Early-Onset Kidney Stone Disease—Consequences and Opportunities

BackgroundThe relationship between the composition and function of gut microbial communities and early-onset calcium oxalate kidney stone disease is unknown.MethodsWe conducted a case-control study of 88 individuals aged 4–18 years, which included 44 individuals with kidney stones containing ≥50% calcium oxalate and 44 controls matched for age, sex, and race. Shotgun metagenomic sequencing and untargeted metabolomics were performed on stool samples.ResultsParticipants who were kidney stone formers had a significantly less diverse gut microbiome compared with controls. Among bacterial taxa with a prevalence >0.1%, 31 taxa were less abundant among individuals with nephrolithiasis. These included seven taxa that produce butyrate and three taxa that degrade oxalate. The lower abundance of these bacteria was reflected in decreased abundance of the gene encoding butyryl-coA dehydrogenase (P=0.02). The relative abundance of these bacteria was correlated with the levels of 18 fecal metabolites, and levels of these metabolites differed in individuals with kidney stones compared with controls. The oxalate-degrading bacterial taxa identified as decreased in those who were kidney stone formers were components of a larger abundance correlation network that included Eggerthella lenta and several Lactobacillus species. The microbial (α) diversity was associated with age of stone onset, first decreasing and then increasing with age. For the individuals who were stone formers, we found the lowest α diversity among individuals who first formed stones at age 9–14 years, whereas controls displayed no age-related differences in diversity.ConclusionsLoss of gut bacteria, particularly loss of those that produce butyrate and degrade oxalate, associates with perturbations of the metabolome that may be upstream determinants of early-onset calcium oxalate kidney stone disease.

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Faculty Opinions recommendation of High urinary calcium excretion and genetic susceptibility to hypertension and kidney stone disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.31371.487862 ◽

2006 ◽

Author(s):

Alan Yu

Keyword(s):

Genetic Susceptibility ◽

Kidney Stone ◽

Urinary Calcium ◽

Stone Disease ◽

Urinary Calcium Excretion ◽

Calcium Excretion ◽

Kidney Stone Disease

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Faculty Opinions recommendation of Evaluation of the economic burden of kidney stone disease in the UK: a retrospective cohort study with a mean follow-up of 19 years.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737186277.793570254 ◽

2020 ◽

Author(s):

Walter Strohmaier

Keyword(s):

Cohort Study ◽

Economic Burden ◽

Retrospective Cohort Study ◽

Kidney Stone ◽

Retrospective Cohort ◽

Stone Disease ◽

Kidney Stone Disease ◽

The Uk

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An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease: Figure 1.

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.11191210 ◽

2011 ◽

Vol 6 (8) ◽

pp. 2062-2068 ◽

Cited By ~ 74

Author(s):

David J. Sas

Keyword(s):

Risk Factors ◽

Kidney Stone ◽

Stone Disease ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Kidney Stone Disease

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Somatosensory and trophic findings in the referred pain area in patients with kidney stone disease

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2013.03.001 ◽

2013 ◽

Vol 4 (3) ◽

pp. 165-170 ◽

Cited By ~ 1

Author(s):

Katja Venborg Pedersen ◽

Asbjørn Mohr Drewes ◽

Ole Graumann ◽

Susanne Sloth Osther ◽

Anne Estrup Olesen ◽

...

Keyword(s):

Ct Scan ◽

Kidney Stone ◽

Stone Disease ◽

Referred Pain ◽

Lateral Side ◽

Pain Thresholds ◽

Kidney Stone Disease ◽

Trophic Changes ◽

Electrical Stimuli ◽

Pain Area

AbstractBackground and purposeVisceral and somatic afferents activate the same neuronal structures in the central nervous system. Assessing somatosensory function and trophic changes in the referred pain area may therefore indirectly increase information on mechanisms involved in painful visceral diseases. The aim of this study was to evaluate the sensory and trophic changes in the flank corresponding to the referred pain area in patients with kidney stone disease.MethodsA total of 24 patients with unilateral pain-causing kidney stone disease were studied before and after endoscopic percutaneous kidney stone surgery. Trophic changes and sensitivity on the affected and on the contra-lateral side in the pain free period were investigated. For this purpose we used standardized experimental sensory testing including pressure stimulation and electrical (single and repeated) skin stimulation. Five repeated stimuli were used to investigate temporal summation (increased responses to repeated stimuli). To investigate trophic changes ultrasound as well as CT-scan was used, since the latter is considered more precise for exact tissue layer measurements.ResultsThe pain tolerance thresholds to pressure and pain thresholds to electrical stimulation were not significantly different on the two sides (all P>0.1). After surgery no significant alterations in sensitivity were detected, but there was a tendency to higher pain thresholds to electrical stimuli on the affected side (single stimuli P=0.06; repeated stimuli P=0.09). No trophic changes were observed (all P>0.3), and there were no relations between the pain thresholds or trophic findings and the number of colics (all P >0.08).ConclusionIn patients with unilateral pain-causing kidney stone disease the pain to experimental pressure and electrical stimuli were comparable on the affected and contra-lateral side. For the first time a CT-scan was used to evaluate tissue thickness in the referred pain area. No trophic changes were seen in the muscle or subcutaneous tissue at the affected side, and there were no correlations between the pain thresholds or trophic findings and the patients history of number of colics. After the operation no significant alterations in sensitivity were detected.ImplicationsThis study could not confirm previous studies showing referred hyperalgesia in the skin and trophic changes in the referred pain area to painful visceral disease. Differences in the pain intensity/duration between different diseases and hence the corresponding central neuronal changes may explain the negative findings in the present study.

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Nutrition and Kidney Stone Disease

Nutrients ◽

10.3390/nu13061917 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1917

Author(s):

Roswitha Siener

Keyword(s):

Kidney Stone ◽

Fluid Intake ◽

Stone Formation ◽

Urinary Stone ◽

Stone Disease ◽

Urinary Stones ◽

Dietary Therapy ◽

Effective Prevention ◽

Kidney Stone Disease ◽

Nutrition And Diet

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.

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