scholarly journals Urinary metabolic profile and stone composition in kidney stone formers with and without heart disease

2021 ◽  
Author(s):  
Matteo Bargagli ◽  
Shabbir Moochhala ◽  
William G. Robertson ◽  
Giovanni Gambaro ◽  
Gianmarco Lombardi ◽  
...  
Keyword(s):  
Kidney Stone ◽  
Heart Valves ◽  
Randomized Clinical Trials ◽  
Urine Analysis ◽  
Stone Formation ◽  
Coronary Revascularization ◽  
Stone Disease ◽  
Stone Composition ◽  
Stone Formers ◽  
Increased Risk

Abstract Objective Kidney stone disease seems to be associated with an increased risk of incident cardiovascular outcomes; the aim of this study is to identify differences in 24-h urine excretory profiles and stone composition among stone formers with and without cardiovascular disease (CVD). Methods Data from patients attending the Department of Renal Medicine’s metabolic stone clinic from 1995 to 2012 were reviewed. The sample was divided according to the presence or absence of CVD (myocardial infarction, angina, coronary revascularization, or surgery for calcified heart valves). Univariable and multivariable regression models, adjusted for age, sex, BMI, hypertension, diabetes, eGFR, plasma bicarbonate and potential renal acid load of foods were used to investigate differences across groups. Results 1826 patients had available data for 24-h urine analysis. Among these, 108 (5.9%) had a history of CVD. Those with CVD were older, have higher prevalence of hypertension and diabetes and lower eGFR. Univariable analysis showed that patients with CVD had significantly lower 24-h urinary excretions for citrate (2.4 vs 2.6 mmol/24 h, p = 0.04), magnesium (3.9 vs 4.2 mmol/24 h, p = 0.03) and urinary pH (6.1 vs 6.2, p = 0.02). After adjustment for confounders, differences in urinary citrate and magnesium excretions remained significant. No differences in the probability of stone formation or stone compositions were found. Conclusions Stone formers with CVD have lower renal alkali excretion, possibly suggesting higher acid retention in stone formers with cardiovascular comorbidities. Randomized clinical trials including medications and a controlled diet design are needed to confirm the results presented here. Graphic abstract

scholarly journals P0175DETERMINANTS OF RENAL PAPILLARY APPEARANCE IN RENAL STONE FORMERS: AN IN-DEPTH EXAMINATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Matteo Bargagli ◽  
Rossella De Leonardis ◽  
Mauro Ragonese ◽  
Angelo Totaro ◽  
Francesco Pinto ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Medical Condition ◽  
Stone Formation ◽  
Blood Parameters ◽  
Stone Disease ◽  
Stone Composition ◽  
Stone Recurrence ◽  
Stone Formers

Abstract Background and Aims Nephrolithiasis is a medical condition characterized by high prevalence among the general population both in Europe and in the U.S. and it is responsible for high costs reaching up to $10 billion per year. It is associated with specific comorbidities such as obesity, arterial hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease. Kidney stones development is believed to start either from Randall’s plaques or from stone plugs. Both these lesions can be seen on renal papillary surfaces, but what promotes the formation of plaques and plugs is not entirely understood. The aim of this study is to investigate the association between the urinary metabolic milieu and a published endoscopic papillary evaluation score (PPLA). We also evaluated the correlation of PPLA score with kidney stone recurrence during follow-up. Method We prospectively enrolled 31 stone forming patients who undergone retrograde intrarenal surgery procedures. Visual inspection of the accessible renal papillae was performed in order to calculate the PPLA score based on the appearance of ductal plugging, surface pitting, loss of papillary contour and Randall’s plaque extension. Demographic information, blood samples, 24h urine collections and kidney stone events during follow-up were collected. Stone composition was analyzed using infrared-spectroscopy. Relative urinary supersaturations (RSS) for calcium oxalate (CaOx), calcium phosphate (CaPi) and uric acid (UA) were calculated using the Equil2 software. PPLA score > 3 was defined as high. Results Median follow-up period was 11 (min/max 5, 34) months. PPLA score was inversely correlated with BMI (rho = −0.39, p = 0.035) and history of recurrent kidney stones (median PPLA 5.0 vs 2.5, p = 0.029), these results were confirmed when PPLA was considered as a categorical variable (median BMI 27 vs 24, recurrent stone disease 12 vs 62%, p= 0.006). Furthermore, high PPLA score was associated with lower odds of new kidney stone events during follow-up (OR 0.154, 95% confidence interval 0.024, 0.998, p = 0.05). No significant correlations were found between PPLA score, stone composition, blood parameters, 24h urine solute excretions and RSS for CaOx, CaPi and UA. Conclusion Different papillary abnormalities seem to be linked to specific mechanisms of stone formation. Although data regarding PPLA score are inconsistent, it may be a valid asset for both medical and surgical management of nephrolithiasis. Larger, long-term prospective clinical studies need to be conducted to assess the validity of PPLA score system in evaluating risk of stone recurrence.

Evaluation of stone formers

2017 ◽  
Author(s):  
Muhammad Waqas Iqbal ◽  
Ghalib Jibara ◽  
Michael E. Lipkin ◽  
Glenn M. Preminger
Keyword(s):  
Stone Formation ◽  
Stone Disease ◽  
Metabolic Evaluation ◽  
Recurrence Rates ◽  
Preventative Measures ◽  
Stone Formers ◽  
Increased Risk ◽  
High Incidence ◽  
Recurrent Stone ◽  
Environmental Temperatures

Urolithiasis is among the most common urologic disorders with high incidence and recurrence rates. High environmental temperatures, prevalence of the Western diet, obesity, age, gender, and race are among the common risk factors associated with this disease. The primary goal of evaluating these patients is to provide a simple, economic, and effective workup, which yields information that is directly applicable to providing relevant medical preventative measures. The management of urolithiasis requires a relevant history, targeted physical exam, appropriate chemistry, urinary and stone analyses results, radiological imaging to accurately identify number, location, and size of stones, as well as a metabolic evaluation. All stone formers whether single or recurrent should have a basic evaluation to identify any factors that may predispose to recurrent stone formation. Comprehensive metabolic evaluations are offered to patients at increased risk of recurrence or morbidity from stone disease, or have difficult to treat stones.

scholarly journals 323 Association of Increased Body Mass Index and Waist to Hip Ratio with Kidney Stone Disease: a Prospective Analysis of 493,410 UK Biobank participants

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Lovegrove ◽  
T Littlejohns ◽  
N Allen ◽  
S Howles ◽  
B Turney
Keyword(s):  
Waist Circumference ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Stone Disease ◽  
Fat Free Mass ◽  
Uk Biobank ◽  
Kidney Stone Disease ◽  
Increased Risk ◽  
The Uk

Abstract Aim To investigate the relationship between measures of adiposity and risk of incident kidney stone disease. Method The UK Biobank is a prospective cohort study of ∼500,000 participants whose height, weight, BMI, waist circumference, hip circumference, waist:hip ratio (WHR), total fat mass, fat-free mass, body-fat percentage, and percentage truncal fat were measured at enrolment with linkage to medical records. ICD-10 and OPCS codes identified individuals with a new diagnosis of nephrolithiasis from 2006-2010. Individuals with a history of kidney stones or incomplete data were excluded. Multivariate Cox-proportional hazard models were used to assess associations between anthropometric measures and incident kidney stones. Results From the UK Biobank, 493,410 individuals were identified for inclusion; 3,466 developed a kidney stone during the study period. Increasing weight, BMI, waist, and hip circumferences, WHR, and body and truncal fat were all associated with increased risk of incident kidney stone disease. However, after adjustment for BMI, only waist circumference and WHR remained significantly associated with risk of nephrolithiasis. In overweight patients, high (men 94-102cm, women 80-88cm) waist circumference or WHR (men >0.9, women >0.85) conferred >40% increased risk of stone formation. Conclusions This study indicates that android fat distribution is independently associated with increased risk of developing nephrolithiasis. Kidney stone disease is known to be associated with hypertension, cardiovascular disease, and diabetes, all of which have been linked to android body shape. Our findings provide insight into anthropometric risk factors for stone disease, will facilitate identification of patients at greatest risk of stone recurrence, and will inform prevention strategies.

scholarly journals Calcium and Vitamin D Supplementation and Their Association with Kidney Stone Disease: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4363
Author(s):  
Matteo Bargagli ◽  
Pietro Manuel Ferraro ◽  
Matteo Vittori ◽  
Gianmarco Lombardi ◽  
Giovanni Gambaro ◽  
...  
Keyword(s):  
Vitamin D ◽  
Kidney Stone ◽  
Stone Formation ◽  
Vitamin D Supplementation ◽  
Stone Disease ◽  
Normal Body Mass Index ◽  
Calcium Excretion ◽  
Kidney Stone Disease ◽  
Low Calcium Diet ◽  
Stone Formers

Kidney stone disease is a multifactorial condition influenced by both genetic predisposition and environmental factors such as lifestyle and dietary habits. Although different monogenic polymorphisms have been proposed as playing a causal role for calcium nephrolithiasis, the prevalence of these mutations in the general population and their complete pathogenetic pathway is yet to be determined. General dietary advice for kidney stone formers includes elevated fluid intake, dietary restriction of sodium and animal proteins, avoidance of a low calcium diet, maintenance of a normal body mass index, and elevated intake of vegetables and fibers. Thus, balanced calcium consumption protects against the risk for kidney stones by reducing intestinal oxalate availability and its urinary excretion. However, calcium supplementation given between meals might increase urinary calcium excretion without the beneficial effect on oxalate. In kidney stone formers, circulating active vitamin D has been found to be increased, whereas higher plasma 25-hydroxycholecalciferol seems to be present only in hypercalciuric patients. The association between nutritional vitamin D supplements and the risk for stone formation is currently not completely understood. However, taken together, available evidence might suggest that vitamin D administration worsens the risk for stone formation in patients predisposed to hypercalciuria. In this review, we analyzed and discussed available literature on the effect of calcium and vitamin D supplementation on the risk for kidney stone formation.

scholarly journals Kidney Stone Disease: An Update on Current Concepts

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Tilahun Alelign ◽  
Beyene Petros
Keyword(s):  
Kidney Stone ◽  
Stone Formation ◽  
Research Area ◽  
Urinary Stone ◽  
Stone Disease ◽  
New Drugs ◽  
Mitogen Activated Protein Kinase ◽  
World Population ◽  
Kidney Stone Disease ◽  
Increased Risk

Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall’s plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches.

scholarly journals Herbal Alternative for Kidney Stone Diseases

2019 ◽  
Vol 9 (4-s) ◽  
pp. 702-704
Author(s):  
Bhavisha Bhupendrabhai Patel
Keyword(s):  
Calcium Oxalate ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Stone Disease ◽  
World Population ◽  
Kidney Stone Disease ◽  
Increased Risk

Kidney stone disease is an increasing disorder of humans. It affects about 12% of the world population. Epidemiological data have shown that calcium oxalate is the predominant mineral in a majority of kidney stones. [1] It has been associated with an increased risk of end-stage renal failure. Kidney stones   result from a succession of several physicochemical events including super saturation, nucleation, growth, aggregation, and retention within the kidneys. Kidney stones may cause extreme pain and blockage of urine flow .The average life time risk of stone formation has been reported in the range of 5-10 %.Recurrent stone formation is a common part of the medical care of patients with stone disease.[2] Kidney stone disease is usually treated with medications that may cause a number of side-effects. Even improved and besides the high cost that imposes, compelling data now suggest that exposure to shock waves in therapeutic doses may cause acute renal injury, decrease in renal function and an increase in stone recurrence. Data from in vitro, in vivo and clinical trials reveal that phytotherapeutic agents could be useful as either an alternative therapy in the management of urolithiasis. The present review therefore critically explains the potential usefulness of herbal medicines in the management of urolithiasis. Keywords:  Kidney stones, Calcium oxalate, Herbal plant extracts, Alternative medicine

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

scholarly journals Nutrition and Kidney Stone Disease

Nutrients ◽  
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.

MO120STONE COMPOSITION AND CARDIOVASCULAR DISEASE  IN PATIENTS WIITH NEPHROLITHIASIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ana Lucía Valencia ◽  
Armando Coca ◽  
Arturo Lorenzo ◽  
Veronica Fidalgo ◽  
Vicente Perez ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Uric Acid ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Kidney Stone ◽  
Stone Disease ◽  
Stone Composition ◽  
Adjusted Logistic Regression

Abstract Background and Aims Kidney stone disease is widely prevalent in the general population and has been associated with multiple comorbidities including hypertension, diabetes, chronic kidney disease and cardiovascular disease. We aimed to describe the possible link between stone composition and cardiovascular disease and its differential effect among women and men. Method Retrospective review of patients with known stone composition seen in a nephrolithiasis unit in the last five years. Anthropometric and clinical data were gathered from the hospital records. Stone composition was defined as such if ≥50% of the stone was made from a single component. Cardiovascular disease included coronary artery disease, stroke and peripheral vascular disease. Unadjusted and adjusted logistic regression analysis were applied to describe the potential relationship between stone composition and cardiovascular disease. Results 337 patients were included in the study sample. Median age was 57 (IQR 47-67), 61.1% males. 58.2% suffered from recurrent stone disease and 28.5% from family history of stone formation. 32.9% of patients had hypertension, 22,4% diabetes and 13,1% chronic kidney disease. The most common kidney stone component was calcium oxalate (38.6%) followed by calcium phosphate (21.3%), uric acid (14.2%), struvite (8%) and brushite (0.9%). Only uric acid as main stone component was associated with cardiovascular disease among men but not women in our sample in univariate analysis. That relationship was lost in adjusted logistic regression analysis. Conclusion Calcium oxalate and phosphate were the most common components of kidney stones. No relationship was found between stone composition and cardiovascular disease in the study sample.

scholarly journals Urinary extracellular vesicle-associated MCP-1 and NGAL derived from specific nephron segments differ between calcium oxalate stone formers and controls

2019 ◽  
Vol 317 (6) ◽  
pp. F1475-F1482 ◽  
Author(s):  
Robin S. Chirackal ◽  
Muthuvel Jayachandran ◽  
Xiangling Wang ◽  
Samuel Edeh ◽  
Zejfa Haskic ◽  
...  
Keyword(s):  
Surface Area ◽  
Kidney Stone ◽  
Extracellular Vesicle ◽  
Stone Disease ◽  
Calcium Oxalate Stone ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Nephron Segments ◽  
Stone Formers ◽  
Noninvasive Biomarkers ◽  
Neutrophil Gelatinase

Randall’s plaque (RP; subepithelial calcification) appears to be an important precursor of kidney stone disease. However, RP cannot be noninvasively detected. The present study investigated candidate biomarkers associated with extracellular vesicles (EVs) in the urine of calcium stone formers (CSFs) with low (<5% papillary surface area) and high (≥5% papillary surface area) percentages of RP and a group of nonstone formers. RPs were quantitated via videotaping and image processing in consecutive CSFs undergoing percutaneous surgery for stone removal. Urinary EVs derived from cells of different nephron segments of CSFs ( n = 64) and nonstone formers ( n = 40) were quantified in biobanked cell-free urine by standardized and validated digital flow cytometer using fluorophore-conjugated antibodies. Overall, the number of EVs carrying surface monocyte chemoattractant protein (MCP)-1 and neutrophil gelatinase-associated lipocalin (NGAL) were significantly lower in CSFs compared with nonstone former controls ( P < 0.05) but did not differ statistically between CSFs with low and high RPs. The number of EVs associated with osteopontin did not differ between any groups. Thus, EVs carrying MCP-1 and NGAL may directly or indirectly contribute to stone pathogenesis as evidenced by the lower of these populations of EVs in stone formers compared with nonstone formers. Validation of EV-associated MCP-1 and NGAL as noninvasive biomarkers of kidney stone pathogenesis in larger populations is warranted.

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