relevant operative approach for ureteral stones, with comparative results for post-stenting delayed ureteroscopy.
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Affiliation(s)
- Ali Hadi Sabhan
- Department of Surgery, College of Medicine, University of Al-Qadisiyah, Al-Diwaneyah, Iraq
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19
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Huang L, Hu J, Xue C, Ding J, Guo Z, Yu B. Vascular calcification on the risk of kidney stone: a meta-analysis. Ren Fail 2023; 45:2183727. [PMID: 36866867 PMCID: PMC9987734 DOI: 10.1080/0886022x.2023.2183727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The association between vascular calcification (VC) and kidney stone is still inconclusive. Therefore, we conducted a meta-analysis to estimate the risk of kidney stone disease in subjects with VC. METHODS To identify publications from related clinical studies, we performed a search on PubMed, Web of Science, Embase, and Cochrane Library databases from their inceptions until 1 September 2022. According to obvious heterogeneity, a random-effects model was used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Subgroup analysis was conducted trying to dissect the effects of VC in different segments and population regions in predicting kidney stone risk. RESULTS Seven articles were included with a total number of 69,135 patients, of which 10,052 have vascular calcifications and 4728 have kidney stones. There was a significantly higher risk of kidney stone disease in participants with VC versus control (OR = 1.54, 95% CI: 1.13-2.10). Sensitivity analysis confirmed the stability of the results. VC can be separated into abdominal, coronary, carotid, and splenic aortic calcification while pooled analysis of abdominal aorta calcification did not indicate a significant higher kidney stone risk. An obvious higher risk of kidney stone was observed in Asian VC patients (OR = 1.68, 95% CI: 1.07-2.61). CONCLUSION Combined evidence of observational studies suggested patients with VC may be associated with an increased risk of kidney stone disease. Despite the predictive value was relatively low, it is still worth noting that patients with VC are under the threat of kidney stone disease.
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Affiliation(s)
- Linxi Huang
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Junjie Hu
- Department of Cell Biology, Center for Stem Cell and Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Cheng Xue
- Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Jiarong Ding
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Zhiyong Guo
- Department of Nephrology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Bing Yu
- Department of Cell Biology, Center for Stem Cell and Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
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20
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Courbebaisse M, Travers S, Bouderlique E, Michon-Colin A, Daudon M, De Mul A, Poli L, Baron S, Prot-Bertoye C. Hydration for Adult Patients with Nephrolithiasis: Specificities and Current Recommendations. Nutrients 2023; 15:4885. [PMID: 38068743 PMCID: PMC10708476 DOI: 10.3390/nu15234885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24 h urine volume, which, under physiological conditions, approximately reflects daily fluid intake. The aim of this study is to synthesize and highlight the role of hydration in the treatment of nephrolithiasis. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) and also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake to at least at 2.5 L/day to prevent stone formation, and even to 3.5-4 L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate, or magnesium content). Finally, some additional advice has to be given to avoid certain beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.
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Affiliation(s)
- Marie Courbebaisse
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Institut Necker Enfants Malades, Inserm U1151, F-75015 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Simon Travers
- Équipe Biologie, Lip(Sys)2, EA7357, UFR de Pharmacie, Université Paris-Saclay, F-91400 Orsay, France
- Clinical Chemistry Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France
| | - Elise Bouderlique
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Arthur Michon-Colin
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Michel Daudon
- Department of Multidisciplinary Functional Explorations, Tenon Hospital, AP-HP, F-75019 Paris, France
| | - Aurélie De Mul
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, F-69500 Bron, France
| | - Laura Poli
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Stéphanie Baron
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
| | - Caroline Prot-Bertoye
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
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Modou N, Mohamed D, Motoula Latou L, Racine K, Lamine N, Dominique D, Mohamed SS. Epidemiology and composition of upper urinary tract lithiasis in Senegalese population: a multicenter retrospective study. Urolithiasis 2023; 52:4. [PMID: 37982903 DOI: 10.1007/s00240-023-01498-4] [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: 04/21/2023] [Accepted: 10/24/2023] [Indexed: 11/21/2023]
Abstract
Urolithiasis is a major public health issue due to its increasing prevalence. The objective of this study was to describe the spectrophotometric profile of upper urinary tract stones (UTS) in Senegal. We conducted a multicenter retrospective study of all patients treated for upper UTS whose chemical composition was analyzed from January 2014 to January 2020 in eight regions of Senegal. Socio-demographic, clinical, paraclinical, and prognosis data were collected and analyzed. Three hundred and thirty-four patients were included in this study with a mean age of 46.3 ± 18.4 years and a sex ratio of 1.38. About one-third of patients (31.1%) had a body mass index > 25 kg/m2 and 74.2% presented with lumbar pain was the main clinical symptom. Calcium oxalate and calcium phosphate stones were the predominant types found, respectively, in 37.7% and 24.5% of patients. Uric acid was the main stone constituent in 18.6% of patients and struvites represented 14.7% of cases. Stones were located in the renal calyces and pelvis in 71.2% of cases. Surgical lithotomy was performed in 62.7% of patients for UTS extraction. Upper UTS are frequent condition in Senegalese with predominance of males and young adults. Calcium and uric acid stones are the main types. Preventive dietary and lifestyle measures are needed to reduce their burden.
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Affiliation(s)
- Ndongo Modou
- Nephrology and Dialysis, Regional Hospital of Kedougou, Dakar, Senegal
| | - Dahaba Mohamed
- Nephrology and Dialysis Department, Regional Hospital of Ndioum, Dakar, Senegal
| | - L Motoula Latou
- Nephrology and Dialysis Department, Military Hospital of Ouakam, Dakar, Senegal
| | - Kane Racine
- Urology Department, Hopital Principal, Dakar, Senegal
| | - Niang Lamine
- Urology Department, Idrissa Pouye General Hospital, Dakar, Senegal
| | - Doupa Dominique
- Faculty of Health Sciences, IRL-3189/ESS/UGB/CNRS/UCAD/CNRST/USTB, University Gaston Berger, Saint-Louis, Senegal
| | - Seck Sidy Mohamed
- Nephrology and Dialysis, Regional Hospital of Kedougou, Dakar, Senegal.
- Faculty of Health Sciences, IRL-3189/ESS/UGB/CNRS/UCAD/CNRST/USTB, University Gaston Berger, Saint-Louis, Senegal.
- CEA AGIR, Cheikh Anta DIOP University, Dakar, Senegal.
- Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, Sanar, BP 234, Saint-Louis, Sénégal.
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22
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Wang X, Zhang J, Ma Z, Yang Y, Dang Y, Cao S, Shi X, Ouyang C, Pan J, Hu X. Association and interactions between mixed exposure to trace elements and the prevalence of kidney stones: a study of NHANES 2017-2018. Front Public Health 2023; 11:1251637. [PMID: 37965524 PMCID: PMC10642183 DOI: 10.3389/fpubh.2023.1251637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background The association between exposure to trace elements mixture and the prevalence of kidney stones and the interactions between elements are unclear. The aim of this study was to explore the association between exposure to trace elements mixture and the prevalence of kidney stones and the interactions between the elements. Methods A total of 1,244 participants (139 kidney stone formers and 1,105 non-stone former participants) in NHANES 2017-2018 were included. The exposure to trace elements was evaluated by measuring their concentration in urine samples. Three methods, Logistic regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR), were used for analysis. Results According to the results from qgcomp and BKMR, a negative association was found between exposure to the 13 trace elements and the prevalence of kidney stones [OR = 0.50 (0.32, 0.78)]. Subgroup analysis revealed that Co, As, and iodine in the whole population, Co, As, and Ni in males, and Cs, iodine, and Sb in females, were most strongly associated with kidney stones. Kidney stone was found to be positively correlated with Co and negatively correlated with the other elements. Besides, there were significant interactions between Ni and Pb in the whole population, Co and iodine in males, and Pb and iodine in females. Conclusion There was a negative association between exposure to the mixture of 13 trace elements and the prevalence of kidney stones.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Xiaobin Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
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23
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Filler G, Dave S, Ritter V, Ross S, Viprakasit D, Hatch JE, Bjazevic J, Burton J, Gilleskie D, Gilliland J, Lin FC, Jain N, McClure JA, Razvi H, Bhayana V, Wang P, Coulson S, Sultan N, Denstedt J, Fearrington L, Diaz-Gonzalez de Ferris ME. In focus: perplexing increase of urinary stone disease in children, adolescent and young adult women and its economic impact. Front Med (Lausanne) 2023; 10:1272900. [PMID: 37937142 PMCID: PMC10626457 DOI: 10.3389/fmed.2023.1272900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023] Open
Abstract
Background Urinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones. The reasons for this epidemiological trend are unknown. Methods This perspective presents the extent of USD with data from a Canadian Province and a North American institution, explanations for these findings and offers potential solutions to decrease this trend. We describe the economic impact of USD. Findings There was a significant increase of 46% in overall surgical interventions for USD in Ontario. The incidence rose from 47.0/100,000 in 2002 to 68.7/100,000 population in 2016. In a single United States institution, the overall USD annual unique patient count rose from 10,612 to 17,706 from 2015 to 2019, and the proportion of women with USD was much higher than expected. In the 10-17-year-old patients, 50.1% were girls; with 57.5% in the 18-34 age group and 53.6% in the 35-44 age group. The roles of obesity, diet, hormones, environmental factors, infections, and antibiotics, as well as the economic impact, are discussed. Interpretation We confirm the significant increase in USD among women. We offer potential explanations for this sex disparity, including microbiological and pathophysiological aspects. We also outline innovative solutions - that may require steps beyond typical preventive and treatment recommendations.
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Affiliation(s)
- Guido Filler
- Department of Paediatrics, Western University, London, ON, Canada
- Department of Medicine, Western University, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON, Canada
| | - Sumit Dave
- Department of Surgery, Western University, London, ON, Canada
| | - Victor Ritter
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sherry Ross
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Davis Viprakasit
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Joseph E. Hatch
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Jeremy Burton
- Department of Surgery, Western University, London, ON, Canada
- Department of Microbiology and Immunology, Western University, London, ON, Canada
| | - Donna Gilleskie
- Department of Economics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jason Gilliland
- Department of Geography, Western University, London, ON, Canada
| | - Feng-Chang Lin
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Nina Jain
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Hassan Razvi
- Department of Surgery, Western University, London, ON, Canada
| | - Vipin Bhayana
- Department of Pathology and Laboratory Medicine, Western University, London, ON, Canada
| | - Peter Wang
- Department of Surgery, Western University, London, ON, Canada
| | - Sherry Coulson
- Department of Paediatrics, Western University, London, ON, Canada
| | - Nabil Sultan
- Department of Medicine, Western University, London, ON, Canada
| | - John Denstedt
- Department of Surgery, Western University, London, ON, Canada
| | - Loretta Fearrington
- North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Tung HT, Liu CM, Huang HS, Lu ZH, Liu CJ. Increased risk of chronic kidney disease in uric acid stone formers with high neutrophil-to-lymphocyte ratio. Sci Rep 2023; 13:17686. [PMID: 37848540 PMCID: PMC10582096 DOI: 10.1038/s41598-023-45034-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 10/19/2023] Open
Abstract
Urolithiasis is associated with an increased risk of chronic kidney disease (CKD), irrespective of stone compositions. Chronic inflammation is an important factor for CKD progression. Neutrophil-to-lymphocyte ratio (NLR) has been recognized as a reliable biomarker of inflammation, yet its use in predicting renal deterioration in patients with urolithiasis remains limited. We aimed to explore whether the combination of stone composition and NLR could be useful as a predictor for CKD risk. A total of 336 stone formers with at least one stone submission for analysis were enrolled in the retrospective study. Stones were classified into uric acid and calcium groups. Renal functions were assessed at least one month after stone treatment. Uric acid stone formers had significantly lower estimated glomerular filtration rate (eGFR) compared with calcium stone formers (p < 0.001). NLR was significantly higher in uric acid stone formers (p = 0.005), and a significantly negative correlation (p < 0.001) between NLR and eGFR had been observed only in uric acid stone group. Univariate and multivariate logistic regression analyses showed that higher proportion of uric acid stone composition and higher NLR were both significantly associated with CKD risks. A nomogram integrating independent predictors was generated for CKD prediction, yielding an AUC of 0.811 (0.764-0.858). In conclusion, our study demonstrated that stone formers with higher proportion of uric acid composition and higher NLR levels were associated with higher CKD risk.
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Affiliation(s)
- Hsiu-Ting Tung
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Chia-Min Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Ho-Shiang Huang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Ze-Hong Lu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan.
| | - Chan-Jung Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan.
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25
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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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26
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Kowalczyk NS, Prochaska ML, Worcester EM. Metabolomic profiles and pathogenesis of nephrolithiasis. Curr Opin Nephrol Hypertens 2023; 32:490-495. [PMID: 37530089 PMCID: PMC10403267 DOI: 10.1097/mnh.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW Kidney stone disease is caused by supersaturation of urine with certain metabolites and minerals. The urine composition of stone formers has been measured to prevent stone recurrence, specifically calcium, uric acid, oxalate, ammonia, citrate. However, these minerals and metabolites have proven to be unreliable in predicting stone recurrence. Metabolomics using high throughput technologies in well defined patient cohorts can identify metabolites that may provide insight into the pathogenesis of stones as well as offer possibilities in therapeutics. RECENT FINDINGS Techniques including 1H-NMR, and liquid chromatography paired with tandem mass spectroscopy have identified multiple possible metabolites involved in stone formation. Compared to formers of calcium oxalate stones, healthy controls had higher levels of hippuric acid as well as metabolites involved in caffeine metabolism. Both the gut and urine microbiome may contribute to the altered metabolome of stone formers. SUMMARY Although metabolomics has offered several potential metabolites that may be protective against or promote stone formation, the mechanisms behind these metabolomic profiles and their clinical significance requires further investigation.
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27
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Adomako EA, Li X, Sakhaee K, Moe OW, Maalouf NM. Urine pH and Citrate as Predictors of Calcium Phosphate Stone Formation. KIDNEY360 2023; 4:1123-1129. [PMID: 37307531 PMCID: PMC10476682 DOI: 10.34067/kid.0000000000000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
Key Points The occurrence of calcium phosphate stones has increased over the past five decades, and this is most notable in female stone formers. High urine pH and hypocitraturia are the most discriminatory urine parameters between calcium phosphate and calcium oxalate stone formers. High urine pH in calcium phosphate stone formers is independent of the effect of dietary alkali and acid. Background Urinary parameters, including urine pH and citrate, are recognized as critical in the pathophysiology of calcium-based stones. The factors contributing to variation in these parameters between calcium oxalate (CaOx) and calcium phosphate (CaP) stone formers (SFs) are, however, not well-understood. In this study, using readily available laboratory data, we explore these differences to delineate the odds of forming CaP versus CaOx stones. Methods In this single-center retrospective study, we compared serum and urinary parameters between adult CaP SFs, CaOx SFs, and non–stone formers. Results Urine pH was higher and urine citrate lower in CaP SFs compared with same-sex CaOx SFs and non–stone formers. In CaP SFs, higher urine pH and lower citrate were independent of markers of dietary acid intake and gastrointestinal alkali absorption, suggesting abnormal renal citrate handling and urinary alkali excretion. In a multivariable model, urine pH and urine citrate were most discriminatory between CaP SFs and CaOx SFs (receiver-operating characteristic area under the curve of 0.73 and 0.65, respectively). An increase in urine pH by 0.35, a decrease in urine citrate by 220 mg/d, a doubling of urine calcium, and female sex all independently doubled the risk of CaP stone formation compared with CaOx stones. Conclusions High urine pH and hypocitraturia are two clinical parameters that distinguish the urine phenotype of CaP SFs from CaOx SFs. Alkalinuria is due to intrinsic differences in the kidney independent of intestinal alkali absorption and is accentuated in the female sex.
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Affiliation(s)
- Emmanuel A. Adomako
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas
| | - Xilong Li
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas
| | - Khashayar Sakhaee
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Orson W. Moe
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
- Department of Physiology, UT Southwestern Medical Center, Dallas, Texas
| | - Naim M. Maalouf
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
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Oh KT, Jun DY, Choi JY, Jung DC, Lee JY. Predicting Urinary Stone Composition in Single-Use Flexible Ureteroscopic Images with a Convolutional Neural Network. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1400. [PMID: 37629690 PMCID: PMC10456355 DOI: 10.3390/medicina59081400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Analysis of urine stone composition is one of the most important factors in urolithiasis treatment. This study investigated whether a convolutional neural network (CNN) can show decent results in predicting urinary stone composition even in single-use flexible ureterorenoscopic (fURS) images with relatively low resolution. Materials and Methods: This study retrospectively used surgical images from fURS lithotripsy performed by a single surgeon between January 2018 and December 2021. The ureterorenoscope was a single-use flexible ureteroscope (LithoVue, Boston Scientific). Among the images taken during surgery, a single image satisfying the inclusion and exclusion criteria was selected for each stone. Cases were divided into two groups according to whether they contained any calcium oxalate (the Calcium group) or none (the Non-calcium group). From 506 total cases, 207 stone surface images were finally included in the study. In the CNN model, the transfer learning method using Resnet-18 as a pre-trained model was used, and only endoscopic digital images and stone classification data were input to achieve minimally supervised learning. Results: There were 175 cases in the Calcium group and 32 in the Non-calcium group. After training and validation, the model was tested using the test set, and the total accuracy was 81.8%. Recall and precision of the test results were 88.2% and 88.2% in the Calcium group and 60.0% and 60.0% in the Non-calcium group, respectively. The area under the receiver operating characteristic curve of the model, which represents its classification performance, was 0.82. Conclusions: Single-use flexible ureteroscopes have financial benefits but low vision quality compared with reusable digital flexible ureteroscopes. As far as we know, this is the first artificial intelligence study using single-use fURS images. It is meaningful that the CNN performed well even under these difficult conditions because these results can further expand the possibilities of its use.
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Affiliation(s)
- Kyung Tak Oh
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (K.T.O.); (D.Y.J.)
| | - Dae Young Jun
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (K.T.O.); (D.Y.J.)
| | - Jae Young Choi
- Department of Urology, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea;
| | - Dae Chul Jung
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea;
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (K.T.O.); (D.Y.J.)
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
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De Santo NG, Bisaccia C, De Santo LS. High Prevalence of Kidney Stone Disease of Gouty Origin in Roman Pontiffs Reigning in the Years 537-2005. EXP CLIN TRANSPLANT 2023; 21:91-94. [PMID: 37496353 DOI: 10.6002/ect.iahncongress.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Many Roman pontiffs are known to have had kidney stone disease. However, no specific report has explored the prevalence of the various stones in popes, which is the purpose of this study. MATERIALS AND METHODS We extensively studied the histories of all popes (n = 264) from Saint Peter to John Paul II (34-2005). RESULTS Among 206 popes reigning from 537 to 2005, 26 popes (12.6%) had uric acid stones. In the same period, 11 of 206 popes (5.3%) had nongouty stones (mainly calcium stones). In total, 37 of 208 (17.8%) popes complained of kidney stone disease. The ratio of calcium stone formers to other stone formers (including uric acid) was 0.42. CONCLUSIONS The data suggest a higher prevalence of uric acid stones, which is linked to higher consumption of meat and sodium chloride. However, the last pope with kidney stone disease died in 1914. Although renal stone disease disappeared from papal palaces, population studies now indicate an increase in uric acid levels in the general population. The data can be explained based on the "Theory of Epidemiological Transition," pointing to the importance of education in eradicating poor lifestyles.
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Simmons KE, Nair HR, Phadke M, Motamedinia P, Singh D, Montgomery TA, Dahl NK. Risk Factors for Common Kidney Stones Are Correlated with Kidney Function Independent of Stone Composition. Am J Nephrol 2023; 54:329-336. [PMID: 37253348 DOI: 10.1159/000531046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/01/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Kidney stone type varies with age, sex, season, and medical conditions. Lower estimate glomerular filtration rate (eGFR) leads to changes in urine chemistry, and risk factors for kidney stones are thought to vary by stone type. We explore the association between eGFR, urine risk factors, and common stone compositions. METHODS This was a retrospective cohort study of 811 kidney stone patients seen at Yale Medicine between 1994 and 2021 with serum chemistries and 24-h urine chemistries matched within 1 year of baseline stone analysis. Patients' eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation. Demographics and medical history were compared by χ2 tests. 24-h urine chemistries and stone analyses were analyzed by one-way ANOVA. Linear regressions were performed to control for demographics, comorbidities, and stone composition. RESULTS With lower eGFR, the proportion of calcium stones declined while uric acid (UA) stones increased. On univariable analysis, lower eGFR was associated with lower urine pH, calcium, citrate, UA, magnesium, phosphorus, and ammonium. On multivariable analysis, controlling for age, sex, ethnicity, body mass index, comorbidities, and stone type, these factors remained significant. Stone formers with lower eGFR had elevated supersaturation for UA, but reduced supersaturations for calcium-containing stones. Though urine oxalate was significant on univariable analysis, it was not on multivariable analysis. CONCLUSION Changes in urine parameters are strongly correlated with eGFR regardless of stone type. Renal function may play a key role in modulating kidney stone risk factors. Strategies to mitigate stone risk may need to vary with kidney function, especially when patient urine or stone composition data are unavailable.
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Affiliation(s)
- Kathryn E Simmons
- Yale Section of Nephrology, Yale School of Medicine, New Haven, Connecticut, USA,
| | - Hari R Nair
- Yale Section of Nephrology, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Manali Phadke
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Piruz Motamedinia
- Yale Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dinesh Singh
- Yale Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Tinika A Montgomery
- Yale Section of Nephrology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Neera K Dahl
- Yale Section of Nephrology, Yale School of Medicine, New Haven, Connecticut, USA
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Xiao Y, Yin S, Bai Y, Yang Z, Wang J, Cui J, Wang J. Association between circadian syndrome and the prevalence of kidney stones in overweight adults: a cross-sectional analysis of NHANES 2007-2018. BMC Public Health 2023; 23:960. [PMID: 37237298 DOI: 10.1186/s12889-023-15934-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To explore the association between circadian syndrome (CircS) and the prevalence of kidney stones in overweight people. MATERIALS AND METHODS A cross-sectional analysis was conducted based on the NHANES 2007-2018. Overweight people aged ≥ 20 years were the target population. Three multivariable logistic regression models were built to examine the association between CircS and kidney stones. Subgroup analysis based on age, gender, and race were also employed. Interaction and stratification analysis was also conducted to identify whether some factors modify the association. RESULT A total of 4,603 overweight participants were included in the study. The multivariable logistic regression suggested that CircS was positively associated with the prevalence of kidney stones (OR = 1.422, 95% CI 1.057 to 1.912). The subgroup analysis showed that the association was more obvious in females (OR = 1.604, 95% CI 1.023 to 2.516) or in the population aged 35 to 49 years old (OR = 2.739, 95% CI 1.428 to 5.254). Additionally, the same trend was present when people were Mexican American (OR = 3.834, 95% CI 1.790 to 8.215) or other races (OR = 4.925, 95% CI 1.776 to 13.656). The interaction and stratification analysis showed that the results above were robust. CONCLUSION CircS was positively associated with the prevalence of kidney stones in overweight people, especially people as females, aged 35 to 49, and Mexican Americans.
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Affiliation(s)
- Yunfei Xiao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, P.R. China
| | - Shan Yin
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yunjin Bai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, P.R. China
| | - Zhenzhen Yang
- Department of Clinical Laboratory, Nanchong Central Hospital, Nanchong, China
| | - Jiahao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, P.R. China
| | - Jianwei Cui
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, P.R. China
| | - Jia Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, P.R. China.
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Leong KA, Husk KE. Stone accumulation overlying vaginal mesh exposure: A case report. World J Obstet Gynecol 2023; 12:28-32. [DOI: 10.5317/wjog.v12.i3.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Vaginal stones are rare with current literature limited to case reports. Vaginal stones are classified as primary or secondary stones. Primary stones form in the vagina when there is urinary stasis. Secondary stones form in the presence of a vaginal foreign body that acts as a nidus for the deposition of urinary salts. Foreign bodies, such as surgical mesh, make vaginal stone formation more likely, particularly in patients with urinary incontinence and conditions that predispose them to urinary calculi formation.
CASE SUMMARY A 71-year-old female with a history of sacrocolpopexy, hyperaldosteronism, and urgency urinary incontinence presented with vaginal stone accumulation overlying two areas of vaginal sacrocolpopexy mesh exposure. The vaginal stones were initially removed to permit examination, but the stones reaccumulated at the site of the exposed mesh, later requiring definitive surgical management.
CONCLUSION Patients with vaginal mesh exposure and conditions that predispose them to kidney stones are not ideal candidates for expectant management of mesh exposure, particularly if they have coexisting urinary incontinence. These individuals should be counseled about possible vaginal stone accumulation, and surgical management should be considered.
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Affiliation(s)
- Karissa A Leong
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY 12208, United States
| | - Katherine E Husk
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY 12208, United States
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Day PL, Wermers M, Pazdernik V, Jannetto PJ, Bornhorst JA. Detection of Cadmium and Lead in Kidney Stones. Associations with Patient Demographics, Stone Composition, and Smoking. J Appl Lab Med 2023; 8:330-340. [PMID: 36575923 DOI: 10.1093/jalm/jfac089] [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: 08/04/2022] [Accepted: 09/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Kidney stones are a highly prevalent disease worldwide. Additionally, both environmental and occupational exposure to Pb and Cd continue to be prevalent globally and can result in renal toxicity. The objective of this study was to examine the potential presence of Pb and Cd in kidney stones, and to assess for correlation with demographic factors including smoking, gender, age, and kidney stone matrix composition. METHODS Patient kidney stones (n = 96) were analyzed using Fourier transform infrared spectroscopy to identify the stone constituents. Cd and Pb concentrations (µg/g) were determined by inductively coupled plasma mass spectrometry. Cd and Pb concentrations were correlated using bivariable and multivariable statistical analysis with demographic factors (age, gender, smoking status), and kidney stone composition. RESULTS Kidney stone Cd (median 0.092 µg/g, range 0.014 to 2.46) and Pb concentrations (median 0.95 µg/g, range 0.060 to 15.4) were moderately correlated (r = 0.56, P < 0.0001). Cd concentrations were positively associated with patient history of smoking, patient age, and calcium oxalate monohydrate levels while negatively associated with struvite and uric acid/uric acid dihydrate. Pb concentrations were positively associated with females and apatite levels while negatively associated with uric acid/uric acid dihydrate. After holding constant other stone type composition levels, smoking status, and age, both Pb and Cd were positively associated with apatite and negatively associated with uric acid/uric acid dihydrate, struvite, and calcium carbonate. CONCLUSIONS Cd and Pb kidney stone concentrations are associated with specific kidney stone types. Cd and Pb kidney stone concentrations are both associated with smoking.
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Affiliation(s)
- Patrick L Day
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Michelle Wermers
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Pazdernik
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Paul J Jannetto
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Joshua A Bornhorst
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Adomako EA, Maalouf NM. Type 4 renal tubular acidosis and uric acid nephrolithiasis: two faces of the same coin? Curr Opin Nephrol Hypertens 2023; 32:145-152. [PMID: 36683539 PMCID: PMC9881823 DOI: 10.1097/mnh.0000000000000859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW The present review summarizes findings of recent studies examining the epidemiology, pathophysiology, and treatment of type 4 renal tubular acidosis (RTA) and uric acid nephrolithiasis, two conditions characterized by an abnormally acidic urine. RECENT FINDINGS Both type 4 RTA and uric acid nephrolithiasis disproportionately occur in patients with type 2 diabetes and/or chronic kidney disease. Biochemically, both conditions are associated with reduced renal ammonium excretion resulting in impaired urinary buffering and low urine pH. Reduced ammoniagenesis is postulated to result from hyperkalemia in type 4 RTA and from insulin resistance and fat accumulation in the renal proximal tubule in uric acid nephrolithiasis. The typical biochemical findings of hyperkalemia and systemic acidosis of type 4 RTA are rarely reported in uric acid stone formers. Additional clinical differences between the two conditions include findings of higher urinary uric acid excretion and consequent urinary uric acid supersaturation in uric acid stone formers but not in type 4 RTA. SUMMARY Type 4 RTA and uric acid nephrolithiasis share several epidemiological, clinical, and biochemical features. Although both conditions may be manifestations of diabetes mellitus and thus have a large at-risk population, the means to the shared biochemical finding of overly acidic urine are different. This difference in pathophysiology may explain the dissimilarity in the prevalence of kidney stone formation.
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Affiliation(s)
- Emmanuel A. Adomako
- Department of Internal Medicine, Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Naim M. Maalouf
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Zheng X, Zhu W, Zeng G. A case-based review of dietary management of calcium oxalate stones. World J Urol 2023; 41:1269-1274. [PMID: 36826485 DOI: 10.1007/s00345-023-04324-z] [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: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE The purpose of this paper is to help patients with calcium oxalate stones to access prevention and treatment options with dietary management. METHODS Typical cases in our hospital and other hospitals were selected for case review; combined with literature review through PubMed search, comprehensive analysis and suggestions were put forward. RESULTS By retrieving the literature with sufficient evidence, selecting, and summarizing, analysis of dietary liquid, oxalate and oxalate precursors, calcium, protein, fruits and vegetables, salt, high dietary fiber, and other content with high evidence index was carried out, respectively. CONCLUSION Through the retrospective analysis of typical cases and literature review, the importance of diet management in the prevention and treatment of calcium oxalate stones was emphasized again, and suggestions were put forward to promote the prevention and treatment of calcium oxalate stones.
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Affiliation(s)
- Xiaopeng Zheng
- 1Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Haizhu District, Kangda Road 1#, Guangzhou, 510230, Guangdong, China
| | - Wei Zhu
- 1Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Haizhu District, Kangda Road 1#, Guangzhou, 510230, Guangdong, China
| | - Guohua Zeng
- 1Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Haizhu District, Kangda Road 1#, Guangzhou, 510230, Guangdong, China.
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Li X, Tang P, Liang F, Wang L, Huang X, Li J, Zhen X. Machine learning based multi-label classification of single or mixed-composition urinary stones in in vivo spectral CT. Med Phys 2023; 50:661-674. [PMID: 36520004 DOI: 10.1002/mp.16154] [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: 08/30/2021] [Revised: 10/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Urinary stones comprise both single and mixed compositions. Knowledge of the stone composition helps the urologists choose appropriate medical interventions for patients. The parameters from the spectral computerized tomography (CT) analysis have potential values for identification of the urinary stone compositions. PURPOSE The present study aims to identify the compositions of urinary stones in vivo using parameters from spectral CT and machine learning, based on multi-label classification modeling. METHODS This retrospective study collected 252 urinary stone samples with single/mixed compositions (including carbapatite [CP], calcium oxalate monohydrate [COM], calcium oxalate dehydrate [COD], uric acid [UA], and struvite [STR]), which were confirmed by ex vivo infrared spectroscopy. Parameters were extracted from an energy spectrum analysis (ESA) of the spectral CT, including the effective atomic number (Zeff ), Zeff histogram, CT values at a given x-ray energy level, and material densities. These ESA parameters were utilized for composition analysis via a multi-label classification fusion framework, where 250 multi-label models were built and the classification decisions from the top performance models were integrated by a multi-criterion weighted fusion (MCWF) approach in order to reach a consensus prediction. An example-based metric A c c e x a m $Ac{c_{exam}}$ and label-based metric A c c l a b e l $Ac{c_{label}}$ were used for global and label-wise accuracy evaluations, respectively. The top-ranked parameters associated with discriminating the stone composition were also identified. RESULTS The multi-label classification fusion framework achieved an overall A c c e x a m $Ac{c_{exam}}$ of 81.2%, with A c c l a b e l $Ac{c_{label}}$ of 86.7% (CP), 90.6% (COM), 80.6% (COD), 95.0% (UA), and 94.4% (STR) for each composition on the independent testing cohort 1, and A c c e x a m $Ac{c_{exam}}$ of 76.4% with A c c l a b e l $Ac{c_{label}}$ of 80.5% (CP), 88.7% (COM), 74.9% (COD), 94.4% (UA), and 98.5% (STR) on the independent testing cohort 2. CONCLUSION The parameters extracted from the ESA on spectral CT can be utilized to characterize single or mixed stone compositions via multi-label classification modeling. The generalization capability of the proposed methodology still requires further verification.
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Affiliation(s)
- Xian Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Peng Tang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Fangrong Liang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Linjing Wang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaoyan Huang
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jieer Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xin Zhen
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
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Jeong JY, Cho KS, Kim DH, Jun DY, Moon YJ, Lee JY. A New Parameter for Calcium Oxalate Stones: Impact of Linear Calculus Density on Non-Contrast Computed Tomography. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020267. [PMID: 36837469 PMCID: PMC9962263 DOI: 10.3390/medicina59020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023]
Abstract
Background and Objectives: Non-contrast computed tomography (NCCT) is widely used to evaluate urolithiasis. The NCCT attenuation, measured in Hounsfield units (HU), has been evaluated to predict stone characteristics. We propose a novel parameter, linear calculus density (LCD), and analyze variables from NCCT imaging to predict calcium oxalate (CaOx) stones, which are common and challenging to fragment. Materials and Methods: We retrospectively reviewed the medical records of patients with urolithiasis between 2014 and 2017. Among those, 790 patients were included. Based on the NCCT pre-treatment, the maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) were obtained. In addition, the variation coefficient of stone density (VCSD = SHI/MSD × 100) and linear calculus density (LCD = VCSD/MSL) were calculated. In accordance with the stone analysis, the patients were divided into two groups (CaOx and non-CaOx groups). The logistic regression model and receiver operating characteristic (ROC) curve were used for predictive modeling. Results: In the CaOx group, the SHI, VCSD, and LCD were more significant than in the non-CaOx group (all p < 0.001). SHI (OR 1.002, 95% CI 1.001-1.004, p < 0.001), VCSD (OR 1.028, 95% CI 1.016-1.041, p < 0.001), and LCD (OR 1.352, 95% CI 1.270-1.444, p < 0.001) were significant independent factors for CaOx stones in the logistic regression models. The areas under the ROC curve for predicting CaOx stones were 0.586 for SHI, 0.66 for VCSD, and 0.739 for LCD, with a cut-point of 2.25. Conclusions: LCD can be a useful new parameter to provide additional information to help discriminate CaOx stones before treatment.
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Affiliation(s)
- Jae Yong Jeong
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Kang Su Cho
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Dae Ho Kim
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Dae Young Jun
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Young Joon Moon
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Center of Evidence-Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Republic of Korea
- Correspondence: ; Tel.: +82-2-2228-2320; Fax: +82-2-312-2538
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Yitgin Y, Asrak H, Tefik T. Role, importance and assessment of dietary habits in urolithiasis patient. World J Urol 2023; 41:1229-1233. [PMID: 36697917 DOI: 10.1007/s00345-023-04277-3] [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: 11/02/2022] [Accepted: 12/30/2022] [Indexed: 01/27/2023] Open
Abstract
Urolithiasis, which prevalence is increasing, poses a risk for chronic kidney disease in patients. Dietary habits play a significant role in stone formation, growth and recurrence. Also, comorbidities and lifestyle changes are among the factors affecting stone formation. The next step should be to detect metabolic disorders, if any, with analyzes to be made after a detailed anamnesis, and to arrange the necessary treatment. Insufficient fluid intake is considered to be the main dietary risk factor for urolithiasis. A daily fluid intake of 2.5-3.0 L/day or diuresis of 2.0-2.5 L/day is recommended to prevent recurrence of kidney stones. Not all beverages are beneficial, and some may even increase the risk of stone formation. Dietary management, vitamins and supplements, physical activity are important components in reducing the risk of recurrent urolithiasis. A detailed dietary assessment is recommended as dietary habits affect the faith of the disease. In this review we evaluated the dietary approach of urolithiasis patients with and without comorbidities, the recommended daily fluid intake, vitamin supplementation, and relation of the urolithiasis with physical activity.
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Affiliation(s)
- Yasin Yitgin
- Department of Urology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Halime Asrak
- Department of Nutrition and Dietetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tzevat Tefik
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Santoro G, Lombardi G, Andreola S, Salvagno GL, Treccani M, Locatelli E, Ferraro PM, Lippi G, Malerba G, Gambaro G. Association analysis of 10 candidate genes causing Mendelian calcium nephrolithiasis in the INCIPE study: a South European general population cohort. Clin Kidney J 2023; 16:521-527. [PMID: 36865011 PMCID: PMC9972819 DOI: 10.1093/ckj/sfac225] [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: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background Idiopathic calcium nephrolithiasis (ICN) is a common condition with a complex phenotype influenced by both environmental and genetic factors. In our study we investigated the association of allelic variants with the history of nephrolithiasis. Methods We genotyped and selected 10 candidate genes potentially related to ICN from 3046 subjects participating in the INCIPE survey cohort (Initiative on Nephropathy, of relevance to public health, which is Chronic, possibly in its Initial stages, and carries a Potential risk of major clinical End-points), a study enrolling subjects from the general population in the Veneto region in Italy. Results Overall, 66 224 variants mapping on the 10 candidate genes were studied. A total of 69 and 18 variants in INCIPE-1 and INCIPE-2, respectively, were significantly associated with stone history (SH). Only two variants, rs36106327 (chr20:54 171 755, intron variant) and rs35792925 (chr20:54 173 157, intron variant) of the CYP24A1 gene were observed to be consistently associated with ICN. Neither variant has been previously reported in association with renal stones or other conditions. Carriers of CYP24A1 variants showed a significant increase in the ratio of 1,25 (OH)2 vitamin D to 25 (OH) vitamin D compared with controls (P = .043). Although not associated with ICN in this study, the rs4811494 CYP24A1 variant that was reported to be causative of nephrolithiasis was very prevalent in heterozygosity (20%). Conclusion Our data suggest a possible role for CYP24A1 variants in the risk of nephrolithiasis. Genetic validation studies in larger sample sets will be necessary to confirm our findings.
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Affiliation(s)
| | | | - Stefano Andreola
- Division of Nephrology, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Gian Luca Salvagno
- University of Verona and Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Mirko Treccani
- Section of Section of Biology and Genetics, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Locatelli
- Section of Section of Biology and Genetics, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Giuseppe Lippi
- Central Laboratory, Department of Pathology and Diagnostics, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giovanni Malerba
- Section of Section of Biology and Genetics, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Gambaro
- Division of Nephrology, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Siener R, Löhr P, Hesse A. Urinary Risk Profile, Impact of Diet, and Risk of Calcium Oxalate Urolithiasis in Idiopathic Uric Acid Stone Disease. Nutrients 2023; 15:nu15030572. [PMID: 36771279 PMCID: PMC9919786 DOI: 10.3390/nu15030572] [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] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
The role of diet in the pathogenesis of uric acid (UA) nephrolithiasis is incompletely understood. This study investigated the effect of dietary intervention on the risk of UA stone formation under standardized conditions. Twenty patients with idiopathic UA stone disease were included in the study. Dietary intake and 24 h urinary parameters were collected on the usual diet of the patients and a standardized balanced mixed diet. Although urinary UA excretion did not change, the relative supersaturation of UA decreased significantly by 47% under the balanced diet primarily due to the significant increase in urine volume and pH. Urinary pH was below 5.8 in 85% of patients under the usual diet, and in 60% of patients under the balanced diet. The supersaturation of calcium oxalate declined significantly under the balanced diet due to the significant decrease in urinary calcium and oxalate excretion and the increase in urine volume. Dietary intervention is a key component in the management of UA nephrolithiasis. Urinary calcium and oxalate excretion should also be monitored in patients with pure UA calculi to reduce the risk of mixed stone formation with calcium oxalate. Lower urinary pH in UA stone patients can only be partially explained by diet.
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Anti-Struvite, Antimicrobial, and Anti-Inflammatory Activities of Aqueous and Ethanolic Extracts of Saussurea costus (Falc) Lipsch Asteraceae. Molecules 2023; 28:molecules28020667. [PMID: 36677724 PMCID: PMC9866937 DOI: 10.3390/molecules28020667] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/01/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Saussurea costus (Falc) Lipsch is a traditional herb used to treat kidney stone problems because it contains several molecules used to treat this health problem, such as quercitrin. Infectious stones are the most painful of all urinary tract disorders, with ammonium phosphate (struvite) and carbapatite stones being the most common, caused by a bacterial infection with urease activity. These stones are treated with antibiotics, but antibiotic resistance is on the rise. The current study investigated the anti-urolithic activities of S. costus aqueous and ethanolic extracts of against struvite crystals synthesized using microscopic crystallization and turbidimetric methods, respectively. The utilized methods indicated that the ethanolic extract of this plant has a significant inhibitory effect on struvite crystallization, with a percentage inhibition of (87.45 ± 1.107) (p < 0.001) for a concentration of 1 mg mL−1 and a decrease in the number of struvite crystals, reaching values less than 100/mm3. For the number of struvite crystals inhibited by cystone, we found a value of 400/mm3 and with the aqueous extract we found 700/mm3. The antibacterial activity of the plant extracts studied was examined against several urease-producing bacteria, and this activity was evaluated by qualitative and quantitative evaluation methods; the highest minimum inhibitory concentration was seen in the ethanolic extract, with an MIC of 50 mg mL−1 for Staphylococcus aureus followed by an MIC of 200 mg mL−1 for Klebsiella pneumoniae. It showed a minimal bactericidal concentration (MBC) against S. aureus and K. pneumoniae (>50 mg mL−1 and >200 mg mL−1, respectively). Furthermore, to determine the extract’s anti-inflammatory activity, in vivo anti-inflammatory activity was investigated in rats. The results show that at a dose of 400 mg kg−1, the ethanolic extract has a maximum edema inhibition of 66%.
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Tanthanuch M, Jakjaroenrit N, Boonchai S, Bejrananda T. The changing composition of urinary calculi in Southern Thailand over the past 14 years. Urol Ann 2023; 15:82-87. [PMID: 37006209 PMCID: PMC10062514 DOI: 10.4103/ua.ua_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/23/2022] [Indexed: 04/04/2023] Open
Abstract
Objective A worldwide increased incidence of urolithiasis has been observed over the past few decades. Insight into the composition of these stones can lead to enhanced medical treatment and outcomes. The objective of this study was to examine the distribution and chemical composition of urinary calculi in Southern Thailand over the past decade. Materials and Methods An analysis was conducted on 2611 urinary calculi submitted to the Stone Analysis Laboratory, Songklanagarind Hospital, a single stone analysis laboratory in Southern Thailand. The analysis was performed from 2007 to 2020 using Fourier-transform infrared spectroscopy. The demographic results were described using descriptive statistical analyses, and the Chi-square test for trends was performed to identify changes in urinary calculi composition. Results The patients' demographic data revealed a male-to-female ratio of 2.2:1; the most common age group of affected men was 50-69 years, whereas the most common age group of affected women was 40-59 years. The most common components found in the calculi were uric acid (30.6%), mixed calcium oxalate with calcium phosphate (29.2%), and calcium oxalate (26.7%). We noted a trend of increasing uric acid calculi for 14 years (P = 0.00493), whereas the trend for the other major components was decreasing. Conclusion The most common component of urinary calculi analyzed in Southern Thailand was uric acid, with a significant rising trend in proportion in the past decade; the trend of other major components, such as mixed calcium oxalate-calcium phosphate and calcium oxalate, decreased.
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Affiliation(s)
- Monthira Tanthanuch
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Nattawit Jakjaroenrit
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Sarayuth Boonchai
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Tanan Bejrananda
- Department of Surgery, Division of Urology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Muacevic A, Adler JR, Jacobs M, Miller D, Diah J, Desroches BR, Shields JM. Association of Height and Prevalence of Kidney Stones. Cureus 2022; 14:e32919. [PMID: 36699765 PMCID: PMC9872204 DOI: 10.7759/cureus.32919] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
Introduction and objectives Nephrolithiasis is universally understood to be a multifactorial disease resulting from genetic and environmental factors including gender, diet, calcium, and uric acid excretion. Notably, several of these factors may be related to body habitus. Because men are more likely to develop kidney stones and on average have a larger body size, height may be an important risk factor for stone formation. Several studies have demonstrated that short adult stature is associated with numerous conditions such as hypertension, hypercholesterolemia, and cardiovascular diseases. However, other studies have demonstrated otherwise. Additionally, stones have been shown to be correlated with a high body mass index (BMI). This is likely due to dietary factors. Although height is a component of BMI, there is minimal literature regarding the relationship of height to stone prevalence adjusting for weight. Methods We aimed to examine whether short adult height is associated with the development of kidney stones using a population-based cohort of the National Center for Health Statistics. Data was gathered from National Health and Nutrition Examination Surveys (NHANES) "Kidney Conditions - Urology" and "Weight History" questionnaire datasets from March 2017 to March 2020 along with demographic data. Logistic regression analysis was used to determine an association between current self-reported height (inches) and if the participant has ever had kidney stones, controlling for weight, gender, age, race, educational level, and marital status. Results We found that those who were shorter had higher odds of reporting a history of stones (OR: 1.017; 95%CI: 1.005-1.028). This association was found after controlling for covariates such as age, gender, race, education, and weight. In addition, the male gender and Hispanic race had higher odds of reporting a history of stones (OR: 1.43 and 1.073, respectively). Conclusion Our results suggest that short height is related to the prevalence of kidney stones independent of weight, age, gender, and race. This supports previous literature indicating height to be a component of renal disease.
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Lin Z, Jayachandran M, Haskic Z, Kumar S, Lieske JC. Differences of Uric Acid Transporters Carrying Extracellular Vesicles in the Urine from Uric Acid and Calcium Stone Formers and Non-Stone Formers. Int J Mol Sci 2022; 23:ijms231710010. [PMID: 36077407 PMCID: PMC9456222 DOI: 10.3390/ijms231710010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Low urine pH and volume are established risk factors for uric acid (UA) stone disease (UASD). Renal tubular epithelial cells exposed to an acidic pH and/or UA crystals can shed extracellular vesicles (EVs) into the tubular fluid, and these EVs may be a pathogenic biomarker of UASD. Methods: Urinary EVs bearing UA transporters (SLC2A9, SLC17A3, SLC22A12, SLC5A8, ABCG2, and ZNF365) were quantified in urine from UA stone formers (UASFs), calcium stone formers (CSFs), and age-/sex-matched non-stone formers (NSFs) using a standardized and published method of digital flow cytometry. Results: Urinary pH was lower (p < 0.05) and serum and urinary UA were greater (p < 0.05) in UASFs compared with NSFs. Urinary EVs carrying SLC17A3 and SLC5A8 were lower (p < 0.05) in UASFs compared with NSFs. Urinary EVs bearing SLC2A9, SLC22A12, SLC5A8, ABCG2, and ZNF365 were lower (p < 0.05) in CSFs than UASFs, while excretion of SLC17A3-bearing EVs did not differ between groups. Conclusion: EVs bearing specific UA transporters might contribute to the pathogenesis of UASD and represent non-invasive pathogenic biomarkers for calcium and UA stone risk.
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Affiliation(s)
- Zhijian Lin
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
| | - Muthuvel Jayachandran
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
- Division of Hematology Research, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
| | - Zejfa Haskic
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
| | - Sanjay Kumar
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
- Department of Life Science, School of Basic Sciences and Research, Sharda University, Greater Noida 201310, Uttar Pradesh, India
| | - John C. Lieske
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN 55905, USA
- Correspondence: ; Tel.: +(507)-266-7960; Fax: +(507)-266-9315
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Deffert C, Stoermann Chopard C, Lambeng N. 10,000 urinary stones for 10 years of analysis: a retrospective study in western Switzerland. CR CHIM 2022. [DOI: 10.5802/crchim.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pozdzik A, Hamade A, Racapé J, Roumeguère T, Wolff F, Cotton F. The epidemiology of kidney stones in Belgium based on Daudon’s morpho-constitutional classification: a retrospective, single-center study. CR CHIM 2022. [DOI: 10.5802/crchim.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Michael KGFT, Michael S, Abusada E, Srirangam SJ, Bourdoumis A, Surange R. Does the mineral content of tap water correlate with urinary calculus composition? Urolithiasis 2022; 50:691-699. [DOI: 10.1007/s00240-022-01358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
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Jewell DE, Tavener SK, Hollar RL, Panickar KS. Metabolomic changes in cats with renal disease and calcium oxalate uroliths. Metabolomics 2022; 18:68. [PMID: 35962261 PMCID: PMC9374649 DOI: 10.1007/s11306-022-01925-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There is a significant incidence of cats with renal disease (RD) and calcium oxalate (CaOx) kidney uroliths in domesticated cats. Foods which aid in the management of these diseases may be enhanced through understanding the underlying metabolomic changes. OBJECTIVE Assess the metabolomic profile with a view to identifying metabolomic targets which could aid in the management of renal disease and CaOx uroliths. METHOD This is a retrospective investigation of 42 cats: 19 healthy kidney controls, 11 with RD, and 12 that formed CaOx nephroliths. Cats were evaluated as adults (2 through 7 years) and at the end of life for plasma metabolomics, body composition, and markers of renal dysfunction. Kidney sections were assessed by Pizzolato stain at the end of life for detection of CaOx crystals. CaOx stone presence was also assessed by analysis of stones removed from the kidney at the end of life. RESULTS There were 791 metabolites identified with 91 having significant (p < 0.05, q < 0.1) changes between groups. Many changes in metabolite concentrations could be explained by the loss of renal function being most acute in the cats with RD while the cats with CaOx stones were intermediate between control and RD (e.g., urea, creatinine, pseudouridine, dimethylarginines). However, the concentrations of some metabolites differentiated RD from CaOx stone forming cats. These were either increased in the RD cats (e.g., cystathionine, dodecanedioate, 3-(3-amino-3-carboxypropyl) uridine, 5-methyl-2'-deoxycytidine) or comparatively increased in the CaOx stone forming cats (phenylpyruvate, 4-hydroxyphenylpyruvate, alpha-ketobutyrate, retinal). CONCLUSIONS The metabolomic changes show specific metabolites which respond generally to both renal diseases while the metabolomic profile still differentiates cats with RD and cats with CaOx uroliths.
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Affiliation(s)
- Dennis E Jewell
- Department of Grain Science and Industry, Kansas State University, Manhattan, KS, 66506, USA.
| | - Selena K Tavener
- Science and Technology Center, Hill's Pet Nutrition®, Inc, Topeka, KS, 66617, USA
| | - Regina L Hollar
- Science and Technology Center, Hill's Pet Nutrition®, Inc, Topeka, KS, 66617, USA
| | - Kiran S Panickar
- Science and Technology Center, Hill's Pet Nutrition®, Inc, Topeka, KS, 66617, USA
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Collins MT, Marcucci G, Anders HJ, Beltrami G, Cauley JA, Ebeling PR, Kumar R, Linglart A, Sangiorgi L, Towler DA, Weston R, Whyte MP, Brandi ML, Clarke B, Thakker RV. Skeletal and extraskeletal disorders of biomineralization. Nat Rev Endocrinol 2022; 18:473-489. [PMID: 35578027 DOI: 10.1038/s41574-022-00682-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 12/15/2022]
Abstract
The physiological process of biomineralization is complex and deviation from it leads to a variety of diseases. Progress in the past 10 years has enhanced understanding of the genetic, molecular and cellular pathophysiology underlying these disorders; sometimes, this knowledge has both facilitated restoration of health and clarified the very nature of biomineralization as it occurs in humans. In this Review, we consider the principal regulators of mineralization and crystallization, and how dysregulation of these processes can lead to human disease. The knowledge acquired to date and gaps still to be filled are highlighted. The disorders of mineralization discussed comprise a broad spectrum of conditions that encompass bone disorders associated with alterations of mineral quantity and quality, as well as disorders of extraskeletal mineralization (hyperphosphataemic familial tumoural calcinosis). Included are disorders of alkaline phosphatase (hypophosphatasia) and phosphate homeostasis (X-linked hypophosphataemic rickets, fluorosis, rickets and osteomalacia). Furthermore, crystallopathies are covered as well as arterial and renal calcification. This Review discusses the current knowledge of biomineralization derived from basic and clinical research and points to future studies that will lead to new therapeutic approaches for biomineralization disorders.
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Affiliation(s)
- Michael T Collins
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA.
| | - Gemma Marcucci
- Bone Metabolic Diseases Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Hans-Joachim Anders
- Department of Medicine IV, Hospital of the University of Munich, Ludwig-Maximilians University, Munich, Germany
| | - Giovanni Beltrami
- Department Paediatric Orthopedic Oncology, Careggi and Meyer Children Hospital, Florence, Italy
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Rajiv Kumar
- Departments of Medicine, Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Agnès Linglart
- APHP, Endocrinologie et diabète de l'enfant, Paris, France
| | - Luca Sangiorgi
- Medical Genetics and Skeletal Rare Diseases, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Dwight A Towler
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ria Weston
- Cardiovascular Research Group, Manchester Metropolitan University, Manchester, UK
| | - Michael P Whyte
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children-St Louis, St Louis, MO, USA
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA
| | | | - Bart Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Bokhari AA, Aldarwish HA, Alsanea SA, Al-Tufaif MA, Alghaslan SA, Alghassab AA, Alshammari BB, Al-Tufaif AA. Prevalence and Risk Factors of Urolithiasis Among the Population of Hail, Saudi Arabia. Cureus 2022; 14:e26983. [PMID: 35989769 PMCID: PMC9381884 DOI: 10.7759/cureus.26983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/05/2022] Open
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