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Annamalai G, Poornachandran K, Arumugam N, Poornachandran P, Arumugam V, Venkateswaran ST. Effects of Laghoo Shankaprakshalana (yogic colon cleansing) on anthropometric measurements in obese individuals. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 0:jcim-2024-0048. [PMID: 38708964 DOI: 10.1515/jcim-2024-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Obesity is considered as one of the major public health burden and it is predictor of cardiovascular risk factor. Yoga is a mind-body medicine helps to promote health. This study was aimed to explore whether Laghoo Shankaprashalana (LS) reduce the body weight in obese individuals. METHODS This was a single group pre-post study. A total of 40 subjects (9 Male, 31 Female) aged between 18 and 40 years were recruited. This study was conducted in government yoga and naturopathy medical college, Chennai. Subjects were practiced weekly once LS for eight weeks (eight sessions). Subjects were assessed pre and post on body weight, body mass index, waist circumference, hip circumference, waist hip ratio, pulse rate and blood pressure. Variables were analyzed using Paired sample t test except waist hip ratio, which were analyzed using Wilcoxon's signed ranks test. RESULTS There was significant reduction in the body weight (p<0.001, 5.81 %), Body Mass Index (p<0.001, 5.88 %), Waist Circumference (p<0.001, 7.20 %), Hip Circumference (p<0.001, 5.04 %), and Waist Hip Circumference (p<0.001, 3.19 %) after LS. However, there was no statistical significance difference in pulse rate, blood pressure. CONCLUSIONS Eight sessions of Laghoo Shankaprakshalana helps to reduces body weight, body mass index, waist circumference, hip circumference and waist hip ratio. Reduction in the waist circumference might helps to reduce the cardiovascular risk. LS may be one of the cost effective intervention that can be incorporated in the weight loss regimen.
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Affiliation(s)
- Gayathri Annamalai
- Department of Yoga, International Institute of Yoga and Naturopathy Medical Sciences, Chengalpattu, India
| | - Kumaresan Poornachandran
- Department of Yoga, 80305 Government Yoga and Naturopathy Medical College and Hospital , Chennai, India
| | - Naveena Arumugam
- Department of Yoga and Naturopathy, Southern Railway Headquarters Hospital, Chennai, India
| | - Prabu Poornachandran
- Department of Yoga, 80305 Government Yoga and Naturopathy Medical College and Hospital , Chennai, India
| | - Velan Arumugam
- Department of Yoga, International Institute of Yoga and Naturopathy Medical Sciences, Chengalpattu, India
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Karkin K, Aydamirov M, Aksay B, Kaplan E, Gürlen G. Which Method Is More Effective for the Treatment of 1-2 cm Renal Pelvis Stones in Obese Patients: Extracorporeal Shock Wave Therapy or Flexible Ureterorenoscopy? Cureus 2024; 16:e54194. [PMID: 38496118 PMCID: PMC10942129 DOI: 10.7759/cureus.54194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE This study aimed to compare the clinical outcomes and complications of obese patients who underwent extracorporeal shock wave lithotripsy (ESWL) and flexible ureterorenoscopy (FURS) for treating 1-2 cm renal pelvic stones. METHODS This study included 89 patients with a body mass index (BMI) >30 who underwent ESWL and FURS surgeries for 10-20 mm renal pelvic stones between January 2015 and July 2023. Three months after the treatments, patients underwent full abdominal computed tomography (CT) and were examined for stone-free status and the presence of residual stones. The presence of ≥4 mm residual stones on imaging was considered a failure, and these patients were treated again. Demographic data, stone characteristics, stone-free rate (SFR) three months after the procedure, surgery/procedure time, and complications such as bleeding, urosepsis, and collecting system perforation were compared between the groups. RESULTS The patients included in the study were divided into two groups: ESWL (n=46) and FURS (n=43). Demographic and clinical data were similar between the groups. Retreatment rates were higher in the ESWL group compared to the FURS group. The mean procedure time was similar between the groups (p=0.085). The three-month SFR was found to be higher in the FURS group (88.3% vs. 73.9%; p=0.043). There was no difference in complication rates between groups. CONCLUSION FURS is a more effective treatment method than ESWL in obese patients with stones 1-2 cm in size located in the renal pelvis.
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Affiliation(s)
- Kadir Karkin
- Department of Urology, Health Sciences University, Adana City Training And Research Hospital Urology Clinic, Adana, TUR
| | - Mubariz Aydamirov
- Department of Urology, Başkent University, Alanya Application and Research Center, Antalya, TUR
| | - Buğra Aksay
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana, TUR
| | - Eyüp Kaplan
- Department of Urology, Abdulkadir Yüksel State Hospital Urology Clinic, Gaziantep, TUR
| | - Güçlü Gürlen
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana, TUR
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Scurt FG, Ganz MJ, Herzog C, Bose K, Mertens PR, Chatzikyrkou C. Association of metabolic syndrome and chronic kidney disease. Obes Rev 2024; 25:e13649. [PMID: 37783465 DOI: 10.1111/obr.13649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/15/2023] [Indexed: 10/04/2023]
Abstract
The prevalence of kidney disease is increasing rapidly worldwide, reflecting rising rates of obesity, diabetes, and associated metabolic syndrome (MetS). Chronic kidney disease and related comorbidities such as obesity, diabetes, and hypertension place a significant financial burden on healthcare systems. Despite the widespread use of RAAS inhibitors, intensive blood pressure and glycemic control, and newer therapeutic options consisting of sodium/glucose cotransporter-2 (SGLT-2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists, a significant risk of progression to end-stage renal disease remains in the high-risk obese and diabetic population. The MetS is a cluster of cardiovascular risk factors that adversely affect the development and progression of chronic kidney failure. According to the criteria of the World Health Organization, it is defined by visceral adiposity, impaired glucose tolerance or insulin resistance, atherogenic dyslipidemia, raised blood pressure, and microalbuminuria with a albumin-to-creatinine ratio ≥30 mg/g. At molecular level MetS is marked by a proinflammatory state and increased oxidative stress leading to various pathophysiological changes causing endothelial dysfunction and a hypercoagulable state. Because the kidney is a highly vascularized organ, it is especially susceptible for those microvascular changes. Therefore, the MetS and its individual components are associated with the premature development, acceleration, and progression of chronic kidney disease. Therefore, it is becoming increasingly important to elucidate the underlying mechanisms of MetS-associated chronic kidney disease in order to develop new strategies for preventing and slowing the progression of renal disease. In this review, we will elucidate (i) the renal structural, hemodynamic, and metabolic changes that occur in obesity and obesity-related kidney injury; (ii) the clinicopathological characteristics of obesity-related kidney injury, primarily focusing on obesity-associated glomerulopathy; (iii) the potential additional factors or predisposing factors that may turn patients more susceptible to renal structural or functional compensatory failure and subsequent injury.
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Affiliation(s)
- Florian G Scurt
- University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany
| | - Maximilian J Ganz
- University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany
| | - Carolin Herzog
- University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany
| | - Katrin Bose
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Peter R Mertens
- University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, Medical Faculty, Otto-von Guericke University Magdeburg, Magdeburg, Germany
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Liang D, Liu C, Yang M. The association of visceral adiposity index with the risk of kidney stone and kidney stone recurrence. BMC Nephrol 2023; 24:368. [PMID: 38087224 PMCID: PMC10717979 DOI: 10.1186/s12882-023-03421-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
AIM Our aim in this study was primarily to assess the relationship between visceral adiposity index (VAI) and the risk of kidney stones and kidney stone recurrence in US adults. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 for our analysis. VAI was calculated from waist circumference (WC), body mass index (BMI), triglycerides (TG), and high-density lipoprotein-cholesterol (HDL-C). Kidney stones and recurrence of kidney stones were obtained from questionnaire interview data. We used multivariate logistic regression analysis to explore the correlation between VAI and the risk of kidney stone and kidney stone recurrence. In addition, we performed subgroup analysis, interaction tests, and restricted cubic spline (RCS) analysis. RESULTS A total of 9886 participants were included in this study, with a prevalence of 9.24% for kidney stones and 2.97% for recurrence of kidney stones. The prevalence of kidney stones and kidney stone recurrence increased with higher quartiles of VAI. We observed a significantly positive correlation between VAI and the risk of kidney stone and kidney stone recurrence. Participants with the highest VAI quartiles had a 48% (OR: 1.48, 95%CI: 1.08-2.02) and 52% (OR: 1.52, 95%CI: 0.86-2.71) increased risk of kidney stones and kidney stone recurrence, respectively, compared to participants with the lowest VAI quartiles. Subgroup analysis and interaction tests demonstrated this positive association independent of different subgroup factors. CONCLUSION Visceral fat accumulation may be associated with an increased risk of kidney stones and kidney stone recurrence.
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Affiliation(s)
- Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China
- The West China College of Medicine, Sichuan University, Chengdu, China
| | - Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Mei Yang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China.
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Dargahi A, Rahimpouran S, Rad HM, Eghlimi E, Zandian H, Hosseinkhani A, Vosoughi M, Valizadeh F, Hossinzadeh R. Investigation of the link between the type and concentrations of heavy metals and other elements in blood and urinary stones and their association to the environmental factors and dietary pattern. J Trace Elem Med Biol 2023; 80:127270. [PMID: 37506467 DOI: 10.1016/j.jtemb.2023.127270] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/04/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Kidney and urinary tract stones are among the most common and important health problems, the prevalence of which is increasing nowadays due to a sedentary lifestyle, improper nutrition, destructive habits in fluid consumption, and improper use of medications. One of the causing factors in the formation of urinary stones is heavy metals. These metals present in tiny amounts in the environment and enter the nature and food cycle due to industrial activities and practices that are not compliant with environmental laws. METHODS In this context, the present case-control study was conducted to determine the concentrations of heavy metals and other urinary stone-forming elements in both blood and urinary stones and investigate their relationship with environmental factors and dietary patterns in people with urinary stones in Ardabil city in 2022. The sampling of blood and urinary stones was done randomly from patients with urinary stones who were admitted to the Urology Clinic of Imam Reza Hospital, Ardabil. ICP-MS was used to measure the concentrations of heavy metals in the samples. The obtained data were analysed by chi-square test, ANOVA test, t-test, and Tukey test. RESULTS The body mass index (BMI) was 27.39 ± 3.72 in the case group and 26.37 ± 2.95 in the control group. The copper and selenium concentrations in blood and urinary stones were higher than in other metals. There was a significant relationship between the history of kidney stones and the probability of developing kidney stones. Moreover, a meaningful relationship was found between the concentration of lead element and the formation of kidney stones. The results showed a significant difference in the concentration of nickel and copper in people who consumed vegetables on a daily basis with those with different types of kidney stones. CONCLUSION The comparison amongst the concentration of heavy metals in various kinds of urinary stones showed that the amount of lead metal was higher in calcium phosphate stones than in calcium oxalate stones.
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Affiliation(s)
- Abdollah Dargahi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran; Department of Environmental Health Engineering, Khalkhal University of Medical Sciences, Khalkhal, Iran.
| | - Shima Rahimpouran
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Mohseni Rad
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elika Eghlimi
- Student of Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran; Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK.
| | - Ali Hosseinkhani
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Vosoughi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farzin Valizadeh
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Rahman Hossinzadeh
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Huang H, Chen S, Zhang W, Wang T, Bai P, Xing J, Wang H, Chen B. High perirenal fat thickness predicts a greater risk of recurrence in Chinese patients with unilateral nephrolithiasis. Ren Fail 2023; 45:2158870. [PMID: 36637005 PMCID: PMC9848376 DOI: 10.1080/0886022x.2022.2158870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the association between recurrence-free survival (RFS) and perirenal fat thickness (PFT) in a cohort of Chinese population with unilateral nephrolithiasis. METHODS We retrospectively reviewed the medical records of 81 patients with unilateral nephrolithiasis in our center from January 2019 to June 2019. PFT measured on computed tomography (CT) scans was evaluated. Kaplan-Meier curves and log-rank tests were used to assess significant differences in RSF between high-PFT and low-PFT groups within sexes. Univariable and multivariable Cox regression analyses were used to evaluate the potential risk factors for renal stone recurrence. RESULTS High PFT was significantly associated with high BMI and hyperlipidemia (p = .003 and.047, respectively). The PFT of stone-bearing kidney was significantly greater than PFT of non-stone-bearing kidney (0.77 ± 0.60 cm vs. 0.67 ± 0.58 cm, p = .002) . During the follow-up periods (median 31 months), 21 (25.9%) patients experienced ipsilateral renal stone recurrence. In addition, Kaplan-Meier survival curves showed that patients with low PFT had a significant better RFS than those with high PFT (p = .012). In the univariable Cox analyses, male sex and high PFT were significantly associated with a poor RFS (p = .042 and .018, respectively). Moreover, both male sex and high PFT retained significance in the multivariable analyses (p = .045 and .020, respectively). CONCLUSIONS Our findings suggested that PFT is a noninvasive and feasible parameter, which may help in the risk stratification of renal stone recurrence in the follow-up periods.
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Affiliation(s)
- Haichao Huang
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Shi Chen
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Wenzhao Zhang
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Tao Wang
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Peide Bai
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jinchun Xing
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Huiqiang Wang
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,CONTACT Huiqiang Wang
| | - Bin Chen
- Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,The Third Clinical Medical College, Fujian Medical University, Fuzhou, China,Bin Chen Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
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Wei C, He J, Wei Z, Huang Y, Xiong M, Deng C, Chen Z, Li W, Zhang X. Association between N, N-diethyl-m-toluamide exposure and the odds of kidney stones in US adults: a population-based study. Front Public Health 2023; 11:1248674. [PMID: 38074723 PMCID: PMC10704602 DOI: 10.3389/fpubh.2023.1248674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Currently, there is limited research on the specific relationship between N, N-diethyl-m-toluamide (DEET) exposure and the odds of kidney stones. We aimed to investigate the relationship between DEET exposure and the prevalence of kidney stones. Methods We included 7,567 qualified participants in our research from the 2007-2016 NHANES survey. We carried out three logistic regression models to explore the potential association between DEET exposure and the odds of kidney stones. Spline smoothing with generalized additive models (GAM) was utilized to assess the non-linear relationship and restricted cubic spline (RCS) curves was to determine the dose-response association. Multivariate regression models were used to conduct stratified analysis and sensitivity analysis. Results Baseline characteristics of study participants presented the distribution of covariables. Regression analysis revealed that the odds of kidney stones were positively associated with the main metabolites of 3-diethyl-carbamoyl benzoic acid (DCBA) (log2) (OR = 1.05, 95% CI 1.02 to 1.08). The fourth quartile of urine DCBA showed a greater risk of kidney stones in the fully adjusted model (OR = 1.36, 95% CI 1.08 to 1.72). Another DEET metabolite of N, N-diethyl-3-hydroxymethylbenzamide (DHMB) was used to confirm the accuracy and stability of the results. The spline smoothing curve represented two main DEET metabolites had similar no-linear relationships and a positive trend with kidney stones proportion. RCS implied that the incidence of kidney stones rose with increasing levels of DEET exposure. High-risk groups on kidney stones were exhibited by stratified analysis under DEET exposure. Conclusion Our study suggests that DEET exposure is positively associated with odds of kidney stones. Further investigation into the underlying processes of this association is required to guide the prevention and treatment of kidney stones.
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Affiliation(s)
- Chengcheng Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiatai He
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Wei
- Department of Urology, The Central Hospital of Xiaogan, Xiaogan, China
| | - Yu Huang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Xiong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changqi Deng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaohui Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wencheng Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhang H, Huang Y, Zhang J, Su H, Ge C. Causal effects of inflammatory bowel diseases on the risk of kidney stone disease: a two-sample bidirectional mendelian randomization. BMC Urol 2023; 23:162. [PMID: 37828486 PMCID: PMC10571288 DOI: 10.1186/s12894-023-01332-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Existing epidemiological observational studies have suggested interesting but inconsistent clinical correlations between inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), and kidney stone disease (KSD). Herein, we implemented a two-sample bidirectional Mendelian randomization (MR) to investigate the causal relationship between IBD and KSD. METHODS Data on IBD and KSD were obtained from Genome-Wide Association Studies (GWAS) summary statistics and the FinnGen consortium, respectively. Strict selection steps were used to screen for eligible instrumental SNPs. We applied inverse variance weighting (IVW) with the fix-effects model as the major method. Several sensitivity analyses were used to evaluate pleiotropy and heterogeneity. Causal relationships between IBD and KSD were explored in two opposite directions. Furthermore, we carried out multivariable MR (MVMR) to obtain the direct causal effects of IBD on KSD. RESULTS Our results demonstrated that CD could increase the risk of KSD (IVW: OR = 1.06, 95% CI = 1.03-1.10, p < 0.001). Similar results were found in the validation group (IVW: OR = 1.05, 95% CI = 1.01-1.08, p = 0.013) and in the MVMR analysis. Meanwhile, no evidence of a causal association between UC and KSD was identified. The reverse MR analysis detected no causal association. CONCLUSIONS This MR study verified that CD plays a critical role in developing kidney stones and that the effect of UC on KSD needs to be further explored.
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Affiliation(s)
- Huayang Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yong Huang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Junyong Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Huiyi Su
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Chengguo Ge
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
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Perez D, Neeman BB, Dotan D, Raisin G, Chertin B, Kafka I. Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study. Urolithiasis 2023; 51:111. [PMID: 37688633 DOI: 10.1007/s00240-023-01485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/22/2023] [Indexed: 09/11/2023]
Abstract
Percutaneous nephrolithotomy (PCNL) is considered gold standard treatment of renal stones larger than 20 mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than fluoroscopy. A higher body mass index (BMI) can make ultrasound-guided renal access more difficult and unsuccessful. We present a prospective analysis and comparison of ultrasound-guided PCNL in patients with normal and increased body mass index. We performed a prospective comparison of patients who underwent ultrasound-guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87-obese) were compared to those with BMIs less than 30 (mean 25.69-non-obese). Demographic, perioperative, and follow-up data were collected, analyzed, and included in this study. Total of 98 consecutive patients, with 49 patients in each group were analyzed. No statistically significant differences were observed in terms of stone volume (P = 0.085), stone density (P = 0.5590), location of renal access (P = 0.108), surgery duration (P = 0.38), blood loss (P = 0.54), or laboratory changes after surgery (P = 0.60). 87.76% of obese patients were stone free per CT scan at follow-up, compared to 73.47% of normal-weight patients (P = 0.1238). According to Clavien-Dindo classification, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to six patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications. There was no significant correlation between body mass index and the success or safety of ultrasound-guided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone-free status postoperatively and can diminish or avoid both patient's and medical team's exposure to ionizing radiation.
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Affiliation(s)
- Dolev Perez
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel.
| | - Binyamin B Neeman
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel
| | - David Dotan
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel
| | - Galiya Raisin
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel
| | - Boris Chertin
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel
| | - Ilan Kafka
- Department of Urology, Shaare Zedek Medical Center, P.O.B 3235, 91031, Jerusalem, Israel
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Shee K, Chan C, Yang H, Sui W, Bowman M, Hamouche F, Charondo LB, Ho S, Chi T, Stoller ML. Voided volume may not impact stone outcomes: Review of a large institutional nephrolithiasis cohort. BJUI COMPASS 2023; 4:556-561. [PMID: 37636214 PMCID: PMC10447213 DOI: 10.1002/bco2.216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/06/2022] [Accepted: 12/19/2022] [Indexed: 08/29/2023] Open
Abstract
Background Urologic guidelines universally recommend increasing fluid intake for kidney stone prevention. Increased voided volume is thought to help reduce stone recurrence and severity, but supporting evidence is limited. Patients and Methods Nephrolithiasis outcomes and 24-h urine data for patients from the Registry for Stones of the Kidney and Ureter (ReSKU), a registry of nephrolithiasis patients collected between 2015 and 2020, were retrospectively analysed. Outcome was stone events, either an office visit where a patient reports symptomatic passage of stones or surgery for stone removal. Results We identified 450 stone patients with 24-h urine and kidney stone outcome data. There was no significant difference in 24-h voided volume between patients with one stone event and patients with two or more stone events. On multivariable logistic regression, after controlling for age, gender, BMI, and 24-h sodium and creatinine per kilogram, no significant associations were found between voided volume and stone events. There was a statistically significant negative correlation noted between voided volume and stone events in calcium oxalate dihydrate stone formers (Spearman R = -0.42, p = 0.04), but not others. Conclusions Twenty-four-hour voided volume was not associated with stone events in a large institutional cohort, and subset analysis reveals that some stone formers may benefit more from increased voided volume than others; identifying such patients represents a novel precision medicine opportunity.
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Affiliation(s)
- Kevin Shee
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | - Carter Chan
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | - Heiko Yang
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | - Wilson Sui
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | - Max Bowman
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | | | | | - Sunita Ho
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
| | - Thomas Chi
- Department of UrologyUCSFSan FranciscoCaliforniaUSA
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Bayne D, Maru J, Srirangapatanam S, Hicks C, Neuhaus J, Scales C, Chi T, Stoller M. Effects of Delayed Surgical Intervention Following Emergency Department Presentation on Stone Surgery Complexity. J Endourol 2023; 37:729-737. [PMID: 37158820 PMCID: PMC10280210 DOI: 10.1089/end.2022.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Introduction and Objective: Prior literature had demonstrated increased stone burden and higher rates of staged surgery in individuals of lower socioeconomic status (SES). Low SES individuals are more likely to experience delays in definitive stone surgery after initial presentation to the emergency department (ED) for kidney stones. This study aims to investigate the relationship between delays in definitive kidney stone surgery and the subsequent need for percutaneous nephrolithotomy (PNL) and/or staged surgical procedures using a statewide data set. Methods: This retrospective cohort study gathered longitudinal data from 2009 to 2018 using the California Department of Health Care Access and Information data set. Patient demographic characteristics, comorbidities, diagnosis/procedure codes, and distance were analyzed. Complex stone surgery was defined as initial PNL and/or undergoing more than one procedure within 365 days of initial intervention. Results: A total of 1,816,093 billing encounters from 947,798 patients were screened, resulting in 44,835 patients with ED visits for kidney stones followed by a urologic stone procedure. Multivariable analysis revealed that relative to patients who underwent surgery within 1 month of initial ED visit for stone disease, patients were at increased odds of undergoing complex surgery if waiting ≥6 months (odds ratio [OR] 1.18, p = 0.022), ≥1 year (OR 1.29, p < 0.001), and ≥3 years (OR 1.43, p < 0.001). Conclusions: Delays in definitive stone surgery after initial ED encounter for stone disease were associated with increased likelihood of undergoing a complex stone treatment.
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Affiliation(s)
- David Bayne
- Department of Urology, University of California San Francisco, San Francisco, California, USA
| | - Johsias Maru
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Cameron Hicks
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - John Neuhaus
- Division of Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Charles Scales
- Department of Urology, Duke University, Durham, North Carolina, USA
| | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, California, USA
| | - Marshall Stoller
- Department of Urology, University of California San Francisco, San Francisco, California, USA
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12
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Xi Y, Liu X, Wang S, Wang W, Guo Q, Wang J. Causal association of genetically predicted urinary sodium-potassium ratio and upper urinary calculi. Urolithiasis 2023; 51:63. [PMID: 37014457 DOI: 10.1007/s00240-023-01438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/25/2023] [Indexed: 04/05/2023]
Abstract
The causality between the urinary sodium-potassium ratio and upper urinary calculi has not been clarified and easily affected by confounders. We performed two-sample and multivariable Mendelian randomization (MR) analysis to evaluate the potential causal role of the urinary sodium-potassium ratio in upper urinary calculi. Data of the urinary sodium-potassium ratio (N = 326,938), upper urinary calculi (N = 337,199), and confounding factors including BMI (N = 336,107), ever-smoke (N = 461,066), hypertension (N = 218,754), diabetes (N = 218,792), and alcohol intake frequency (N = 462,346) were obtained from the IEU OpenGWAS Project database. The inverse-variance weighted (IVW), weighted median, and MR-Egger methods were used to estimate MR effects. The MR-Egger intercept test, Cochran's Q test, MR-PRESSO, leave-one-out method, and funnel plot were used for sensitivity analysis. A causal relationship was found between the urinary sodium-potassium ratio and upper urinary calculi (OR = 1.008, 95% CI = 1.002-1.013, P = 0.011). FinnGen data supported this conclusion (OR = 2.864, 95% CI = 1.235-6.641, P = 0.014). The multivariable Mendelian randomization analysis result showed that after adjusting for the effects of five confounders, the urinary sodium-potassium ratio was still positively correlated with upper urinary calculi (OR = 1.005, 95% CI = 1.001-1.009, P = 0.012). This study demonstrated a positive causal association between the urinary sodium-potassium ratio and upper urinary calculi using MR analysis. Timely identification of changes in urine composition and dietary regulation of sodium and potassium intake could greatly reduce the incidence of future urinary calculi.
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Affiliation(s)
- Yujia Xi
- Department of Urology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China
| | - Xuchang Liu
- Department of Urology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shuang Wang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Wei Wang
- Department of Urology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China
| | - Qiang Guo
- Department of Urology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China
| | - Jingqi Wang
- Department of Urology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China.
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Tallman JE, Stone BV, Sui W, Miller NL, Hsi RS. Association between obstructive sleep apnea and 24-h urine chemistry risk factors for urinary stone disease. Urolithiasis 2023; 51:46. [PMID: 36881138 DOI: 10.1007/s00240-023-01421-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
The effect of obstructive sleep apnea (OSA) on 24-h urine parameters and resultant kidney stone risk is unknown. We sought to compare urinary lithogenic risk factors among patients with kidney stone disease with and without OSA. We performed a retrospective cohort study of adult patients with nephrolithiasis undergoing both polysomnography and 24-h urine analysis. Measures of acid load including gastrointestinal alkali absorption, urinary titratable acid, and net acid excretion were calculated from 24-h urine. We performed univariable comparisons of 24-h urine parameters between those with and without OSA and fit a multivariable linear regression model adjusting for age, sex, and BMI. Overall, there were 127 patients who underwent both polysomnography and a 24-h urine analysis from 2006 to 2018. There were 109 (86%) patients with OSA and 18 (14%) without. Patients with OSA were more commonly male, had greater BMI and had higher rates of hypertension. Patients with OSA had significantly higher levels of 24-h urinary oxalate, uric acid, sodium, potassium, phosphorous, chloride, and sulfate; higher supersaturation of uric acid; higher titratable acid, and net acid excretion; and lower urinary pH and supersaturation of calcium phosphate (p < 0.05). The difference in urinary pH and titratable acid, but not net acid excretion, remained significant when adjusting for BMI, age, and gender (both p = 0.02). OSA is associated with changes in urinary analytes that promote kidney stone formation, similar to those observed with obesity. After accounting for BMI, OSA is independently associated with lower urine pH and increased urinary titratable acid.
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Affiliation(s)
- Jacob E Tallman
- Vanderbilt University Medical Center, 1301 Medical Center Dr Suite 3823, Nashville, TN, 37232, USA.
| | - Benjamin V Stone
- Vanderbilt University Medical Center, 1301 Medical Center Dr Suite 3823, Nashville, TN, 37232, USA
| | - Wilson Sui
- Vanderbilt University Medical Center, 1301 Medical Center Dr Suite 3823, Nashville, TN, 37232, USA
| | - Nicole L Miller
- Vanderbilt University Medical Center, 1301 Medical Center Dr Suite 3823, Nashville, TN, 37232, USA
| | - Ryan S Hsi
- Vanderbilt University Medical Center, 1301 Medical Center Dr Suite 3823, Nashville, TN, 37232, USA
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Singh S, Gupta S, Mishra T, Banerjee BD, Sharma T. Risk Factors of Incident Kidney Stones in Indian Adults: A Hospital-Based Cross-Sectional Study. Cureus 2023; 15:e35558. [PMID: 37007314 PMCID: PMC10060047 DOI: 10.7759/cureus.35558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
Background The diverse manifestations of urolithiasis provide very interesting epidemiological data. This has prompted various studies to look into the etiopathogenesis of renal stones, which is believed to be multifactorial, both exogenous and endogenous. VDR Fok1 is a risk factor for renal stone formation and could cause the formation of renal stones through the mechanism of crystal induction and crystallization in the urine. While a few recent studies have shown the role of heavy metals like cadmium and lead in the formation of renal stones, the current knowledge is still insufficient. Methods This case-control prospective study was conducted in Guru Teg Bahadur (GTB) Hospital, a tertiary care facility in Delhi with 30 cases and 30 controls. Patients visiting the department of surgery between November 2011 and April 2013 were enrolled in the study. Cases were defined as patients with renal stones diagnosed on the basis of history and radiological investigations. Controls were selected from the patients admitted to the department of surgery for reasons other than renal stones. The study protocol was approved by the Institutional Ethical Committee of the University College of Medical Sciences, GTB Hospital, Delhi. Written informed consent was obtained from all patients. A structured questionnaire was used to collect data. Metal levels were analyzed by an atomic absorption spectrophotometer (Shimadzu Flame AA-680, Shimadzu Corp., Kyoto, Japan) at Delhi University. The vitamin D receptor gene was measured using genomic DNA. Horizontal agarose gel electrophoresis was used for the quantification of the genomic DNA. Results There were 30 cases and 30 controls in the study. Stress was more prevalent among cases (63%) compared to controls (36%). Nearly 83% of cases had the ff allele of the Vitamin D receptor gene compared to 46% of controls. The median arsenic and lead levels were higher among cases compared to controls. In the unadjusted model of logistic regression, we found stressed patients had three times higher odds of developing renal stones compared to non-stressed patients (OR (95% CI): 2.98 (1.04-8.52); p=0.04). Similarly, patients with higher blood concentrations of arsenic and lead had higher odds of developing renal stones compared to those with lower concentrations. Conclusions There was a definitive role of heavy metals, including lead, cadmium, and arsenic, seen with renal stones. A significant association was seen between the ff allele of VDR polymorphism (Fok1 enzymes) and patients with renal stones. Other parameters, including male and stress factors, seem to have an important role in renal stone formation.
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15
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Tang TY, Lee JI, Shen JT, Lee YC, Wang HS, Tsao YH, Wu YH, Huang SP, Chen SC, Jhan JH, Geng JH. The association between menopause, postmenopausal hormone therapy, and kidney stone disease in Taiwanese women. Ann Epidemiol 2023; 78:13-18. [PMID: 36494042 DOI: 10.1016/j.annepidem.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The association between menopause, postmenopausal hormone therapy, and kidney stone disease has long been a topic of discussion and is still unclear. Moreover, most previous research has focused on Caucasians. Therefore, we aimed to explore this issue in an Asian population. METHODS In this cross-sectional study, we enrolled female participants aged between 30 and 70 years from the Taiwan Biobank. The presence of kidney stone disease (KSD) was defined through a self-reported questionnaire. The participants were divided into two groups according to the presence of menopause; premenopausal and postmenopausal groups. The associations among menopause, postmenopausal hormone therapy, and KSD were examined using binary logistic regression models. RESULTS A total of 17,460 women with available information were recruited, including 5976 in the premenopausal group and 11,484 in the postmenopausal group. Compared to the premenopausal group, the postmenopausal group had a significantly higher prevalence of KSD (3% vs. 6%). The odds ratio for KSD was higher in the postmenopausal group than in the premenopausal group (odds ratio = 1.50; 95% confidence interval = 1.17-1.92) after adjusting for confounders. We also examined associations between the type of menopause (natural and surgical) and KSD, and found that both types of menopause were associated with KSD in age-adjusted and multivariable models. Compared with those who had never received postmenopausal hormone therapy, those who had received postmenopausal hormone therapy were not associated with a higher risk of KSD. CONCLUSIONS Our study suggests that natural and surgical menopause were associated with KSD. However, we found no association between the postmenopausal hormone therapy and KSD in the postmenopausal women.
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Affiliation(s)
- Tsz-Yi Tang
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jung-Tsung Shen
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsun-Shuan Wang
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Hsuan Tsao
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsuan Wu
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jhen-Hao Jhan
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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16
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Fluid intake recommendations in urolithiasis and general advice to patients without metabolic risk factors. World J Urol 2023; 41:1251-1259. [PMID: 36692534 DOI: 10.1007/s00345-023-04285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
Urolithiasis is a highly prevalent global disease with substantially increasing incidence in the last two decades. Data from the literature suggests that 26%-50% of patients will have a recurrence within 10 years after an initial symptomatic stone episode. Therefore, interest has been raised in preventive strategies, aiming to modify the risk factors of stone recurrence by implementing dietary and lifestyle changes and specific medical treatments for stone formers, depending on their recurrence risk factors. Certain dietary factors are thought to contribute significantly to the increased incidence of urolithiasis, particularly a diet low in fiber and high in animal protein, fat, and sodium. Fluid intake is perhaps the most important and modifiable step in the prevention of urolithiasis, irrespective of stone composition. However, the amount of fluid to be consumed and the implications of various fluid types on stone formation are still controversial. In this article, the relationship between fluid intake, beverage types and stone formation-prevention will be discussed. Moreover, general dietary recommendations for patients without metabolic risk factors will be reviewed based on the current literature.
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Yin S, Wang J, Bai Y, Yang Z, Cui J, Wang J. Association between sleep duration and kidney stones in 34 190 American adults: A cross-sectional analysis of NHANES 2007-2018. Sleep Health 2022; 8:671-677. [PMID: 36216750 DOI: 10.1016/j.sleh.2022.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 07/14/2022] [Accepted: 08/12/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the association between sleep duration and kidney stones among United States adults. PARTICIPANTS AND METHODS This cross-sectional study is based on National Health and Nutrition Examination Surveys (NHANES) 2007-2018. Participants aged 20 years and above who self-reported history of kidney stones and sleep duration were included. Weighted proportions, multivariable analysis, and piecewise linear regression were used to evaluate the associations between sleep duration and kidney stones, while adjusting for gender, age, race, poverty income ratio, body mass index, education, marital status, trouble sleeping, smoking, alcohol and some comorbidities. Stratified logistic regression models were used in subgroup analyses and included all potential confounding factors above. RESULTS Of the 34,190 participants, the overall weighted kidney stone prevalence was 9.73%, weighted mean age was 47.67 ± 16.99 years, and mean sleep duration was 7.15 ± 1.44 hours. The fully adjusted multivariable model demonstrated that people with normal (7-9 hours) and long (>9 hours) sleep duration had 17% and 20% lower odds of kidney stone prevalence than people with short sleep duration (<7 hours), respectively. However, fitting a smooth curve showed a nonlinear association between sleep duration and kidney stones. A piecewise linear regression model showed that one hour longer sleep duration was associated with 7% lower kidney stone prevalence for people with short sleep duration and with 22% higher prevalence for participants with long sleep duration. However, for people with normal sleep duration, increasing sleep duration was nonsignificantly associated with lower prevalence of kidney stones. Subgroup analysis showed no significant interaction effects. CONCLUSIONS There is a curvilinear relationship between sleep duration and kidney stones. Normal sleep duration is associated with lower prevalence of kidney stones than short sleep duration. This study provides new insight into potential strategies for the prevention and treatment of kidney stones.
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Affiliation(s)
- Shan Yin
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiahao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunjin Bai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenzhen Yang
- Department of Clinical Laboratory, Nanchong Central Hospital, Nanchong, China
| | - Jianwei Cui
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
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Nephrolithiasis: A Red Flag for Cardiovascular Risk. J Clin Med 2022; 11:jcm11195512. [PMID: 36233380 PMCID: PMC9573143 DOI: 10.3390/jcm11195512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023] Open
Abstract
Epidemiological evidence shows that nephrolithiasis is associated with cardiovascular (CV) morbidities. The association between nephrolithiasis and CV disease is not surprising because both diseases share conditions that facilitate their development. Metabolic conditions, encompassed in the definition of metabolic syndrome (MS), and habits that promote nephrolithiasis by altering urine composition also promote clinical manifestations of CV disease. By inducing oxidative stress, these conditions cause endothelial dysfunction and increased arterial stiffness, which are both well-known predictors of CV disease. Furthermore, the subtle systemic metabolic acidosis observed in stone formers with CV disease may have a pathogenic role by increasing bone turnover and leading to reduced mineral content and osteoporosis/osteopenia. Heart valves and/or coronary artery and aortic calcifications are frequently associated with reduced mineral density. This is known as the 'calcification paradox' in osteoporosis and has also been observed in subjects with calcium nephrolithiasis. Evidence supports the hypothesis that osteoporosis/osteopenia is an independent risk factor for the development of CV calcifications. In the long term, episodes of renal stones may occur from the onset of metabolic derangements/MS to arterial stiffness/atherosclerosis and CV morbidities. These episodes should be considered a warning sign of an ongoing and silent atherosclerotic process. The evaluation of cardiometabolic risk factors and MS components should be routine in the assessment of renal stone formers. This would allow for treatment and prevention of the development of CV complications, which are much more severe for the patient and for public health.
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Rasool M, Mousa T, Alhamadani H, Ismael A. Therapeutic potential of medicinal plants for the management of renal stones: A review. BAGHDAD JOURNAL OF BIOCHEMISTRY AND APPLIED BIOLOGICAL SCIENCES 2022. [DOI: 10.47419/bjbabs.v3i02.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Kidney stone disease is the third most common urological ailment worldwide, people. The mechanism of stone formation includes: urine supersaturation, aggregation, retention, nucleation, and growth of crystals in the cells of the renal tubular epithelium. Kidney stones may cause extreme pain and blockage of urine flow. They are usually treated with conventional drugs and shock wave (ESWL) as well as a variety of medications that may cause several adverse effects. The remaining stone fragments and the risk of infection following ESWL are major challenges in the treatment of kidney stones. Recently, despite the emergence of modern drugs, medicinal plants have been recognized and utilized in many nations clinically due to their safety profile, efficiency, cultural acceptance, and fewer side effects than approved drugs. Medicinal plants are used in different cultures as a reliable source of natural remedies. The aim of this review is to provide comprehensive information about traditionally used plants as well as their scientifically proven pharmacological activities, their primary chemical ingredients, and potential mechanisms of action, such as analgesic, astringent, demulcent, diuretic activity, antioxidant activity, inhibition of the inflammatory process, nucleation inhibition, crystallization inhibition, inhibition of crystal aggregation, reducing , reducing stone size, and reducing urine supersaturation.
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Shahait M, Nevo A, El-Asmar JM, Siripong N, Khater N, Denk J, Jackman S, Averch T, Semins M. Twenty-four hour urine parameters in nephrolithiasis patients with obstructive sleep apnea syndrome. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221088683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To study 24-hour urine metabolic abnormalities in patients with obstructive sleep apnea syndrome (OSAS), diagnosed by polysomnography. The purpose was to identify whether OSAS is independently associated with a distinctive set of 24-hour urine studies in a cohort of stone formers. Patients and Methods: Using our institutional stone database (2013–2017), 1132 consecutive patients with 24-hour urine collections were identified. After applying our exclusion criteria, the final cohort consisted of 376 patients of which 45 patients had OSAS. Descriptive statistics were used to compare 24-hour urine parameters between patients with and without OSAS. Logistic regression models were used to assess the association between OSAS and 24-hour urine parameters. Results: On univariate analysis, patients with OSAS were older (57.7 versus 48.2, p < 0.001) with a higher body mass index (BMI) (35 versus 27.8, p < 0.001), and higher likelihood of diabetes mellitus (DM) (57.8 versus 10.6%, p < 0.001) and hypertension (HTN) (60% versus 23.9%, p < 0.001). Patients with OSAS had higher 24-hour total amount of urine volume (2018 versus 1818 ml, p = 0.03), calcium (279.7 versus 208 mg, p = 0.02), oxalate (41.6 versus 31.3 mg, p < 0.001), yet lower 24-hour urine pH (5.75 versus 6.03, p = 0.001). On multivariable linear regression analysis, OSAS did not affect any of the 24-hour urinary parameters. Conclusion: OSAS is a prevalent comorbidity among nephrolithiasis patients. We found no major differences in 24-hour urine parameters between nephrolithiasis patients with OSAS and those without OSAS. Further study is needed to determine whether the severity of OSAS and compliance with treatment play a role in the pathogenesis of stone formation. Level of evidence: 2b
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Affiliation(s)
- Mohammed Shahait
- Department of Urology, University of Pittsburgh Medical Center, USA
- Department of Surgery, King Hussein Cancer Center, Jordan
| | - Amihay Nevo
- Department of Urology, University of Pittsburgh Medical Center, USA
| | - Jose M El-Asmar
- Division of Urology, Department of Surgery, American University of Beirut, Lebanon
| | - Nalyn Siripong
- Department of Urology, University of Pittsburgh Medical Center, USA
- The Clinical and Translational Science Institute, University of Pittsburgh, USA
| | - Nazih Khater
- Department of Urology, University of Pittsburgh Medical Center, USA
- Department of Urology, Louisiana State University Health Sciences Center Shreveport, USA
| | - Jordan Denk
- Department of Urology, University of Pittsburgh Medical Center, USA
| | - Stephen Jackman
- Department of Urology, University of Pittsburgh Medical Center, USA
| | - Timothy Averch
- Department of Urology, University of Pittsburgh Medical Center, USA
- Department of Urology, Palmetto Health USC Medical Group, USA
| | - Michelle Semins
- Department of Urology, University of Pittsburgh Medical Center, USA
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Wang X, Zhang Y, Zhao F, Li J, Yian Y. Symptomatic recurrence rate of upper urinary tract calculi in children after endourological procedures. J Pediatr Urol 2022; 18:141.e1-141.e7. [PMID: 35300915 DOI: 10.1016/j.jpurol.2021.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The recurrence rate of paediatric urolithiasis was less reported, especially in Asians. Our aim was to verify the symptomatic recurrence rate of Chinese paediatric urolithiasis and to determine the predictive factors for stone recurrence. MATERIALS AND METHODS We performed a retrospective review of children who presented with first upper urinary tract calculi from June 2014 to September 2019. For the follow-up, we generated Kaplan-Meier plots with time to stone recurrence and Cox proportional hazard regression analyses were applied. The recurrence was defined as a new symptomatic stone on ultrasound and/or computerized tomography. RESULTS A total of 230 children with a median age of 5 yr (IQR 4-8) were included. Calcium oxalate was found in 72% of stones, and calcium apatite was found in 32% of stones. After a median follow-up of 39.5 months, 34 (14.8%) children had stone recurrence. Median time to stone recurrence was 31 months. Among them, 31 (91.2%) required surgical intervention. Older children (P < 0.01), higher BMI (HBM) (P < 0.01) and higher stone burden (P < 0.01) were shown to be associated with stone recurrence in the univariate analysis. The multivariate Cox regression analysis showed that children with stone burden > 2 cm3 had a higher risk of recurrence (HR 4.84, 95%CI 2.28-10.3). Children with HBM had an increased recurrence rate compared to normal BMI children (HR 2.99, 95%CI 1.36-6.56). CONCLUSIONS The symptomatic recurrence rate of paediatric urolithiasis in Chinese is not as high as that reported in Caucasians. HBM and higher stone burden are associated with higher recurrence rates.
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Affiliation(s)
- Xiaochuan Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Yu Zhang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Fangzhou Zhao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Ye Yian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
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Hou B, Shen X, He Q, Chen Y, Xu Y, Chen M, Xi J, Hao Z. Is the visceral adiposity index a potential indicator for the risk of kidney stones? Front Endocrinol (Lausanne) 2022; 13:1065520. [PMID: 36531468 PMCID: PMC9751392 DOI: 10.3389/fendo.2022.1065520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/15/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To determine whether the visceral adiposity index (VAI) was linked to the risk of kidney stones (KS) in the representative U.S. adults. METHODS We investigated 59842 participants who joined the 2007-2018 National Health and Nutrition Examination Survey. The association between the visceral adiposity index (VAI) and KS was identified by logistic regression analysis. Meanwhile, the subgroup analysis as well as the calculation of dose-response curves were also utilized to identify sensitive groups. RESULTS Data from 29384 participants were available, including 2781 self-reported ever experiencing KS diseases. Overall, the VAI was 0.74 (0.70, 0.78) in the KS group, while 0.55 (0.52, 0.57) in the control group. After adjusting for confounders, the prevalence of KS increased by 13% for each unit of VAI increment (OR = 1.13, 95% CI: 1.08, 1.19). Moreover, a linear relationship was found between the VAI and the prevalence of KS. By subgroup analysis, we found that a positive correlation between VAI and the risk of KS both in male (OR=1.14, 95%CI:1.07, 1.22) and female (OR=1.14, 95%CI:1.05, 1.24), White (OR=1.20, 95%CI:1.11, 1.28) and other race, all aged subgroups, nonhypertensive (OR=1.06, 95%CI:1.08, 1.25) and nondiabetic subgroups (OR=1.14, 95%CI:1.07, 1.21). CONCLUSIONS Elevated VAI was strongly associated with KS in representative U.S. adults, which may be a promising indicator for the risk of kidney stones.
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Affiliation(s)
- Bingbing Hou
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Xudong Shen
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Qiushi He
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yang Chen
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yuexian Xu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Mingwei Chen
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Zongyao Hao, ; Junhua Xi, ; Mingwei Chen,
| | - Junhua Xi
- Department of Urology, the Second People’s Hospital of Hefei (Hefei Hospital Affiliated to Anhui Medical University), Hefei, China
- *Correspondence: Zongyao Hao, ; Junhua Xi, ; Mingwei Chen,
| | - Zongyao Hao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- *Correspondence: Zongyao Hao, ; Junhua Xi, ; Mingwei Chen,
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Liu X, Xia D, Peng E, Tong Y, Liu H, Wang X, He Y, Chen Z, Tang K. Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients. World J Urol 2021; 40:513-518. [PMID: 34766214 DOI: 10.1007/s00345-021-03872-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To compare the outcomes of mini percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) for the management of 2-3 cm lower pole renal calculi (LPC) in obese patients. PATIENTS AND METHODS 120 obese patients with 2-3 cm LPC were randomly divided into mPNL group and RIRS group. Demography, clinical characteristics, perioperative complications, and stone free rate (SFR) were recorded. Stone-free status means no stone on computed tomography 3 months after surgery, or residual fragments were less than 3 mm. RESULTS Baseline characteristics were similar between the two groups. The mean stone burden was 585.39 ± 131.06 mm2 in the mPNL group and 548.64 ± 123.55 mm2 in the RIRS group (P = 0.125). The SFR of mPNL group was significantly better than that of RIRS group (86.2% vs 61.4%, P = 0.002). Besides, the overall complication rate was 22.4% in the mPNL group and 7% in the RIRS group (P = 0.02). Patients performed with mPNL required longer length of hospital stay than those with RIRS (P = 0.001). There were no significant differences in operative time and stone composition between the two groups. CONCLUSION In our study, both mPNL and RIRS are safe and effective techniques for the treatment of 2-3 cm LPC in obese patients. Compared to RIRS, mPNL has better SFR at the expense of the higher incidence of complications and prolonged length of hospital stay.
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Affiliation(s)
- Xiao Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ejun Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yonghua Tong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hailang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xinguang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu He
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Lee MR, Ke HL, Huang JC, Huang SP, Geng JH. Obesity-related indices and its association with kidney stone disease: a cross-sectional and longitudinal cohort study. Urolithiasis 2021; 50:55-63. [PMID: 34714367 DOI: 10.1007/s00240-021-01288-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022]
Abstract
Obesity increases the risk of several diseases, including kidney stone disease (KSD). The study aimed to explore the relationship between KSD and various obesity-related indices. A total of 121,605 participants in the Taiwan Biobank from December 2008 to February 2020 were analyzed. The association between self-reported history of KSD and eight obesity-related indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), abdominal volume index (AVI), body roundness index (BRI), conicity index, and triglyceride glucose index was examined in cross-sectional analysis; additionally, the risk of developing kidney stones was analyzed in a longitudinal cohort of 25,268 participants without KSD at baseline, which was a subset of the main cohort. Of all participants, 77,904 (64.1%) were female. Overall, 10.7% of males and 4.0% of females had KSD. Multivariate-adjusted logistic regression showed that all obesity-related indices were significantly associated with KSD. During a mean follow-up of 47 months, kidney stones occurred in 642 (2.5%) participants, and after adjusting for confounders, the risk of developing kidney stones was higher in participants with higher BMI, WC, WHtR, WHR, AVI and BRI. BMI, WC, WHtR, WHR, AVI, and BRI were found to be associated with a higher prevalence of kidney stones as well as development of incident kidney stones, which could be used as predictive factors for development of KSD in clinical practice.
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Affiliation(s)
- Ming-Ru Lee
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Lung Ke
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Kaohsiung Medical University, Kaohsiung, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Keskin E, Erdoğan A, Koçak M, Turan A. Relationship between urolithiasis and the fat halo sign. Int J Clin Pract 2021; 75:e14453. [PMID: 34105869 DOI: 10.1111/ijcp.14453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/24/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION This study aimed to examine the relationship between urolithiasis and gastric wall fat halo sign (FHS). MATERIALS AND METHOD The data of 382 patients who presented to our clinic with the complaint of flank pain were analyzed retrospectively. According to the results of noncontrast computed tomography, the patients were divided into two groups those with ureteral stones (Group 1) and those without urinary stones (Group 2). The patients' age, gender, weight, height, body mass index (BMI), cholesterol, triglyceride, blood urea nitrogen, creatinine, and gastric wall FHS data were evaluated. RESULTS When Groups 1 and 2 were compared in terms of FHS positivity, FHS was detected in 140 (57.3%) of 244 patients in Group 1 and 24 (17%) of 138 patients in Group 2, indicating a statistically significant difference (P < .001). CONCLUSION A statistically significant relationship was found between urinary stone disease and gastric wall FHS.
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Affiliation(s)
- Ercüment Keskin
- Department of Urology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Abdullah Erdoğan
- Department of Urology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Mehmet Koçak
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Abdullah Turan
- Department of Urology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Huang Y, Bao M, Liu C, Zheng S, Du T, Wu K. Distribution of APOE gene polymorphism in the Chinese Uyghur children & its association with urolithiasis. Indian J Med Res 2021; 154:108-114. [PMID: 34782536 PMCID: PMC8715683 DOI: 10.4103/ijmr.ijmr_1208_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND & OBJECTIVES This study was to survey the apolipoprotein E (APOE) gene polymorphism distribution among Chinese Uyghur children and to explore the relationship between APOE gene polymorphism and the occurrence of urolithiasis. METHODS A total of 144 Uyghur children with urolithiasis and 274 without the history of urolithiasis were enrolled in this study. Venous blood samples were collected from all participants, and APOE genotyping, derived from rs429358 and rs7412, was performed using Sanger sequencing. RESULTS Among the 418 children, the most prevalent genotype was E3/3, accounting for 71.3 per cent in the urolithiasis group and 71.4 per cent in the control group, followed by E3/4 and E2/3. Higher frequencies of the ɛ2 and ɛ4 alleles and lower frequencies of the ɛ3 allele were observed in the test group, and the unusual allele ɛ1 was also found in them. However, there were no significant differences between cases and controls at both rs429358 and rs7412 genotype and allele frequencies [odds ratio (OR)=0.98, 95% confidence interval (CI): 0.57-1.67; 0.98 (0.59-1.63); 1.43 (0.75-2.74) and 1.40 (0.74-2.62), respectively]. Likewise, none of significant differences was found between cases and controls at both APOE genotype and allele frequencies [OR=0.88, 95% CI: 0.51-1.53; 0.74 (0.33-1.64); 1.10 (0.73-1.66); 1.13 (0.76-1.67) and 1.14 (0.76-1.70), respectively]. INTERPRETATION & CONCLUSIONS The present study does not support any association between APOE genotyping and urolithiasis in Uyghur children.
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Affiliation(s)
- Yuanni Huang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
| | | | - Caixia Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Shukai Zheng
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Taifeng Du
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
- For correspondence: Dr Kusheng Wu, Department of Preventive Medicine, Shantou University Medical College, No. 22, Xinling Rd., Shantou 515041, Guangdong, PR China e-mail:
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Popov E, Almusafer M, Belba A, Bello JO, Bhatti KH, Boeri L, Davidoff K, Hameed BZ, Halinski A, Pfeferman Heilberg I, Hui H, Petkova K, Rawa B, Guedes Rodrigues F, Saltirov I, Spivacow FR, Trinchieri A, Buchholz N. Obesity rates in renal stone formers from various countries. ACTA ACUST UNITED AC 2021; 93:189-194. [PMID: 34286554 DOI: 10.4081/aiua.2021.2.189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To collect evidence on the rate of obesity in renal stone formers (RSFs) living in different climatic areas and consuming different diets. MATERIALS AND METHODS Data of adult renal stone formers were retrospectively collected by members of U-merge from 13 participant centers in Argentina, Brazil, Bulgaria (2), China, India, Iraq (2), Italy (2), Nigeria, Pakistan and Poland. The following data were collected: age, gender, weight, height, stone analysis and procedure of stone removal. RESULTS In total, 1689 renal stone formers (1032 males, 657 females) from 10 countries were considered. Average age was 48 (±14) years, male to female ratio was 1.57 (M/F 1032/657), the average body mass index (BMI) was 26.5 (±4.8) kg/m2. The obesity rates of RSFs in different countries were significantly different from each other. The highest rates were observed in Pakistan (50%), Iraq (32%), and Brazil (32%), while the lowest rates were observed in China (2%), Nigeria (3%) and Italy (10%). Intermediate rates were observed in Argentina (17%), Bulgaria (17%), India (15%) and Poland (22%). The age-adjusted obesity rate of RSFs was higher than the age-adjusted obesity rate in the general population in Brazil, India, and Pakistan, whereas it was lower in Argentina, Bulgaria, China, Italy, and Nigeria, and similar in Iraq and Poland. CONCLUSIONS The age-adjusted obesity rate of RSFs was not higher than the age-adjusted obesity rate of the general population in most countries. The relationship between obesity and the risk of kidney stone formation should be reconsidered by further studies carried out in different populations.
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Affiliation(s)
- Elenko Popov
- U-merge Ltd. (Urology for emerging countries), London, UK; Acibadem City Clinic Tokuda Hospital, Sofia.
| | - Murtadha Almusafer
- U-merge Ltd. (Urology for emerging countries), London, UK; College of Medicine, University of Basrah, Basrah.
| | - Arben Belba
- U-merge Ltd. (Urology for emerging countries), London, UK; Ospedale Santo Stefano, Prato and Casa di Cura Villa Donatello, Sesto Fiorentino.
| | - Jibril O Bello
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Surgery, Urology Unit, University of Ilorin Teaching Hospital.
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for emerging countries), London, UK; Urology Department, Hamad Medical Corporation, Doha.
| | - Luca Boeri
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan.
| | - Kaloyan Davidoff
- U-merge Ltd. (Urology for emerging countries), London, UK; Acibadem City Clinic Tokuda Hospital, Sofia.
| | - Bm Zeeshan Hameed
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology, Kasturba Medical College, Manipal, Karnataka.
| | - Adam Halinski
- U-merge Ltd. (Urology for emerging countries), London, UK; Private Medical Center "Klinika Wisniowa" Zielona Gora.
| | - Ita Pfeferman Heilberg
- U-merge Ltd. (Urology for emerging countries), London, UK; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo.
| | - Hongyi Hui
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai.
| | - Kremena Petkova
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology and Nephrology, Military Medical Academy, Sofia.
| | - Bapir Rawa
- U-merge Ltd. (Urology for emerging countries), London, UK; Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | - Fernanda Guedes Rodrigues
- U-merge Ltd. (Urology for emerging countries), London, UK; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo.
| | - Iliya Saltirov
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology and Nephrology, Military Medical Academy, Sofia.
| | - Francisco R Spivacow
- U-merge Ltd. (Urology for emerging countries), London, UK; Instituto de Investigaciones Metabólicas (IDIM), Buenos Aires.
| | | | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London.
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Penniston KL, Knoll T. Diätetische Aspekte der Urolithiasis. Urolithiasis 2021. [DOI: 10.1007/978-3-662-62454-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Qin Z, Zhao J, Geng J, Chang K, Liao R, Su B. Higher Triglyceride-Glucose Index Is Associated With Increased Likelihood of Kidney Stones. Front Endocrinol (Lausanne) 2021; 12:774567. [PMID: 34912299 PMCID: PMC8667164 DOI: 10.3389/fendo.2021.774567] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS We aimed to assess the association between triglyceride-glucose (TyG) index and kidney stones in US adults. METHODS Data were obtained from the 2007-2014 National Health and Nutrition Examination Survey (NHANES). Participants aged ≥18 years who were not pregnant and provided complete data about TyG index and kidney stones were included in the analysis. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between TyG index and nephrolithiasis and recurrence. RESULTS A total of 20,972 participants were included with the mean TyG index of 8.71 ± 0.72. The prevalence rates of nephrolithiasis and recurrence were 9.30% and 3.17% overall and increased with the higher TyG index tertiles (Nephrolithiasis: Tertile 1, 6.98%; Tertile 2, 9.15%; Tertile 3, 11.98%, p < 0.01; Recurrence: Tertile 1, 1.84%; Tertile 2, 3.27%; Tertile 3, 4.50%, p < 0.01). Each unit increase in TyG index was associated with 12% and 26% higher odds of nephrolithiasis [odds ratio (OR) = 1.12; 95% CI: 1.02-1.22; p = 0.02] and recurrence (OR = 1.26; 95% CI: 1.08-1.46; p < 0.01). Interaction tests indicated no significant effect of gender, age, body mass index, hypertension, and diabetes on this association between TyG index and kidney stones. CONCLUSIONS Higher TyG index was associated with an increased likelihood of nephrolithiasis and recurrence. Considering TyG index is a reliable indicator of insulin resistance (IR). Treatment and management of IR at a younger age may improve or alleviate the occurrence and recurrence of kidney stones.
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Affiliation(s)
- Zheng Qin
- Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China
- Med-X Center for Materials, Sichuan University, Chengdu, China
| | - Junjie Zhao
- West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jiwen Geng
- Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China
- Med-X Center for Materials, Sichuan University, Chengdu, China
| | - Kaixi Chang
- Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China
- Med-X Center for Materials, Sichuan University, Chengdu, China
| | - Ruoxi Liao
- Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China
- Med-X Center for Materials, Sichuan University, Chengdu, China
| | - Baihai Su
- Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China
- Med-X Center for Materials, Sichuan University, Chengdu, China
- *Correspondence: Baihai Su,
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Dadon T, Tsvetov G, Levi S, Gorshtein A, Slutzky-Shraga I, Hirsch D. Gender differences in the presentation, course and outcomes of primary hyperparathyroidism. Maturitas 2020; 145:12-17. [PMID: 33541557 DOI: 10.1016/j.maturitas.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate gender-associated differences in the presentation, course, and outcomes of primary hyperparathyroidism (PHPT). STUDY DESIGN A retrospective institutional cohort. METHODS The database of a tertiary endocrine institute was retrospectively screened for patients treated for PHPT in 2010-2018. Clinical, biochemical, and imaging data were collected. Presentation, management, and outcome variables were compared by gender and by age at diagnosis (<50/≥50 years). RESULTS The cohort included 182 women and 161 men diagnosed with PHPT at age 57.6 ± 12.8 and followed for 6.3 ± 5.5 years. There were no gender differences in age at detection of hypercalcemia and basal levels of serum and urinary calcium, serum PTH, and serum 25-hydroxyvitamin D. Men had a higher prevalence of nephrolithiasis (33 % vs 21 %, p = 0.01). Women had a higher frequency of osteoporosis (65 % vs 45 %, p < 0.001), and a lower mean lumbar spine T-score at PHPT diagnosis. At last follow-up, women had worse bone mineral density (BMD) results in all measured sites (lumbar spine, femoral neck, distal radius) and more fractures (34 % vs 20 %, p = 0.004), despite more frequent and longer pharmacological treatment of osteoporosis. On analysis by age, all these gender-associated differences were statistically significant only in patients diagnosed at age ≥50 years. Parathyroidectomy was performed in 52 % of women and 42 % of men (p = 0.06). CONCLUSION The main differences between male and female patients with PHPT are the higher prevalence, more intensive pharmacological treatment, and worse outcomes of osteoporosis in women. Tailoring the optimal medical and/or surgical treatment for fracture prevention in patients with PHPT remains a major challenge, especially in older women.
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Affiliation(s)
- Tal Dadon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gloria Tsvetov
- Department of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Sigal Levi
- Statistical Education Unit, The Academic College of Tel Aviv Yaffo, Israel; Sackler Faculty of Exact Sciences, Tel Aviv, University, Tel Aviv, Israel.
| | - Alexander Gorshtein
- Department of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ilana Slutzky-Shraga
- Department of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Dania Hirsch
- Department of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Simmons RM, McKnight SM, Edwards AK, Wu G, Satterfield MC. Obesity increases hepatic glycine dehydrogenase and aminomethyltransferase expression while dietary glycine supplementation reduces white adipose tissue in Zucker diabetic fatty rats. Amino Acids 2020; 52:1413-1423. [PMID: 33057941 DOI: 10.1007/s00726-020-02901-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 10/06/2020] [Indexed: 12/31/2022]
Abstract
Obesity is associated with altered glycine metabolism in humans. This study investigated the mechanisms regulating glycine metabolism in obese rats. Eight-week-old Zucker diabetic fatty rats (ZDF; a type-II diabetic animal model) received either 1% glycine or 1.19% L-alanine (isonitrogenous control) in drinking water for 6 weeks. An additional group of lean Zucker rats also received 1.19% L-alanine as a lean control. Glycine concentrations in serum and liver were markedly lower in obese versus lean rats. Enteral glycine supplementation restored both serum and hepatic glycine levels, while reducing mesenteric and internal white fat mass compared with alanine-treated ZDF rats. Blood glucose and non-esterified fatty acid (NEFA) concentrations did not differ between the control and glycine-supplemented ZDF rats (P > 0.10). Both mRNA and protein expression of aminomethyltransferase (AMT) and glycine dehydrogenase, decarboxylating (GLDC) were increased in the livers of obese versus lean rats (P < 0.05). In contrast, glycine cleavage system H (GCSH) hepatic mRNA expression was downregulated in obese versus lean rats, although there was no change in protein expression. These findings indicate that reduced quantities of glycine observed in obese subjects likely results from an upregulation of the hepatic glycine cleavage system and that dietary glycine supplementation potentially reduces obesity in ZDF rats.
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Affiliation(s)
- Rebecca M Simmons
- Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA
| | - Sorin M McKnight
- Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA
| | - Ashley K Edwards
- Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA
| | - Michael C Satterfield
- Department of Animal Science, Texas A&M University, College Station, TX, 77843, USA.
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Abufaraj M, Xu T, Cao C, Waldhoer T, Seitz C, D'andrea D, Siyam A, Tarawneh R, Fajkovic H, Schernhammer E, Yang L, Shariat SF. Prevalence and Trends in Kidney Stone Among Adults in the USA: Analyses of National Health and Nutrition Examination Survey 2007-2018 Data. Eur Urol Focus 2020; 7:1468-1475. [PMID: 32900675 DOI: 10.1016/j.euf.2020.08.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/26/2020] [Accepted: 08/25/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The contemporary prevalence and trends of kidney stones are not clear. OBJECTIVE To evaluate the gender-specific prevalence and trends in kidney stones among the US population. DESIGN, SETTING, AND PARTICIPANTS Data on self-reported history of kidney stones from 34 749 participants aged ≥20 yr from the National Health and Nutrition Examination Survey (NHANES) were analyzed. INTERVENTION Six 2-yr study cycles (2007-2008 to 2017-2018) of nationally representative series of surveys evaluated the health status of the US population. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Weighted prevalence estimates of kidney stones and 95% confidence intervals (CIs) were calculated in each study cycle. Multivariable-adjusted logistic regression models were used to investigate the temporal trends. RESULTS AND LIMITATIONS In the 2017-2018 cycle, the prevalence of kidney stones was 10.9% (CI: 9.3-12.7) in men as compared with 9.5% (CI: 8-11.2) in women. The prevalence of kidney stones increased steadily from 6.5% in the 2007-2008 cycle to 9.4% in the 2017-2018 cycle (ptrend = 0.001) among women but not among men (ptrend = 0.1). These trends remained after adjusting for sociodemographic correlates in both genders. Sensitivity analyses further adjusting for dietary information held the same results in trends (men: ptrend = 0.15; women: ptrend = 0.001). Non-Hispanic white ethnicity, obesity, gout, history of two or more pregnancies, menopause, and using female hormones were associated with a higher prevalence of kidney stones. The main limitation is the cross-sectional design of the study. CONCLUSIONS Although kidney stones are more common in men than in women in the USA, the gender gap in kidney stone prevalence appears to be closing in the past decade. Kidney stones are consistently higher among non-Hispanic white and obese, and women who have had multiple pregnancies or have used female hormone therapy. PATIENT SUMMARY The prevalence of kidney stones remains higher in adult US men than in women, but the trend has been increasing only in women, closing the gender gap in kidney stone prevalence.
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Affiliation(s)
- Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Tianlin Xu
- Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chao Cao
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Christian Seitz
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - David D'andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Abdelmuez Siyam
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Rand Tarawneh
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Harun Fajkovic
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria; Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Harvard Medical School, Boston, MA, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
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Youssef RF, Martin JW, Sakhaee K, Poindexter J, Dianatnejad S, Scales CD, Preminger GM, Lipkin ME. Rising occurrence of hypocitraturia and hyperoxaluria associated with increasing prevalence of stone disease in calcium kidney stone formers. Scand J Urol 2020; 54:426-430. [PMID: 32715836 DOI: 10.1080/21681805.2020.1794955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate metabolic risk factors in calcium kidney stone formers from two different decades, comparing changes in metabolic profiles over time. METHODS A retrospective analysis was performed of calcium kidney stone formers who underwent metabolic evaluation of urolithiasis with 24-hour urine collections at a single institution. There were 309 patients evaluated from 1988 to 1994 (Group A), and 229 patients from 2007 to 2010 (Group B). A comparison between both groups was performed to assess changes in demographics and in metabolic stone profiles. RESULTS Comparing Group A to Group B, the percentage of females increased from 43 to 56%, obese patients (BMI ≥ 30) increased from 22 to 35%, and patients ≥ 50 years increased from 29 to 47% (all p < 0.005). A greater percentage of patients had hypocitraturia in the recent cohort (46-60%, p = 0.001), with hypocitraturia significantly more frequent in obese patients (p = 0.005). Hyperoxaluria was also increased in Group B compared to Group A (23-30% p = 0.07), a finding that was significant in males (32-53%, p = 0.001). CONCLUSIONS Urolithiasis has increased in females, obese, and older patients, consistent with population-based studies. We report a rising incidence of hypocitraturia and hyperoxaluria in the contemporary cohort, particularly in obese patients and in males, respectively. Further studies are needed to better characterize the metabolic changes corresponding to the increase in stone disease.
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Affiliation(s)
- Ramy F Youssef
- Department of Urology, University of California, Irvine, CA, USA
| | - Jeremy W Martin
- Department of Urology, University of California, Irvine, CA, USA
| | - Khashayar Sakhaee
- Department of Internal Medicine, Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, University of Texas Southwestern, Dallas, TX, USA
| | - John Poindexter
- Department of Internal Medicine, Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, University of Texas Southwestern, Dallas, TX, USA
| | | | - Charles D Scales
- Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Glenn M Preminger
- Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Michael E Lipkin
- Division of Urology, Duke University Medical Center, Durham, NC, USA
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Feng X, Wu W, Zhao F, Xu F, Han D, Guo X, Lyu J. Relationship Between Body Mass Index and Kidney Stones Based on Dose-Response Analyses Using Restricted Cubic Splines Applied to NHANES 2011-2016 Data. J Ren Nutr 2020; 31:263-269. [PMID: 32693968 DOI: 10.1053/j.jrn.2020.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/16/2020] [Accepted: 05/03/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The objective of the study was to estimate the dose-response relationship between body mass index (BMI) and the self-reported prevalence of kidney stones based on a restricted cubic spline (RCS) method. METHODS This cross-sectional study analyzed 13,223 adults aged ≥20 years who had participated in the National Health and Nutrition Examination Survey performed during 2011-2016. Kidney stones were identified using a standard questionnaire, and physical examinations were used to determine BMI. Logistic regression was used to assess the relationship between BMI and the prevalence of kidney stones, with the dose-response relationship explored using RCSs. RESULTS The overall prevalence of kidney stones was 9.7%: 10.6% in males and 8.9% in females. After adjusting for potential confounders, compared with those with a BMI in quartile 1, the odds ratios of kidney stones among those with BMIs in quartiles 2, 3, and 4 were 1.45, 1.60, and 2.00, respectively (95% confidence interval = 1.21-1.75, 1.33-1.92, and 1.67-2.39; all P < .001). Multivariate RCS regression revealed that BMI was related to kidney stones in a nonlinear manner (P for nonlinearity <0.001). There was a significant positive relationship, with the curves being steeper when BMI was <28 kg/m2. CONCLUSION This analysis of National Health and Nutrition Examination Survey data has demonstrated that BMI is significantly associated with the prevalence of kidney stones.
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Affiliation(s)
- Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaojuan Guo
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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Patel PM, Kandabarow AM, Druck A, Hart S, Blackwell RH, Kadlec A, Farooq A, Turk TMT, Baldea KG. Association of Impaired Renal Function With Changes in Urinary Mineral Excretion and Stone Composition. Urology 2020; 141:45-49. [PMID: 32294484 DOI: 10.1016/j.urology.2020.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/03/2020] [Accepted: 03/15/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effect of kidney function on stone composition and urinary mineral excretion in patients undergoing surgical intervention for nephrolithiasis. METHODS Using our institutional kidney stone database, we performed a retrospective review of stone patients who underwent surgical intervention between 2004 and 2015. Patients' demographic information, 24-hour urinary mineral excretion, and stone characteristics were reported. The patients' estimated glomerular filtration rates (eGFR) were compared with their stone compositions and 24-hour urine mineral excretions. RESULTS A statistically significant difference was noted between the groups, with uric acid stones being associated with lower eGFR and calcium phosphate stones associated with higher eGFR. No relationship could be demonstrated between eGFR and calcium oxalate or struvite stones. Patients with lower eGFR also demonstrated a statistically significant association with lower urinary pH as well as lower urinary excretion of calcium and citrate. CONCLUSION While various factors have been found to play significant roles in kidney stone formation and composition, our findings demonstrate a definite relationship between these and renal function. This paper highlights the fact that renal function evaluation should be considered an important component in the evaluation, counseling, and management of patients with nephrolithiasis.
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Affiliation(s)
- Parth M Patel
- Department of Urology, Loyola University Medical Center, Maywood, IL.
| | | | - Aleksander Druck
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL
| | - Spencer Hart
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | | | | | - Ahmer Farooq
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Thomas M T Turk
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Kristin G Baldea
- Department of Urology, Loyola University Medical Center, Maywood, IL
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Biochemical Alterations in Patients with Oxalocalcic Lithiasis, the Influence of Sex, Age, and Body Mass Index. Nephrourol Mon 2020. [DOI: 10.5812/numonthly.103639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Urolithiasis is a disorder that has a high prevalence in the population. Also, lithiasic patients have biochemical alterations that predispose them to the formation of stones. The knowledge of these alterations may be useful for future preventive interventions. Objectives: The objectives were to describe the metabolic characteristics of patients with oxalocalcic lithiasis, identifying the most frequent biochemical alterations, and their variation with different demographic variables. In this way, we can prevent the formation of the lithiasis before it appears, instead of treating it once established. Methods: A descriptive cross-sectional study of serum and 24 hour-urine parameters in patients with oxalocalcic lithiasis was performed. The most frequent biochemical alterations were described, and their association with age, sex, and body mass index (BMI) were assessed. Results: In this study, 100% of the 151 patients had biochemical alterations, the most frequent being hypocitraturia (84.7%), hypercalciuria (51.7%), and urinary pH decrease (44.4%). There were differences according to sex, age, and BMI with regard to the biochemical alterations. Hypouricemia, hypouricosuria, hypophosphaturia and hypomagnesuria were more frequent in women. Men had a higher percentage of hyperzinquemia, hyperphosphaturia, and excess of urinary urea. Urine density in men was slightly higher than in women. A higher percentage of hyperphosphaturia, excess urinary urea, and excess of serum urea was found in overweight patients. Patients not overweight showed a higher percentage of hypouricemia and hypomagnesuria. Urinary density was slightly higher in overweight patients. Urinary volume was higher in middle-aged subjects. Conclusions: Patients with oxalocalcic lithiasis have biochemical alterations that may predispose to stone formation. These alterations vary with sex, age, and BMI.
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Abstract
As the prevalence of obesity has increased, bariatric surgery has become more common because of its proven efficacy at promoting weight loss and improving weight-related medical comorbidities. Although generally successful, bariatric surgery may also lead to complications and negatively affect health. This article highlights some common and rare complications of bariatric surgery. Specifically, it discusses the risk of nutrient deficiencies (which is influenced by surgery type) and their downstream effects, including ill-effects on bone health. Rarer complications, such as postbypass hypoglycemia and alcohol use disorder, are also discussed.
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Affiliation(s)
- Maria L Collazo-Clavell
- Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA
| | - Meera Shah
- Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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Melkonian V, Nguyen MTJP. Managing the Obese Living Kidney Donor. CURRENT TRANSPLANTATION REPORTS 2020. [DOI: 10.1007/s40472-020-00279-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
PURPOSE OF REVIEW The incidence of urolithiasis has shown a prominent increase in the last two to three decades and evidence-based data have clearly indicated the certain role of obesity and overweight in both children and adults. As a certain component of metabolic syndrome, 'obesity' has been found to have a significant impact on the urinary metabolic risk factors which may be important in stone formation. In this present review article, we aimed to evaluate the possible association between obesity and urolithiasis and related risk factors. The epidemiology, pathophysiology, and management of stone disease in obese cases will be discussed in detail. RECENT FINDINGS The possible influence of overweight/obesity on the metabolic stone-forming risk factors has been subjected to several studies which in turn well demonstrated the increased risk of stone formation in this population. Although the exact underlying mechanisms are still to be outlined, some certain pathogenetic factors, namely, changes in urinary pH and increased excretion of some urinary stone components have been well demonstrated. Given this increased risk status, these cases require a more comprehensive workup for urolithiasis. Appropriate metabolic evaluation-based medical therapy alongside dietary recommendations will be effective in preventing stone formation. SUMMARY Patients suffering from obesity problem have particular risk factors for urolithiasis when compared with their normal-weight counterparts. All efforts should be taken to increase the awareness of this problem and necessary precautions with well-planned treatment plan are the main tasks for urologists.
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Almannie RM, Al-Nasser KA, Al-Barraq KM, Alsheheli MM, Al-Hazmi HH, Binsaleh SA, Althunayan AM, Alomar MA. The effect of the body mass index on the types of urinary tract stones. Urol Ann 2020; 12:42-48. [PMID: 32015616 PMCID: PMC6978960 DOI: 10.4103/ua.ua_161_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 09/18/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives: Urinary tract stones are a common public health problem worldwide. In addition, identifying the composition of stones is important for the further metabolic evaluation of patients. We conducted this study to further correlate the relationship between body mass index (BMI) and different compositions of urinary tract stones. Materials and Methods: A retrospective study of 433 patients who underwent urinary tract stone analysis via Fourier-transform infrared spectroscopy at King Khalid University Hospital in Riyadh from May 2015 to June 2017 was performed. Their BMI at the time of stone analysis was recorded. Results: A total of 433 stones were analyzed by the statistical data analysis software. The BMI was classified according to the WHO classification. We divided our patients into seven age groups. Most patients were between the age group of 35 and 44 years and were overweight. The incidence of calcium oxalate, carbonate apatite, and uric acid stones was higher in patients with a BMI above thirty than in patients with a lower BMI. However, cystine stones were more common in normal-weight patients. Conclusions: In this study, we found that the incidence of certain types of stones, such as calcium oxalate, cystine, and uric acid stones, in Saudi Arabia can be predicted by BMI measurement.
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Affiliation(s)
- Raed M Almannie
- Department of Surgery, Division of Urology, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Hamdan H Al-Hazmi
- Department of Surgery, Division of Urology, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Saleh A Binsaleh
- Department of Surgery, Division of Urology, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz M Althunayan
- Department of Surgery, Division of Urology, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Alomar
- Department of Surgery, Division of Urology, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Baatiah NY, Alhazmi RB, Albathi FA, Albogami EG, Mohammedkhalil AK, Alsaywid BS. Urolithiasis: Prevalence, risk factors, and public awareness regarding dietary and lifestyle habits in Jeddah, Saudi Arabia in 2017. Urol Ann 2019; 12:57-62. [PMID: 32015619 PMCID: PMC6978981 DOI: 10.4103/ua.ua_13_19] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 10/09/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction: Urolithiasis is a public health concern, yet there are limited studies in our community. This study aimed to provide a current estimate of the prevalence of urolithiasis and to evaluate the public's awareness about dietary and lifestyle habits that impact on urolithiasis among the Jeddah population in 2017. Methods: This is an observational cross-sectional study design where a self-administered questionnaire was distributed in two major malls in Jeddah. The total number of participants was 2173, who were Saudis and non-Saudis aged 18 years and above. The questionnaire includes five sections: demographics, general information related to urolithiasis, dietary information related to urolithiasis, lifestyle habits, and medical conditions. Results: The overall prevalence of urolithiasis was 11.2%, 48.8% of which had a family history with a first-degree relative. The odds of urolithiasis among males was 1.8 times higher than in females (odds ratio [OR] =1.8, 95% confidence interval [CI], 1.4–2.4). The median age of stone disease was 33 years (25%–75%: 26–42 years). Diabetic individuals were 3.2 times more likely to have urolithiasis when compared to nondiabetic individuals (OR = 3.2, 95% CI, 2.1–4.9). Low level of awareness was observed in this cohort group with a mean score of 37.7%; 64.1% of the population were in the low awareness level, 35.3% were in the medium level, and only 0.6% participants were in the high level of awareness. Conclusion: This study highlights the lack of public awareness about urolithiasis and knowledge about its causation despite the high prevalence. There is a clear need to inform and educate the public on matters relating to the known risk factors associated with urolithiasis.
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Affiliation(s)
- Nada Yasser Baatiah
- Clinical Nutrition Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Raghad Bader Alhazmi
- Clinical Nutrition Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Fatmah Ali Albathi
- Clinical Nutrition Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Esraa Ghazi Albogami
- Clinical Nutrition Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah Khalid Mohammedkhalil
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Basim Saleh Alsaywid
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Nephrolithiasis and Polycystic Ovary Syndrome: A Case-Control Study Evaluating Testosterone and Urinary Stone Metabolic Panels. Adv Urol 2019; 2019:3679493. [PMID: 31772573 PMCID: PMC6854272 DOI: 10.1155/2019/3679493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 09/09/2019] [Indexed: 02/01/2023] Open
Abstract
Introduction Both elevated testosterone and polycystic ovary syndrome (PCOS) have been speculated as possible risk factors for kidney stone formation; however, the details of this potential relationship with regards to 24-hour urine metabolic panels and stone composition have not previously been characterized. Methods A total of 74 PCOS patients were retrospectively identified and matched with a cohort of female stone formers at a 3 : 1 ratio (by age and BMI). All patients had 24-hour urinary metabolic panels and stone compositions. These groups were compared using Pearson chi-square and Student t-tests. Additionally, the PCOS group was differentiated based on free testosterone using multivariate analysis. Results The case-control cohort showed that PCOS patients had significantly lower sodium excretion (p=0.015) and hypernatriuria rates (28.9% vs 50.9%, p=0.009). The PCOS-testosterone cohort demonstrated that high testosterone patients had significantly higher citrate values (p=0.041) and significantly lower odds of hypocitraturia (36.7% vs 54.2%, OR = 0.2, p=0.042). The high testosterone group also had higher sodium excretion (p=0.058) with significantly higher odds of having hypernatriuria (40.0% vs 13.6%, OR = 13.3, p=0.021). No significant patterns were revealed based on stone composition analysis. Conclusions Compared to healthy stone formers, PCOS patients did not demonstrate significant differences in 24-hour urine and stone composition values. Elevated free testosterone in PCOS patients has a significant association with higher urinary citrate and sodium values: findings that in and of themselves do not confirm the hypothesized increased risk of stone formation. This patient cohort may provide deeper insight into the interplay between androgens and stone formation; however, further study is needed to fully characterize the possible relationship between PCOS and stone formation.
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Song Y, Xu Y, Liang Z, Yang Y, Liu X. Lower body mass index and higher height are correlated with increased varicocele risk. Andrologia 2019; 51:e13391. [PMID: 31475746 DOI: 10.1111/and.13391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/25/2019] [Accepted: 07/10/2019] [Indexed: 01/11/2023] Open
Abstract
To evaluate the anthropometric indexes in subjects with varicocele compared to controls and the incidence of varicocele in different body mass index (BMI) groups for the purpose of exploring the association between varicocele and anthropometric indexes. A comprehensive literature search was conducted by using PubMed, MEDLINE, EMBASE databases and Cochrane Library up to February 2019. A systematic review and meta-analysis was conducted by STATA, and Newcastle-Ottawa Scale was utilised for assessing risk of bias. Ultimately, 13 articles containing seven case-control studies and six cross-sectional studies with 1,385,630 subjects were involved in our study. Pooled results demonstrated that varicocele patients had a lower BMI (WMD = -0.77, 95% CI = -1.03 to -0.51) and a higher height than nonvaricocele participants, especially in grade 3 varicocele patients. Subgroup analyses showed that normal BMI individuals had a higher risk of varicocele than obese or overweight individuals and a lower risk than underweight individuals. In conclusion, this study indicates that varicocele patients have a lower BMI and a higher height than nonvaricocele participants. Moreover, men with excess bodyweight have a lower incidence of varicocele compared to normal weight or underweight people. That is to say, high BMI and adiposity protect against varicocele and high BMI is associated with a decreased risk of varicocele.
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Affiliation(s)
- Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yawei Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Urology, Xiaogan Central Hospital, Xiaogan, China
| | - Zhen Liang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongjiao Yang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Testosterone replacement therapy is associated with an increased risk of urolithiasis. World J Urol 2019; 37:2737-2746. [DOI: 10.1007/s00345-019-02726-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/07/2019] [Indexed: 10/27/2022] Open
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Rapid kVp switching dual-energy CT in the assessment of urolithiasis in patients with large body habitus: preliminary observations on image quality and stone characterization. Abdom Radiol (NY) 2019; 44:1019-1026. [PMID: 30415309 DOI: 10.1007/s00261-018-1808-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to investigate the image quality (IQ) considerations of rapid kVp switching dual-energy CT (rsDECT) in the assessment of urolithiasis in patients with large body habitus and to evaluate whether it allows stone characterization. MATERIALS AND METHODS In this IRB-approved, HIPAA compliant retrospective study, 93 consecutive patients (M/F = 72/21, mean age 56.9 years, range 23-83 years) with large body habitus (> 90 kg/198 lbs) who underwent dual-energy (DE) stone protocol CT on a rapid kVp switching DECT scanner between January 2013 and December 2016 were included. Scan acquisition protocol included an initial unenhanced single-energy CT (SECT) scan of KUB followed by targeted DECT in the region of stones. Two readers evaluated both CT data sets (axial 5 mm 120 kVp/140 kVp QC/70 keV monoenergetic, material density water/iodine images and coronal/sagittal 3 mm images) for the assessment of image quality (Scores: 1-4) and characterization of stone composition (reference standard: crystallography). RESULTS One hundred and five CT examinations were performed in 93 patients (mean body weight 105.12 ± 13.53 kg, range 91-154 kg), and a total of 321 urinary tract calculi (mean size-4.8 ± 3.2 mm, range 1.2-22 mm) were detected. Both SECT and targeted monoenergetic images were of acceptable image quality (mean IQ: 3.77 and 3.83, kappa 0.79 and 0.87 respectively). Material density water and iodine images had lower IQ scores (mean IQ: 2.97 and 3.09 respectively) with image quality deterioration due to severe photon starvation/streak artifacts in 20% (21/105) and 17% (18/105) scans, respectively. Characterization of stone composition into uric acid/non-uric acid stones was achieved in 93.14% (299/321) of calculi (mean size: 4.99 ± 3.3 mm, range 1.2-22 mm), while 7% (22/321) stones could not be characterized (mean size 3.03 ± 1.16 mm, range 1.6-6.4 mm) (p < 0.001). Most common reason for non-characterization was image quality deterioration of the material density iodine images due to severe photon starvation artifacts. On multivariate regression, stone size and patient weight were predictors of stone composition determination on DECT (p < 0.05). The transverse diameter had a weak negative correlation with stone composition determination, but it was not statistically significant. Stone characterization into uric acid vs. non-uric acid stones was accurate in 95% (n = 38/40) of stones in comparison with crystallography. CONCLUSION In patients with large body habitus, rsDECT allowed characterization of most calculi (93%) despite image quality deterioration due to photon starvation/streak artifacts in up to 20% of material density images. Stone size and patient weight were predictors of stone composition determination on DECT, and small calculi in very large patients may not be characterized.
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Natami M, Makarem A, Ahmed F, Dastgheib N, Zahraei AH. A giant ureteral stone in a 32-year-old man: a case report. Int Med Case Rep J 2019; 12:43-46. [PMID: 30858733 PMCID: PMC6385762 DOI: 10.2147/imcrj.s192592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Giant ureteral calculi are defined as stones greater than 5 cm in length or circumference. These giant calculi can cause blockage of the ureter, dilation of the kidney and also decreased kidney function if not treated in time. The patient in this report presented with complaints of bilateral episodic pain of the bilateral lumbar region. Kidney, ureter and bladder (KUB) X-ray test showed a large bilateral ureteral stone about 14 cm in length and 106 g weight in the left ureter and 3 cm longitudinal diameter in the right ureter and also a staghorn stone in the left upper collecting system. Thereafter, the ureteric calculi were managed successfully using the combination of open and endoscopic techniques.
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Affiliation(s)
- Mohammad Natami
- Department of Urology, Hormozgan University of Medical Science, Bandar Abbas, Iran
| | - Alireza Makarem
- Department of Urology, Shiraz University of Medical Science, Shiraz, Iran,
| | - Faisal Ahmed
- Department of Urology, Shiraz University of Medical Science, Shiraz, Iran,
| | - Niloofar Dastgheib
- Department of Urology, Shiraz University of Medical Science, Shiraz, Iran
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Dual-Source Dual-Energy CT in Detection and Characterization of Urinary Stones in Patients With Large Body Habitus: Observations in a Large Cohort. AJR Am J Roentgenol 2019; 212:796-801. [PMID: 30673342 DOI: 10.2214/ajr.18.20293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective of our study was to investigate the impact of large body habitus on dual-energy CT (DECT) image quality and stone characterization. MATERIALS AND METHODS We retrospectively included 105 consecutive patients with large body habitus (> 90 kg) who underwent stone protocol DECT between 2015 and 2017. The evaluation of DECT datasets was performed for image quality assessment based on European Guidelines on Quality Criteria for Computed Tomography and for determination of stone composition (i.e., uric acid vs non-uric acid). Correlation between DECT characterization and crystallography results was performed when available. The cohort was divided into two groups on the basis of body weight (≤ 104 kg and > 104 kg), and comparisons were made for image quality and stone characterization. RESULTS One hundred ninety-seven urinary tract calculi (size: mean ± SD, 5.7 ± 5.3 mm; range, 1.4-56 mm) were detected in 73% (79/108) of examinations in 105 patients (weight: mean ± SD, 104.0 ± 12.7 kg; range, 91-163 kg). The overall mean image quality score of blended images and color maps was 3.7 and 3.9, respectively, and the effective dual-energy FOV limitation did not hamper stone characterization. The diagnostic acceptability scores of blended images and color maps were slightly lower in patients weighing > 104 kg than in patients ≤ 104 kg (mean scores [highest score, 4 points]: blended images, 3.62 vs 3.82 [p = 0.0314]; color maps, 3.75 vs 3.98 [p = 0.0034]), but the scores were within acceptable range. Stone characterization as uric acid versus non-uric acid was achieved in 80% (158/197) of calculi (size: mean ± SD, 6.4 ± 5.7 mm; range, 1.6-56 mm), and DECT stone characterization was (95.6%) accurate with reference to crystallography. Twenty percent (39/197) of calculi could not be characterized on DECT, and these calculi were significantly smaller in size (size: mean ± SD, 2.8 ± 1.4 mm; range, 1.4-8.2 mm; p < 0.001) than those that could be characterized. The mean size of uncharacterized calculi was slightly larger in patients weighing > 104 kg (3.3 ± 1.6 mm) than in those weighing ≤ 104 kg (2.2 ± 0.6 mm). CONCLUSION In patients with large body habitus, dual-source DECT provides acceptable image quality and allows characterization of almost all clinically significant calculi.
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Metabolically healthy and unhealthy obesity phenotypes and risk of renal stone: a cohort study. Int J Obes (Lond) 2018; 43:852-861. [PMID: 30006578 DOI: 10.1038/s41366-018-0140-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/11/2018] [Accepted: 04/17/2018] [Indexed: 02/04/2023]
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Abstract
Global obesity rates have increased exponentially in recent decades. People are becoming obese younger, morbid obesity is increasing and the full health implications are only beginning to be seen. This article discusses the latest epidemiological data on obesity in adults and children, and systemically reviews the complications associated with the condition.
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Affiliation(s)
- D Kinlen
- From the Obesity Immunology Group, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
- National Children's Research Centre, Crumlin, Dublin 12, Ireland
- Department of Diabetes and Endocrinology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - D Cody
- National Children's Research Centre, Crumlin, Dublin 12, Ireland
- Department of Diabetes and Endocrinology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - D O'Shea
- From the Obesity Immunology Group, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
- Department of Endocrinology, St Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland
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Carbone A, Al Salhi Y, Tasca A, Palleschi G, Fuschi A, De Nunzio C, Bozzini G, Mazzaferro S, Pastore AL. Obesity and kidney stone disease: a systematic review. MINERVA UROL NEFROL 2018; 70:393-400. [PMID: 29856171 DOI: 10.23736/s0393-2249.18.03113-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Currently, abdominal obesity has reached an epidemic stage and obesity represents an important challenge for worldwide health authorities. Epidemiologic studies have demonstrated that the stone risk incidence increases with Body Mass Index, through multiple pathways. Metabolic syndrome and diabetes are associated with an increased renal stones disease incidence. The aim of this systematic review was to investigate the prevalence, morbidity, risk factors involved in the association between obesity and urolithiasis. EVIDENCE ACQUISITION The search involved finding relevant studies from MEDLINE, EMBASE, Ovid, the Cochrane Central Register of Controlled Trials, CINAHL, Google Scholar, and individual urological journals between January 2001 and May 2017. The inclusion criteria were for studies written in the English language, reporting on the association between obesity and urinary stones. EVIDENCE SYNTHESIS The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are observed frequently in these patients. Insulin resistance is thought to alter the renal acid-base metabolism, resulting in a lower urine pH, and increasing the risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances and with an increase in urinary tract infection incidence. Recent studies highlighted that renal stone disease increases the risk of myocardial infarction, progression of chronic kidney disease, and diabetes. Contemporary, bariatric surgery has been shown to be associated with hyperoxaluria and oxalate nephropathy. Certainly, the many health risks of obesity, including nephrolithiasis, will add more burden on urologists and nephrologists. CONCLUSIONS Obesity related nephrolithiasis seems to necessitate weight loss as primary treatment, but the recognition of the associated complications is necessary to prevent induction of new and equally severe medical problems. The optimal approach to obesity control that minimizes stone risk needs to be determined in order to manage obesity-induced renal stones disease.
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Affiliation(s)
- Antonio Carbone
- Unit of Urology, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.,Uroresearch, No Profit Research Association, Latina, Italy
| | - Yazan Al Salhi
- Unit of Urology, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy
| | - Andrea Tasca
- Department of Medicine, International University for Peace, Rome, Italy
| | - Giovanni Palleschi
- Unit of Urology, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.,Uroresearch, No Profit Research Association, Latina, Italy
| | - Andrea Fuschi
- Unit of Urology, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy
| | | | - Giorgio Bozzini
- Department of Urology, Mater Domini Humanitas, Castellanza, Varese, Italy
| | - Sandro Mazzaferro
- Unit of Nephrology and Hemodialysis, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy
| | - Antonio L Pastore
- Unit of Urology, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy - .,Uroresearch, No Profit Research Association, Latina, Italy
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