Temporal Trends of Dietary Risk Factors after a Diagnosis of Kidney Stones

2021 ◽  
pp. CJN.09200721
Author(s):  
Pietro Manuel Ferraro ◽  
Tamara Cunha ◽  
Eric Taylor ◽  
Gary Curhan
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Dietary Factors ◽  
Dash Score ◽  
Sweetened Beverages ◽  
Stone Formers ◽  
Supplemental Calcium ◽  
History Of

Diet is an important contributor to kidney stone formation, but there are limited data regarding long-term changes in dietary factors after a diagnosis of a kidney stone. We analyzed data from three longitudinal cohorts, the Health Professionals Follow-Up Study and the Nurses' Health Studies I and II, comparing changes in dietary factors in participants with and without a history of kidney stones during follow-up. The total daily intake of dietary calcium, supplemental calcium, animal protein, caffeine, fructose, potassium, sodium, oxalate, phytate, vitamin D, vitamin C, sugar-sweetened beverages, fluids, NEAP and DASH score were assessed by repeat FFQs and computed as absolute differences; a difference-in-differences (DID) approach was used to account for general temporal changes using data from participants without a history of kidney stones from the same calendar period. 184,398 participants with no history of kidney stones were included, 7,095 of whom became confirmed stone formers. Several intakes changed significantly over time in stone formers compared with non-formers, with some showing a relative increase up to 8 years later, including caffeine (DID 8.8 mg/day, 95% CI 3.4, 14.1), potassium (23.4 mg/day, 95% CI 4.6, 42.3), phytate (12.1 mg/day, 95% CI 2.5, 21.7), sodium (43.1 mg/day, 95% CI 19.8, 66.5) and fluid intake (47.1 mL/day, 95% CI 22.7, 71.5). Other dietary factors showed a significant decrease, such as oxalate (−7.3 mg/day, 95% CI −11.4, −3.2), vitamin C (−34.2 mg/day, 95% CI −48.8, −19.6), and vitamin D (−18.0 IU/day, 95% CI −27.9, −8.0). A significant reduction in sugar-sweetened beverages of −0.5 (95% CI −0.8, −0.3) and −1.4 (95% CI −1.8, −1.0) servings/week and supplemental calcium −105.1 (95% CI −135.4, −74.7) and −69.4 (95% CI −95.4, −43.4) mg/day for NHS I and NHS II, respectively intake was observed in women. Animal protein, dietary calcium, fructose intake, DASH score and NEAP did not change significantly over time. After the first episode of a kidney stone, mild and inconsistent changes were observed concerning dietary factors associated with kidney stone formation.

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 Family history and risk of kidney stones.

1997 ◽  
Vol 8 (10) ◽  
pp. 1568-1573
Author(s):  
G C Curhan ◽  
W C Willett ◽  
E B Rimm ◽  
M J Stampfer
Keyword(s):  
Family History ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
History Of ◽  
Kidney Stone Formation ◽  
Risk Of Stone Formation

Kidney stones develop more frequently in individuals with a family history of kidney stones than in those without a family history; however, little information is available regarding whether the increased risk is attributable to genetic factors, environmental exposures, or some combination. In this report, the relation between family history and risk of kidney stone formation was studied in a cohort of 37,999 male participants in the Health Professionals Follow-up Study. Information on family history, kidney stone formation, and other exposures of interest, including dietary intake, was obtained by mailed questionnaires. A family history of kidney stones was much more common in men with a personal history of stones at baseline in 1986 than in those without a history of stones (age-adjusted prevalence odds ratio, 3.16; 95% confidence interval [CI], 2.90 to 3.45). During 8 yr of follow-up, 795 incident cases of stones were documented. After adjusting for a variety of risk factors, the relative risk of incident stone formation in men with a positive family history, compared with those without, was 2.57 (95% CI, 2.19 to 3.02). Family history did not modify the inverse association between dietary calcium intake and the risk of stone formation. These results suggest that a family history of kidney stones substantially increases the risk of stone formation. In addition, these data suggest that dietary calcium restriction may increase the risk of stone formation, even among individuals with a family history of kidney stones.

scholarly journals Intake of Vitamins B6 and C and the Risk of Kidney Stones in Women

1999 ◽  
Vol 10 (4) ◽  
pp. 840-845
Author(s):  
GARY C. CURHAN ◽  
WALTER C. WILLETT ◽  
FRANK E. SPEIZER ◽  
MEIR J. STAMPFER
Keyword(s):  
Relative Risk ◽  
Vitamin C ◽  
Confidence Interval ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Vitamin B6 ◽  
Stone Formation ◽  
Dietary Factors ◽  
Incident Cases ◽  
Kidney Stone Formation

Abstract. Urinary oxalate is an important determinant of calcium oxalate kidney stone formation. High doses of vitamin B6 may decrease oxalate production, whereas vitamin C can be metabolized to oxalate. This study was conducted to examine the association between the intakes of vitamins B6 and C and risk of kidney stone formation in women. The relation between the intake of vitamins B6 and C and the risk of symptomatic kidney stones were prospectively studied in a cohort of 85,557 women with no history of kidney stones. Semiquantitative food-frequency questionnaires were used to assess vitamin consumption from both foods and supplements. A total of 1078 incident cases of kidney stones was documented during the 14-yr follow-up period. A high intake of vitamin B6 was inversely associated with risk of stone formation. After adjusting for other dietary factors, the relative risk of incident stone formation for women in the highest category of B6 intake (≥40 mg/d) compared with the lowest category (<3 mg/d) was 0.66 (95% confidence interval, 0.44 to 0.98). In contrast, vitamin C intake was not associated with risk. The multivariate relative risk for women in the highest category of vitamin C intake (≥1500 mg/d) compared with the lowest category (<250 mg/d) was 1.06 (95% confidence interval, 0.69 to 1.64). Large doses of vitamin B6 may reduce the risk of kidney stone formation in women. Routine restriction of vitamin C to prevent stone formation appears unwarranted.

scholarly journals P0561ACUTE KIDNEY INJURY AS A RISK FACTOR FOR KIDNEY STONES: A PROPENSITY MATCHED ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Cheikh Hassan Hicham Ibrahim ◽  
Maureen Lonergan ◽  
Judy Mullan ◽  
Brendan McAlister ◽  
Kelly Lambert ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Lower Risk ◽  
Stone Formation ◽  
Kidney Injury ◽  
Entire Cohort ◽  
Icd 10 ◽  
History Of ◽  
Kidney Stone Formation

Abstract Background and Aims Kidney stones affects 6-9% of the population, with an almost 30% risk of reoccurrence. Factors associated with kidney stone formation include male gender, ethnicity, family history and stone type. The underlying pathology of stone formation is complex and includes increased urine saturation, decreased urine stone inhibitors in addition to metabolic factors. Acute kidney injury (AKI) refers to the abrupt decrease in kidney function, resulting in retention of urea and other waste products and the dysregulation of fluid and electrolyte balance. AKI affects 10-15% of the hospitalised population and is associated with long-term outcomes, such as chronic kidney disease, end-stage kidney disease (ESKD), cardiovascular disease, fractures and earlier mortality. There is evidence that AKI may result in long-term renal damage and fibrosis. A potential effect is impairment in urine concentration which would limit kidney stone formation. However there has been no previous investigation about this potential association. We aim to investigate if there is an association between AKI and kidney stone formation. Method Retrospective clinical data available for all adult (≥18 years of age) hospital admissions to a local health district in Australia between January 2008 and December 2017 was used in the analysis. We excluded 1) non-residents, 2) stone diagnosis pre-AKI, 3) death within 1 month of an AKI episode, 4) dialysis dependent ESKD prior to an AKI episode and 5) incomplete patient information. AKI episode was diagnosed from ICD-10 coding and kidney stone from ICD-10 and SNOMED coding. Our outcome was a kidney stone episode. We examined the entire cohort in addition to propensity score matching (PSM) using 1:1 optimal matching, caliper 0.1 and without replacement based on covariates known to be associated with renal calculi and AKI. Balance before and after PSM was assessed between the groups to evaluate quality using standardised means. Baseline characteristics were compared with chi-square and Mann Whitney U. Multivariate analysis was compared using Logistic regression. Results For the cohort of 180,927 patients, after exclusions, 12,338 (6.8%) patients were diagnosed with an AKI and 4,495 (2.5%) patients with a kidney stone. Patients with an AKI (12,338), compared to patients with no AKI (168,523), were more likely to be older (75.0 vs 50.0 years, p&lt;0.001) with more comorbidities such as hypertension (31.8% vs 12.7%, p&lt;0.001), diabetes (21.5% vs 9.4%, p&lt;0.001), coronary artery disease (14.6% vs 7.0%, p&lt;0.001) and peripheral vascular disease (5.4% vs 1.8%, p&lt;0.001). The risk of kidney stone formation for the entire cohort in patients with a history of AKI was lower when compared to the no AKI patients (1.1% vs 2.6%, Hazard ratio 0.42, 95% confidence interval 0.36- 0.52, p&lt;0.001). After PSM 12,336 patients with AKI were matched with 12,336 patients with no AKI with good balance of covariates. Patients with a history of AKI had a lower risk of kidney stone formation when compared to no AKI patients (Hazard ratio 0.57, 95% Confidence Interval 0.36- 0.51, p&lt;0.001) Conclusion Our findings suggest that patients with AKI appear to be at a significantly lower risk of developing subsequent kidney stone formation when compared to patients with no previous AKI episodes. Further analysis on a greater scale are required to confirm these findings and their implications.

scholarly journals Mediterranean diet adherence and risk of incident kidney stones

2020 ◽  
Author(s):  
Adrian Rodriguez ◽  
Gary C Curhan ◽  
Giovanni Gambaro ◽  
Eric N Taylor ◽  
Pietro Manuel Ferraro
Keyword(s):  
Uric Acid ◽  
Mediterranean Diet ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Health Study ◽  
P Value ◽  
Linear Regression Models ◽  
Kidney Stone Formation

ABSTRACT Background Diet plays an important role in kidney stone formation. Several individual components have been associated with the risk of kidney stone formation, but there is limited evidence regarding the role of healthful dietary patterns. Objective To prospectively study the association between adherence to the Mediterranean diet and the risk of incident kidney stones. Methods We conducted a longitudinal study using 3 different cohorts: the Health Professionals Follow-up Study (n = 42,902 men), the Nurses’ Health Study I (n = 59,994 women), and the Nurses’ Health Study II (n = 90,631 women). We assessed diet every 4 y using an FFQ and calculated adherence to a Mediterranean diet using the alternate Mediterranean diet score (aMED). A subgroup of 6077 participants provided ≥1 24-h urine sample, and urinary solute excretion was analyzed. We used Cox proportional hazards regression to examine the independent association between the aMED and incidence of kidney stones, adjusting for potential confounders. We used adjusted linear regression models to study the relation between aMED and urine composition. Results During 3,316,633 person-years of follow-up, 6576 cases of incident kidney stones were identified. For participants in the highest aMED score category, the risk of developing a kidney stone was between 13% and 41% lower compared with participants in the lowest score (pooled HR: 0.72, 95% CI: 0.59, 0.87; P value for trend &lt;0.001). A higher aMED score was associated with higher urinary citrate, magnesium, oxalate, phosphate, uric acid, volume, and pH, and lower urinary sodium, resulting in lower supersaturation for calcium oxalate, calcium phosphate, and uric acid. Conclusion Adherence to a Mediterranean diet is associated with a lower risk of developing a kidney stone.

Evaluation of the Relationship between Perirenal Fat Volume and Nephrolithiasis

2021 ◽  
Vol 17 ◽  
Author(s):  
Sedat Tastemur ◽  
Samet Senel ◽  
Esin Olcucuoglu ◽  
Emre Uzun
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Control Group ◽  
Contrast Enhanced ◽  
Computed Tomography Scans ◽  
Independent Risk Factors ◽  
The Relationship ◽  
Fat Volume ◽  
Perirenal Fat

Objective: To examine the relation between perirenal fat volume, which is one of the visceral fat measurements, and kidney stones. Method: 169 patients admitted to our clinic between January 2018 and May 2021 were included in the study. The patients were divided into 2 groups as Control Group and Unilateral Kidney Stone Group (88 patients with unilateral kidney stones). Contrast-enhanced abdominal computed tomography scans were used to measure perirenal fat volume and the results were transferred to workstations. The total perirenal fat volumes in the bilateral kidneys of patients were compared between the two groups. The perirenal fat volume in stone-bearing and non-stone bearing kidneys of patients were also compared. Results: The total perirenal fat volume was higher in the Unilateral Kidney Stone Group than in the other groups and the perirenal fat volume of the patients in this group was higher in the stone bearing kidney (295.6±164.4cm3) than in the non-stone bearing kidney (273.1±179.6cm3). In the ROC analysis, it was concluded that total perirenal fat volume>387cm3 increased the risk of kidney stones. Presence of hypertension, presence of hyperlipidemia and total perirenal fat volume>387cm3 were found to be independent risk factors for the presence of kidney stones. Conclusion: Perirenal fat volume is higher in stone bearing kidneys compared to non-stone bearing kidneys. Therefore, stone formation in a kidney is directly related to the perirenal fat volume of that kidney. Also, total perirenal fat volume>387cm3 increases the risk of kidney stones independently of body mass index, and predicts it better.

scholarly journals Temporal Effects of Quercetin on Tight Junction Barrier Properties and Claudin Expression and Localization in MDCK II Cells

2019 ◽  
Vol 20 (19) ◽  
pp. 4889 ◽  
Author(s):  
Gamero-Estevez ◽  
Andonian ◽  
Jean-Claude ◽  
Gupta ◽  
Ryan
Keyword(s):  
Tight Junction ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Barrier Properties ◽  
Tight Junction Proteins ◽  
Sodium Calcium ◽  
Flavonoid Quercetin ◽  
Kidney Stone Formation ◽  
Junction Proteins

: Kidney stones affect 10% of the population. Yet, there is relatively little known about how they form or how to prevent and treat them. The claudin family of tight junction proteins has been linked to the formation of kidney stones. The flavonoid quercetin has been shown to prevent kidney stone formation and to modify claudin expression in different models. Here we investigate the effect of quercetin on claudin expression and localization in MDCK II cells, a cation-selective cell line, derived from the proximal tubule. For this study, we focused our analyses on claudin family members that confer different tight junction properties: barrier-sealing (Cldn1, -3, and -7), cation-selective (Cldn2) or anion-selective (Cldn4). Our data revealed that quercetin’s effects on the expression and localization of different claudins over time corresponded with changes in transepithelial resistance, which was measured continuously throughout the treatment. In addition, these effects appear to be independent of PI3K/AKT signaling, one of the pathways that is known to act downstream of quercetin. In conclusion, our data suggest that quercetin’s effects on claudins result in a tighter epithelial barrier, which may reduce the reabsorption of sodium, calcium and water, thereby preventing the formation of a kidney stone.

scholarly journals A test of the hypothesis that the collecting duct calcium-sensing receptor limits rise of urine calcium molarity in hypercalciuric calcium kidney stone formers

2009 ◽  
Vol 297 (4) ◽  
pp. F1017-F1023 ◽  
Author(s):  
Kristin J. Bergsland ◽  
Fredric L. Coe ◽  
Daniel L. Gillen ◽  
Elaine M. Worcester
Keyword(s):  
Water Conservation ◽  
Kidney Stone ◽  
Stone Formation ◽  
Collecting Duct ◽  
Urine Volume ◽  
Calcium Excretion ◽  
Calcium Sensing Receptor ◽  
Urine Calcium ◽  
Calcium Sensing ◽  
Stone Formers

The process of kidney stone formation depends on an imbalance between excretion of water and insoluble stone-forming salts, leading to high concentrations that supersaturate urine and inner medullary collecting duct (IMCD) fluid. For common calcium-containing stones, a critical mechanism that has been proposed for integrating water and calcium salt excretions is activation of the cell surface calcium-sensing receptor (CaSR) on the apical membranes of IMCD cells. High deliveries of calcium into the IMCD would be predicted to activate CaSR, leading to reduced membrane abundance of aquaporin-2, thereby limiting water conservation and protecting against stone formation. We have tested this hypothesis in 16 idiopathic hypercalciuric calcium stone formers and 14 matched normal men and women in the General Clinical Research Center. Subjects were fed identical diets; we collected 14 urine samples at 1-h intervals during a single study day, and one sample overnight. Hypercalciuria did not increase urine volume, so urine calcium molarity and supersaturation with respect to calcium oxalate and calcium phosphate rose proportionately to calcium excretion. Thus CaSR modulation of urine volume via IMCD CaSR activation does not appear to be an important mechanism of protection against stone formation. The overnight period, one of maximal water conservation, was a time of maximal stone risk and perhaps a target of specific clinical intervention.

Demographic Study of Water Hardness with Potential to Predict Formation of Renal Crystals

2012 ◽  
Vol 584 ◽  
pp. 504-508 ◽  
Author(s):  
Deeptiman Chatterjee ◽  
Vishaka Verma ◽  
Amiti ◽  
Sheija Rohil ◽  
Narayanasamy Arunai Nambi Raj ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Formation ◽  
Water Hardness ◽  
Renal Calculi ◽  
Developing Nations ◽  
Preventive Strategy ◽  
Drinking Purposes ◽  
Demographic Study ◽  
Kidney Stone Formation

Kidney stones or renal calculi or Nephrolithiasis is a common health problem in both developed and developing nations [1,2]. Analysis of the chemical and physical properties of renal calculi helps in preventing their formation and treatment. In this study, we evaluated the hardness of water used for drinking purposes, in an attempt to correlate water hardness with an increased incidence of stone formation. Identifying risk factors help to develop a preventive strategy to reduce the risk of renal calculi formation. The incidence of kidney stone formation in Vellore district was correlated with the hardness of water samples taken from different areas in Vellore. The study can be employed at a larger demographic level for effective and economic monitoring of the risk of kidney stone formation.

scholarly journals Risk of chronic kidney disease in patients with kidney stones—A nationwide cohort study

2020 ◽  
Author(s):  
Tzung-Fang Chuang ◽  
Hung-Chang Hung ◽  
Shu-Fen Li ◽  
Mei-Wen Li ◽  
Chin-Tun Hung
Keyword(s):  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Cohort Study ◽  
Kidney Disease ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Population Based ◽  
Control Group ◽  
Self Awareness ◽  
Stone Formers

Abstract Background Chronic kidney disease (CKD) and kidney stones are common in Taiwan; in particular, CKD has a high prevalence but low self-awareness rate. CKD-related risk factors such as diabetes, hypertension, and nephrotoxic drugs are well-known and uncontested; however, kidney stones are relatively less studied and easily overlooked as a risk factor. The objective of this study was to investigate whether kidney stones are a risk factor for CKD.Methods We conducted a nationwide population-based matched cohort study to assess the risk of incident CKD in people with kidney stones. Data on incident stones formers in the year 2001—excluding those with a history of CKD—were obtained from Taiwan’s National Health Insurance database. Stone formers were matched (1:4) to control subjects according to sex, age, and index date. The total observation period of the study was 10 years, and the primary end-point was the occurrence of CKD. Student’s t-test and Chi-squared test were used to compare continuous and categorical data, respectively. Logistic regression was used to calculate the odds ratio of kidney stone patients with incident CKD relative to the control group. Cox proportional hazard regression model was used to obtain the hazards ratio for development of incident CKD among patients with kidney stones.Results The incidence of CKD in the kidney stone cohort was 11.2%, which was significantly higher than that of the control group (P < .001). Survival analysis showed that the stones cohort was 1.82 times more likely to experience CKD than the controls. Age, sex, hypertension, diabetes mellitus, and hyperlipidemia increased the risk of CKD incidence (1.04, 1.27, 1.55, 3.31, and 1.25 times, respectively).Conclusion Kidney stones are a definite risk factor for CKD; therefore, patients with stones are suggested to undergo regular renal function monitoring and receive appropriate treatment to avoid CKD.

Sign in / Sign up

Export Citation Format

Share Document