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.

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 &gt; 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.

The impact of metaphylaxis of kidney stone disease in the renal function at long term in active kidney stone formers patients

2011 ◽  
Vol 40 (3) ◽  
pp. 225-229 ◽  
Author(s):  
Jose A. Meneses ◽  
Fernando M. Lucas ◽  
Fernando C. Assunção ◽  
Junia P. P. Castro ◽  
Rogério B. Monteiro
Keyword(s):  
Renal Function ◽  
Kidney Stone ◽  
Stone Disease ◽  
Kidney Stone Disease ◽  
Stone Formers ◽  
The Impact

scholarly journals Papillary Pathology in Calcium Oxalate Stone Formers Who Do and Do Not Form Their Stones on Randall’s Plaque

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Haider N. Al-Awadi, BS ◽  
James C. Williams, Jr., PhD
Keyword(s):  
Calcium Oxalate ◽  
Surface Area ◽  
Stone Formation ◽  
Lower Percentage ◽  
Still Images ◽  
Calcium Oxalate Stone ◽  
Randall’S Plaque ◽  
Stone Formers ◽  
Patient Groups ◽  
Randall's Plaque

Background and Hypothesis: Nephrolithiasis currently affects about one-in-eleven people with a recurrence in up to half of those individuals. Formation of calcium oxalate (CaOx) stone is most common. Some CaOx stones are known to form on Randall’s plaque, which is a calcification of the renal papilla, and this kind of stone can be identified by morphology. We divided CaOx stone formers into two groups: Randall’s plaque (RP) stone formers (RPSF) and non-Randall’s plaque stone formers (NRPSF). We hypothesized that renal papillary pathologies would be different between these two groups of stone formers. Experimental Design or Project Methods: Surgical videos were assessed for papillary pathology using a semiquantitative grading system to measure papillary appearance in terms of ductal plugging and dilation, tissue surface pitting, loss of papillary contour, and RP. The second measure computed the papillary percent surface area of Randall’s plaque and ductal plugging using still images of the papilla. The scoring and quantitative measures of the papillae were compared between the two patient groups. All work was done in a manner blinded to the patient group. Results: Two-tailed t-test showed that RPSF group had higher scores of pitting and RP and lower scores for plugging when compared to the NRPSF group. Similarly, the quantitative data showed that RPSF group had a lower percentage of plugging surface area and higher percentage of RP surface area. Conclusion and Potential Impact: These data show that persons forming their CaOx stones primarily on RP have a papillary pathology that differs from CaOx stone formers who make their stones by other mechanisms. RPSF have more RP and less ductal plugging. Since the underlying pathologies existing in RP stone formation are different from other CaOx stone formers, it is possible that certain treatments could be especially effective for this group, and thus these results suggest that clinical trials that separate out this group of CaOx stone formers are warranted.

scholarly journals Correlation between Neutrophil Gelatinase-Associated Lipocalin and Endoscopic, Histopathologic and Clinical Activities of Ulcerative Colitis

2020 ◽  
pp. 136-144
Author(s):  
Mohammed G. Flefel ◽  
Heba A. Mourad ◽  
Eiman A. Hasby ◽  
Sherif E. Ezzat ◽  
Waleed S. Mohamed
Keyword(s):  
Ulcerative Colitis ◽  
Disease Activity ◽  
Complete Blood Count ◽  
Control Group ◽  
Clinical Activity ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Mayo Score ◽  
Liver And Kidney ◽  
Noninvasive Biomarkers ◽  
Neutrophil Gelatinase

Introduction: Detection of activity of ulcerative colitis (UC) is vital for predicting treatment outcome. The assessment depends on clinical, serologic, and endoscopic findings. One of the noninvasive biomarkers for disease activity detection is serum Neutrophil Gelatinase-Associated Lipocalin (NGAL). Aim: To assess the relationship between NGAL and endoscopic, histopathologic and clinical activity of UC. Methods: This study was conducted on 50 cases with definitive diagnosis of UC and 15 cases with normal colonoscopy examination as controls. UC cases were considered active if Geobes score was ≥3.1. Complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and liver and kidney function tests were done. Serum NGAL was estimated using ELISA technique. Results: UC cases were classified into active group (n = 36) and inactive group (n = 14). In active UC cases, median value (IQR) of serum NGAL was significantly increased (101.15 (67.53 – 156.40) ng/mL) compared to inactive cases (63.35 (60.98–65.20) ng/mL) and control group (24.80 (15.50 – 31.50) ng/mL). Serum NGAL was well correlated with Geobes score, Mayo score, CRP and ESR. Serum NGAL at cut-off ≥ 63 can predict activity with sensitivity 88.89%, specificity 85.71%, PPV 94.12% and NPV 75%. Conclusion: Serum NGAL is valuable noninvasive marker for assessment of UC disease activity.

[14C]Oxalate absorption by normal persons, calcium oxalate stone formers, and patients with surgically disturbed intestinal function.

1981 ◽  
Vol 27 (10) ◽  
pp. 1682-1685 ◽  
Author(s):  
H G Tiselius ◽  
C Ahlstrand ◽  
B Lundström ◽  
M A Nilsson
Keyword(s):  
Calcium Oxalate ◽  
Normal Subjects ◽  
Jejunoileal Bypass ◽  
Stone Disease ◽  
Ileocecal Resection ◽  
Intestinal Function ◽  
Calcium Oxalate Stone ◽  
Oxalate Absorption ◽  
Stone Formers ◽  
Significant Difference

Abstract Intestinal absorption of oxalate can be judged from the urinary excretion of orally administered [14C]oxalate. Fifteen normal subjects, 21 patients with "idiopathic" calcium oxalate stone disease and a high oxalate excretion, four patients operated with ileocecal resection, and seven patients operated with jejunoileal bypass were so investigated. We saw no significant difference in the amount of isotope excreted by normal subjects and idiopathic stone formers; 13.6% (SD 5.9%) and 14.4% (SD 6.5%), respectively, of the administered dose was accounted for in the urine. The patients with resection or bypass showed a quite different pattern of isotope excretion, and 18.3% (SD 7.0%) and 36.8% (SD 14.0%), respectively, of the isotope was accounted for in the urine.

Rising occurrence of hypocitraturia and hyperoxaluria associated with increasing prevalence of stone disease in calcium kidney stone formers

2020 ◽  
Vol 54 (5) ◽  
pp. 426-430
Author(s):  
Ramy F. Youssef ◽  
Jeremy W. Martin ◽  
Khashayar Sakhaee ◽  
John Poindexter ◽  
Sharmin Dianatnejad ◽  
...  
Keyword(s):  
Kidney Stone ◽  
Stone Disease ◽  
Stone Formers

scholarly journals Perturbations of the Gut Microbiome and Metabolome in Children with Calcium Oxalate Kidney Stone Disease

2020 ◽  
Vol 31 (6) ◽  
pp. 1358-1369 ◽  
Author(s):  
Michelle R. Denburg ◽  
Kristen Koepsell ◽  
Jung-Jin Lee ◽  
Jeffrey Gerber ◽  
Kyle Bittinger ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Kidney Stones ◽  
Gut Microbiome ◽  
Early Onset ◽  
Kidney Stone ◽  
Stone Disease ◽  
Metagenomic Sequencing ◽  
Kidney Stone Disease ◽  
Stone Formers ◽  
Age Related

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.

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 Overweight and Obesity: Risk Factors in Calcium Oxalate Stone Disease?

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Beate Maria Wrobel ◽  
Gernot Schubert ◽  
Markus Hörmann ◽  
Walter Ludwig Strohmaier
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Calcium Oxalate ◽  
Recurrence Rate ◽  
Stone Disease ◽  
Overweight And Obesity ◽  
Urine Ph ◽  
Calcium Oxalate Stone ◽  
Stone Formers ◽  
Obesity Risk Factors

Introduction. Several studies showed an association of overweight and obesity with calcium oxalate stone disease (CaOx). However, there are no sufficient data on the influence of body weight on the course of the disease and the recurrence rate.Patients and Methods.N=100consecutive stone formers with pure CaOx were studied. Different parameters were investigated. According to the BMI, patients were divided into three groups: (1)BMI≤25; (2) BMI 25.1–30; (3)BMI>30.Results.N=32patients showed aBMI≤25,n=42patients showed a BMI of 25.1–30 andn=26patients showed aBMI≥30. The groups differed significantly concerning BMI (by definition), urine pH, and urine citrate. The recurrence rate was not significantly different.Discussion. Our study demonstrated that body weight negatively influences single risk factors in CaOx, but obesity is not a predictor for the risk of recurrence in CaOx.

scholarly journals Prevalence of Hypertension in Patients with Nephrolithiasis

2021 ◽  
pp. 92-96
Author(s):  
I. Adhavan ◽  
S. Prasanna Karthik
Keyword(s):  
Blood Pressure ◽  
Kidney Stone ◽  
Diastolic Pressure ◽  
Tertiary Care ◽  
Systolic Pressure ◽  
Stone Disease ◽  
Kidney Stone Disease ◽  
Arterial Blood ◽  
Stone Formers ◽  
Study Participants

Introduction: Kidney stone disease, also known as nephrolithiasis, is a prevalent illness that affects people of all ages and genders. Hypertension is defined as persistent elevation of systemic arterial blood pressure (systolic pressure ≥ 140 mmHg and/or diastolic pressure ≥ 90 mmHg). Methodology: This was a prospective study conducted over a period of 3 months between February 2021 and April 2021 at the Department of General Medicine in our tertiary care center. A total of 280 patients who came to the outpatient department (OPD) were included in the study as study participants. After recording blood pressure, participants were classified as normotensives (218) and hypertensives (62).  The study participants were examined for the development of kidney stone disease. In those study participants who had clinical features suggesting nephrolithiasis, the diagnosis was confirmed by Ultrasonography. Results: It was observed that 25 of 62 hypertensives and 47 of 218 normotensives developed nephrolithiasis. And there were 43 men and 29 women among the 72 stone formers. Conclusion: Our study showed a male preponderance for stone formers. And it is also evident that nephrolithiasis is more prevalent among hypertensives than normotensives though not statistically significant.

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