24-hour urinary constituents in stone formers: a study from Kashmir

Background: Urolithiasis is a common disorder. Studies have shown that metabolic causes of urolithiasis include hypercalciuria, hypocitraturia, high or low pH of urine, hyperuricosuria, hyperoxaluria and hypomagnesuria. We intended to conduct this study with the aim to provide historical data regarding the 24-hour urinary analysis in this part of India with a distinct and different geographical and cultural background.Methods: A total of 186 patients having urinary stone disease attending the departments of Nephrology and Urology in Sher-I- Kashmir institute of medical sciences were included. 26 healthy members of hospital staff were taken as controls. Demographic and clinico-pathological characteristics of each patient were recorded in a questionnaire. Urine was collected for 24-hours from 186 patients and 26 controls. 10ml sample of this urine collection was stored at 20c0 before processing for urinary parameters.Results: The mean concentration of calcium salts, Magnesium, Oxalate and Uric acid in the 24-hour urinary analysis of urolithiasis patients is higher than that of the normal healthy controls and the relation was statistically significant. On comparing the 24-hour urinary constituents among urolithiasis patients and health controls, the concentration of phosphate was almost equal in both cases and controls while the concentration of oxalate was much higher in cases than controls.Conclusions: In present study hypercalciuria is main cause of renal calculi along with hypocitraturia, hypomagnesuria and hyperphosphaturia in our valley. Measurement of 24-hour urine constituents is still gold standard for evaluation of stone formers.

Download Full-text

SLIPS-LAB—A bioinspired bioanalysis system for metabolic evaluation of urinary stone disease

Science Advances ◽

10.1126/sciadv.aba8535 ◽

2020 ◽

Vol 6 (21) ◽

pp. eaba8535

Author(s):

Hui Li ◽

Eugene Shkolyar ◽

Jing Wang ◽

Simon Conti ◽

Alan C. Pao ◽

...

Keyword(s):

Urinary Stone ◽

Stone Disease ◽

Clinical Samples ◽

Metabolic Evaluation ◽

Biologically Inspired ◽

Urinary Stone Disease ◽

Liquid Handling ◽

Stone Formers ◽

Pharmacologic Treatments ◽

Urine Testing

Urinary stone disease is among the most common medical conditions. Standard evaluation of urinary stone disease involves a metabolic workup of stone formers based on measurement of minerals and solutes excreted in 24-hour urine samples. Nevertheless, 24-hour urine testing is slow, expensive, and inconvenient for patients, which has hindered widespread adoption in clinical practice. Here, we demonstrate SLIPS-LAB (Slippery Liquid-Infused Porous Surface Laboratory), a droplet-based bioanalysis system, for rapid measurement of urinary stone–associated analytes. The ultra-repellent and antifouling properties of SLIPS, which is a biologically inspired surface technology, allow autonomous liquid handling and manipulation of physiological samples without complicated sample preparation procedures and supporting equipment. We pilot a study that examines key urinary analytes in clinical samples from patients with urinary stone. The simplicity and speed of SLIPS-LAB hold the potential to provide actionable diagnostic information for patients with urinary stone disease and rapid feedback for responses to dietary and pharmacologic treatments.

Download Full-text

Safety and Efficacy of Percutaneous Nephrolithotomy in The Treatment of Renal Stones in Children

QJM ◽

10.1093/qjmed/hcaa070.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M A Badran ◽

Y M Kotb ◽

M K A Tolba

Keyword(s):

Percutaneous Nephrolithotomy ◽

Renal Stones ◽

Urinary Stone ◽

Stone Disease ◽

Age Group ◽

Intraoperative Blood Loss ◽

Urinary Stone Disease ◽

Group A ◽

The Mean ◽

Group B

Abstract Background the incidence of urinary stone disease has been increased due to the change in dietary habits, lifestyle factors and obesity. The prevalence of urinary stone disease was reported as 11.1% in the adult population, while the prevalence in children varies with age, it is approximately 2-3%. Open surgery was the only surgical treatment option in the past, now most pediatric urinary stones can be treated effectively by other procedures as extracorporial shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS) and laparoscopy. Aim of the Study to assess the safety and efficacy of percutaneous nephrolithotomy in the treatment of renal stones more than 15 mm in children aged 2-14 years old. Patients and Methods our study included 40 patients (28 males and 12 females) with a mean age (8.35 ± 3.69) with a range (2 to 14 years) managed by PCNL in 2 groups: Group A (Preschool age group): included 18 patients, 12 males (67%) and 6 females (33%) aged (2-6 years) managed by mini PCNL.Group B (School age group): included 22 patients, 16 male (73%) and 6 females (27%) aged (7-14 years) managed by standard PCNL. Results Success rate was nearly similar in both groups, it was 88.9% in group A and 95.5% in group B. Regarding the mean operative time it was 72.22 ± 12.63 in group A and 70.00 ± 15.74 in group B. Regarding the intraoperative blood loss it was more significant in group B with the mean intraoperative blood loss as 76.67 ± 15.34 in group A and 116.36 ± 22.79 in group B. Postoperative pain was more in group B than in group A, so 6 patients (33.3%) postoperative weak opiate analgesia in group A for less than 24 hours, while 16 patients (72.7%) needed postoperative weak opiate analgesia in group B. Hospital stay was 2.44 ± 0.51 in group A and 2.91 ± 1.02 in group B. Conclusion PCNL is a safe and effective procedure for management of renal stones in children, with accepted stone clearance rates and postoperative morbidity in addition to short hospital stay.

Download Full-text

A 13 year hospital based study on the Trend of Urinary Stone Disease in Uttarakhand, India

Nepal Journal of Epidemiology ◽

10.3126/nje.v11i1.35896 ◽

2021 ◽

Vol 11 (1) ◽

pp. 949-958

Author(s):

Monica Kakkar ◽

Rakesh Kakkar

Keyword(s):

Retrospective Study ◽

Renal Stones ◽

Urinary Stone ◽

Stone Disease ◽

Urinary Stones ◽

Religious Groups ◽

Medical Sciences ◽

Urinary Stone Disease ◽

Disease Site ◽

Keywords Urolithiasis

Background: The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet. Methods: A retrospective study covering a period of about 13 years (2005-18) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated. Results: The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts. However, in all religious groups, 21-40 years old subjects were found to be most susceptible to the problem and approximately 90% of the urinary stones were recovered from the kidneys and primarily composed of calcium oxalate. Conclusion: The co-relationship between the occurrence of urinary stones with age, sex of the patients, their religion & site of stones on diagnosis was found to be statistically significant. Keywords: Urolithiasis, Urinary Stone disease, Urinary calculus, Renal stones.

Download Full-text

An empirical study on hospital-based prevention of recurrent urinary stone disease in Germany

World Journal of Urology ◽

10.1007/s00345-021-03813-3 ◽

2021 ◽

Author(s):

Alina Reicherz ◽

Patricia Rausch ◽

Roman Herout ◽

Joachim Noldus ◽

Peter Bach

Keyword(s):

High Risk ◽

Preventive Measures ◽

Urinary Stone ◽

Stone Disease ◽

Lifestyle Changes ◽

Published Data ◽

Common Disease ◽

Dietary Recommendations ◽

Urinary Stone Disease ◽

Stone Formers

Abstract Purpose Urinary stone disease is a common disease with a prevalence of 4.7% in Germany. The incidence increased over the last decades, and recurrence rates are up to 50% in the first 5 years after diagnosis. Adequate preventive measures can avoid up to 46% of stone recurrences. These numbers outline the importance of prevention. Especially among high-risk stone formers, specific diagnostics and measures are required. Published data indicate the divergence between the importance of prevention and its implementation in everyday clinical practice. This is the first survey among German urological departments highlighting medical care concerning the prevention of recurrent urinary stone disease, identifying challenges and providing recommendations for improvements. Methods Two hundred and seventy urological hospital departments in Germany were anonymously surveyed about measurements to prevent recurrent stone disease. The questionnaire comprised 23 items dealing with diagnostics, counselling, knowledge among doctors concerning preventive measures and difficulties in preventing recurrent urinary stone disease. Results Sixty-three urological departments (23.8%) answered the survey. The majority perform stone analysis at first and repeat events. Most patients with urinary stone disease receive general advice on preventive measures during their hospitalization. General recommendations focus on fluid intake and lifestyle changes. However, specific diets are infrequently recommended by inpatient urologists. Diagnostics to identify high-risk stone formers are mostly insufficient, and guideline-compliant urine tests are uncommon. Conclusion The quality of secondary prevention needs to improve considerably. The focus should be put on identifying high-risk stone formers and offering those patients specific counselling. Furthermore, general advice on dietary recommendations should be extended.

Download Full-text

HASAT E KULLIYA WA MASANA (KIDNEY AND BLADDER STONE): A REVIEW

Indian Journal of Unani Medicine ◽

10.53390/ijum.v14.i2.1 ◽

2021 ◽

Vol 14 (2) ◽

Author(s):

Zaid Iqbal ◽

Abuzar Lari ◽

Musarrat Ali

Keyword(s):

Kidney Stones ◽

Surgical Procedure ◽

Renal Stone ◽

Renal Calculi ◽

Urinary Stone ◽

Stone Disease ◽

Bladder Stone ◽

Urinary Stone Disease ◽

Unani Medicine ◽

Ancient Time

In Unani system of medicine renal stone named as Hasat e Kulliya (kidney stones), Hasat e halib (uretric stones), Hasat e masana (bladder stone). Kidney stones or Renal Calculi (from Latin renes, "kidney" and calculi, "pebbles") are solid structures composed of urinary precipitates and crystals. These stones can range in size from less than a millimeters to few centimeters. From ancient time Greeks have many literatures in which they explained urinary stone disease in detail. The association of stones and putrefaction has been known since Hippocrates (460–377 BC). He was first who described diseases of kidney and symptoms of bladder stones. Many Unani physicians explained surgical procedure and instruments used for removal of stone. The aim of this review to explain renal stone in vision of unani medicine.

Download Full-text

Twenty-Four Hour Urine Testing and Prescriptions for Urinary Stone Disease–Related Medications in Veterans

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.03580319 ◽

2019 ◽

Vol 14 (12) ◽

pp. 1773-1780 ◽

Cited By ~ 2

Author(s):

Shen Song ◽

I-Chun Thomas ◽

Calyani Ganesan ◽

Ericka M. Sohlberg ◽

Glenn M. Chertow ◽

...

Keyword(s):

Urinary Stone ◽

Stone Disease ◽

Thiazide Diuretics ◽

Health Administration ◽

Urine Calcium ◽

Absolute Increase ◽

Urinary Stone Disease ◽

Stone Formers ◽

Alkali Therapy ◽

Urine Testing

Background and objectivesCurrent guidelines recommend 24-hour urine testing in the evaluation and treatment of persons with high-risk urinary stone disease. However, how much clinicians use information from 24-hour urine testing to guide secondary prevention strategies is unknown. We sought to determine the degree to which clinicians initiate or continue stone disease–related medications in response to 24-hour urine testing.Design, setting, participants, & measurementsWe examined a national cohort of 130,489 patients with incident urinary stone disease in the Veterans Health Administration between 2007 and 2013 to determine whether prescription patterns for thiazide diuretics, alkali therapy, and allopurinol changed in response to 24-hour urine testing.ResultsStone formers who completed 24-hour urine testing (n=17,303; 13%) were significantly more likely to be prescribed thiazide diuretics, alkali therapy, and allopurinol compared with those who did not complete a 24-hour urine test (n=113,186; 87%). Prescription of thiazide diuretics increased in patients with hypercalciuria (9% absolute increase if urine calcium 201–400 mg/d; 21% absolute increase if urine calcium >400 mg/d, P<0.001). Prescription of alkali therapy increased in patients with hypocitraturia (24% absolute increase if urine citrate 201–400 mg/d; 34% absolute increase if urine citrate ≤200 mg/d, P<0.001). Prescription of allopurinol increased in patients with hyperuricosuria (18% absolute increase if urine uric acid >800 mg/d, P<0.001). Patients who had visited both a urologist and a nephrologist within 6 months of 24-hour urine testing were more likely to have been prescribed stone-related medications than patients who visited one, the other, or neither.ConclusionsClinicians adjust their treatment regimens in response to 24-hour urine testing by increasing the prescription of medications thought to reduce risk for urinary stone disease. Most patients who might benefit from targeted medications remain untreated.

Download Full-text