Medical management for the prevention of kidney stones

2021 ◽  
pp. postgradmedj-2021-140971
Author(s):  
Mark Finger ◽  
Evan Finger ◽  
Alessandro Bellucci ◽  
Deepa A. Malieckal
Keyword(s):  
Kidney Stones ◽  
High Recurrence Rate ◽  
Medical Conditions ◽  
Contributing Factors ◽  
Stone Composition ◽  
Non Invasive ◽  
Stone Formers ◽  
Metabolic Investigation ◽  
First Time ◽  
Successful Prevention

The alarming fact is that approximately one out of every 10 of us will have a kidney stone during our lifetime. The increasing prevalence and associated costs of kidney stones have resulted in it being one of the most commonly encountered and impactful medical conditions. Contributing factors include, but are not limited to, diet, climate, genetics, medications, activity and underlying medical conditions. Symptoms generally parallel stone size. Treatment varies from supportive to procedural (invasive and non-invasive). Prevention remains the best way to avoid this condition especially given the high recurrence rate. First time stone formers require counselling regarding dietary adjustments. Certain risk factors ultimately require a more in-depth metabolic investigation, especially if stones are recurrent. Ultimately, management is defined by stone composition. Where appropriate, we review both pharmacologic and non-pharmacologic options. Pivotal to successful prevention is patient education and the encouragement of compliance with the appropriate regimen.

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 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.

scholarly journals Raman spectroscopic detection of interleukin-10 and angiotensin converting enzyme

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Shuo Zhang ◽  
Frederieke A. M. van der Mee ◽  
Roel J. Erckens ◽  
Carroll A. B. Webers ◽  
Tos T. J. M. Berendschot
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Biomedical Applications ◽  
Interleukin 10 ◽  
Spectral Features ◽  
Converting Enzyme ◽  
Raman Spectroscopic ◽  
Non Invasive ◽  
Confocal Raman ◽  
First Time ◽  
Enzyme Characteristic

AbstractIn this report we present a confocal Raman system to identify the unique spectral features of two proteins, Interleukin-10 and Angiotensin Converting Enzyme. Characteristic Raman spectra were successfully acquired and identified for the first time to our knowledge, showing the potential of Raman spectroscopy as a non-invasive investigation tool for biomedical applications.

Trace-Element Contents of Serum, Urine, and Kidney Stones in Urinary Stone Formers

Urolithiasis ◽  
1989 ◽  
pp. 229-231
Author(s):  
J. Hofbauer ◽  
I. Steffan ◽  
H. Schwetz ◽  
G. Vujicic ◽  
O. Zechner
Keyword(s):  
Trace Element ◽  
Kidney Stones ◽  
Urinary Stone ◽  
Stone Formers ◽  
Trace Element Contents ◽  
Element Contents

scholarly journals Stone composition of renal stone formers from different global regions

2021 ◽  
Vol 93 (3) ◽  
pp. 307-312
Author(s):  
Adam Hali´nski ◽  
Kamran Hassan Bhatti ◽  
Luca Boeri ◽  
Jonathan Cloutier ◽  
Kaloyan Davidoff ◽  
...  
Keyword(s):  
Uric Acid ◽  
Calcium Phosphate ◽  
Calcium Oxalate ◽  
Urinary Stones ◽  
Ureteral Stones ◽  
Stone Analysis ◽  
Stone Composition ◽  
Stone Formers ◽  
Cystine Stones ◽  
Struvite Stones

Objective: To study urinary stone composition patterns in different populations around the world. Materials and methods: Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered. Results: In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases. Conclusions: The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.

scholarly journals Diagnosis of experimental stetohepatosis using ultrasound shear wave elastography

2015 ◽  
Vol 26 (1) ◽  
pp. 109-113
Keyword(s):  
Insulin Resistance ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Mixed Diet ◽  
Sweetened Condensed Milk ◽  
Non Invasive ◽  
Condensed Milk ◽  
First Time ◽  
Diagnosis Technique

According to available literature data, NAFLD may play crucial role in the pathogenesis of type 2 diabetes and other conditions connected with insulin resistance. In order to study the essence of the NAFLD, we have created an experimental model of the steatohepatosis. The mixed diet for 8 weeks consisting of standard food (47%), sweetened condensed milk (44%), vegetable oil (8%) and vegetable starch (1%) develops non-alcoholic steatohepatosis in the animals undergoing the experiment. The morphological signs of the non-alcoholic steatohepatosis comprised as follows in the hepatocytes of the rats undergoing the experiment: presence of fine-drop fattiness (fine-drop steatosis) and accumulation of fat vacuoles shifting the nucleus towards the cell peripheral. Substantial increase in the liver pulp of the animals undergoing the experiment defined using the ultrasound shear wave elastography technique is indicative of the presence of the non-alcoholic steatohepatosis. The ultrasound shear wave elastography technique can be used as a non-invasive diagnosis marker of the non-alcoholic steatohepatosis. The said diagnosis technique has been recommended for the first time.

scholarly journals Detection of Clinical Mesenchymal Cancer Cells from Bladder Wash Urine for Real-Time Detection and Prognosis

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1274 ◽  
Author(s):  
Bee Luan Khoo ◽  
Charlotte Bouquerel ◽  
Pradeep Durai ◽  
Sarannya Anil ◽  
Benjamin Goh ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Cells ◽  
Real Time ◽  
High Efficiency ◽  
Stream Line ◽  
Clinical Samples ◽  
High Recurrence Rate ◽  
Mesenchymal Transition ◽  
Non Invasive ◽  
Real Time Detection

Bladder cancer (BC) is a disease that requires lifelong surveillance due to its high recurrence rate. An efficient method for the non-invasive rapid monitoring of patient prognosis and downstream phenotype characterization is warranted. Here, we develop an integrated procedure to detect aggressive mesenchymal exfoliated bladder cancer cells (EBCCs) from patients in a label-free manner. Using a combination of filtration and inertial focusing principles, the procedure allowed the focusing of EBCCs in a single stream-line for high-throughput separation from other urine components such as large squamous cells and blood cells using a microfluidic sorting device. Characterization of enriched cells can be completed within hours, suggesting a potential utility for real-time detection. We also demonstrate high efficiency of cancer cell recovery (93.3 ± 4.8%) and specific retrieval of various epithelial to mesenchymal transition (EMT) phenotype cell fractions from respective outlets of the microfluidic device. EMT is closely associated with metastasis, drug resistance and tumor-initiating potential. This procedure is validated with clinical samples, and further demonstrate the efficacy of bladder wash procedure to reduce EBCCs counts over time. Overall, the uniqueness of a rapid and non-invasive method permitting the separation of different EMT phenotypes shows high potential for clinical utility. We expect this approach will better facilitate the routine screening procedure in BC and greatly enhance personalized treatment.

scholarly journals The Vehicle Determines the Destination: The Significance of Seminal Plasma Factors for Male Fertility

2020 ◽  
Vol 21 (22) ◽  
pp. 8499
Author(s):  
Fengli Wang ◽  
Weina Yang ◽  
Sijin Ouyang ◽  
Shuiqiao Yuan
Keyword(s):  
Seminal Plasma ◽  
Male Fertility ◽  
Reproductive Tract ◽  
Biological Fluid ◽  
Female Reproductive Tract ◽  
Molecular Structures ◽  
Contributing Factors ◽  
Non Invasive ◽  
Long Time ◽  
Plasma Factors

Of all human infertility cases, up to 50% show contributing factors leading to defects in the male reproductive physiology. Seminal plasma (SP) is the biological fluid derived from the male accessory sex gland which carries spermatozoa passing throughout the male and female reproductive tract during ejaculation. It contains a complicated set of heterogeneous molecular structures, including proteins, cell-free nucleic acid (DNA, microRNA and LncRNA), and small-molecule metabolites as well as inorganic chemicals (ions). For a long time, the substantial significance of seminal plasma factors’ functions has been underestimated, which is restricted to spermatozoa transport and protection. Notably, significant advancements have been made in dissecting seminal plasma components, revealing new insights into multiple aspects of sperm function, as well as fertilization and pregnancy outcomes in recent years. In this review, we summarize the state-of-art discoveries regarding SP compositions and their implications in male fertility, particularly describing the novel understanding of seminal plasma components and related modifications using “omics” approaches and mainly focusing on proteome and RNA-seq data in the latest decade. Meanwhile, we highlighted the proposed mechanism of the regulation of SP molecules on immunomodulation in the female reproductive tract. Moreover, we also discussed the proteins investigated as non-invasive diagnosis biomarkers for male infertility in the clinic.

scholarly journals «Opus artificum universa» estudio colorimétrico de la escultura románica en mármol del Museo Arqueológico Nacional: ejemplos de Galicia y León = «Opus Artificum Universa» Colorimetric Study of the Marble Romanesque Sculpture in the Museo Arqueológico Nacional: Examples from Galicia and León

2018 ◽  
pp. 129
Author(s):  
Sergio Vidal Álvarez ◽  
Marie-Claire Savin ◽  
Carole Biron
Keyword(s):  
Reflectance Spectroscopy ◽  
Santiago De Compostela ◽  
Non Invasive ◽  
Colorimetric Study ◽  
Visible Reflectance ◽  
First Time

El presente estudio da a conocer los resultados de los análisisno invasivosde colorimetría y espectroscopía de reflectancia visible llevados a cabo por primera vez sobre cinco ejemplos de escultura románica en mármol del Museo Arqueológico Nacional (Madrid) de procedencia gallega y leonesa. En concreto se han analizado dos columnas de San Paio de Antealtares (Santiago de Compostela), un parteluz de Vigo, y dos ejemplos procedentes del monasterio de San Benito de Sahagún (León).The present study reveals the results of the non-invasive analysis of colorimetry and visible reflectance spectroscopy, carried out for the first time to five examples of Spanish Romanesque marble sculpture from the National Archaeological Museum (Madrid, Spain) of Galician and Leonese origin. Specifically, two columns of San Paio de Antealtares (Santiago de Compostela), a mullion from Vigo, and two examples from the monastery of San Benito de Sahagún (León) have been analyzed.

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