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Kim JY, Lee JK, Park JT, Chang TI. Risk of incident chronic kidney disease among patients with urolithiasis: a nationwide longitudinal cohort study. Clin Kidney J 2024; 17:sfae030. [PMID: 38435351 PMCID: PMC10906355 DOI: 10.1093/ckj/sfae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Indexed: 03/05/2024] Open
Abstract
Background Urolithiasis has been infrequently implicated to have a causal association with chronic kidney disease (CKD). Recently, several studies have demonstrated the relationship between urolithiasis and CKD. However, the generalizability of their results is limited. This study aimed to investigate the association between urolithiasis and the risk of incident CKD. Methods This longitudinal cohort study used the National Health Insurance Service data, including 219 570 Korean adults with incident urolithiasis requiring procedural interventions and without prior kidney disease and 219 570 age- and sex-matched controls without urolithiasis between 1 January 2002 and 31 December 2020. Primary outcome was the development of CKD, defined by an estimated glomerular filtration rate <60 ml/min/1.73 m2 for at least two consecutive measurements at least 90 days apart. The risk for incident CKD was further examined using the outcome defined by newly occurring diagnostic codes indicating CKD. Results Over a mean follow-up of 6 years, 12 338 (2.8%) primary outcome events of CKD were observed (incidence rate 4.6/1000 person-years). Per multivariable Cox analysis, urolithiasis was associated with a higher risk of incident CKD [adjusted hazard ratio 1.41 (95% confidence interval 1.36-1.46)]. This association remained consistent across all clinically relevant subgroups and when the CKD outcome was defined based on the diagnostic codes in the sensitivity analysis. Conclusions In this large national cohort study, patients with urolithiasis were associated with a higher risk of incident CKD than those without urolithiasis. Further studies are warranted to establish the benefits of preventing urolithiasis in reducing CKD development.
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Affiliation(s)
- Jae Young Kim
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jae Kwang Lee
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae Ik Chang
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
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Tan Z, Hong J, Sun A, Ding M, Shen J. Causal effects of circulating lipids and lipid-lowering drugs on the risk of urinary stones: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1301163. [PMID: 38107516 PMCID: PMC10722409 DOI: 10.3389/fendo.2023.1301163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background Previous studies have yielded conflicting findings regarding the association between circulating lipids and lipid-lowering drugs with urinary stones, and the causal relationship between the two remains inconclusive. Objective This study aimed to assess the causal relationship between circulating lipids (Triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], apolipoprotein A [APOA], apolipoprotein B [APOB] and Pure hypercholesterolaemia), lipid-lowering drugs (HMGCR [HMG-CoA reductase] inhibitors and PCSK9[Proprotein Convertase Subtilisin/Kexin Type 9] inhibitors) and the risk of urinary stones, using genetic data. Methods Genetic instrumental variables (GIVs) for circulating lipids and lipid-lowering drugs were obtained from the UK Biobank and existing literature. Outcome data were extracted from a genetic association database with 3,625 urinary stone cases and 459,308 controls. Two-sample MR analysis, employing the TwoSampleMR software package in R 4.2.3, was conducted to assess the associations between multiple exposures. The primary outcome was determined using the inverse variance weighted (IVW) method for the causal relationship between exposure and outcome, while additional methods such as MR-Egger, weighted median, simple mode, and weighted mode were utilized as supplementary analyses. Robustness of the Mendelian Randomization (MR) analysis results was assessed through leave-one-out analysis and funnel plots. Results The MR analysis revealed a significant association between elevated TG levels per 1 standard deviation and the occurrence of urinary stones (odds ratio [OR]: 1.002, 95% confidence interval [CI]: 1.000-1.003, P = 0.010). However, no significant association was observed between factors other than TG exposure and the risk of urinary stone occurrence across all methods(LDL-C: [OR], 1.001; 95% [CI], 1.000-1.003, P=0.132;HDL-C: [OR], 0.999; 95% [CI], 0.998-1.000, P=0.151;APOA:[OR] being 1.000 (95% [CI], 0.999-1.001, P=0.721;APOB: [OR] of 1.001 (95% [CI], 1.000-1.002, P=0.058;Pure hypercholesterolaemia: [OR] of 1.015 (95% [CI], 0.976-1.055, P=0.455) and lipid-lowering drugs (HMGCR inhibitors: [OR], 0.997; 95% [CI], 0.990-1.003, P=0.301 and PCSK9 inhibitors:[OR], 1.002; 95% [CI], 1.000-1.005, P=0.099). Conclusion Our findings provide conclusive evidence supporting a causal relationship between an increased risk of urinary stones and elevated serum TG levels. However, we did not find a significant association between urinary stone occurrence and the levels of LDL-C, HDL-C, APOA, APOB, Pure hypercholesterolaemia and lipid-lowering drugs.
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Affiliation(s)
- Zilong Tan
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Hong
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Aochuan Sun
- Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mengdi Ding
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianwu Shen
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Zhou Q, Ouyang J, Zhang ZY. Analysis and prediction of postoperative recurrence of unilateral upper ureteral calculi in 243 cases (nomogram). SAGE Open Med 2023; 11:20503121231191995. [PMID: 37564899 PMCID: PMC10411246 DOI: 10.1177/20503121231191995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023] Open
Abstract
Objective: This study aimed to identify the risk factors for postoperative recurrence of unilateral upper ureteral calculi and develop a predictive nomogram. Patients and Methods: A retrospective analysis was conducted on 243 patients diagnosed with unilateral upper ureteral calculi who were treated at our hospital between January 1, 2016 and December 31, 2018. Patients were divided into two groups: recurrence or non-recurrence cohort. Differences in age, gender, smoking and/or drinking habit, laterality, stone diameter, ureteral stricture, stone incarceration, urinary tract infection, surgical intervention, operation time, body mass index, and metabolic syndrome were analyzed. Discrete risk factors were screened, and a nomogram was developed to predict the probability of stone recurrence. Results: The study found that the recurrence of ureteral calculi was associated with factors including stone diameter, ureteral stricture, stone incarceration, surgical intervention, operation time, metabolic syndrome, body mass index, triglycerides, diabetes, and high blood pressure (p < 0.05). Ureteral stricture, surgical intervention, metabolic syndrome, and triglycerides were found to be discrete risk factors for stone recurrence (p < 0.05). In addition, the study revealed that the stone recurrence rate of metabolic syndrome patients was significantly elevated (p < 0.05), as demonstrated by the survival curve. Lastly, using the nomogram, with an area under the curve value of 0.929, the recurrence rate of ureteral calculi was predicted. Conclusions: The study identified that preoperative ureteral stricture, laparoscopic ureterolithotomy, metabolic syndrome, and triglycerides are closely related to postoperative recurrence of ureteral calculi. The nomogram developed in this study can be used as a predictive tool for the recurrence rate of ureteral calculi.
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Affiliation(s)
- Qi Zhou
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Jun Ouyang
- Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Zhi-yu Zhang
- Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, PR China
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Modulatory effects of Lactiplantibacillus plantarum on chronic metabolic diseases. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Shojaei-Zarghani S, Safarpour AR, Askari H, Jahromi HK, Abbasi E, Fattahi MR. Metabolic Syndrome and Nephrolithiasis; A Cross Sectional Population-based Study on the Baseline Data of the PERSIAN Kavar Cohort Study. Urology 2023; 173:61-67. [PMID: 36435345 DOI: 10.1016/j.urology.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the relationship between metabolic syndrome and its components with nephrolithiasis. METHODS In current study, 4,901 individuals from the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Kavar cohort study were included. Metabolic syndrome was defined according to the ATP III criteria (2005 revision). The nephrolithiasis was assessed using a structured questionnaire, and ultrasound findings were reviewed in subjects who reported positive history of nephrolithiasis. We applied logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS The prevalence of nephrolithiasis and metabolic syndrome was 28.5% and 40.91%, respectively. Almost 31% of the patients with metabolic syndrome had a history of nephrolithiasis. Multivariable logistic regression analysis revealed a positive association between metabolic syndrome and nephrolithiasis (OR= 1.30, 95% CI: 1.14-1.49, P<.001) after adjustment age, sex, ethnicity, physical activity, smoking status, and alcohol intake. Furthermore, the relation was higher for elders aged 50 years or more (P for interaction= .016) and Turk Nomad participants (P for interaction= 0.044) than the others. There was also a positive independent association between hypertension (OR=1.29, 95% CI: 1.12-1.48, P<.001) and hypertriglyceridemia (OR= 1.15, 95% CI: 1.01-1.31, P=.033) with nephrolithiasis. CONCLUSION In this large sample study, we demonstrate a weak positive association between metabolic syndrome, hypertension, and hypertriglyceridemia with nephrolithiasis.
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Affiliation(s)
- Sara Shojaei-Zarghani
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hassan Askari
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Kargar Jahromi
- Research center for non-Communicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran; Zoonoses research center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Abbasi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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He Q, Tang Y, Li Y, Wang F, Bao J, Gupta S. A pilot dynamic analysis of formative factors of nephrolithiasis related to metabolic syndrome: evidence in a rat model. Ren Fail 2022; 44:1134-1143. [PMID: 35837686 PMCID: PMC9291672 DOI: 10.1080/0886022x.2022.2097922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction and objective To examine the dynamic changes in the formative factors of nephrolithiasis and the final micromorphological changes in an obesity-initiated metabolic syndrome (MS) rat model. Methods Forty five-week-old male Sprague–Dawley (SD) rats were randomly divided into four groups: the regular diet group (RD), high-fat diet group (HFD), regular diet with drug (ethylene glycol and ammonium chloride) group (RDD), and high-fat diet with drug group (HFDD). A dynamic assessment of MS components (body weight (BW), body length (BL), Lee’s index (LI), blood glucose (BG), total cholesterol (TC), and triglycerides (TGs)) and stone-forming factors (urinary pH, urinary calcium, and urinary oxalate acid) was carried out. In addition, the levels of oxidative stress (OS) markers (CAT, SOD, TAC, GSH-PX, and MDA) were measured, and histological analysis was carried out at the end of 16 weeks. Results MS-related parameters, such as BW, LI, BG, TC, and TG, were significantly higher in HFD-fed rats than in RD-fed rats (p < 0.001). In the HFDD group, significantly lower urinary pH, hyperoxaluria, and hypocalciuria were noted in the dynamic assessment of stone-forming factors (p < 0.001). CAT, TAC, and MDA were notably changed in the HFD-fed groups, particularly the HFDD rats. Histological analysis showed that the renal tubules of HFDD rats had the highest scores for both inflammation and renal crystallization deposition (p < 0.05). Conclusions Our results suggest that male SD rats with MS are prone to developing nephrolithiasis. Validation in an in vivo model may lead to an understanding of the underlying pathophysiological mechanisms of action of MS-related nephrolithiasis in humans.Key messages Male SD rats with metabolic syndrome are more prone to developing calcium oxalate nephrolithiasis after treatment with ethylene glycol and ammonium chloride compared to control lean rats. MS-related nephrolithiasis in rats induced by ethylene glycol and ammonium chloride is mainly related to increased hyperoxaluria and inflammation and decreased antioxidant levels. High-fat diet-fed SD rats treated with ethylene glycol and ammonium chloride are a stable and valid in vivo model for understanding the potential mechanism of action of MS-related nephrolithiasis.
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Affiliation(s)
- Qiqi He
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Yangguo Tang
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, China.,College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Yuzhuo Li
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Fei Wang
- Department of Paediatric, Lanzhou University Second Hospital, Lanzhou, China
| | - Junsheng Bao
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Sanjay Gupta
- Department of Urology, University Hospitals Case Medicine Center, Case Western Reserve University, Cleveland, OH, USA
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Dyslipidemia Increases the Risk of Incident Kidney Stone Disease in a Large Taiwanese Population Follow-Up Study. Nutrients 2022; 14:nu14071339. [PMID: 35405952 PMCID: PMC9000795 DOI: 10.3390/nu14071339] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
The prevalence and incidence rates of kidney stone disease (KSD) in Taiwan are high; however, the association between lipid profile and KSD has yet to be investigated. The aim of this longitudinal study was to investigate the association between lipid profile with baseline and incident KSD in a large Taiwanese cohort. A total of 27,002 people enrolled in the Taiwan Biobank (TWB) were followed for a median of 4 years and classified into two groups according to whether they had (n = 1813; 6.7%) or did not have (n = 25,189; 93.3%) KSD at baseline. The presence of KSD was defined according to a self-reported history of kidney stones. The participants with baseline KSD (n = 1813) were excluded from the follow-up study, and the remaining participants were classified into two groups consisting of those who had (n = 640; 2.5%) or did not have (n = 24,549; 97.5%) incident KSD. After multivariable analysis, compared to quartile 1 of lipid profile, the participants in quartile 4 of triglycerides, quartiles 3 and 4 of high-density lipoprotein cholesterol (HDL-C), and quartile 4 of total cholesterol (Chol)/HDL-C ratio were significantly associated with baseline KSD. In the follow-up study, the participants in quartiles 2, 3, and 4 of triglycerides; quartile 2 of Chol; quartile 4 of HDL-C; quartile 3 of LDL-C; and quartiles 3 and 4 of Chol/HDL-C ratio were significantly associated with incident KSD. Our results showed that hypertriglyceridemia (67−93 mg/dL) was associated with a 1.463-fold increased risk of incident KSD and that low HDL-C (>63 mg/dL) protected against incident KSD formation. In addition, a Chol/HDL-C ratio larger than 3.64 was associated with a 1.381-fold increased risk of incident KSD. Our findings may imply that the optimal management of dyslipidemia may be associated with a lower risk of developing kidney stones.
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Hood VL, Sternberg KM, de Waal D, Asplin JR, Mulligan C, Callas PW. Association of Urine Findings with Metabolic Syndrome Traits in a Population of Patients with Nephrolithiasis. KIDNEY360 2021; 3:317-324. [PMID: 35373120 PMCID: PMC8967639 DOI: 10.34067/kid.0002292021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/23/2021] [Indexed: 01/10/2023]
Abstract
Background The odds of nephrolithiasis increase with more metabolic syndrome (MetS) traits. We evaluated associations of metabolic and dietary factors from urine studies and stone composition with MetS traits in a large cohort of stone-forming patients. Methods Patients >18 years old who were evaluated for stones with 24-hour urine collections between July 2009 and December 2018 had their records reviewed retrospectively. Patient factors, laboratory values, and diagnoses were identified within 6 months of urine collection and stone composition within 1 year. Four groups with none, one, two, and three or four MetS traits (hypertension, obesity, dyslipidemia, and diabetes) were evaluated. Trends across groups were tested using linear contrasts in analysis of variance and analysis of covariance. Results A total of 1473 patients met the inclusion criteria (835 with stone composition). MetS groups were 684 with no traits, 425 with one trait, 211 with two traits, and 153 with three or four traits. There were no differences among groups for urine volume, calcium, or ammonium excretion. There was a significant trend (P<0.001) for more MetS traits being associated with decreasing urine pH, increasing age, calculated dietary protein, urine uric acid (UA), oxalate, citrate, titratable acid phosphate, net acid excretion, and UA supersaturation. The ratio of ammonium to net acid excretion did not differ among the groups. After adjustment for protein intake, the fall in urine pH remained strong, while the upward trend in acid excretion was lost. Calcium oxalate stones were most common, but there was a trend for more UA (P<0.001) and fewer calcium phosphate (P=0.09) and calcium oxalate stones (P=0.01) with more MetS traits. Conclusions Stone-forming patients with MetS have a defined pattern of metabolic and dietary risk factors that contribute to an increased risk of stone formation, including higher acid excretion, largely the result of greater protein intake, and lower urine pH.
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Affiliation(s)
- Virginia L. Hood
- Department of Nephrology, University of Vermont Medical Center, Burlington, Vermont
| | - Kevan M. Sternberg
- Department of Urology, University of Vermont Medical Center, Burlington, Vermont
| | - Desiree de Waal
- Department of Nephrology, University of Vermont Medical Center, Burlington, Vermont
| | - John R. Asplin
- Litholink Corporation, Laboratory Corporation of America Holdings, Itasca, Illinois
| | - Carley Mulligan
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Peter W. Callas
- Medical Biostatistics, University of Vermont, Burlington, Vermont
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Bamberger JN, Rosen DC, Khusid JA, Kaplan-Marans E, Gallante B, Kapoor A, Paranjpe I, Atashsokhan DJ, Atallah WM, Gupta M. The impact of metabolic syndrome components on urinary parameters and risk of stone formation. World J Urol 2021; 39:4483-4490. [PMID: 34264364 DOI: 10.1007/s00345-021-03790-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the relationship between metabolic syndrome (MS) and urinary abnormalities in stone-forming patients. Additionally, to delineate whether severity of urinary derangements is impacted by the number of co-occurring MS components. METHODS Stone-forming patients who underwent initial metabolic workup prior to medical intervention at a comprehensive stone clinic were retrospectively reviewed and included in the study. Patients were given a six point (0-5) Metabolic Syndrome Severity Score (MSSS) based on the number of co-occurring MS components and split into six respective groups. Baseline clinical characteristics and metabolic profiles were compared between groups. RESULTS Four-hundred-ninety-five patients were included in the study. Median age and median BMI was 58 years and 27.26 kg/m2, respectively. Several significant metabolic differences were noted, most notably a downward trend in median urinary pH (p < 0.001) and an upward trend in median urinary supersaturation uric acid (p < 0.001) across groups as MSSS increased. Multivariate analysis demonstrated an independent association between higher MSSS and increasing number of urinary abnormalities. A second multivariate analysis revealed that all MS components except hyperlipidemia were independently associated with low urinary pH. Additionally, obesity was independently associated with the greatest number of urinary abnormalities and had the strongest association with hyperuricosuria. CONCLUSIONS Prior research has attributed the strong association of nephrolithiasis and MS to high prevalence of UA nephrolithiasis and low urinary pH. Our findings indicate that all MS components with the exception of hyperlipidemia were independently associated with low urinary pH suggesting a mechanism independent from insulin resistance.
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Affiliation(s)
- Jacob N Bamberger
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,SUNY Downstate College of Medicine, Brooklyn, NY, USA.
| | - Daniel C Rosen
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johnathan A Khusid
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elie Kaplan-Marans
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Blair Gallante
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arjun Kapoor
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ishan Paranjpe
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Danie J Atashsokhan
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William M Atallah
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mantu Gupta
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wu B, Xie J, Guo J, Wang J, Lang H. Association between metabolic syndrome and calcium oxalate stone risk in Chinese individuals: a nomogram prediction model. J Int Med Res 2021; 49:300060520986726. [PMID: 33596688 PMCID: PMC7897830 DOI: 10.1177/0300060520986726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This retrospective study explored the association between calcium oxalate (CaOx) stones and metabolic syndrome. It also developed and validated a nomogram to aid in the prediction of CaOx stones. Methods This case-control study enrolled 150 patients with CaOx stones and 635 individuals without urolithiasis from October 2016 to October 2018. Student’s t-test, the chi-squared test, and logistic univariate and multivariate regression analyses were used. A nomogram for prediction of CaOx stones was established based on independent associated factors. The concordance index and calibration curves were plotted to determine nomogram accuracy. Results Female sex, age ≥66 years, blood pressure (systolic pressure ≥130 mmHg and/or diastolic pressure ≥85 mmHg), and blood uric acid level independently influenced the risk of CaOx stones, according to multivariate logistic regression analysis; these factors were included in the nomogram. The concordance index was 0.701 (95% confidence interval: 0.658–0.737). The standard curve showed a robust fit with the calibrated predictive curve. Conclusions Female sex, age ≥66 years, elevated blood pressure, and blood uric acid level independently influenced the risk of CaOx stones. Our nomogram for the prediction of CaOx stones may provide a clinical basis for the assessment of CaOx stone and facilitate early prevention efforts.
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Affiliation(s)
- Baisuo Wu
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Junhao Xie
- Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Junyi Guo
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Jinbo Wang
- Department of Urology, No. 83 Central Hospital of Xinxiang Medical College, Xinxiang, Henan, China
| | - Hongjuan Lang
- Department of Nursing, The Fourth Military Medical University, Xi'an, China
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Besiroglu H, Ozbek E. Association between blood lipid profile and urolithiasis: A systematic review and meta-analysis of observational studies. Int J Urol 2018; 26:7-17. [PMID: 30151863 DOI: 10.1111/iju.13781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/08/2018] [Indexed: 01/11/2023]
Abstract
The objective of this study was to pool individual studies regarding the association of blood lipid profiles with urolithiasis to carry out a systematic review and meta-analysis. We searched MEDLINE, PubMed, Embase and Cochrane Library to identify the relevant studies up to November 2017. Studies that met all inclusion criteria were chosen, and a pooled analysis of the odds ratio between urolithiasis and dyslipidemia traits was calculated. A total of 11 observational studies (seven cross-sectional, three cohort, one case-control) with a total of 282 479 participants were examined. The overall pooled analysis of eight studies showed that high triglyceride was associated with increased estimated risk of urolithiasis (odds ratio 1.287, 95% CI 1.073-1.544; P = 0.007). Estimates of the total effect size were consistent in the sensitivity analysis. No evidence of publication bias was detected. The overall pooled analysis of nine studies showed low high-density lipoprotein was weakly associated with increased estimated risk of urolithiasis (odds ratio 1.171, 95% CI 1.010-1.358; P = 0.032). The sensitivity analysis showed conflicting results. No evidence of publication bias was detected. Three studies on the association between any dyslipidemia traits and urolithiasis showed a significant association (odds ratio 1.309, 95% CI 1.202-1.425; P < 0.001). The present meta-analysis showed that patients with higher triglyceride and lower high-density lipoprotein had an increased estimated risk of urolithiasis. A triglyceride-urolithiasis association was found to be more coherent and consistent compared with the high-density lipoprotein-urolithiasis association. Although somewhat contradictory results have been found, the meta-analysis is encouraging for evaluating urolithiasis as a systemic disorder. Further well-designed prospective randomized controlled or cohort studies are necessary to better elucidate the causal association of dyslipidemia and urolithiasis.
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Affiliation(s)
- Huseyin Besiroglu
- Department of Urology, Catalca Ilyas Cokay State Hospital, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Cerrahpasa Medicine Faculty, Istanbul University, Istanbul, Turkey
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Dhondup T, Kittanamongkolchai W, Vaughan LE, Mehta RA, Chhina JK, Enders FT, Hickson LJ, Lieske JC, Rule AD. Risk of ESRD and Mortality in Kidney and Bladder Stone Formers. Am J Kidney Dis 2018; 72:790-797. [PMID: 30146423 DOI: 10.1053/j.ajkd.2018.06.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 06/11/2018] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVES Kidney stones have been associated with increased risk for end-stage renal disease (ESRD). However, it is unclear whether there is also an increased risk for mortality and if these risks are uniform across clinically distinct categories of stone formers. STUDY DESIGN Historical matched-cohort study. SETTING & PARTICIPANTS Stone formers in Olmsted County, MN, between 1984 and 2012 identified using International Classification of Diseases, Ninth Revision codes. Age- and sex-matched individuals who had no codes for stones were the comparison group. PREDICTOR Stone formers were placed into 5 mutually exclusive categories after review of medical charts: incident symptomatic kidney, recurrent symptomatic kidney, asymptomatic kidney, bladder only, and miscoded (no stone). OUTCOMES ESRD, mortality, cardiovascular mortality, and cancer mortality. ANALYTICAL APPROACH Cox proportional hazards models with adjustment for baseline comorbid conditions. RESULTS Overall, 65 of 6,984 (0.93%) stone formers and 102 of 28,044 (0.36%) non-stone formers developed ESRD over a mean follow-up of 12.0 years. After adjusting for baseline hypertension, diabetes mellitus, dyslipidemia, gout, obesity, and chronic kidney disease, risk for ESRD was higher in recurrent symptomatic kidney (HR, 2.34; 95% CI, 1.08-5.07), asymptomatic kidney (HR, 3.94; 95% CI, 1.65-9.43), and miscoded (HR, 6.18; 95% CI, 2.25-16.93) stone formers, but not in incident symptomatic kidney or bladder stone formers. The adjusted risk for all-cause mortality was higher in asymptomatic kidney (HR, 1.40; 95% CI, 1.18-1.67) and bladder (HR, 1.37; 95% CI, 1.12-1.69) stone formers. Chart review of asymptomatic and miscoded stone formers suggested increased risk for adverse outcomes related to diagnoses including urinary tract infection, cancer, and musculoskeletal or gastrointestinal pain. CONCLUSIONS The higher risk for ESRD in recurrent symptomatic compared with incident symptomatic kidney stone formers suggests that stone events are associated with kidney injury. The clinical indication for imaging in asymptomatic stone formers, the correct diagnosis in miscoded stone formers, and the cause of a bladder outlet obstruction in bladder stone formers may explain the higher risk for ESRD or death in these groups.
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Affiliation(s)
- Tsering Dhondup
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | | | - Lisa E Vaughan
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Ramila A Mehta
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Jasdeep K Chhina
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Felicity T Enders
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | | | - John C Lieske
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
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