scholarly journals Hypertensive and Metabolic Issues in Nephrolithiasis with Pregnancy

2019 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Blood Pressure ◽  
Research Group ◽  
Stone Formation ◽  
Renal Stones ◽  
P Values ◽  
The Metabolic Syndrome ◽  
Stone Formers ◽  
Potential Marker ◽  
Stone Former

Background: Renal stones are correlated clinically with forthcoming development of hypertension, diabetes, and the metabolic syndrome. Objective of the study: To evaluate and investigate whether stone formation before pregnancy is correlated with metabolic and hypertensive medical development emergence in gestation. The research team hypothesis was based on that stone development is considered a potential marker of metabolic disease and will be linked with greater risk for maternal complications in pregnancy. Methodology: We conducted a two-group cohort study of women who delivered infants at El Sahel teaching Hospital 2015to 20118. Women with abdominal imaging investigate (computed tomography or sonography) before pregnancy were incorporated in the analysis. 923 cases were assessed for eligibility for the study 817 cases were eligible consequently they were categorized into stone formers (126 cases) and non-stone formers (691 cases .finally 110 cases were enrolled for each arm of the study 8 cases were lost during follow up in the stone former research group and 6 cases were lost during follow up in non-stone former research group. Gestational outcomes in women with documented renal stones by imaging were compared with those of women without stones on imaging. Females with preexisting chronic kidney disease, hypertension, and diabetes were excluded. Results: Stone former research group had statistically significantly more frequent hypertension, gestational hypertension, preeclampsia and preterm (p values=0.005,0.035,0.034,0.017, consecutively) as well as higher Maximum systolic blood pressure, diastolic blood pressure and glucose tolerance test (p values<0.001,0.030,0.039, consecutively). Conclusions: In women without preexisting diabetes, hypertension, and CKD, a history of nephrolithiasis was associated with gestational diabetes and hypertensive disorders of pregnancy, especially in women with high first trimester body mass index.

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.

Considerations on Thermal Behaviour and Porosity of Renal Calculi in Bisphosphonate -Treated Postmenopausal Women

2017 ◽  
Vol 68 (6) ◽  
pp. 1259-1263
Author(s):  
Rodica Narcisa Tanasescu ◽  
Razvan Bardan ◽  
Adriana Ledeti ◽  
Ionut Ledeti ◽  
Petru Matusz ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Renal Stones ◽  
Renal Calculi ◽  
Bisphosphonate Therapy ◽  
Calcium Balance ◽  
Exclusion Criteria ◽  
Specific Effects ◽  
Stone Formers ◽  
Decomposition Processes

A longitudinal, randomized, five year follow-up clinical and experimental study was conducted during May 1, 2011 - June 30, 2016. A number of 125 eligible postmenopausal women (BMD T-score spine (-2.8 � 0.5)); BMD at the femoral hip (-2.6 � 0.8), treated only with biphosphonates, were enrolled in the study. The patient�s age ranged between 60 and 65 years. All the women were stone formers, with more than five episodes of crystalluria in the last five years. Exclusion criteria: kidney chronic diseases, use of drugs known to affect bone metabolism and renal function, patients with multi-morbidities. The aim of our study was to assess the connection between postmenopausal osteoporosis and the risk of worsening calcium balance in urolithiasis, based on the complex thermogravimetric findings and porosity studies of renal stones eliminated by these patients. The study of renal-urinary concretions offers the possibility to amplify the specific effects of the thermal decomposition processes of substances, reflecting the sample�s global composition. The research of calculi porosity gives information about the dissolution possibilities of the renal-urinary concretions. In conclusion, in postmenopausal women, proper administration of bisphosphonate therapy must accompany the supplementary medication with calcium and vitamin D, always correlated to the metabolic status of the osteoporotic patient.

Abstract 19742: Effects of a "Health Partner" Intervention on the Metabolic Syndrome

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Natalee K Wilson ◽  
Ibhar Al Mheid ◽  
Lynn Cunningham ◽  
Kenneth Brigham ◽  
Greg S. Martin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Vascular Function ◽  
Action Plan ◽  
Well Being ◽  
Academic Program ◽  
Atherogenic Dyslipidemia ◽  
The Metabolic Syndrome ◽  
Cardiovascular Morbidity And Mortality

Introduction: The Metabolic Syndrome (MetS) is highly prevalent, afflicting a third of U.S. adults, and confers higher cardiovascular morbidity and mortality. Features of MetS include abdominal obesity, elevated blood pressure, dysglycemia and atherogenic dyslipidemia. While lifestyle modifications are the first-line of MetS treatment, sustained adherence is achieved by a minority of patients. We investigated the effects of a Health Partner (HP) intervention on MetS. Methods and Results: A total of 119 university employees with MetS (51±9 years, 59% women, 26% African Americans) were enrolled in an academic program that promotes clinical self-knowledge and healthier lifestyles at the Center for Health Discovery and Well Being at Emory University in Atlanta, GA. Baseline anthropometric, laboratory and vascular function measurements were used by the HP to generate an action plan with detailed strategies to improve dietary and exercise habits, and subjects returned for follow up at 6 months and annually thereafter for 2 years. Repeated measures ANOVA showed statistically significant changes in waist circumference (p=0.007; baseline vs. 2 years: 103.1 vs. 98.2 cm), weight (p=0.004; 216.1±35 vs. 204.9±37 lbs), body fat percent (p=0.042; 39.6±7.4 vs. 38.1±7.9), fasting insulin levels (p=0.034; 11.4±8.3 vs. 7.9±9.9 μIU/ml), low density lipoprotein (p=0.005; 114.7±31.2 vs. 104.9±28.9 mg/dl), as well as a reduction in carotid-femoral pulse wave velocity (p=0.016; 7.4±2.2 vs. 6.7±1.1 m/s), systolic (p=0.001; 131.6±17.5 vs. 125.7±14.2 mmHg) and diastolic blood pressure (p=006; 84.7±11.1 vs. 80.1±10). There were no significant changes in glucose, triglyceride levels or brachial-artery flow mediated dilation. Conclusion: A personalized, goal directed HP intervention improves abnormalities associated with MetS, including body habitus, lipid and insulin secretion abnormalities, and resulted in significant blood pressure improvements that accompanied decreased central arterial stiffness. These improvements were sustained after two years of follow-up. Whether HP intervention improves long-term outcomes and whether it is cost-effective needs further investigation.

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.

Patients with Recurrent Renal Stones Have a Physico-Chemically Altered Urinary Tamm-Horsfall Glycoprotein Profile

1996 ◽  
Vol 33 (6) ◽  
pp. 540-544 ◽  
Author(s):  
A Jefferson ◽  
T M Reynolds ◽  
A Elves ◽  
A S Wierzbicki
Keyword(s):  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Band Pattern ◽  
Urine Samples ◽  
Laboratory Staff ◽  
Calcium Stone ◽  
Stone Formers ◽  
Fresh Urine

We describe an immunoblotting method for examining the electrophoretic properties of urinary Tamm-Horsfall protein. Using this method we tested frozen urine samples from a group of 37 thoroughly investigated recurrent idiopathic renal calcium stone formers and compared this with fresh urine from 19 non-stone forming laboratory staff. We found that there was a statistically significant different pattern of Tamm-Horsfall protein bands in the two sets of urines, with stone formers tending to have two bands and non-stone formers tending to have three bands. This could have been due to storage artefact and therefore a further group of 13 fresh urines from unselected renal stone formers was tested. A smaller proportion of these cases showed the two-band pattern, possibly because not all of this group were idiopathic calcium stone formers. This suggests that but does not prove that there is no significant storage artefact and that there may be an in vivo effect causing stone formation.

scholarly journals Heavy Encrustation and Stone Formation on Forgotten Double “J” Ureteral Stent: A Case Repot

2020 ◽  
pp. 1-3
Author(s):  
Muhammad Rafique ◽  
Shoaib Rafique ◽  
Muhammad Rafique
Keyword(s):  
Stone Formation ◽  
Renal Stones ◽  
Postoperative Recovery ◽  
Ureteral Stent ◽  
Patient Counseling ◽  
Related Factors ◽  
Ureteric Stent ◽  
History Of ◽  
Complete Blood Counts

Background: Placement of double “J” ureteral stent for various indications is common in urological surgery. The encrustation and stone formation on forgotten DJ stents can result in significant morbidity and its management remains a challenging task. Case Presentation: A 51 years male presented with history of right flank pain of over 6 months duration. He had undergone right pyelolithotomy for right renal stones 4 years ago at some other hospital. There was no medical record available and the patient did not present himself to the surgeon for follow-up. Clinical examination was unremarkable. His complete blood counts, random blood sugar, renal function tests were normal. Urinalysis revealed many pus cells/hpf. At ultrasonography, there were two renal stone with moderate hydronephrosis and a 2 cm vesical stone. An x-ray KUB, revealed a forgotten ureteric stent with stones at its both ends. The patient underwent cystoscopy and a large stone on ureteric stent was dealt with by litholapaxy. The stone on the proximal end of was managed by percutaneous lithotripsy and stent was removed. The postoperative recovery was uneventful. On stone analysis, it was made of calcium oxalate 30% and ammonium urate 70%. Conclusion: The management of encrusted stents is challenging, and each case has to be dealt with individually depending on stone site and burden, and patient related factors. Endourological management is the preferred option. Adequate patient counseling and proper stent documentation (stent placement, proposed duration and removal of stent) is necessary to minimize stent related complications.

scholarly journals Urinary phosphorus rather than urinary calcium possibly increases renal stone formation in a sample of Asian Indian, male stone-formers

2007 ◽  
Vol 98 (6) ◽  
pp. 1224-1228 ◽  
Author(s):  
Shoma Berkemeyer ◽  
Anupam Bhargava ◽  
Usha Bhargava
Keyword(s):  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Urinary Calcium ◽  
Healthy Controls ◽  
Dietary Intakes ◽  
Stone Formers ◽  
Dietary Record ◽  
Biochemical Analyses ◽  
Serum And Urine

The contribution of dietary Ca and P in renal stone formation is debated. Thus, the main objective was to investigate if there were any differences in the dietary, serum and urine values of Ca and P in stone formers (SF) compared with healthy controls (HC). The secondary aim was to analyse if dietary, serum and urine Ca and P correlated. The study enrolled ten patients with renal stones admitted for stone removal and ten healthy controls. Their dietary macronutrients, Ca and P intakes were calculated from 2-d dietary records. On the second day of dietary record 24-h urine was collected and on the third day morning a 5 ml blood sample was collected. Biochemical analyses were conducted for serum and urine Ca, P and uric acid with qualitative renal stone analysis. All the dietary intakes and urine P were significantly higher (P < 0·05) in SF than in HC. Correlation results showed that in SF dietary Ca correlated to serum and urine Ca. No such correlations were seen for P. Additionally, in SF urine Ca correlated to dietary proteins and fats but not to carbohydrates. None of the biochemical values lay outside the normal range of values. The study suggests urine P rather than urine Ca to be probably at work in the formation of renal stones. Limitation of protein intake with normal Ca intakes could provide a suitable measure to avoid renal stone formation.

The Role of Inhibitors and other Factors in the Pathogenesis of Recurrent Calcium-Containing Renal Stones

1977 ◽  
Vol 53 (2) ◽  
pp. 141-148 ◽  
Author(s):  
J. M. Baumann ◽  
S. Bisaz ◽  
R. Felix ◽  
H. Fleisch ◽  
U. Ganz ◽  
...  
Keyword(s):  
Inhibitory Activity ◽  
Stone Formation ◽  
Renal Stones ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Crystal Formation ◽  
Inorganic Pyrophosphate ◽  
Control Subjects ◽  
Stone Formers

1. In order to assess the relative importance of possible pathogenetic factors in the formation of calcium-containing renal stones, a group of 18 patients (12 men, six women) with active, recurrent stone disease were compared with 16 age-matched control subjects (10 men, six women) given an identical diet. 2. Fifteen (83%) of the patients showed at least one, eight (44%) showed two, and one (6%) patient showed three abnormalities that might predispose to stone formation. 3. Increased urinary calcium excretion was the most common abnormality (11 patients, 61%), particularly in the women (83%). 4. A diminished excretion of inhibitors of crystal formation of calcium phosphate was the next most common abnormality, which occurred in eight patients (44%), all of whom were men. It was largely attributable to a diminished excretion of inorganic pyrophosphate (PPi). The PPi/orthophosphate ratios were also lower in the stone-formers. Significant differences in residual inhibitory activity after enzymatic removal of PPi between control subjects and stone-formers could not be found in 24 h urine samples but were present during certain times of the day. Pyrophosphate showed a higher inhibitory activity in urine than in control solutions, this enhancement being absent in stone-formers. 5. Nine (50%) of the patients, but only one of the control subjects, produced crystal aggregates greater than 50 μm in diameter after an oral load of oxalate.

Calcium Oxalate Crystalluria and Urine Saturation in Recurrent Renal Stone-Formers

1971 ◽  
Vol 40 (5) ◽  
pp. 365-374 ◽  
Author(s):  
W. G. Robertson ◽  
M. Peacock ◽  
B. E. C. Nordin
Keyword(s):  
Calcium Oxalate ◽  
Stone Formation ◽  
Basal Diet ◽  
Renal Stones ◽  
Degree Of Saturation ◽  
Sodium Oxalate ◽  
Spontaneous Crystallization ◽  
Control Series ◽  
Control Subjects ◽  
Stone Formers

1. The degree of saturation with calcium oxalate has been determined in fresh urine samples from six patients with recurrent calcium oxalate-containing renal stones and six normal control subjects who were studied under the same conditions of diet and fluid intake. 2. The degree of saturation of urine with calcium oxalate was significantly higher in the group of stone-formers than in the control series and more often exceeded the amount needed for spontaneous crystallization of calcium oxalate (formation product). This was accounted for by the higher concentration of calcium and oxalate in the urine of the stone-formers. 3. Crystals of calcium oxalate were observed in all freshly examined urines in which the formation product of calcium oxalate was exceeded. Since the formation product of calcium oxalate was exceeded more often in the urines of stone-formers than in the urines of the control subjects, this accounted for the greater calcium oxalate crystalluria of the stone-formers. 4. Addition of a small quantity of sodium oxalate to the basal diets of the two groups resulted in a greater increase in the urine saturation and calcium oxalate crystalluria of the stone-formers, thus accentuating the difference observed between the two groups when they were given the basal diet. 5. Calcium oxalate crystalluria was related quantitatively to the degree of over-saturation of urine with calcium oxalate, although uric acid solubility may play a small role at low pH values. 6. The results are consistent with a ‘hyperexcretion—crystallization’ mechanism of stone formation.

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