Increased renal papillary density in kidney stone formers detectable by CT scan is a potential marker of stone risk, but is unrelated to underlying hypercalciuria

Urolithiasis ◽  
2016 ◽  
Vol 44 (5) ◽  
pp. 471-475 ◽  
Author(s):  
Linda Shavit ◽  
Daniela Girfoglio ◽  
Alex Kirkham ◽  
Darrell Allen ◽  
Pietro Manuel Ferraro ◽  
...  
Keyword(s):  
Ct Scan ◽  
Kidney Stone ◽  
Stone Formers ◽  
Potential Marker

scholarly journals Excretion of urine extracellular vesicles bearing markers of activated immune cells and calcium/phosphorus physiology differ between calcium kidney stone formers and non-stone formers

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jiqing Zhang ◽  
Sanjay Kumar ◽  
Muthuvel Jayachandran ◽  
Loren P. Herrera Hernandez ◽  
Stanley Wang ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Calcium Oxalate ◽  
Extracellular Vesicles ◽  
Immune Cells ◽  
Kidney Stone ◽  
Fibroblast Growth Factor 23 ◽  
Pathogenic Mechanisms ◽  
Phosphorus Excretion ◽  
Stone Formers ◽  
Calcium Phosphorus

Abstract Backgrounds: Previous studies have demonstrated that excretion of urinary extracellular vesicles (EVs) from different nephron segments differs between kidney stone formers and non-stone formers (NSFs), and could reflect pathogenic mechanisms of urinary stone disease. In this study we quantified selected populations of specific urinary EVs carrying protein markers of immune cells and calcium/phosphorus physiology in calcium oxalate stone formers (CSFs) compared to non-stone formers (NSFs). Methods Biobanked urine samples from CSFs (n = 24) undergoing stone removal surgery and age- and sex- matched NSFs (n = 21) were studied. Urinary EVs carrying proteins related to renal calcium/phosphorus physiology (phosphorus transporters (PiT1 and PiT2), Klotho, and fibroblast growth factor 23 (FGF23); markers associated with EV generation (anoctamin-4 (ANO4) and Huntington interacting protein 1 (HIP1)), and markers shed from activated immune cells were quantified by standardized and published method of digital flow cytometry. Results Urine excretion of calcium, oxalate, phosphorus, and calcium oxalate supersaturation (SS) were significantly higher in CSFs compared to NSFs (P < 0.05). Urinary excretion of EVs with markers of total leukocytes (CD45), neutrophils (CD15), macrophages (CD68), Klotho, FGF23, PiT1, PiT2, and ANO4 were each markedly lower in CSFs than NSFs (P < 0.05) whereas excretion of those with markers of monocytes (CD14), T-Lymphocytes (CD3), B-Lymphocytes (CD19), plasma cells (CD138 plus CD319 positive) were not different between the groups. Urinary excretion of EVs expressing PiT1 and PiT2 negatively (P < 0.05) correlated with urinary phosphorus excretion, whereas excretion of EVs expressing FGF23 negatively (P < 0.05) correlated with both urinary calcium and phosphorus excretion. Urinary EVs with markers of HIP1 and ANO4 correlated negatively (P < 0.05) with clinical stone events and basement membrane calcifications on papillary tip biopsies. Conclusions Urinary excretion of EVs derived from specific types of activated immune cells and EVs with proteins related to calcium/phosphorus regulation differed between CSFs and NSFs. Further validation of these and other populations of urinary EVs in larger cohort could identify biomarkers that elucidate novel pathogenic mechanisms of calcium stone formation in specific subsets of patients.

scholarly journals Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community

2015 ◽  
Vol 90 (10) ◽  
pp. 1356-1365 ◽  
Author(s):  
Prince Singh ◽  
Felicity T. Enders ◽  
Lisa E. Vaughan ◽  
Eric J. Bergstralh ◽  
John J. Knoedler ◽  
...  
Keyword(s):  
Kidney Stone ◽  
Stone Composition ◽  
Stone Formers ◽  
First Time

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

2013 ◽  
Vol 4 (3) ◽  
pp. 165-170 ◽  
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.

scholarly journals MP82-07 PRIMARY HYPERPARATHYROIDISM: CHALLENGES IN SCREENING AND DIAGNOSIS IN KIDNEY STONE FORMERS

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Leslee Matheny ◽  
Tracy Marien ◽  
Mustafa Kadihasanoglu ◽  
Nicole L. Miller
Keyword(s):  
Primary Hyperparathyroidism ◽  
Kidney Stone ◽  
Stone Formers ◽  
Screening And Diagnosis

Risk of metabolic syndrome in kidney stone formers: A comparative cohort study

2021 ◽  
Vol 79 ◽  
pp. S341-S342
Author(s):  
R. Geraghty ◽  
E. Brain ◽  
P. Cook ◽  
P. Roderick ◽  
B.K. Somani
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Kidney Stone ◽  
Stone Formers ◽  
Comparative Cohort Study

scholarly journals Feasibility and Efficacy of a Decision Aid for Emergency Department Patients with Suspected Ureterolithiasis: Protocol for an Adaptive Randomized Controlled Trial

2021 ◽  
Author(s):  
Elizabeth M Schoenfeld ◽  
Kye E Poronsky ◽  
Lauren M Westafer ◽  
Paul Visintainer ◽  
Brianna M DiFronzo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Kidney Stone ◽  
Decision Aid ◽  
Controlled Trial ◽  
Signs And Symptoms ◽  
Patient Knowledge ◽  
Randomized Controlled

Abstract Background: Approximately 2 million patients present to Emergency Departments in the US annually with signs and symptoms of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone). Both ultrasound and CT scan can be used for diagnosis, but the vast majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. Because of these and other trade-offs, this decision has been proposed as appropriate for Shared Decision-Making (SDM), where clinicians and patients discuss clinical options and their consequences and arrive at a decision together. We developed a decision aid to facilitate SDM in this scenario. The objective of this study is to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization. Methods: This is the protocol for an adaptive randomized controlled trial to determine the effects of the intervention – a decision aid (“Kidney Stone Choice”) – on patient-centered outcomes, compared with usual care. Patients age 18-55 presenting to the Emergency Department with signs and symptoms consistent with acute uncomplicated ureterolithiasis will be consecutively enrolled and randomized. Participants will be blinded to group allocation. We will collect outcomes related to patient knowledge, radiation exposure, trust in physician, safety, and downstream healthcare utilization. Discussion: We hypothesize that this study will demonstrate that “Kidney Stone Choice,” the decision aid created for this scenario, improves patient knowledge and decreases exposure to ionizing radiation. The adaptive design of this study will allow us to identify issues with fidelity and feasibility and subsequently evaluate the intervention for efficacy. Trial registration: ClinicalTrials.gov - NCT04234035https://clinicaltrials.gov/ct2/show/NCT04234035Registered January 21, 2020 – Retrospectively Registered

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