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Flisiński M, Brymora A, Skoczylas-Makowska N, Stefańska A, Manitius J. Fructose-Rich Diet Is a Risk Factor for Metabolic Syndrome, Proximal Tubule Injury and Urolithiasis in Rats. Int J Mol Sci 2021; 23:203. [PMID: 35008629 PMCID: PMC8745542 DOI: 10.3390/ijms23010203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022] Open
Abstract
Excessive consumption of fructose (FR) leads to obesity, metabolic syndrome (MS) and insulin resistance, which are known risk factors for kidney stones. The epidemiological study has suggested the association between fructose consumption and urolithiasis, but the precise mechanism is still not well understood. Male Wistar rats were assigned for 8 weeks to three groups with different FR content in diet: RD (n = 5)-regular diet with a FR < 3%; F10 (n = 6)-regular diet with an addition of 10% Fr in drinking water; F60 (n = 5)-60% FR as a solid food. Serum concentration of FR, creatinine (Cr), insulin (Ins), triglycerides (Tg), homocysteine (HCS), uric acid (UA), calcium (Ca), phosphate (Pi), magnesium (Mg) and sodium (Na) were measured. Based on 24 h urine collection the following tests were performed: urine pH, proteinuria (PCR), excretion of N-Acetyl-(D)-Glucosaminidase (NAG), monocyte chemoattractant protein (MCP-1), uric acid (uUAEx), phosphate (uPiEx), calcium (uCaEx), magnesium (uMgEx) and sodium (uNaEx). The creatinine clearance (CrCl) was calculated. Calcium deposits in kidney sections were examined using hematoxylin and eosin (HE) and von Kossa stains. The rats on F10 and F60, as compared to the RD diet, showed a tendency for lower CrCl, higher HCS level and some features of MS as higher Ins and TG levels. Interestingly, F10 (fluid) versus F60 (solid) diet led to higher serum Ins levels. F10 and F60 versus RD demonstrated higher urinary excretion of MCP-1 and NAG which were suggestive for inflammatory injury of the proximal tubule. F10 and F60 as compared to RD showed significantly lower uUAEx, although there were no differences in clearance and fractional excretion of UA. F60 versus RD induced severe phosphaturia (>30×) and natriuria (4×) and mild calciuria. F10 versus RD induced calciuria (3×), phosphaturia (2×) and mild natriuria. Calcium phosphate stones within the tubules and interstitium were found only in rats on FR diet, respectively, in two rats from the F10 group and another two in the F60 group. The rats which developed stones were characterized by significantly higher serum insulin concentration and urinary excretion of calcium and magnesium. A fructose-rich diet may promote development of calcium stones due to proximal tubule injury and metabolic syndrome.
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Affiliation(s)
- Mariusz Flisiński
- Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (A.B.); (J.M.)
| | - Andrzej Brymora
- Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (A.B.); (J.M.)
| | - Natalia Skoczylas-Makowska
- Department of Clinical Pathology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland;
| | - Anna Stefańska
- Department of Laboratory Medicine Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland;
| | - Jacek Manitius
- Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (A.B.); (J.M.)
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Turudic D, Golubic AT, Lovric M, Bilic M, Milosevic D. Age-Specific Excretion of Calcium, Oxalate, Citrate, and Glycosaminoglycans and Their Ratios in Healthy Children and Children with Urolithiasis. Biomolecules 2021; 11:biom11050758. [PMID: 34069381 PMCID: PMC8158688 DOI: 10.3390/biom11050758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 11/23/2022] Open
Abstract
We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mmol/mmol creatinine) and the calcium/citrate ratio (mol/mmol) are the only variables that differentiate children before puberty from healthy children (ROC analysis confirmed only calcium/citrate as a significant variable with cut-off value > 0.84). Peri-pubertal children are distinguished from age- and gender-matched healthy children by the following variables: citrate (mmol/mol creatinine), calcium/citrate (mol/mmol), oxalate/glycosaminoglycans (mmol/g), oxalate/citrate ratios (mmol/mmol) and oxalate/(citrate × glycosaminoglycans) (mol oxalate × mol creatinine)/(mol citrate × g glycosaminoglycans). All variables were confirmed by ROC analysis with cut-off values ≤ 327.87, >1.02, >11.24, >0.12 and >0.03, respectively. These results indicate a different risk of urinary stones development before puberty vs. pubertal/postpubertal children and increasing importance (deficiency) of citrate and glycosaminoglycans in such children. J48 classifier confirmed the importance of the oxalate/(citrate × glycosaminoglycans) and the calcium/citrate ratios (Ox/Cit × GAG 0.22 and Cit/GAG 0.612) with the practically applicable classification tree for distinguishing between pubertal/postpubertal children with urolithiasis with age- and gender-matched healthy children.
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Affiliation(s)
- Daniel Turudic
- Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- Correspondence:
| | - Anja Tea Golubic
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Mila Lovric
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Marko Bilic
- Department of Urology, University Hospital “Sveti Duh”, 10000 Zagreb, Croatia;
| | - Danko Milosevic
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- General Hospital Zabok and Croatian Veterans Hospital, 49210 Zabok, Croatia
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Wang YH, Wu CF, Liu CC, Hsieh TJ, Tsai YC, Wu MT, Chen CC. A probabilistic approach for benchmark dose of melamine exposure for a marker of early renal dysfunction in patients with calcium urolithiasis. Ecotoxicol Environ Saf 2020; 200:110741. [PMID: 32497990 DOI: 10.1016/j.ecoenv.2020.110741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
Environmental exposure to melamine has been associated with early renal injury in urolithiasis patients even when urinary concentrations of melamine are low. The aim of this study was to derive a benchmark dose (BMD) for melamine for urolithiasis patients. To do this, one-spot urine sample from 309 participants was obtained to measure urinary melamine and N-acetyl β-D-glucosaminidase (NAG), an early renal damage biomarker. The participants were then classified into four exposure groups based on the outcomes of melamine tableware usage questionnaire. A beta distribution of urinary excretion fraction for each group was assumed to estimate their average daily intakes (AvDIs) of melamine. The BMD and the corresponding one-sided 95% lower bound (BMDL) was then derived based on Bayesian model averaging of alternative regression models between the participants' NAG levels and their estimated AvDIs, adjusting for age, gender, and other covariates. Bayesian Markov chain Monte Carlo simulations were used for all the estimates. With a benchmark response of 0.10, the simulated BMDL of 4.89 μg/kg-bw/day for melamine exposure threshold was much lower than the WHO's current recommended tolerable daily intake of 200 μg/kg_bw/day and the US FDA's 63 μg/kg_bw/day. The current regulation level of melamine might not safeguard urolithiasis patients from further deterioration of renal function.
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Affiliation(s)
- Yin-Han Wang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Chia-Fang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan
| | - Chia-Chu Liu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Rd, Kaohsiung, 80708, Taiwan
| | - Tusty-Jiuan Hsieh
- Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Yi-Chun Tsai
- Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Tsang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan; Department of Public Health, Kaohsiung Medical University, Taiwan; Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Taiwan.
| | - Chu-Chih Chen
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Taiwan.
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Saouli A, Jabri Y, Karmouni T, Elkhader K, Koutani A, Iben Attya Andalousi A. [Bacteriological correlation of urinary stones and preoperative urine culture: Is there a significant impact on postoperative infectious risk? (Moroccan experience)]. Prog Urol 2020; 31:78-84. [PMID: 32651101 DOI: 10.1016/j.purol.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 11/19/2022]
Abstract
AIM The objectives of this study were to evaluate the impact of preoperative urine culture and the infected nature of stones on the occurrence of postoperative urinary sepsis. MATERIAL AND METHODS A prospective monocentric study included 29 patients operated on for urolithiasis between January and June 2018. RESULTS Postoperative urinary sepsis was observed in 4 patients (14%). Urinary colonization rate on preoperative CBU exam was 27.6% (8 of 29) while the rate of colonized stones was 31% (9 of 29). The occurrence of urinary sepsis was observed in 37.5% (3 of 8) of patients with urinary colonization, compared to 44.4% of patients with colonized stones (4 of 9). By comparing the bacteriological results observed during sepsis, the germs isolated in postoperative urine were the same found in the culture of stones. The chemical nature of the colonized stones was mainly calcium oxalate (monohydrate, dihydrate) P=0.02. There was a statistically significant correlation between the preoperative urine culture, the bacteriological culture of stones and the postoperative urinary sepsis (P=0.05, P=0.005) respectively. CONCLUSION Our study demonstrated a strong association between the bacteriological culture of stones and postoperative urinary sepsis superior to preoperative urine culture. It makes it possible to anticipate the occurrence of sepsis in patients requiring many endoscopic treatments. However, several multicentric prospective series may prove necessary to validate these results. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- A Saouli
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc.
| | - Y Jabri
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc
| | - T Karmouni
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc
| | - K Elkhader
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc
| | - A Koutani
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc
| | - A Iben Attya Andalousi
- Service d'urologie B, faculté de médecine et de pharmacie de Rabat, université Mohamed-V, CHU Ibn-Sina, Rabat, Maroc
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Runolfsdottir HL, Palsson R, Thorsteinsdottir UA, Indridason OS, Agustsdottir IMS, Oddsdottir GS, Thorsteinsdottir M, Edvardsson VO. Urinary 2,8-dihydroxyadenine excretion in patients with adenine phosphoribosyltransferase deficiency, carriers and healthy control subjects. Mol Genet Metab 2019; 128:144-150. [PMID: 31378568 PMCID: PMC6864267 DOI: 10.1016/j.ymgme.2019.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disorder of adenine metabolism that results in excessive urinary excretion of the poorly soluble 2,8-dihydroxyadenine (DHA), leading to kidney stones and chronic kidney disease. The purpose of this study was to assess urinary DHA excretion in patients with APRT deficiency, heterozygotes and healthy controls, using a recently developed ultra-performance liquid chromatography - tandem mass spectrometry (UPLC-MS/MS) assay. METHODS Patients enrolled in the APRT Deficiency Registry and Biobank of the Rare Kidney Stone Consortium (http://www.rarekidneystones.org/) who had provided 24-h and first-morning void urine samples for DHA measurement were eligible for the study. Heterozygotes and healthy individuals served as controls. Wilcoxon-Mann-Whitney test was used to compare 24-h urinary DHA excretion between groups. Associations were examined using Spearman's correlation coefficient (rs). RESULTS The median (range) 24-h urinary DHA excretion was 138 (64-292) mg/24 h and the DHA-to-creatinine (DHA/Cr) ratio in the first-morning void samples was 13 (4-37) mg/mmol in APRT deficiency patients who were not receiving xanthine oxidoreductase inhibitor therapy. The 24-h DHA excretion was highly correlated with the DHA/Cr ratio in first-morning void urine samples (rs = 0.84, p < .001). DHA was detected in all urine samples from untreated patients but not in any specimens from heterozygotes and healthy controls. CONCLUSIONS High urinary DHA excretion was observed in patients with APRT deficiency, while urine DHA was undetectable in heterozygotes and healthy controls. Our results suggest that the UPLC-MS/MS assay can be used for diagnosis of APRT deficiency.
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Affiliation(s)
- Hrafnhildur L Runolfsdottir
- Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Runolfur Palsson
- Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Unnur A Thorsteinsdottir
- Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Olafur S Indridason
- Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Inger M Sch Agustsdottir
- Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - G Steinunn Oddsdottir
- Department of Clinical Biochemistry, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Margret Thorsteinsdottir
- Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ArcticMass, Reykjavik, Iceland
| | - Vidar O Edvardsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
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Prieto RM, Rodriguez A, Sanchis P, Morey M, Fiol M, Grases F, Castañer O, Martínez-González MA, Salas-Salvadó J, Romaguera D. Association of Adherence to The Mediterranean Diet with Urinary Factors Favoring Renal Lithiasis: Cross-Sectional Study of Overweight Individuals with Metabolic Syndrome. Nutrients 2019; 11:nu11081708. [PMID: 31344950 PMCID: PMC6723981 DOI: 10.3390/nu11081708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 07/21/2019] [Accepted: 07/21/2019] [Indexed: 11/16/2022] Open
Abstract
Our purpose was to study the relationship of adherence to the Mediterranean diet (MedDiet) with urinary factors that favor the formation of renal calcium and uric acid stones in overweight and obese participants who had metabolic syndrome. This cross-sectional study examined 267 participants. A well-known MedDiet score (range 0–9) was calculated for each patient, and patients were then categorized has having low (≤3), medium (4–5), or high (≥6) adherence to the MedDiet. Baseline characteristics and urinary parameters were also analyzed. High calcium salt urinary crystallization risk (CaUCR) and high uric acid urinary crystallization risk (UrUCR) were calculated from urinary parameters using pre-defined criteria. More than half of patients with MedDiet scores ≤3 had high UrUCR (55.4%) and high CaUCR (53.8%). In contrast, fewer patients with high adherence (≥6) to the MedDiet had high UrUCR (41.2%) and high CaUCR (29.4%). Relative to those with low adherence, individuals with high adherence had a prevalence ratio (PR) of 0.77 for a high UrUCR (95% CI: 0.46–1.12; p for trend: 0.069) and a PR of 0.51 for a high CaUCR (95% CI: 0.26–0.87; p for trend: 0.012) after adjusting for age, sex, body mass index, type 2 diabetes, and total energy intake. Our findings indicate that greater adherence to the MedDiet was associated with a reduced CaUCR and a reduced UrUCR. This suggests that adequate dietary management using the MedDiet patterns may prevent or reduce the incidence and recurrence of calcium salt and uric acid renal stones.
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Affiliation(s)
- Rafael M Prieto
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS-IdISBa). University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain.
| | - Adrian Rodriguez
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS-IdISBa). University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Pilar Sanchis
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS-IdISBa). University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Margalida Morey
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Miquel Fiol
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Science Research (IUNICS-IdISBa). University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Research Institute (IMIM), 08003 Barcelona, Spain
| | - Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, 31009 Pamplona, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, 43204 Reus, Spain
- Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, 43003 Tarragona, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de les Illes Balears (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
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Yen Y, Cheng B, Chan C, Lin C, Chen H. Heavy Metal Components in Blood and Urinary Stones of Urolithiasis Patients. Biol Trace Elem Res 2018; 185:266-274. [PMID: 29488068 DOI: 10.1007/s12011-018-1253-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/18/2018] [Indexed: 11/24/2022]
Abstract
Lifestyle, food intake, and exposure to chemicals are potential risk factors for the development of calcium urolithiasis. Pb, Cd, and Hg have been proved to cause renal illness, and urinary tract stones might be caused by exposure to metals. Therefore, this study aimed to measure the concentration of metals in urinary tract stones and blood simultaneously in urolithiasis patients. Moreover, we intended to determine whether urinary tract stones can be regarded as a biomarker of exposure or an effect marker in a population with environmental exposure to metals. Thirty-five urolithiasis patients (case) and 34 healthy inhabitants (control) were recruited in this study. The contents of Pb, Cd, Cr, Cu, Ni, As, Zn, and Hg were determined in urinary stones and blood in the case and control groups. The most abundant metals were Zn and Cu in blood and Zn and Ni in urinary stones. Significantly higher levels of Zn, Ni, and As were found in calcium phosphate stones than in calcium oxalate or uric acid stones. The majority of metals were not present at consistent levels in both blood and urinary stones, except for Zn. Urinary stones might be explained as providing another metabolic pathway for metal contamination. Moreover, as the metals with the highest content in urinary stones were Ni and Zn, and Ni content was very much higher than in other countries, contamination by Ni should be further taken into consideration if there is any serious contamination in Taiwan.
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Affiliation(s)
- Yunhe Yen
- Department of Urology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Borshuh Cheng
- Department of Urology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Changchung Chan
- Department of Urology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Chiwei Lin
- Institute of Occupational Safety and Hazard Prevention, Hung Kuang University, No. 1018, Sec. 6, Taiwan BLVD, Shalu District, Taichung, 43302, ROC, Taiwan
| | - Hsiuling Chen
- Institute of Occupational Safety and Hazard Prevention, Hung Kuang University, No. 1018, Sec. 6, Taiwan BLVD, Shalu District, Taichung, 43302, ROC, Taiwan.
- Department of Food Safety/Hygiene and Risk Management, National Cheng Kung University, Tainan, Taiwan.
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Demidko LS, Rudenko VI, Grigoryan VA, Demidko YL, Enikeev ME, Inoyatov ZS, Amosova MV. [Characteristic features of urinary calcium excretion and osteoporosis risk factors in patients with urolithiasis]. Urologiia 2018:5-8. [PMID: 29901287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
RELEVANCE The prevalence of urolithiasis and osteoporosis (OP) indicates that these diseases may be found concurrently in the same patient. The detection of risk factors for OP and disorders of calcium metabolism in patients with urolithiasis is of interest in the context of primary stone formation and metaphylaxis. AIM To identify risk factors for osteoporosis and disorders of calcium metabolism in patients with urolithiasis. MATERIALS AND METHODS Osteoporosis risk factors were studied in 45 urolithiasis patients undergoing surgical treatment. Patients were asked to fill out the osteoporosis risk factor questionnaire, and urinary calcium excretion was measured in 24-h collections. RESULTS Risk factors for osteoporosis were detected in 20 (44.4%) urolithiasis patients. Patients with osteoporosis risk factors identified by the questionnaire were statistically significantly older (p=0.032). Osteoporosis risk factors were found in 20% of patients with newly diagnosed urolithiasis and 24.4% of patients with recurrent urolithiasis. The study patients showed increased urinary calcium excretion and decreased diuresis. The negative correlation between urinary calcium excretion and 24-h diuresis was greater in patients who had than in those who did not have osteoporosis. CONCLUSION An increase in urinary calcium excretion and a decrease in diuresis can be a predisposing factor for the recurrence of urolithiasis. In patients with risk factors for osteoporosis, it can provide a rationale for administering drugs aimed at preventing stone formation (thiazide diuretics).
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Affiliation(s)
- L S Demidko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - V I Rudenko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - V A Grigoryan
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - Yu L Demidko
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - M E Enikeev
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - Zh Sh Inoyatov
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - M V Amosova
- Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
- Department of Endocrinology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
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Abstract
The formation of urinary stone, urolithiasis, is one the oldest known disease affecting human throughout different civilizations and times. The exact pathophysiological mechanism of urolithiasis is not yet clear, as these calculi are of various types and too complex for simple understanding. A single theory cannot explain its formation; therefore, different theories are presented in various times for its explanation like free particle, fixed particle, Randall's plaque theory. In addition, various factors and components are identified that play an important role in the formation of these urinary calculi. In this review, composition of kidney stones, its prevalence/incidence, explanation of pathophysiological mechanisms and role of various factors; urinary pH, uric acid, parathyroid hormone, citrate, oxalate, calcium and macromolecules; osteopontin, matrix Gla protein, kidney injury molecules, urinary prothrombin fragment-1, Tamm-Horsfall protein, inter-α-inhibitors, have been discussed in detail.
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Affiliation(s)
- Aslam Khan
- Basic Sciences Department, College of Science and Health Professions-(COSHP-J), King Saud bin Abdulaziz University for Health Sciences, Mail Code: 6666, P.O. Box 9515, Jeddah, 21423, Kingdom of Saudi Arabia.
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Kamalov AA, Okhobotov DA, Nizov AN. [Changes in the concentration of urolitiasis markers depending on stone-forming activity in patients with recurrent urolithiasis]. Urologiia 2018:15-19. [PMID: 29634128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED The study aimed to investigate the changes in the concentration of bikunin, osteopontin, and nephrocalcin, depending on the changes in the renal stone-forming activity in patients with recurrent urolithiasis. MATERIALS AND METHODS The study comprised 152 patients with recurrent calcium oxalate stones at various localizations. Patients of the study group (n=78) were administered complex preventive treatment (water load, Blamaren, thiazide diuretics, oral calcium supplementation) aimed at reducing the activity of urolithiasis. Patients of the control group (n=74) received no treatment. The studied parameters included concentrations of urine bikunin, osteopontin, and nephrocalcin in using ELISA. The follow-up period was six months. RESULTS By the end of the follow-up, the bikunin concentration in the control group was significantly higher than in the study group (7.0+/-0.81 mg/ml vs. 3.28+/-0.86 mg/ml, respectively, p<0.05) while osteopontin level was significantly lower (2.4+/-0.39 mg/ml vs. 3.4+/-0.36 mg/ml, p<0.05). The nephrocalcin concentrations during the follow-up period did not change significantly (p>0.05). The presence of hypercalciuria did not lead to significant changes in the concentration of stone formation inhibitors. DISCUSSION The increase in bikunin concentration in control patients is associated with an increase in the expression of this stone formation inhibitor due to the rise in the urolithiasis activity. Reduction in the osteopontin concentration in patients with high urolithiasis activity is a consequence of osteopontin being a constituent of calcium oxalate stones. CONCLUSION In patients with calcium oxalate urolithiasis, testing for urine concentrations of bikunin and osteopontin as potential markers can be used to estimate the risk of stone recurrence.
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Affiliation(s)
- A A Kamalov
- Medical Research and Educational Center, Lomonosov MSU, Moscow, Russia
- Lomonosov MSU, Faculty of Fundamental Medicine, Department of Urology and Andrology, Moscow, Russia
| | - D A Okhobotov
- Medical Research and Educational Center, Lomonosov MSU, Moscow, Russia
- Lomonosov MSU, Faculty of Fundamental Medicine, Department of Urology and Andrology, Moscow, Russia
| | - A N Nizov
- Medical Research and Educational Center, Lomonosov MSU, Moscow, Russia
- Lomonosov MSU, Faculty of Fundamental Medicine, Department of Urology and Andrology, Moscow, Russia
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Liu CC, Hsieh TJ, Wu CF, Tsai YC, Huang SP, Lee YC, Huang TY, Shen JT, Chou YH, Huang CN, Wu WJ, Wu MT. Urinary melamine excretion and increased markers of renal tubular injury in patients with calcium urolithiasis: A cross-sectional study. Environ Pollut 2017; 231:1284-1290. [PMID: 28939127 DOI: 10.1016/j.envpol.2017.08.091] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/27/2017] [Accepted: 08/26/2017] [Indexed: 06/07/2023]
Abstract
Environmental low-dose melamine exposure has been associated with urolithiasis risk in adults, but it is unclear if this exposure can cause early renal damage. This cross-sectional study investigated the association of this exposure and early renal damage in patients with calcium urolithiasis. We recruited patients diagnosed with upper urinary tract calcium urolithiasis from three hospitals in southwestern Taiwan between November 2010 and January 2015. All patients completed a structured questionnaire and provided one-spot urine samples for the measurement of melamine level and markers of early renal injury, including N-acetyl b-d-glucosaminidase (NAG), β2-microglobulin (β2-MG), and microalbumin. We used urinary melamine levels as an indicator of environmental melamine exposure. A total of 309 patients (mean age of 54.7 ± 12.8 years) were studied. Median urinary melamine level (μg/mmol Cr) was 1.26 (interquartile range 0.48-3.29). A significant and positive correlation was found between urinary melamine concentration and urinary NAG levels (Spearman correlation coefficient, r = 0.157, p = 0.006, n = 309). With urinary melamine levels categorized into quartiles, multivariate regression results showed the same relationship, particularly in those with first stone episode. In this group, patients with the highest quartile of urinary melamine concentration had a 3.95-fold risk (95% confidence interval = 1.43-10.94) of high NAG levels (dichotomized by median), compared to the lowest quartile after adjustment. No association was found between urinary melamine concentration and urinary microalbumin levels. In conclusion, urinary melamine is significantly associated with urinary marker of early renal tubular injury, NAG, in urolithiasis patients, especially ones with first stone episode.
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Affiliation(s)
- Chia-Chu Liu
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Depravement of Urology, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Tusty-Jiuan Hsieh
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chia-Fang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yi-Chun Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Shu-Pin Huang
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yung-Chin Lee
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Tsung-Yi Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Jung-Tsung Shen
- Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan
| | - Yii-Her Chou
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chun-Nung Huang
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Wen-Jeng Wu
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ming-Tsang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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Sharma I, Khan W, Ahmad S. In vitro and ex vivo approach for anti-urolithiatic potential of bioactive fractions of gokhru with simultaneous HPLC analysis of six major metabolites and their exploration in rat plasma. Pharm Biol 2017; 55:701-711. [PMID: 27982733 PMCID: PMC6130657 DOI: 10.1080/13880209.2016.1266671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 11/18/2016] [Accepted: 11/26/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT Tribulus terrestris L. (Zygophyllaceae) fruits have long been used in traditional systems of medicine for the treatment of various urinary diseases including urolithiasis. OBJECTIVE To explore the anti-urolithiatic potential of gokhru and to develop an analytical method for quantitative estimation of metabolites for its quality control. MATERIALS AND METHODS Aqueous extract of gokhru fruit was prepared through maceration followed by decoction to produce a mother extract, which was further used for polarity-based fractionations. In vitro and ex vivo anti-urolithiatic activity of mother extract and fractions at different concentration (100-1000 μg/mL) were carried out using aggregation assay in synthetic urine and in rat plasma, however, nucleation assay for 30 min was done using confocal microscopy. A simultaneous HPLC method has been developed for quantification of diosgenin, catechin, rutin, gallic acid, tannic acid and quercetin in mother extract and in fractions. RESULTS The extraction resulted in 14.5% of w/w mother extract, however, polarity-based fractionation yielded 2.1, 2.6, 1.5, 1.3 and 6.1% w/w of hexane, toluene, dichloromethane (DCM), n-butanol and water fractions, respectively. In vitro and ex vivo studies showed a significant anti-urolithiatic potential of n-butanol fraction. Further, HPLC analysis revealed significantly (p < 0.01) higher content of quercetin (1.95 ± 0.41% w/w), diosgenin (12.75 ± 0.18% w/w) and tannic acid (9.81 ± 0.47% w/w) in n-butanol fraction as compared to others fractions. DISCUSSION AND CONCLUSION In vitro and ex vivo studies demonstrated potent anti-urolithiatic activity of n-butanol fraction which can be developed as new phytopharmaceuticals for urolithiasis. HPLC method can be used for quality control and pharmacokinetic studies of gokhru.
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Affiliation(s)
- Ikshit Sharma
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Bioactive Natural Product Laboratory, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Washim Khan
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Bioactive Natural Product Laboratory, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Sayeed Ahmad
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Bioactive Natural Product Laboratory, Jamia Hamdard (Hamdard University), New Delhi, India
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Kadyrov ZA, Suleymanov SI, Ramishvili VS, Istratov VG. [Clinical and biochemical aspects of pathogenesis of urolithiasis]. Urologiia 2017:43-49. [PMID: 29376594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM To investigate the role of infection in the pathogenesis of urolithiasis using chromatography mass spectrometry analysis. MATERIALS AND METHODS The study analyzed clinical and laboratory data of 316 urolithiasis patients hospitalized between February 2005 and January 2015. All patients underwent a comprehensive clinical examination, including laboratory tests (hematological and biochemical blood tests, clinical and bacteriological tests of urine) and chromatography mass spectrometry analysis urine and blood. The laboratory testing was carried out both during the patients hospital stay and outpatient follow-up. RESULTS We analyzed the biological material for the presence of characteristic ions. Urine samples of 316 urolithiasis patients were found to contain activators of "cooperative sensitivity." Moreover, there was a significant increase in the concentration of signaling compounds of the "cooperative sensitivity" of microorganisms in patients with complicated urolithiasis in comparison with the control indices (lactones-0.006 plus/minus 0.0004 mmol/L, normal values less than 0.002, quinolones 0.004 plus/minus 0.0003 mmol/l, normal values - less than 0.002 and furan esters - 0.005 plus/minus 0.0004, normal values less than 0.002). Threshold values of the activators of "cooperative sensitivity" demonstrated the readiness of the microbial community to initiate an inflammatory process. The presence of activators such as lactones, quinolones and furan esters in the samples of urolithiasis patients predisposes to the activation of pathogenic genes in a large group of microorganisms, including gram positive and gram negative species. DISCUSSION In our opinion, to improve the quality of diagnostic, treatment and preventive measures in patients with different types of stone formation, it is advisable to use chromatography mass spectrometry analysis, which allows determination of priority clinical and laboratory indicators. CONCLUSION The data on the role of infection in the pathogenesis of urolithiasis obtained by chromatographic methods suggest the possibility of using the indicators of the activators of the "cooperative sensitivity" of microbes in patients with various forms of urolithiasis to assess the disease severity.
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Affiliation(s)
- Z A Kadyrov
- Faculty of Postgraduate Education of the RUDN University, Moscow, Russia
- A.V. Vishnevsky Institute of Surgery. A.V., Moscow, Russia
| | - S I Suleymanov
- Faculty of Postgraduate Education of the RUDN University, Moscow, Russia
- A.V. Vishnevsky Institute of Surgery. A.V., Moscow, Russia
| | - V Sh Ramishvili
- Faculty of Postgraduate Education of the RUDN University, Moscow, Russia
- A.V. Vishnevsky Institute of Surgery. A.V., Moscow, Russia
| | - V G Istratov
- Faculty of Postgraduate Education of the RUDN University, Moscow, Russia
- A.V. Vishnevsky Institute of Surgery. A.V., Moscow, Russia
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Tavasoli S, Taheri M, Khoshdel A, Basiri A. Association of Body Mass Index, Waist Circumference, and Waist-Stature Ratio With Urine Composition in Patients With Urolithiasis. Iran J Kidney Dis 2017; 11:371-378. [PMID: 29038393 DOI: pmid/29038393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 02/06/2017] [Accepted: 02/10/2017] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This study was aimed to evaluate the correlation of body mass index (BMI), waist circumference (WC), and waist-stature ratio (WSR) with urinary composition in urolithiasis patients. MATERIALS AND METHODS Medical reports of 1410 urolithiasis patients referred to a tertiary in Tehran, from 2010 to 2015, were reviewed. Collected data included WC, BMI, and WSR, 24-hour urine composition, and the first-morning urine pH. Urinary relative supersaturation of calcium oxalate, calcium phosphate, and uric acid were calculated. Linear correlation and logistic regression models were used for study analyses. RESULTS A total of 511 records were reviewed. In the women, supersaturation of calcium oxalate significantly correlated with BMI, WC, and WSR. Supersaturation of uric acid significantly correlated with WC. Using regression analyses, BMI and WSR were associated with greater supersaturation of calcium oxalate abnormality, which persisted after adjustment for confounding factors (odds ratio, 1.080; 95% confidence interval, 1.001 to 1.166 for BMI; odds ratio, 1.053; 95% confidence interval, 1.001 to 1.108 for WSR). Larger WC accompanied abnormal values for supersaturation of calcium oxalate; however, the model was marginally significant (odds ratio, 1.032; 95% confidence interval, 1.000 to 1.065; P = .05) in multivariable analysis. In the men on the other hand, none of the obesity indexes were associated with the supersaturation measures. CONCLUSIONS Although both obesity and abdominal obesity correlated with supersaturation of calcium oxalate, mostly by changes in urine volume and pH in women, none of those indexes showed significant correlation with urine composition in the men population of our study.
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Affiliation(s)
- Sanaz Tavasoli
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Deng T, Mai Z, Cai C, Duan X, Zhu W, Zhang T, Wu W, Zeng G. Influence of weight status on 24-hour urine composition in adults without urolithiasis: A nationwide study based on a Chinese Han population. PLoS One 2017; 12:e0184655. [PMID: 28886192 PMCID: PMC5591005 DOI: 10.1371/journal.pone.0184655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/28/2017] [Indexed: 01/08/2023] Open
Abstract
Objectives This study sought to explore the influence of different body weight statuses on 24-hour urine compositions in adults without urolithiasis based on a nationwide study of a Chinese Han population. Material and methods Twenty-four-hour urine samples from 584 Chinese Han adults without urolithiasis in six cities were analyzed. The participants were divided into four body weight status types according to their body mass indices (BMIs) according to WHO guidelines. The baseline characteristics and 24-hour urine compositions of the standard weight group were compared with those of the underweight, overweight and obese groups. The influences of different body weight statuses on the 24-hour urine compositions were explored using univariate and multivariate logistic regressions. Results The numbers of participants in the underweight, standard weight, overweight and obese status groups were 24, 376, 149 and 35, respectively. The overweight and obese groups suffered significantly higher risks of hypertension and diabetes mellitus than the standard weight group. In the univariate analyses, compared with the standard weight group, the overweight group had significantly higher levels of urine citrate (mean difference [MD] = 0.51 mmol, 95% confidence interval [CI]: 0.15–0.87, P = 0.001), potassium (MD = 6.63 mmol, 95% CI: 1.13–12.14, P = 0.01) and magnesium (MD = 0.38 mmol, 95% CI: 0.08–0.69, P = 0.014). Significant increases in urine citrate (MD = 0.85 mmol, 95% CI: 0.01–1.68, P = 0.046), magnesium (MD = 0.69 mmol, 95% CI: 0.13–1.25, P = 0.016) and phosphate (MD = 2.28 mmol, 95% CI: 0.03–4.54, P = 0.047) were found in the obese group. No significant differences were detected between the standard weight and underweight groups. In the multivariate logistic regression analyses, we only observed significantly higher levels of urine potassium (odds ratio [OR] = 1.02, 95% CI: 1.00–1.04, P = 0.03) in the overweight group and phosphate (OR = 1.32, 95% CI: 1.05–1.66, P = 0.018) in the obese group when compared with the standard weight group. Conclusions Nonstone-forming adults with overweight or obese statuses were at higher risks of hypertension and diabetes mellitus. Obese nonstone-formers might have a greater risk of urinary stone formation due to increased urinary phosphate excretion. Additionally, underweight status had no influence on 24-hour urine composition.
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Affiliation(s)
- Tuo Deng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Zanlin Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Chao Cai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Wei Zhu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Tao Zhang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
- * E-mail:
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Kuzmin MD, Peshkova YI, Pashkova TM, Kartashova OL, Pashinina OA, Meshcheryakov AO. [Structure of microorganism species cultured from urine of urolithiasis patients]. Urologiia 2017:18-21. [PMID: 28952686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM To investigate the incidence of microorganisms of different taxonomic groups and their associations in the pelvic and bladder urine of adult urolithiasis patients. MATERIALS AND METHODS A bacteriological method and metagenomic sequencing were used to investigate the bacterial spectrum of microflora cultured from pelvic and bladder urine sampled during surgical interventions in urolithiasis patients. RESULTS The both microbiotas had approximately the same spectrum, but in 26.1% of patients it was inconsistent. Metagenomic analysis detected DNA of microorganisms in urine samples which were found free of microflora by the bacteriological method. CONCLUSION The study findings showed species diversity of microorganisms cultured from pelvic and bladder urine sampled during surgical interventions in urolithiasis patients.
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Affiliation(s)
- M D Kuzmin
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
| | - Yu I Peshkova
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
| | - T M Pashkova
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
| | - O L Kartashova
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
| | - O A Pashinina
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
| | - A O Meshcheryakov
- Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
- Orenburg State Medical University of Minzdrav of Russia
- Orenburg Regional Clinical Hospital, Orenburg, Russia
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Wang RC, Rodriguez RM, Fahimi J, Hall MK, Shiboski S, Chi T, Smith-Bindman R. Derivation of decision rules to predict clinically important outcomes in acute flank pain patients. Am J Emerg Med 2017; 35:554-563. [PMID: 28082160 PMCID: PMC5701802 DOI: 10.1016/j.ajem.2016.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/09/2016] [Accepted: 12/08/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Routine CT for patients with acute flank pain has not been shown to improve patient outcomes, and it may unnecessarily expose patients to radiation and increased costs. As preliminary steps toward the development of a guideline for selective CT, we sought to determine the prevalence of clinically important outcomes in patients with acute flank pain and derive preliminary decision rules. METHODS We analyzed data from a randomized trial of CT vs. ultrasonography for patients with acute flank pain from 15 EDs between October 2011 and February 2013. Clinically important outcomes were defined as inpatient admission for ureteral stones and alternative diagnoses. Clinically important stones were defined as stones requiring urologic intervention. We sought to derive highly sensitive decision rules for both outcomes. RESULTS Of 2759 participants, 236 (8.6%) had a clinically important outcome and 143 (5.2%) had a clinically important stone. A CDR including anemia (hemoglobin <13.2g/dl), WBC count >11000/μl, age>42years, and the absence of CVAT had a sensitivity of 97.9% (95% CI 94.8-99.2%) and specificity of 18.7% (95% 17.2-20.2%) for clinically important outcome. A CDR including hydronephrosis, prior history of stone, and WBC count <8300/μl had a sensitivity of 98.6% (95% CI 94.5-99.7%) and specificity of 26.0% (95% 24.2-27.7%) for clinically important stone. CONCLUSIONS We determined the prevalence of clinically important outcomes in patients with acute flank pain, and derived preliminary high sensitivity CDRs that predict them. Validation of CDRs with similar test characteristics would require prospective enrollment of 2100 patients.
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Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Robert M Rodriguez
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jahan Fahimi
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - M Kennedy Hall
- Division of Emergency Medicine, University of Washington, Seattle, WA, USA
| | - Stephen Shiboski
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Tom Chi
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Rebecca Smith-Bindman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Sikarwar I, Dey YN, Wanjari MM, Sharma A, Gaidhani SN, Jadhav AD. Chenopodium album Linn. leaves prevent ethylene glycol-induced urolithiasis in rats. J Ethnopharmacol 2017; 195:275-282. [PMID: 27864113 DOI: 10.1016/j.jep.2016.11.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 10/15/2016] [Accepted: 11/15/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The leaves of Chenopodium album Linn. are traditionally used for correction of kidney diseases and urinary stones. The present work investigated the effect of methanolic and aqueous extracts of leaves of Chenopodium album on experimentally-induced urolithiasis in rats to substantiate its traditional use as antilithiatic agent. MATERIALS AND METHODS The leaf extract was standardized by HPLC. Urolithiasis was induced in rats by administration of 0.75% v/v of ethylene glycol (EG) in distilled water and in addition, vehicle or methanol (CAME) or aqueous (CAAE) extract of the leaves of Chenopodium album each in the dose 100, 200 and 400mg/kg or Cystone (750mg/kg) were administered daily orally for 28 days. Urolithiasis was assessed by estimating the calcium, phosphorus, urea, uric acid, and creatinine in both urine and plasma. The volume, pH and oxalate levels were also estimated in urine. The renal oxalate content was estimated in kidney while calcium oxalate deposits were observed histologically. RESULTS The treatment with CAME or CAAE for 28 days significantly attenuated the EG-induced elevations in the urine and plasma levels of calcium, phosphorus, urea, uric acid and creatinine along with decrease in urine volume, pH and oxalates. The treatments also decreased renal tissue oxalate and deposition of oxalate crystals in kidney due to EG treatment. The effects of CAME and CAAE were comparable to standard antilithiatic agent, cystone. The findings indicate the preventive effect of CAME and CAAE which can be due to inhibitory effect on crystallization and stone dissolution. The effect was attributed to the presence of phytochemicals like flavonoids and saponins. CONCLUSION In conclusion, Chenopodium album leaves exhibited antilithiatic effect and validates its ethnomedicinal use in urinary disorders and kidney stones.
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Affiliation(s)
- Indu Sikarwar
- Shri Ram College of Pharmacy, Banmore 474 011, Madhya Pradesh, India
| | - Yadu Nandan Dey
- National Research Institute for Ayurveda-Siddha Human Resource Development, Aamkho, Gwalior 474 009, Madhya Pradesh, India
| | - Manish M Wanjari
- National Research Institute for Ayurveda-Siddha Human Resource Development, Aamkho, Gwalior 474 009, Madhya Pradesh, India.
| | - Ajay Sharma
- Shri Ram College of Pharmacy, Banmore 474 011, Madhya Pradesh, India
| | - Sudesh N Gaidhani
- Central Council for Research in Ayurvedic Sciences, Ministry of AYUSH, New Delhi 110 058, India
| | - Ankush D Jadhav
- National Research Institute for Ayurveda-Siddha Human Resource Development, Aamkho, Gwalior 474 009, Madhya Pradesh, India
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Kumar BN, Wadud A, Jahan N, Sofi G, Bano H, Makbul SAA, Husain S. Antilithiatic effect of Peucedanum grande C. B. Clarke in chemically induced urolithiasis in rats. J Ethnopharmacol 2016; 194:1122-1129. [PMID: 27825989 DOI: 10.1016/j.jep.2016.10.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 10/01/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Duqu (Peucedanum grande C. B. Clarke) has been used by Unani physicians since ancient times in retention of urine, renal and bladder calculi, nephritis and other associated disorders in different dosage forms. AIM OF THE STUDY The aim of the study was to evaluate the antiurolithiatic activity of Peucedanum grande C. B. Clarke in experimental model. MATERIALS AND METHODS The experiment was carried out in male Sprague Dawley rats divided into 5 groups of 8 animals each. Animals of negative control received 1ml of 5% Gum acacia throughout the study. Remaining four groups received Ethylene glycol 0.75% and Ammonium chloride 1% by adding in their drinking water for first seven days to induce urolithiasis. From 8th day, positive control received 1ml of 5% Gum acacia, standard control received Cystone in the dose of 750mg/kg while test groups A and B were treated with hydroalcoholic extract of test drug in the dose of 56mg/kg and 97mg/kg respectively up to 21 days, thereafter the animals were sacrificed. Number of CaOx crystals in urine, levels of serum calcium, phosphorus, creatinine, urea, urinary calcium and sodium were observed. Kidney homogenate analysis and histopathology were also carried out. RESULTS Test drug reduced number of CaOx crystals in urine (p<0.001); levels of serum calcium, phosphorus, creatinine, (p<0.001) urea, (p<0.05); urinary calcium (p<0.001) and sodium decreased significantly in standard and test groups. The urine volume increased significantly (p<0.05, 0.01) in both the test groups. Histopathology of kidney showed no CaOx crystal deposition in both the test groups. CONCLUSION On the basis of above findings, it can be concluded that the test drug possesses significant antiurolithiatic activity.
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Affiliation(s)
- B N Kumar
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Abdul Wadud
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Nasreen Jahan
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Ghulamuddin Sofi
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Humaira Bano
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | | | - Sadique Husain
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
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20
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Kutluev MM, Pulin IL, Ryakhov AY, Mochalov KS, Farkhutdinov RR. [Prospects for using biological markers in various types of urinary stone lithotripsy]. Urologiia 2016:11-16. [PMID: 28248037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To investigate the feasibility of using biological markers for determining the optimal timing to repeat lithotripsy of urinary stones. MATERIALS AND METHODS This was a prospective, randomized, single-center cohort study of 100 patients randomized into 4 groups. Patients of group I (n=46), II (n=20), III (n=18) and IV (n=16) were used contact lithotripsy (URS), ESWL, PNL, combined lithotripsy. In all patients, before surgery and at 1, 7, 14, 20 days after lithotripsy, iron-induced urine chemiluminescence was measured to determine the level of reactive oxygen species (ROS) and concentration of medium-mass molecules (MMM) in urine. RESULTS Analyzing the time of operation and the size of stones only in group I was detected the significant negative correlation (r=-0,479, p<0,05). In patients of all groups, the level of ROS have decreased after the surgery with further returning to baseline level. Dynamics of changes MMM in urine has not revealed a reliable change tendency. CONCLUSION The definition of the quantity of ROS in urine is a promising criterion in measuring the degree of urinary system damage and the time for repeated lithotripsy. The level of ROS in the urine after URS, ESWL and the ESWL-URS combination returns to baseline on the 7th day and after PNL on the 14th day postoperatively, thus allowing to pathogenetically define the optimal timing of repeat lithotripsy.
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Affiliation(s)
- M M Kutluev
- Multidisciplinary Medical Medical Clinic Medservice, Department of Urology, Salavat
| | - I L Pulin
- Multidisciplinary Medical Medical Clinic Medservice, Department of Urology, Salavat
| | - A Ya Ryakhov
- Multidisciplinary Medical Medical Clinic Medservice, Department of Urology, Salavat
| | - K S Mochalov
- Bashkir State Medical University, Central Medical and Scientists Laboratory, Ufa
| | - R R Farkhutdinov
- Bashkir State Medical University, Central Medical and Scientists Laboratory, Ufa
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21
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Thorsteinsdottir M, Thorsteinsdottir UA, Eiriksson FF, Runolfsdottir HL, Agustsdottir IMS, Oddsdottir S, Sigurdsson BB, Hardarson HK, Kamble NR, Sigurdsson ST, Edvardsson VO, Palsson R. Quantitative UPLC-MS/MS assay of urinary 2,8-dihydroxyadenine for diagnosis and management of adenine phosphoribosyltransferase deficiency. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1036-1037:170-177. [PMID: 27770717 PMCID: PMC5445224 DOI: 10.1016/j.jchromb.2016.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
Abstract
Adenine phosphoribosyltransferase (APRT) deficiency is a hereditary disorder that leads to excessive urinary excretion of 2,8-dihydroxyadenine (DHA), causing nephrolithiasis and chronic kidney disease. Treatment with allopurinol or febuxostat reduces DHA production and attenuates the renal manifestations. Assessment of DHA crystalluria by urine microscopy is used for therapeutic monitoring, but lacks sensitivity. We report a high-throughput assay based on ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) for quantification of urinary DHA. The UPLC-MS/MS assay was optimized by a chemometric approach for absolute quantification of DHA, utilizing isotopically labeled DHA as an internal standard. Experimental screening was conducted with D-optimal design and optimization of the DHA response was performed with central composite face design and related to the peak area of DHA using partial least square regression. Acceptable precision and accuracy of the DHA concentration were obtained over a calibration range of 100 to 5000ng/mL on three different days. The intra- and inter-day accuracy and precision coefficients of variation were well within ±15% for quality control samples analyzed in replicates of six at three concentration levels. Absolute quantification of DHA in urine samples from patients with APRT deficiency was achieved wihtin 6.5min. Measurement of DHA in 24h urine samples from three patients with APRT deficiency, diluted 1:15 (v/v) with 10mM ammonium hydroxide (NH4OH), yielded a concentration of 3021, 5860 and 10563ng/mL and 24h excretion of 816, 1327 and 1649mg, respectively. A rapid and robust UPLC-MS/MS assay for absolute quantification of DHA in urine was successfully developed. We believe this method will greatly facilitate diagnosis and management of patients with APRT deficiency.
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Affiliation(s)
| | | | - Finnur F Eiriksson
- University of Iceland, Reykjavik, Iceland; ArcticMass, Reykjavik, Iceland.
| | | | - Inger M Sch Agustsdottir
- Childreńs Medical Center, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Steinunn Oddsdottir
- Department of Clinical Biochemistry, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Baldur B Sigurdsson
- ArcticMass, Reykjavik, Iceland; Center for Biomedicine, European Academy of Bolzano/Bozen, Bolzano, Italy.
| | | | | | | | - Vidar O Edvardsson
- University of Iceland, Reykjavik, Iceland; Childreńs Medical Center, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Runolfur Palsson
- University of Iceland, Reykjavik, Iceland; Division of Nephrology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
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Imran K, Zafar MN, Ozair U, Khan S, Rizvi SAH. Metabolic risk factors in pediatric stone formers: a report from an emerging economy. Urolithiasis 2016; 45:379-386. [PMID: 27744630 DOI: 10.1007/s00240-016-0922-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/12/2016] [Indexed: 11/27/2022]
Abstract
The goal of this study was to investigate metabolic risk factors in pediatric stone formers in an emerging economy. A prospective, data collection enrolled 250 children age <1-15 years at our center. Risk factors were evaluated by gender and in age groups <1-5, 6-10 and 11-15 years. Patients were evaluated for demographics, blood and 24 h urine for calcium, magnesium, phosphate, uric acid, electrolytes and additional protein, citrate, ammonia and oxalate in urine. All reported values were two sided and statistical significance was considered at p value ≤0.05. The mean age at diagnosis was 7.50 ± 3.56 years with a male to female ratio of 1.84:1. A family history of urolithiasis was found in 41 (16.4 %), urinary tract infection in 18 (7 %) and chronic diarrhea in 75 (30 %). Hypercalcemia was seen in 37 (14.8 %), hyperuricemia in 23 (9.2 %) and hyperphosphatemia in 6 (2.4 %). Urinary metabolic abnormalities were identified in 248 (98 %) of the cases. Hypocitraturia was found in 207 (82.8 %), hyperoxaluria in 62 (26.4 %), hyperuricosuria in 82 (32.8 %), hypercalciuria in 51 (20.4 %), hyperphosphaturia in 46 (18.4 %), hyperammonuria in 10 (4 %), hypocalciuria in 82 (32.8 %), and hypovolemia in 73 (29.2 %). Risk factors were similar between genders except higher rates of hyponatriuria, hypophosphaturia, and hypocalciuria in females. Hyperuricosuria, hyponatriuria, and hypovolemia were highest in 1-5 years (52, 49, 49 %) as compared to (18, 21, 12 %) those in 11-15 years (p < 0.001), respectively. This study shows that careful metabolic analysis can identify risk factors in 98 % of the children where appropriate metaphylaxis can be undertaken both for treatment and prevention of recurrence.
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Affiliation(s)
- Kiran Imran
- Department of Chemical Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
| | - Mirza Naqi Zafar
- Department of Chemical Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Uzma Ozair
- Department of Chemical Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Sadia Khan
- Department of Chemical Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Syed Adibul Hasan Rizvi
- Department of Chemical Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
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23
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Onaran M, Orhan N, Farahvash A, Ekin HN, Kocabıyık M, Gönül İI, Şen İ, Aslan M. Successful treatment of sodium oxalate induced urolithiasis with Helichrysum flowers. J Ethnopharmacol 2016; 186:322-328. [PMID: 27085940 DOI: 10.1016/j.jep.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 04/02/2016] [Accepted: 04/03/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Helichrysum (Asteraceae) flowers, known as "altın otu, yayla çiçeği, kudama çiçeği" , are widely used to remove kidney stones and for their diuretic properties in Turkey. AIM OF THE STUDY To determine the curative effect of infusions prepared from capitulums of Helichrysum graveolens (M. Bieb.) Sweet (HG) and H. stoechas ssp. barellieri (Ten.) Nyman (HS) on sodium oxalate induced kidney stones. MATERIALS AND METHODS Infusions prepared from the capitulums of HG and HS were tested for their curative effect on calcium oxalate deposition induced by sodium oxalate (70mg/kg i.p.). Following the injection of sodium oxalate for 5 days, plant extracts were administered to rats at two different doses. Potassium citrate was used as positive control. Water intake, urine volume, body, liver and kidney weights were measured; biochemical and hematological analyses were conducted on urine and blood samples. Additionally, histopathological examinations were done on kidney samples. RESULTS H. stoechas extract showed prominent effect at 156mg/kg dose (stone formation score: 0.33), whereas number of kidney stones was maximum in sodium oxalate group (stone formation score: 2.33). The reduction in the uric acid and oxalate levels of urine samples and the elevation in the urine citrate levels are significant and promising in extract groups. Some hematological, biochemical and enzymatic markers are also ameliorated by the extracts. CONCLUSIONS This is the first report on the curative effect of immortal flowers. Our preliminary study indicated that Helichrysum extracts may be used for treatment of urolithiasis and Helichrysum extracts are an alternative therapy to potassium citrate for patients suffering from kidney stones.
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Affiliation(s)
- Metin Onaran
- Department of Urology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey
| | - Nilüfer Orhan
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Etiler, 06330 Ankara, Turkey
| | - Amirali Farahvash
- Department of Urology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey
| | - Hasya Nazlı Ekin
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Etiler, 06330 Ankara, Turkey
| | - Murat Kocabıyık
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey
| | - İpek Işık Gönül
- Department of Pathology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey
| | - İlker Şen
- Department of Urology, Faculty of Medicine, Gazi University, 06560 Ankara, Turkey
| | - Mustafa Aslan
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Etiler, 06330 Ankara, Turkey.
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Landa SB, Al-Shukri SH, Gorbachev MI, Egorov VV, Emanuel YV, Emanuel VL. [The pathochemical characteristics of oligomeric forms of Tamm-Horsfall protein under urolithiasis]. Klin Lab Diagn 2016; 61:335-341. [PMID: 30601623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The role of Tamm-Horsfall protein in pathogenesis of urolithiasis was analyzed. The study of oligomeric forms of protein was carried out using technique of dynamic light scattering. The sampling of 57 patients with urolithiasis and 51 patients of control group of comparative age and gender were examined. The degree of purification of Tamm-Horsfall protein was controlled using denaturant electrophoresis in polyacridine amyl gel. The reversing change of oligomeric form of protein with molecule size 2 Mda in polymeric form 28 Mda under impact of guanidinhydrochloride. Under urolithiasis, the form of protein associated with non-organic components and with size of macromolecular complex larger than 1500 nm was detected. The diagnostic criterion of urolithiasis was proposed based on totality of biochemical and biophysical analyses of urine.
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Sridharan B, Ganesh RN, Viswanathan P. Polyacrylic acid attenuates ethylene glycol induced hyperoxaluric damage and prevents crystal aggregation in vitro and in vivo. Chem Biol Interact 2016; 252:36-46. [PMID: 27018375 DOI: 10.1016/j.cbi.2016.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/04/2016] [Accepted: 03/20/2016] [Indexed: 02/05/2023]
Abstract
The study explores calcium oxalate crystal inhibiting characteristic of polyacrylic acid (pAA), an anionic polymer in in vitro and in vivo. Animals were divided into 5 groups where group 1 served as control, group 2 were made hyperoxaluric by supplementing with Ethylene glycol (EG) 0.75% (v/v) for 30 days. Group 3, 4 & 5 were also given with EG and treated simultaneously with 2.5, 5 & 10 mg of pAA/kg of body weight, respectively. Urine, serum and tissue analyses along with histological studies were performed at the end of the 30 days study. In vitro crystallization was significantly inhibited by pAA and further it was supported by particle size analyses, XRD and FT-IR studies. Toxicological analyses showed that pAA was safe to use in animals at concentrations below 100 mg/kg BW. In vivo anti-urolithic study showed significant improvement in urinary lithogenic factors (calcium, oxalate, phosphate, citrate & magnesium) and renal function parameters (creatinine, urea and protein). Tissue analyses on anti-oxidant enzyme activity and lipid peroxides showed maintenance of tissue antioxidant status in the pAA supplemented rats and histological studies demonstrated the nephroprotection offered by pAA and were concurrent to the biochemical analyses. Supplementation of pAA not only reduces the crystal aggregation but also regulates the expression and localization of crystal inhibiting proteins and gene expression of inflammatory cytokines in experimental animals. In summary, pAA is a potent anti-urolithic agent in rats and we can propose that 10 mg/kg body weight is the effective dosage of pAA and this concentration can be used for further studies.
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Affiliation(s)
- Badrinathan Sridharan
- Renal Research Lab, Centre for Biomedical Research, School of Biosciences and Technology, VIT University, Vellore, Tamil Nadu, India
| | - Rajesh Nachiappa Ganesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Pragasam Viswanathan
- Renal Research Lab, Centre for Biomedical Research, School of Biosciences and Technology, VIT University, Vellore, Tamil Nadu, India.
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Martín-Way DA, Puche-Sanz I, Pascual-Geler M, Vázquez-Alonso F, Flores-Martín JF, Cózar-Olmo JM. [Evolution of urinary lithiasis composition in a Spanish health care area over the last four decades]. ARCH ESP UROL 2016; 69:155-161. [PMID: 27225059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To provide an updated epidemiological description of urinary lithiasis in a health area in the Western hemisphere over the past four decades. METHODS 2704 urinary lithiases analysed in our institution between 1980 and 2015 were retrospectively reviewed. They were analyzed using polarized light microscopy, and in the case this method had questionable results we used X-ray diffraction. The variables collected were the lithiasis chemical composition (oxalates, phosphates, uric acid, infectious, cystine, mixed, other). Regarding the date of the analysis, the series of cases was grouped into four periods (1980-1989, 1990- 1999, 2000-2009, and 2010-2015), and also by sex and age of the patient. RESULTS The mean age at diagnosis was 48.32 years (49.37 in men vs 46.53 in women, p=0.005). A male predominance was found (58.7%). Throughout the four decades, the involvement of women has progressively diminished compared to men. Of all the lithiases, the most frequent were those composed of oxalates (43.3%), followed by uric acid (16.9%) and infectious types (10.7%). The uric acid and oxalate lithiases were more common in men than in women (67.4% vs. 32.6% and 59.1% vs. 40.9%, respectively, p<0.001), while the lithiasis of infectious origin was more frequent in women than in men (56.3% vs. 43.7%, p<0.001). Throughout the time period, a trend of increasing oxalic lithiases and decreasing uric acid and phosphate lithiases was observed, as well as an increase of infectious lithiases over the past five years. CONCLUSIONS In our setting, urinary lithiases appear more frequently in males at the end of the fourth decade of life. The most common lithiases are composed of oxalates, and their frequency has increased over time, while uric acid and phosphates lithiases have decreased.
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Affiliation(s)
- David Alejandro Martín-Way
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
| | - Ignacio Puche-Sanz
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
| | - Manrique Pascual-Geler
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
| | - Fernando Vázquez-Alonso
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
| | - José Francisco Flores-Martín
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
| | - José Manuel Cózar-Olmo
- Bio-Healthe Research Institute (Instituto de Investigación Biosanitaria ibs). Granada. Spain. Complejo Hospitalario Universitario de Granada (CHUG). Universidad de Granada. Spain
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Alyaev YG, Rudenko VI, Perekalina AN, Kraev IG, Inoyatov ZS. [Plant-derived terpenes in treating patients with urolithiasis]. Urologiia 2016:103-110. [PMID: 28247652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Numerous metabolic abnormalities intrinsic to urolithiasis require drug therapy. At the same time, despite the constant expansion of synthetic drugs, plant-derived medications play a large role in the treatment and prevention of the disease. AIM To evaluate the effect of a plant-derived preparation Rowatinex in patients with urolithiasis after extracorporeal shock wave lithotripsy (ESWL) and analyze the changes in blood and urine parameters in patients receiving the preparation. MATERIALS AND METHODS Depending on the type of post-ESWL treatment, patients were divided into two groups. After ESWL, patients of group A (n=107) and group B (n=50) were administered Rowatinex and antispasmodic drugs, respectively. RESULTS AND DISCUSSION Clearance of stone fragments after ESWL within 1-5 days was achieved in 76 (71.1%) patients of group A and in 20 (40.4%) of group B. Analysis of the effect of the therapy on blood count, biochemistry tests and 24h excretion (magnesium, uric acid, calcium, etc.) did not reveal significant differences between group A group B and reference values. Increased diuresis caused by antispasmodic effects of Rowatinex resulted in the complete clearance of stone fragments. Urinalysis in patients of the two groups showed decreased leukocyturia. Furthermore, stabilization of urine pH within the 6.2-6.8 was noted in group A, which is important and necessary in metaphylaxis of recurrent stone formation. CONCLUSIONS Administration of Rowatinex increases the percentage of stone fragment clearance after ESWL and reduces pain intensity. Rowatinex reduces leukocyturia, increases 24h diuresis and stabilizes the pH of urine. Increasing and stabilizing urine pH in patients with calcium oxalate and urate stones reduces the risk of recurrence after ESWL. No complications associated with Rowatinex were reported, allowing long-term administration of the preparation in the complex lithokinetic therapy and for metaphylaxis of recurrent stone formation.
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Affiliation(s)
- Yu G Alyaev
- Department of Urology, Sechenov First Moscow State Medical University, Moscow
| | - V I Rudenko
- Department of Urology, Sechenov First Moscow State Medical University, Moscow
| | - A N Perekalina
- Department of Urology, Sechenov First Moscow State Medical University, Moscow
| | - I G Kraev
- Department of Urology, Sechenov First Moscow State Medical University, Moscow
| | - Zh Sh Inoyatov
- Department of Urology, Sechenov First Moscow State Medical University, Moscow
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28
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Stogov MV, Schurova EN, Kireieva EA. [THE SEARCH AFTER PROGNOSTIC TESTS OF DEVELOPMENT OF UROLITHIASIS OF PATIENTS WITH VERTEBRO-CEREBROSPINAL TRAUMA]. Klin Lab Diagn 2015; 60:28-30. [PMID: 26999862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The article presents analysis of alterations of biochemical indicators in blood serum and day urine of 22 patients in acute and early periods after vertebro-cerebrospinal trauma. Out of total number of patients in 10 (main group) in post-traumatic period urolithiasis developed In 12 patients no signs of urolithiasis were detected These examinedpatients were included into comparative group. The reference group was composed with 20 healthy individuals. The concentration of urea, creatinine, uric acid, calcium and inorganic phosphate in blood serum and day urine were detected In patients of main group statistically significant increasing of levels of urea and creatinine was detected in blood serum relative to patients of comparative group. In examined patients of main group clearance of urea was reliably lower than both values of comparative group (up to 2.55 times; p < 0.05) and indicators of reference group (up to 3.75 times; p < 0.05). In patients of this group, clearance of uric acid also had reliable differences from indicators both in comparative group and reference group. Therefore, in patients in acute and early periods of vertebro- cerebrospinal trauma expressed disorders of biochemical indicators of blood serum and urine that can be referred to predictors of risk of development of urolithiasis in the following. The most informative tests were increasing of concentration of urea in blood serum more than 5.30 mmol/l (ratio of likelihood ofpositive test--4.26) and decreasing of clearance of uric acid and urea.
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Kustov AV, Strelnikov AL, Airapetyan AO, Moryganov MA, Zhuravleva NI. [DIAGNOSIS OF METABOLIC DISORDERS AND METAPHYLAXIS OF RECURRENT CALCIUM OXALATE UROLITHIASIS]. Urologiia 2015:86-88. [PMID: 26859947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The paper presents the results of the 1-year screening of biochemical parameters of urine in female patient with recurrent calcium urate urolithiasis. Based on the data of quantitative X-ray phase analysis of the composition of stone and a complex of clinical and laboratory examination, reasons for recurrent stone formation were determined. The main reasons included hypocitraturia, hyperosmolarity of urine and uric acid diathesis. Therapy with citrate mixtures and adequate water schedule (daily urine--2-2.5 liters) for 10 weeks allowed to increase the urinary pH, led to 2.5-fold increase in daily urinary citrate excretion and getting rid of residual stones in both kidneys. The effect of citrate therapy lasted for a further six months after drug withdrawal. Subsequently, the daily urinary citrate excretion and pH decreased, but even after 8 months remained still above baseline values. Obviously, for high risk patients it is necessary to define the daily excretion of citrate, and diagnosis of hypocitraturia requires long course therapy with citrate mixtures, with a break ofnot more than six months and obligate maintenance of adequate diuresis.
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Chepurov AK, Pronkin EA, Bolotov AD. [THE MODERN PROSPECT FOR CITRATE MIXTURES IN THE TREATMENT OF UROLITHIASIS]. Urologiia 2015:93-96. [PMID: 26390568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors present a review of literature on the use of litholytic citrate medications for conservative management of urolithiasis. Urate urolithiasis is the most common clinical condition encountered by urologists. Citrate agents, in particular Blemaren, not only may be employed in a conservative therapy of uric acid stones, but can also be successfully used in the treatment of the calcium urolithiasis, i.e. mixed composition stones, which is supported by current international urology guidelines.
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Abstract
Particularly in the urological consultation sessions collection of 24 h urine samples is required to evaluate the metabolic risk factors for urolith formation. To ensure a yield from urinalysis of sufficiently high quality and to minimize the number of potential error sources, correctly performed preanalytical procedures are required. If certain basic quality criteria for the collection procedures are not being followed false data can be determined and the clinical interpretation based on that analysis will result in a wrong rating of the true metabolic status of patients. This article provides practical, feasible and proven solutions in an encouraging, motivating and clear way to ensure that at least the most important steps for a correct urine collection are being taken. The preanalytical requirements for the determination of other urinary parameters which are not in the direct focus of urolithiasis treatment will not be covered by this article.
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Affiliation(s)
- N Laube
- Deutsches Harnsteinzentrum, Medizinisches Zentrum Bonn Friedensplatz, Friedensplatz 16, 53111, Bonn, Deutschland,
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Valezi AC, Fuganti PE, Junior JM, Delfino VD. Urinary evaluation after RYGBP: a lithogenic profile with early postoperative increase in the incidence of urolithiasis. Obes Surg 2014; 23:1575-80. [PMID: 23519632 DOI: 10.1007/s11695-013-0916-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The objective of this study was to assess predictors for new-onset stone formers after Roux-en-Y gastric bypass (RYGBP). METHODS One hundred and fifty-one obese patients underwent RYGBP and were followed for 1 year. The analysis comprised two study time points: preoperative (T0) and 1 year after surgery (T1). They were analyzed for urinary stones, blood tests, and 24-h urinary evaluation. Nonparametric tests, logistic regression, and multivariate analysis were conducted using SPSS 17. RESULTS Median BMI decreased from 44.1 to 27.0 kg/m2 (p < 0.001) in the postoperative period. Urinary oxalate (24 versus 41 mg; p < 0.001) and urinary uric acid (545 versus 645 mg; p < 0.001) increased significantly postoperatively (preoperative versus postoperative, respectively). Urinary volume (1310 versus 930 ml; p < 0.001), pH (6.3 versus 6.2; p = 0.019), citrate (268 versus 170 mg; p < 0.001), calcium (195 versus 105 mg; p < 0.001), and magnesium (130 versus 95 mg; p = 0.004) decreased significantly postoperatively (preoperative versus postoperative, respectively). Stone formers increased from 16 (10.6 %) to 27 (17.8%) patients in the postoperative analysis (p = 0.001). Predictors for new stone formers after RYGBP were postoperative urinary oxalate (p = 0.015) and uric acid (p = 0.044). CONCLUSIONS RYGBP determined profound changes in urinary composition which predisposed to a lithogenic profile. The prevalence of urinary lithiasis increased almost 70% in the postoperative period. Postoperative urinary oxalate and uric acid were the only predictors for new stone formers.
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Affiliation(s)
- Antonio Carlos Valezi
- Department of Surgery, State University of Londrina, Rua Santos 777 apto 1302, 86020041, Londrina, Brazil,
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Stogov MV, Shchurova EN, Bliudenov DN. [Potential biochemical factors for the development of urolithiasis in patients with spinal cord injuries]. Urologiia 2014:10-14. [PMID: 24772768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A comparative analysis of biochemical parameters of blood serum and daily urine in patients with urolithiasis developed after spinal cord injury (study group--35 patients) and patients without development of the disease (comparison group--20 patients) was performed. It was found that patients after spinal cord injury have developed productive azotemia, which led to the disruption of renal excretory function (accumulation of urea and creatinine in blood, and lowering their clearance). Against this background, there is violation of excretion of uric acid, magnesium, decreased sensitivity of the renal tubules to aldosterone (in patients with nephrolithiasis K/Na ratio in urine was lower). As a result, patients have decreased reabsorption of sodium and water retention, increased urine osmolality; against the background of electrolyte imbalance in urine, this leads to the formation of stones. In patients with spinal cord injuries, main trigger mechanism of formation of urinary stones was excessive posttraumatic azotemia. The high concentration of the products of protein-nitrogen catabolism in the serum of patients in the acute and early periods of spinal cord injury may be unfavorable criterion determining the significant risk of developing of kidney stones.
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Konstantinova OV, Dutov VV, Katibov MI, Trapeznikova MF, Ianenko ÈK, Merinov DS. [Experience in the use of mineral water "Naftusya" of Zbruchansk field in the treatment of patients with uroliths]. Urologiia 2013:9-13. [PMID: 24649756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The study has evaluated the effect of combined treatment including slightly mineralized hydrocarbonate-magnesium-calcium mineral water "Naftusya" of Zbruchansk field on the urinary system of 47 adult patients with urolithiasis and chronic pyelonephritis aged 24 to 76 years and 3 children of different age groups. 14 patients dropped out of the study group after 1-3 days after the start of treatment due to the negative reaction of the gastrointestinal tract to the reception of water; thus, study group consisted of 36 patients. At baseline, kidney or ureteral stones were diagnosed in all patients. For adult patients, water was administered at a dose 200 ml 3 times a day, for children--50-150 ml 3 times a day, 30-40 minutes before meals for 7-20 days. Examination of patients was performed using laboratory, ultrasound and radiographic methods. It was revealed that against the background of complex treatment, discharge of small stones, their fragments and urinary sand have occurred 1-3 days earlier than with standard treatment. There was no effect on calcium and inorganic phosphate metabolism. The trend to uric acid crystalluria and reducing the pH of urine was revealed. Statistically significant reduction of leukocyturia and erythrocyturia was identified. 60% of patients had a disappearance of bacteriuria or reduction of the titer of bacteria. The results led to the conclusion of advisability of use of mineral water "Naftusya" of Zbruchansk field in the complex treatment of inflammatory processes in the urinary system and for stimulation of discharge of ureteral stones with sizes enabaling to presume their independent discharge.
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Dzerganov NK, Egshatian LV, Mokrysheva NG, Peretokina EV. [Clinical and laboratory parameters in patients with urolithiasis in the presence and absence of primary hyperparathyroidism]. Urologiia 2013:14-18. [PMID: 24649757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The clinical and laboratory findings in 78 patients with various forms of urolithiasis depending on the presence of primary hyperparathyroidism (PHPT) were analyzed. PHPT was diagnosed in 17 patients. Group "without PHPT" and group "with PHPT" differed significantly in terms of parathyroid hormone (PTH) level, serum calcium, phosphorus, chloride, alkaline phosphatase, calciuria and kaliuria. In patients with staghorn calculi, PHPT was diagnosed in 12.5%, and staghorn calculi in the presence of PHPT were identified in 17.7% of cases. Hypercalciuria in the group "with PHPT" was detected in 82.4% of patients (all 3 patients with staghorn calculi), and in the group "without PHPT"--in 18% of patients (2 of 21 patients with staghorn calculi). Hyperoxaluria was observed in 42.3% of patients "without PHPT" and in 35.3% of patients "with PHPT", in 36.8% of patients with simple stones and in 57.2%--with staghorn calculi. In 39% of patients "without PHPT", secondary hyperparathyroidism (SHPT) was diagnosed. SHPT prevalence was 28% in patients with staghorn calculi, and 45% in patients with simple stones. In 87.5% of patients with hypomagnesemia, staghorn calculi were observed. Significant relationship between magnesium and triglycerides (r(s) = -0.296; P = 0.041), and magnesium and high-density lipoproteins (r(s) = 0.339; P = 0.032) in all patients with urolithiasis were revealed. Thus, the study found no association between staghorn nephrolithiasis and PHPT. Elevated PTH levels usually indicate SHPT rather than PHPT. In hypocalcemia, there was more strong association between PTH and calcium, in normocalcaemia--between PTH and magnesium.
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Sharma A, Prasongwattana V, Cha’on U, Selmi C, Hipkaeo W, Boonnate P, Pethlert S, Titipungul T, Intarawichian P, Waraasawapati S, Puapiroj A, Sitprija V, Reungjui S. Monosodium glutamate (MSG) consumption is associated with urolithiasis and urinary tract obstruction in rats. PLoS One 2013; 8:e75546. [PMID: 24086562 PMCID: PMC3784461 DOI: 10.1371/journal.pone.0075546] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/17/2013] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The peritoneal injection of monosodium glutamate (MSG) can induce kidney injury in adult rats but the effects of long-term oral intake have not been determined. METHODS We investigated the kidney histology and function in adult male Wistar rats that were fed ad libitum with a standard rat chow pellet and water with or without the addition of 2 mg/g body weight MSG/day in drinking water (n=10 per group). Both MSG-treated and control animals were sacrificed after 9 months when renal function parameters, blood and urine electrolytes, and tissue histopathology were determined. RESULTS MSG-treated rats were more prone to kidney stone formation, as represented by the alkaline urine and significantly higher activity product of calcium phosphate. Accordingly, 3/10 MSG-treated rats developed kidney stones over 9 months versus none of the control animals. Further, 2/10 MSG-treated rats but none (0/10) of the controls manifested hydronephrosis. MSG-treated rats had significantly higher levels of serum creatinine and potassium including urine output volume, urinary excretion sodium and citrate compared to controls. In contrast, MSG-treated rats had significantly lower ammonium and magnesium urinary excretion. CONCLUSION Oral MSG consumption appears to cause alkaline urine and may increase the risks of kidney stones with hydronephrosis in rats. Similar effects in humans must be verified by dedicated studies.
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Affiliation(s)
- Amod Sharma
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vitoon Prasongwattana
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Milan, Italy
- BIOMETRA Department, University of Milan, Milan, Italy
| | - Wiphawi Hipkaeo
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Piyanard Boonnate
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supattra Pethlert
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Tanin Titipungul
- Department of Pathology, Mahasarakham Hospital, Mahasarakham, Thailand
| | | | - Sakda Waraasawapati
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anucha Puapiroj
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Sirirat Reungjui
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Lagun LV, Atanasova IV, Tapal'skiĭ DV. [Formation of microbial biofilms in causative agents of acute and chronic pyelonephritis]. Zh Mikrobiol Epidemiol Immunobiol 2013:18-23. [PMID: 24000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Study the intensity of formation of microbial biofilms by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus strains isolated during various forms of pyelonephritis. MATERIALS AND METHODS 150 clinical isolates of microorganisms isolated from urine ofpatientswith acute and chronic pyelonephritiswere included into the study. Determination of intensity of film-formation was carried out by staining of the formed biofilms by crystal violet with consequent extraction of the dye and measurement of its concentration in washout solution. RESULTS Among causative agents ofpyelonephritis P. aeruginosa isolates had the maximum film-forming ability. The intensity of biofilm formation of these isolates was 2-3 time higher than staphylococcus and enterobacteria strains. Strains isolated from patients with chronic pyelonephritis by ability to form biofilms significantly surpassed strains isolated from acute pyelonephritis patients. A higher ability to form microbial biofilms for microorganisms--causative agents of pyelonephritis progressing against the background ofurolithiasis was noted. CONCLUSION The ability to form biofilms is determined by both causative agent species and character of the infectious process in which this microorganism participates. Intensive formation of biofilms by E. coli, P. aeruginosa, K. pneumoniae, S. aureus clinical isolates may be an important factor of chronization of urinary tract infections.
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La Manna A, Apicella A, Cangiano G, Polito C. [Urolithiasis in children: diagnostic difficulties]. G Ital Nefrol 2013; 30:gin/00072.3. [PMID: 23832455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The incidence of urolithiasis in children has been steadily increasing in developed countries mainly due to changes in dietary habits. The occurrence of symptoms suggestive of urolithiasis in children with urinary solute abnormalities predisposing to stone formation but with normal renal ultrasound and X-ray plain film is approximately 9 times higher than the occurrence of overt stone disease. This discrepancy may depend on several factors, for example: the limited sensitivity of these methods of imaging, the presence of urinary crystals that, while not detectable with imaging, injure bladder epithelium, in addition to imaging studies performed after the passage of calculi giving negative results. Correct technique during urine collection is also essential for diagnosis. Urolithiasis must be suspected in the face of abdominal pain even central or diffuse pain in younger children when there is a positive family history even though specific urinary symptoms such hematuria and dysuria may be lacking.
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Arzoz-Fabregas M, Ibarz-Servio L, Edo-Izquierdo S, Doladé-Botías M, Fernandez-Castro J, Roca-Antonio J. Chronic stress and calcium oxalate stone disease: is it a potential recurrence risk factor? Urolithiasis 2013; 41:119-27. [PMID: 23503873 DOI: 10.1007/s00240-013-0544-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 01/17/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Montserrat Arzoz-Fabregas
- Department of Urology, Hospital Germans Trias i Pujol, Crta. Canyet s/n, 08916, Badalona Barcelona, Spain.
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Kawakami Y, Toyoda E, Kubota R, Kanamori K, Shimomura H, Sakai N, Shiba K. [Molecular heterogeneity of alpha 1-antitrypsin in the urine of the urolithiasis]. Rinsho Byori 2013; 61:25-31. [PMID: 23672078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Randall's plaque theory is regarded as the most plausible mechanism of urinary stone formation; however, we speculated that urine proteins are necessarily involved in the process of stone formation. We focused on alpha 1-antitrypsin (alpha1-AT), a protein verified to be present in urinary calculi, and which is considered as a protein of inflammation, comparing its presence in healthy subjects and patients with urolithiasis. Quantitative analysis of alpha1-AT was performed with ELISA, whereas qualitative analysis was performed with SDS PAGE, two-dimensional electrophoresis, and western blotting. The results revealed a molecular heterogeneity in alpha1-AT, which can be classified into four patterns, a concentration-independent difference in alpha1-AT molecules found in the urine of patients and healthy subjects. A wider distribution of protein isoelectric points was found in urolithiasis (3.0-8.0) than in healthy subjects (4.0-5.0). We suggest that this new finding with molecular heterogeneity was due to the urolithiasis.
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Affiliation(s)
- Yasuko Kawakami
- Department of Clinical Laboratory Medicine, Bunkyo Gakuin University, Bunkyo-ku, Tokyo 113-0023, Japan.
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Alías-Melgar A, Neave-Sánchez E, Suárez-Cuenca JA, Morales-Covarrubias J. Association of urine oncofetal fibronectin levels with urology's most common disorders. Ann Clin Lab Sci 2013; 43:420-423. [PMID: 24247799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Urine oncofetal fibronectin (OnfFN) has proven useful in the assessment of malignant diseases such as transitional cell carcinoma (TCC) of the bladder. This study aimed to explore whether OnfFN may identify benign and common urinary diseases. METHODS The urine OnfFN concentrations from patients who had bladder TCC (8 patients), benign urinary diseases (10 benign prostatic enlargement [BPE] patients, 10 urolithiasis patients), or controls (10 healthy individuals) were determined by ELISA and compared. RESULTS The urine OnfFN concentration was significantly higher in patients with bladder TCC and lithiasis (mean ± SE 0.43 ± 0.18 and 0.45 ± 0.23 ug/mL) than in patients with BPE and in healthy individuals (0.15 ± 0.06 and 0.10 ± 0.02 ug/mL, p<0.05). The urine OnfFN level (cutoff value 0.038 μg/mL), was able to identify 75% of patients with bladder TCC, 60% of patients with BPE and 80% of patients with urolithiasis, achieving a sensitivity of 0.75 for the recognition of either cancer or a urinary disorder. The OnfFN level had a high sensitivity (0.9) for the identification of urolithiasis. CONCLUSION The urine OnfFN level proved helpful in the identification of bladder TCC patients. However, it had a better performance for the identification of urolithiasis, highlighting the potential usefulness of OnfFN as a biomarker for urothelial inflammation and repair.
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Affiliation(s)
- Alejandro Alías-Melgar
- MD; Departamento de Urología, Centro Médico Nacional "20 de Noviembre", I.S.S.S.T.E. Avenida Félix Cuevas, número 540, Colonia Del Valle, Delegación Benito Juárez, México, D.F., México. Código Postal 03229; phone: 00(+5255)55583132; fax: 00(+5255)51351347; e mail:
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Abstract
OBJECTIVE To investigate the determinants of urinary stone formation in patients with fat malabsorption, because, although the prevalence of urolithiasis is greater in patients with intestinal diseases, the pathogenetic mechanisms and risk factors associated with urolithiasis in this population remain partially unsolved. MATERIALS AND METHODS The present study retrospectively analyzed the determinants of urolithiasis in 51 patients with fat malabsorption due to different intestinal diseases. Anthropometric, clinical, blood, 24-hour urinary parameters, and dietary intake were assessed. RESULTS The resection rate (ie, pancreatic and/or bowel resection) differed significantly between stone formers (SF; n=10) and nonstone formers (NSF; n=41; 70% vs 29%; P=.027). Urinary citrate was lower (1.606±1.824 vs 3.156±1.968 mmol/24 h; P=.027), while oxalate excretion (0.659±0.292 vs 0.378±0.168 mmol/24 h; P=.002) and the relative supersaturation of calcium oxalate were greater in SF than NSF (8.16±4.61 vs 3.94±2.93; P=.003). Total cholesterol and low-density lipoprotein cholesterol, but also high-density lipoprotein cholesterol, plasma β-carotene, and vitamin E concentrations, were significantly diminished, whereas serum aspartate aminotransferase activity was significantly greater in SF compared with NSF. Binary logistic regression analysis revealed resection status as a major extrarenal risk factor for stone formation (odds ratio 5.639). CONCLUSION Increased urinary oxalate and decreased citrate excretion, probably resulting from pancreatic and/or bowel resection with mainly preserved colon, were identified as the most crucial urinary risk factors for stone formation in patients with fat malabsorption. The findings suggest that hyperoxaluria predominantly results from increased colonic permeability for oxalate due to disturbed bile acid metabolism. The impaired status of fat-soluble antioxidants β-carotene and vitamin E indicates severe malabsorptive states associated with an enhanced stone-forming propensity.
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Affiliation(s)
- Roswitha Siener
- University Stone Centre, Department of Urology, University of Bonn, Bonn, Germany.
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Patel PK, Patel MA, Vyas BA, Shah DR, Gandhi TR. Antiurolithiatic activity of saponin rich fraction from the fruits of Solanum xanthocarpum Schrad. & Wendl. (Solanaceae) against ethylene glycol induced urolithiasis in rats. J Ethnopharmacol 2012; 144:160-170. [PMID: 22981722 DOI: 10.1016/j.jep.2012.08.043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/06/2012] [Accepted: 08/29/2012] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE A well-known traditional herb Solanum xanthocarpum is widely used in India for the management of different ailments including urolithiasis. This study was designed to rationalize the use of Solanum xanthocarpum in kidney stone and to investigate its mechanism of action. MATERIALS AND METHODS The saponin rich fraction prepared from fruits of Solanum xanthocarpum (SXS) was evaluated for antiurolithiatic activity by in vitro and in vivo studies. In ethylene glycol (EG, 0.75% in drinking water for 28 days) induced urolithiasis model, two different experimental doses (20 mg/kg and 40 mg/kg, p.o., for 28 days) of saponin rich fraction were selected by dose fixation study. After 28 days, various biochemical parameters were measured in urine, serum and kidney homogenate. Kidneys were also subjected to histopathological analysis. RESULTS In vitro calcium oxalate crystal (CaOx) nucleation as well as aggregation was inhibited in artificial urine solution by SXS. The lithogenic treatment caused polyuria, damage renal function and oxidative stress, manifested as increased malondialdehyde, depleted reduced glutathione and decreased antioxidant enzyme catalase activities of the kidneys, which were prevented by simultaneous administration with SXS. Lithogenic treatment also caused crystalluria, hyperoxaluria, hypercalciuria, hypocitrauria, and hypomagnesaemia. Deposition of CaOx in renal tissue and cellular injury were seen in histopathology. Co-administration of SXS had potential to prevent these pathological changes due to lithogenic treatment. Moreover, SXS raised level of glycosaminoglycan, a stone inhibitor macromolecule found in urine which decreased. CONCLUSION The antiurolithiatic activity in Solanum xanthocarpum is mediated possibly through the inhibition of CaOx crystal formation and its effect on the urinary concentration of stone-forming constituents and nephrolithiasis inducing factors and this study rationalizes its medicinal use in urolithiasis.
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Affiliation(s)
- Paras K Patel
- Department of Pharmacology, Maliba Pharmacy College, Bardoli-Mhuva Road, Tarsadi, Bardoli, District-Surat, Gujarat 394350, India.
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Menditto VG, Lucci M, Polonara S. [The role of hypomagnesiuria in urolithiasis and renal colic: results from a prospective study of a metabolic evaluation protocola]. Minerva Med 2012; 103:377-382. [PMID: 23042373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The stone disease of the urinary tract (urolithiasis) is a growing disease. The identification of metabolic disorders, treatable with prophylactic therapy, appears to be clinically important. The aim of this study was the analysis of metabolic disorders that promote and support the urolithiasis in a cohort of patients with renal colic at an Emergency Department. METHODS In this prospective case series, we enrolled consecutive patients with renal colic treated at an Emergency Department within a Regional Teaching Hospital. We implemented a structured metabolic evaluation, which included blood chemistry studies, stone analysis and a 24-hour urine collection. We then evaluated the frequency of metabolic abnormalities alone or in combination. RESULTS We enrolled 39 patients whit renal colic and a diagnosis of urolithiasis: 21 (54%) were males and the median age was 43.6 years (range 20-70). The most frequently observed type of stone was that of calcium oxalate (74%). Hypomagnesiuria was the most common metabolic abnormality found at the 24-hour urine collection (22/39, 56%), followed by hypocalciuria (31%), hypernatruria (20%), hyperuricuria (18%) and hyperoxaluria (15%). Among the associations of metabolic abnormalities, the hypocalciuria /hypomagnesuria was that observed with higher frequency (23%). CONCLUSION We report an incidence of hypomagnesiuria (60%) in patients with renal colic higher than has ever been described in the literature. This result could be of importance in the knowledge of the pathogenesis of the urolithiasis and could have interesting implications in clinical practice.
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Affiliation(s)
- V G Menditto
- Dipartimento di Medicina Interna, Ospedali Riuniti di Ancona, Ancona, Italia.
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Abstract
OBJECTIVE To assess the presence of metabolic disorders in elderly men with urolithiasis. METHODS We performed a case-control study. The inclusion criteria were as follows: (1) men older than 60 years of age and either (2) antecedent renal colic or an incidental diagnosis of urinary lithiasis after age 60 (case arm) or (3) no antecedent renal colic or incidental diagnosis of urolithiasis (control arm). Each individual underwent an interview, and those who were selected underwent all clinical protocol examinations: serum levels of total and ionized calcium, uric acid, phosphorus, glucose, urea, creatinine and parathyroid hormone, urine culture, and analysis of 24-hour urine samples (levels of calcium, citrate, creatinine, uric acid and sodium, pH and urine volume). Each case arm patient underwent two complete metabolic urinary investigations, whereas each control arm individual underwent one examination. ClinicalTrials.gov: NCT01246531. RESULTS A total of 51 subjects completed the clinical investigation: 25 in the case arm and 26 in the control arm. In total, 56% of the case arm patients had hypocitraturia (vs. 15.4% in the control arm; p = 0.002). Hypernatriuria was detected in 64% of the case arm patients and in 30.8% of the controls (p = 0.017). CONCLUSION Hypocitraturia and hypernatriuria are the main metabolic disorders in elderly men with urolithiasis.
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Kadyrov ZA, Suleĭmanov SI, Istratov VN, Ramishvili VS. [The clinical laboratory evaluation of impact of shock wave on the activity of peptidohydrolase in urine of patients with urolithiasis]. Klin Lab Diagn 2012:8-10. [PMID: 22545466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The article presents the results of comprehensive clinical biochemical study of 79 patients with urolithiasis admitted to the urologic department of public clinical hospital No 7 in 2007-2009. The diagnostic evaluation of the impact of shock wave on kidney parenchyma and crystallization processes was implemented. The chromatography-mass spectrometry was applied to analyze the activity of hydrolytic enzymes in urine of patients with urolithiasis underwent the remote lithotripsy sessions. The dependence of the peptidohydrolase activity alteration in urine of patients with urolithiasis after remote lithotripsy from presence/absence of concomitant pyelonephritis was substantiated. This outcome permitted not only to implement the laboratory-based prevention during the pre-operational stage but to plan properly the ratio of repeated sessions of lithotripsy.
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Otocka A, Jabłońska J, Głowińska-Olszewska B, Porowski T, Bossowski A. [Metabolic acidosis in children with newly diagnosed type 1 diabetes and risk factors of urolithiasis]. Pediatr Endocrinol Diabetes Metab 2012; 18:101-106. [PMID: 23146788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Urolithiasis is increasingly being diagnosed in children. Some of the major risk factors for kidney stones are hipercalciuria, hiperoxaluria, hipocitraturia and hydrogen ion content measured by pH. Recently, more and more attention is being paid to the impact of diabetes type 1 and 2 on the development of nephrolithiasis especially in periods of poor metabolic control. AIM OF THE STUDY was to evaluate the BRI (bonn risk index - rate of spontaneous crystallization of calcium oxalate), the concentration of oxalate, citrate and urine pH in children with acid-base balance disturbances occurring in patients with newly diagnosed type 1 diabetes (DMT1). MATERIAL AND METHODS The study group included 40 patients aged 6 to 17 years (average age ± SD: 12,58 ± 3,33) with newly diagnosed DMT1. The study was performed twice: at the beginning of the disease, immediately after the treatment of diabetic ketoacidosis (study I) and after obtaining satisfactory metabolic control (study II), that is after about two weeks. The control group consisted of 100 children (6-17 years, average age 12,34 ± 3,96) without symptoms suggestive of urolithiasis. In every child, a 24-hour urine sample was collected. BRI was implemented in the urine by his own semi-micro method. RESULTS Ionized calcium level was significantly higher immediately after the diagnosis of type 1 diabetes compared to the control group (0,68±0,67 vs. 0,40 ± 0,18 mmol/l; p<0,001) and to study II (0,68 ± 0,67 vs. 0,28 ± 0,23 mmol/l; p=0,008). BRI value was significantly higher in early onset compared to the control group and the study II (3,18 ± 5,54 vs. 0,66 ± 0,52, p<0,001; 3,18 ± 5,54 vs. 0,64 ± 1,56; p=0,034). BRI correlated inversely with pH at admission to the hospital (r=-0,53, p=0,0023). CONCLUSIONS Metabolic alterations occurring during diabetic ketoacidosis at diagnosis of new type 1 diabetes may predispose to the development of the urinary stones, and thereby to the kidney damage.
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Affiliation(s)
- Agnieszka Otocka
- Klinika Pediatrii, Endokrynologii, Diabetologii z Pododdziałem Kardiologii, ul. J. Waszyngtona 17; 15-274 Białystok.
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Borysewicz-Sańczyk H, Porowski T, Hryniewicz A, Baran M, Zasim A, Bossowski A. [Urolithiasis risk factors in obese and overweight children]. Pediatr Endocrinol Diabetes Metab 2012; 18:53-57. [PMID: 22781881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Childhood obesity is becoming a worldwide epidemic and its metabolic and cardiovascular complications may already be evident at a young age. Several epidemiologic studies in adults have clearly demonstrated that obesity and overweight increase the risk of kidney disease and urolithiasis. AIM OF THE STUDY The purpose of this study was to evaluate the relationship between overweight and obesity and urolithiasis risk factors in children. MATERIALS AND METHODS The main kidney stones risk factors in urine such as calcium concentration, oxalate concentration, citrate concentration, pH of urine as well as BRI (Bonn Risk Index) were analyzed in 249 overweight and obese children (study group) and in 281 children with normal weight (control) at the age of 3 to 18 years old. RESULTS In the study group the mean oxalate concentration was significantly higher than in the control (0.52±0.48 vs. 0.26±0.12; p <0.05). The mean calcium concentration of overweight/obese patients was higher than that of normal body weight and the difference was close to statistically significant (3.23±2.55 vs 2.58±1.59; p=0.0537). The mean urine pH in the study group was 6.28±0.46 and was significantly lower (p <0.05) than the mean urine pH in the control, witch was 6.40±0.47. The mean citrate concentration among overweight/obese patients was significantly lower than in control (431,2±309,5 vs. 637,2±310,7; p <0.05). CONCLUSIONS Our results suggest that obesity or overweight at a young age are associated with an increased risk of kidney stones. Weight loss might be explored as a potential treatment to prevent kidney stone formation.
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Affiliation(s)
- Hanna Borysewicz-Sańczyk
- Klinika Pediatrii, Endokrynologii, Diabetologii, Uniwersytetu Medycznego w Bialymstoku, Bialystok.
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Baggio B, Giannossi ML, Medici L, Summa V, Tateo F. X-ray microdiffraction and urine: a new analysis method of crystalluria. J Xray Sci Technol 2012; 20:489-498. [PMID: 23324789 DOI: 10.3233/xst-2012-00355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The qualitative and quantitative analyses of crystalluria have clinical significance in the diagnosis and prognosis of urolithiasis. The aim of this paper is to provide a new accurate methodology to get qualitative and quantitative data on urine particulate in patients with renal stone disease.The procedure involves a urine collection, the separation of the solid residual by centrifugation, and its analysis by X-ray diffraction, utilizing a micro-diffractometer in order to analyze very low amounts of residual. The spectrum obtained was converted into 2 θ -I profiles and quantitatively refined by Rietveld method. The proposed methodology has the advantage to accurately quantify all crystalline phases and the amorphous component of the urine; anyway urine samples have to be centrifuged and analysed as soon as possible, because the quantitative results obtained by the X-ray microdiffraction showed that after some days and at room temperature urine increased significantly both amorphous and crystalline phases.
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Affiliation(s)
- B Baggio
- Dip. Scienze Mediche e Chirurgiche, Università degli Studi di Padova, Padova, Italy
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Akhavan-Sepahi M, Sharifian M, Mohkam M, Vafadar M, Hejazi S. Biochemical risk factors for stone formation in healthy school children. Acta Med Iran 2012; 50:814-818. [PMID: 23456523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Prevalence of urolithiasis in childhood is increasing. The wide geographic variation in the incidence of lithiasis in childhood is related to climatic, dietary, and socioeconomic factors. Many children with stone disease have a metabolic abnormality. In Southeast Asia, urinary calculi are endemic and are related to dietary factors. The main aim of this study was to determine the prevalence of renal stone, urine metabolic abnormality, control of blood pressure and demographic character in elementary school children of Qom. A cross sectional study was performed on 110 primary school children (56 girls and 54 boys) aged 7 to 11 years old. Demographic data such as age, height, weight were gathered, and systolic and diastolic blood pressure, Urine analysis and culture, urinary levels of calcium, creatinine, phosphorus, magnesium, sodium, potassium, uric acid, cystine, citrate, oxalate, protein and sonographic findings were evaluated. The mean (±SD) of age was 8.85±1.51 years. Only one child had renal stone (1%), but the prevalence of abnormal renal sonography was 7%. The most prevalent urine metabolic abnormalities were hypercalciuria (23%) and hypocitraturia (100%). 11.2% of children had positive urine culture that all were female. The prevalence of high blood pressure was 7.1% for girls and 11.1% for boys. The prevalence of renal stone in children in this study was 1%, which means the accurate judgment about the prevalence of renal stone in Qom city needs more comprehensive studies. Similar to other studies in Iran this study shows that the prevalence of hypercalciuria is significantly higher comparing to other countries, it may be associated with excessive intake of sodium.
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Affiliation(s)
- Mohsen Akhavan-Sepahi
- Department of Pediatrics, Nephrology Ward, Hazrat Maasomeh Hospital, Qom University of Medical Sciences, Qom, Iran.
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