Oxalate is an organic dicarboxylic acid that is a common component of plant foods.The kidneys are essential organs for oxalate excretion,but excessive oxalates may induce kidney stones.Jupiter microtubule associated h...Oxalate is an organic dicarboxylic acid that is a common component of plant foods.The kidneys are essential organs for oxalate excretion,but excessive oxalates may induce kidney stones.Jupiter microtubule associated homolog 2(JPT2)is a critical molecule in Ca^(2+)mobilization,and its intrinsic mechanism in oxalate exposure and kidney stones remains unclear.This study aimed to reveal the mechanism of JPT2 in oxalate exposure and kidney stones.Genetic approaches were used to control JPT2 expression in cells and mice,and the JPT2 mechanism of action was analyzed using transcriptomics and untargeted metabolomics.The results showed that oxalate exposure triggered the upregulation of JPT2,which is involved in nicotinic acid adenine dinucleotide phosphate(NAADP)-mediated Ca^(2+)mobilization.Transcriptomic analysis revealed that cell adhesion and macrophage inflammatory polarization were inhibited by JPT2 knockdown,and these were dominated by phosphatidylinositol 3-kinase(PI3K)/AKT signaling,respectively.Untargeted metabolomics indicated that JPT2 knockdown inhibited the production of succinic acid semialdehyde(SSA)in macrophages.Furthermore,JPT2 deficiency in mice inhibited kidney stones mineralization.In conclusion,this study demonstrates that oxalate exposure facilitates kidney stones by promoting crystal-cell adhesion,and modulating macrophage metabolism and inflammatory polarization via JPT2/PI3K/AKT signaling.展开更多
BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with ...BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.展开更多
Objectives: To assess the efficiency in terms of cost-effectiveness (CE) of oral Renalof® treatment versus extracorporeal shockwave lithotripsy (ESWL) in the treatment of kidney stones ≤ 1 cm in Nicaragua. Metho...Objectives: To assess the efficiency in terms of cost-effectiveness (CE) of oral Renalof® treatment versus extracorporeal shockwave lithotripsy (ESWL) in the treatment of kidney stones ≤ 1 cm in Nicaragua. Methods: A cost-effectiveness economic evaluation was carried out based on the results obtained in the randomised, prospective, observational, single-blind, prospective, phase 2 clinical trial. Cost-effectiveness and the incremental cost-effectiveness ratio (ICER) were calculated. Economic data were obtained from the Economics Department of Clínica Senior in Managua, Nicaragua. The monetary cost was expressed in US dollars (USD). Results: Treatment with Renalof® yielded a CE of $1,323.08/% remission, while ESWL was $9,498.54/% remission. The ICER shows that, in order to achieve a high percentage of kidney stone remission with ESWL, an extra $4,734.70 per patient must be invested. Conclusions: The use of Renalof® is shown to be a more cost-effective option than ESWL. It is recommended for the treatment of kidney stones ≤ 1 cm in size.展开更多
The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study t...The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.展开更多
Objective:To observe the clinical efficacy and complication rates of different stone fragmentation techniques in the treatment of kidney stones.Methods:This study selected 100 patients with urinary stones treated at t...Objective:To observe the clinical efficacy and complication rates of different stone fragmentation techniques in the treatment of kidney stones.Methods:This study selected 100 patients with urinary stones treated at the Third Division General Hospital from 2021 to November 2023 as subjects.The control group(n=50)received conventional percutaneous nephrolithotomy(PCNL)for stone fragmentation,while the research group(n=50)received super-mini percutaneous nephrolithotomy(SMP)treatment.Surgical parameters,stone clearance rates,recurrence rates,and complication rates were compared between the two groups.Results:After treatment,the surgical parameters in the research group were significantly better than those in the control group.The research group had a higher stone clearance rate and lower rates of stone recurrence and complications(P<0.05).Conclusion:Compared with conventional PCNL,SMP shows better clinical outcomes for patients with kidney stones.It improves surgical parameters,increases stone clearance rates,and reduces both stone recurrence and complication rates,making it a valuable technique for clinical reference.展开更多
Kidney stones are a common urinary system condition that can progress to kidney disease. Previous studies on the association between tea consumption and kidney stones are inconsistent. A cross-sectional study to inves...Kidney stones are a common urinary system condition that can progress to kidney disease. Previous studies on the association between tea consumption and kidney stones are inconsistent. A cross-sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078 northern Chinese adults. A total of 8,807 participants were included in the final analysis. Participants＇ prevalence of kidney stones was 1.07%, 1.73%, and 2.25% based on their tea consumption frecluencv of never, occasionally,展开更多
Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational ...Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018.The adherence to drug treatment was measured 6 months after its initiation,and the numerical values of the metabolic studies were compared.Wilcoxon tests were performed to compare the difference before and after treatment.Results:Ninety patients were evaluated,with 73.3% of adherence.The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs.There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients(p=0.031 vs.p=0.528).Conclusions:Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation;the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.展开更多
<b><span>Background</span></b><b><span>: </span></b><span>In view of the high recurrence of kidney stones in patients, the search for less aggressive, preventive t...<b><span>Background</span></b><b><span>: </span></b><span>In view of the high recurrence of kidney stones in patients, the search for less aggressive, preventive treatments has become increasingly essential. Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> offers a phytotherapy alternative. Due to its diuretic and kidney stone demineralisation properties, it has been widely used in this patient population, disintegrating and eliminating calcium oxalate and struvite kidney stones painlessly in the genitourinary system. </span><b><span>Methods</span></b><b><span>: </span></b><span>A Phase II, randomised, prospective, observational, single-blind study with two treatment arms was conducted in order to determine the efficacy of this alternative therapy: a total of 155 patients were enrolled, 120 were assigned to a Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> treatment group and 35 to the placebo group. All were over 18 years of age, of both genders, diagnosed with kidney stones of under 10 mm in diameter, present along the entire renal-ureteral-vesicular tract, diagnosed by ultrasound and renal CAT scan. Divided into two study arms, 120 were administered a dosage of a single 325 mg capsule of the Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> product half an hour before the two main meals for 3 months. The presence of kidney stones in any part of the renal-ureteral tract was assessed at monthly consultations using one of the above-mentioned diagnostic tools. </span><b><span>Results</span></b><b><span>: </span></b><span>Study results show a high rate of effectiveness with Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span>, finding up to a 65% expulsion rate (78 patients) in the first 8 weeks of treatment, compared to 11.4% (4 patients) in the placebo control group, P < 0.001. It is likely a longer follow-up period would be necessary in patients with kidney stones of 10 mm in diameter or larger than the period applied in the study.</span><span> </span><b><span>Discussion</span></b><b><span>: </span></b><span>We strongly recommend the inclusion of this product in kidney stone disease management protocols, especially for patients with kidney stones under 10 mm in diameter, where high response and effectiveness have been observed. Thus, it should be evaluated to reduce surgical treatment costs, as well as those for possible colic episodes and other associated complications.</span>展开更多
<strong>Background:</strong> Kidney stone disease, also termed nephrolithiasis is associated with significant morbidities such as severe colicky flank pain, haematuria, urinary tract infection and kidney f...<strong>Background:</strong> Kidney stone disease, also termed nephrolithiasis is associated with significant morbidities such as severe colicky flank pain, haematuria, urinary tract infection and kidney failure. Kidney stone disease was perceived as uncommon in developing countries;however, the global prevalence has been rising over the past two decades due to lifestyle changes. There is very limited literature on kidney stone composition in Africa, including Ghana and South Africa. It was based on this evidence that this study was undertaken. <strong>Aim:</strong> The primary aim of this study was to describe and compare the composition of kidney stone in patients receiving treatment at the Korle-Bu Teaching Hospital (KBTH), Accra (Ghana) and Groote Schuur Hospital (GSH), Cape Town (South Africa). <strong>Methods:</strong> The study was a retrospective folder review of patients treated for nephrolithiasis at the Korle-Bu Teaching Hospital in Accra (Ghana) and Groote Schuur Hospital in Cape Town (South Africa). Patients who were treated for kidney stone disease between 1<sup>st</sup> June 2016 and 31<sup>st</sup> May 2018 were recruited, and their folder numbers were retrieved from theatre logbooks. A total of hundred and sixty-three (n = 163) folders (n = 30 KBTH;n = 133 GSH) were subsequently retrieved from the two facilities’ records department. Demographic data and kidney stone analysis results were analyzed using the <em>R</em> statistical software. <strong>Results:</strong> The age of KBTH patients ranged from 24 to 75 years and age of 45 years, while that of GSH ranged 19 to 77 years and median age 48 years respectively. Males were the majority stone formers for both hospitals [56.7% KBTH;59.4% GSH]. There was no statistical difference in gender (<em>p</em> = 0.9447) and age (<em>p</em> = 0.2612) between the two groups. Calcium oxalate (86.7%) and uric acid (90.0%) were the commonest components of the kidney stones analyzed from the KBTH. Calcium oxalate (66.2%) and carbonate apatite (40.6%) were the most common components stones from GSH. Brushite (3.0%), cystine (3.8%) and struvite (19.6%) stones were only found in GSH patients. All kidney stones from the KBTH were mixed stones. Pure kidney stones were only found among the GSH dataset constituting 48.9%, also female patients from GSH formed more mixed stones than their male counterparts (M:F = 40.5%:66.67%) and infection kidney stones were also predominantly found among female patients. <strong>Conclusion:</strong> The findings indicate that the two facilities’ participants are not different in terms of gender and age. However, the composition of stones was found to be different between participants from both hospitals. This suggests that kidney stone composition may be influenced by patients’ geographical location and or cultural background.展开更多
<strong>Background: </strong>The formation of kidney stones is considered a complicated process. Consequently, there are many questions about the link between kidney stones formation and level of salivary ...<strong>Background: </strong>The formation of kidney stones is considered a complicated process. Consequently, there are many questions about the link between kidney stones formation and level of salivary uric acid and calculus formation on the teeth surfaces. <strong>Objectives:</strong> To evaluate the correlation between the level of salivary uric acid and kidney stones formation and their influence on dental calculus and periodontal status among Saudi patients aged 25 - 70 years. <strong>Materials and Methods:</strong> 120 Saudi male patients were examined (60 of Kidney stones patients and 60 patients of non-kidney stones patients) for clinical evaluation of plaque index (PLI), gingival index (GI), calculus index of oral hygiene (CI) and clinical attachment loss (CAL). Moreover, lab assessment of uric acid level in the collected salivary samples was done. The findings were analyzed using of ANOVA test and Tukey’s test. <strong>Results:</strong> There were statistically significant differences in clinical parameters among kidney stones patients and non-kidney stones patients (p < 0.05), but these differences were highly statistically significant in the correlation between calculus index (CI), plaque index (PLI) and gingival index (GI) among kidney stone patients in group II, moreover, PLI and clinical attachment loss (CAL) among kidney stone patients in group III (p < 0.001). The statistical analyses revealed statistically significant differences in the level of salivary uric acid (mg/dl) in the comparison between kidney stones patients and non-kidney stones patients in group I and group III, whereas there were highly statistically significant in the comparison between kidney stones patients and non-kidney stones patients in group III. <strong>Conclusion:</strong> At the end of this study, we concluded that there was a relationship between dental calculus formation, kidney stones formation, and an increase in the level of salivary uric acid.展开更多
Purpose: As patients with transfusion-dependent thalassemia (TDT) are living longer, novel morbidities are being recognized. The purpose of this review is to summarize the current knowledge regarding the prevalence an...Purpose: As patients with transfusion-dependent thalassemia (TDT) are living longer, novel morbidities are being recognized. The purpose of this review is to summarize the current knowledge regarding the prevalence and risk factors of nephrolithiasis in patients with TDT. Methods: A non-systematic, narrative review of the current literature published up to August 2021 was conducted. Results: Nephrolithiasis has been reported in 18% - 59% of patients with TDT, which is at least twice the prevalence in the general US population. The risk factors for nephrolithiasis can be classified into behavioral (dietary and lifestyle), environmental, metabolic, disease-specific, and genetic factors. While clarifying the true prevalence of nephrolithiasis in different age groups and diagnostic categories of TDT requires further research, prevention, and management of nephrolithiasis is a growing clinical concern. Physicians should be aware of the potential increased risk of stone disease in splenectomized and diabetic patients as well as those treated with certain chelation regimens. Conclusions: The etiology of nephrolithiasis and potential TDT-specific risk factors that may put patients at greater risk are highlighted. There is insufficient evidence at this time to recommend universal screening for nephrolithiasis using ultrasound. Evidence-based recommendations on monitoring, prevention, and management of nephrolithiasis in TDT are provided.展开更多
The incidence of urolithiasis(UL)is increasing,and it has become more common in children and adolescents over the past few decades.Hypercalciuria is the leading metabolic risk factor of pediatric UL,and it has high mo...The incidence of urolithiasis(UL)is increasing,and it has become more common in children and adolescents over the past few decades.Hypercalciuria is the leading metabolic risk factor of pediatric UL,and it has high morbidity,with or without lithiasis as hematuria and impairment of bone mass.The reduction in bone mineral density has already been described in pediatric idiopathic hypercalciuria(IH),and the precise mechanisms of bone loss or failure to achieve adequate bone mass gain remain unknown.A current understanding is that hypercalciuria throughout life can be considered a risk of change in bone structure and low bone mass throughout life.However,it is still not entirely known whether hypercalciuria throughout life can compromise the quality of the mass.The peak bone mass is achieved by late adolescence,peaking at the end of the second decade of life.This accumulation should occur without interference in order to achieve the peak of optimal bone mass.The bone mass acquired during childhood and adolescence is a major determinant of adult bone health,and its accumulation should occur without interference.This raises the critical question of whether adult osteoporosis and the risk of fractures are initiated during childhood.Pediatricians should be aware of this pediatric problem and investigate their patients.They should have the knowledge and ability to diagnose and initially manage patients with IH,with or without UL.展开更多
Objective:To investigate the effect of allicin on the formation of kidney stones in rats by regulating the expression of osteopontin(OPN)and nuclear factor-κB(NF-κB)signaling pathway.Methods:A total of 50 healthy ad...Objective:To investigate the effect of allicin on the formation of kidney stones in rats by regulating the expression of osteopontin(OPN)and nuclear factor-κB(NF-κB)signaling pathway.Methods:A total of 50 healthy adult male SD rats with SPF grade were selected and divided into five groups by random number and computer random combination,with 10 rats in each group.Except the blank group,the other four groups were given 2 m L/d mixed solution of 1%ethylene glycol+2%ammonium chloride to construct the nephrolith model.During the modeling process,the blank group and the model group were given normal saline by gavage.The positive group was given 600 mg/(kg·d)of potassium sodium hydrogen citrate granules by gavage,the low-dose group was given 7.5 mg/(kg·d)of allicin by gavage,and the high-dose group was given 15 mg/(kg·d)of allicin by gavage.After administration,renal function,urine related indicators,calcium oxalate crystallization score,OPN protein expression and NF-κB signaling pathwayrelated protein expression were observed and compared among the five groups of rats.Results:There were significant differences in kidney index,urea nitrogen(BUN)and blood creatinine(Cr)levels among the five groups(P<0.05).There were no differences in kidney index,BUN and Cr levels between the high-dose group and the positive group(P>0.05),and were all lower than those in the model group and low-dose group(P<0.05).There were significant differences in the levels of oxalic acid(OA),calcium(Ca),magnesium(Mg),and phosphorus(P)in the urine of five groups of rats(P<0.05).The high-dose group showed no difference in the levels of OA,Ca,Mg,and P compared to the positive control group(P>0.05),and all were lower than the model group and low-dose group(P<0.05).There were significant differences in the scores of calcium oxalate crystallization and the expression of OPN protein in the five groups(P<0.05).There was no difference in the scores of calcium oxalate crystallization between the high-dose group and the positive group(P>0.05).The expression of OPN protein was higher than that in the positive group(P<0.05),and both were lower than that in the model group and low-dose group(P<0.05).There were significant differences in the expression levels of NF-κB inhibitory protein-α(IκB-α)and NF-κB in five groups(P<0.05),and the expression levels of IκB-αand NF-κB in the high-dose group were lower than those in the model group,positive control group,and low-dose group(P<0.05).Conclusion:Allicin may inhibit the formation of kidney stones in rats by down-regulating the expression levels of OPN and NF-κB signaling pathway-related proteins,and a high dose of allicin can obtain a similar effect of kidney stones inhibition as that of potassium sodium hydrogen citrate granules.展开更多
Objective:Pseudoxanthoma elasticum(PXE)is a rare genetic disorder caused by loss-of-function mutations in the ABCC6 gene.While PXE is characterized by ectopic mineralization of connective tissues clinically affecting ...Objective:Pseudoxanthoma elasticum(PXE)is a rare genetic disorder caused by loss-of-function mutations in the ABCC6 gene.While PXE is characterized by ectopic mineralization of connective tissues clinically affecting the skin,eyes,and cardiovascular system,kidney stones were reported in some individuals with PXE.The aim of this study is to determine whether kidney stones are an incidental finding or a frequent manifestation of PXE.Methods:We first investigated the genetic basis of two siblings diagnosed with PXE.The younger patient presented with recurrent kidney stones since 8 years old.Secondly,to address whether kidney stones are associated with PXE,the prevalence of kidney stones in a survey cohort of 563 respondents with PXE was compared to that of a general U.S.population survey,National Health and Nutrition Examination Survey,with 28,629 participants.Results:Genetic analysis in both patients identified compound heterozygous mutations in ABCC6,c.2787+1G>T,and c.3774_3775insC.The analysis of participants 20 years old and older revealed that 23.4%of PXE patients had previously had a kidney stone,a significant increase compared to 9.2%in the general population(P<0.01).In addition,17.8%of PXE patients reported their first kidney stone episode before age of 18 years old.Conclusions:PXE correlates with an increased risk of developing kidney stones with considerable morbidity and health-care cost.展开更多
Renal calculi are inhomogenous, heterogeneous and complex in nature. There is a large variation in their chemical composition due to food habits of patients and hence geography of the inhabitants in different parts of...Renal calculi are inhomogenous, heterogeneous and complex in nature. There is a large variation in their chemical composition due to food habits of patients and hence geography of the inhabitants in different parts of the world. Ultrasonic studies are made to investigate various physical and other constants of such renal calculi. A double-probe through transmission technique is used to study various propagation parameters. The ultrasonic waves displayed on cathode-ray oscilloscope are complex and complicated in nature. Complete analysis of such wave patterns is given in the present study. The data reported would help in the design of an u ltrasonic lithotripter.展开更多
Stone formation is induced by an increased level of urine crystallization promoters and reduced levels of its inhibitors.Crystallization inhibitors include citrate,magnesium,zinc,and organic compounds such as glycosam...Stone formation is induced by an increased level of urine crystallization promoters and reduced levels of its inhibitors.Crystallization inhibitors include citrate,magnesium,zinc,and organic compounds such as glycosaminoglycans.In the urine,there are various proteins,such as uromodulin(Tamm-Horsfall protein),calgranulin,osteopontin,bikunin,and nephrocalcin,that are present in the stone matrix.The presence of several carboxyl groups in these macromolecules reduces calcium oxalate monohydrate crystal adhesion to the urinary epithelium and could potentially protect against lithiasis.Proteins are the most abundant component of kidney stone matrix,and their presence may reflect the process of stone formation.Many recent studies have explored the proteomics of urinary stones.Among the stone matrix proteins,the most frequently identified were uromodulin,S100 proteins(calgranulins A and B),osteopontin,and several other proteins typically engaged in inflammation and immune response.The normal level and structure of these macromolecules may constitute protection against calcium salt formation.Paradoxically,most of them may act as both promoters and inhibitors depending on circumstances.Many of these proteins have other functions in modulating oxidative stress,immune function,and inflammation that could also influence stone formation.Yet,the role of these kidney stone matrix proteins needs to be established through more studies comparing urinary stone proteomics between stone formers and non-stone formers.展开更多
The kidney is an important organ of humans to purify the blood.The healthy function of the kidney is always essential to balance the salt,potassium and pH levels in the blood.Recently,the failure of kidneys happens ea...The kidney is an important organ of humans to purify the blood.The healthy function of the kidney is always essential to balance the salt,potassium and pH levels in the blood.Recently,the failure of kidneys happens easily to human beings due to their lifestyle,eating habits and diabetes diseases.Early pre-diction of kidney stones is compulsory for timely treatment.Image processing-based diagnosis approaches provide a greater success rate than other detection approaches.In this work,proposed a kidney stone classification method based on optimized Transfer Learning(TL).The Deep Convolutional Neural Network(DCNN)models of DenseNet169,MobileNetv2 and GoogleNet applied for clas-sification.The combined classification results are processed by ensemble learning to increase classification performance.The hyperparameters of the DCNN model are adjusted by the metaheuristic algorithm of Gorilla Troops Optimizer(GTO).The proposed TL model outperforms in terms of all the parameters compared to other DCNN models.展开更多
Medicinal plants have been valued for millennia as a rich source of therapeutic compounds for the prevention of various ailments all throughout the world.Kidney stones and urinary calculi affect a huge percentage of t...Medicinal plants have been valued for millennia as a rich source of therapeutic compounds for the prevention of various ailments all throughout the world.Kidney stones and urinary calculi affect a huge percentage of the population nowadays.Stone sickness has become more prevalent as a result of changes in living conditions,such as industrialization and hunger.The most common stone recorded in India is calcium oxalate kidney stones.Changes in prevalence and incidence,the occurrence of stone kinds and stone position,and stone removal treatment are all discussed.Medicinal herbs have been utilised for centuries because they are safer,more effective,culturally acceptable,and have less adverse effects than manufactured medications.Patients are advised to consume a low-fat diet,as well as fibres from naturally occurring plants and herbal treatments.The current article discusses the steps that should be taken to maximise the potential of medicinal plants for stone dissolving action.Combining herbal remedies with allopathic treatment is an excellent way to eliminate all issues associated with kidney stones.The purpose of this article is to emphasise the use of herbs as a treatment for urinary stones.展开更多
Vitamin C is an essential vitamin for people,but it possibly linked to an increased risk of kidney stones.This view is controversial.The purpose of this assess was to illuminate the relationship between vitamin C inta...Vitamin C is an essential vitamin for people,but it possibly linked to an increased risk of kidney stones.This view is controversial.The purpose of this assess was to illuminate the relationship between vitamin C intake and kidney stones.This paper reviewed relevant articles in the past 40 years from pubmed,analyzed the correlation between vitamin C intake and kidney stones,and pointed out the problems in the research process,which is of great reference significance.展开更多
Objective:Prevalence of kidney stone disease continues to increase globally with recurrence rates between 30%and 50%despite technological and scientific advances.Reduction in recurrence would improve patient outcomes ...Objective:Prevalence of kidney stone disease continues to increase globally with recurrence rates between 30%and 50%despite technological and scientific advances.Reduction in recurrence would improve patient outcomes and reduce cost and stone morbidities.Our objective was to review results of experimental studies performed to determine the efficacy of readily available compounds that can be used to prevent recurrence.Methods: All relevant literature up to October 2020,listed in PubMed is reviewed.Results: Clinical guidelines endorse the use of evidence-based medications,such as alkaline agents and thiazides,to reduce urinary mineral supersaturation and recurrence.However,there may be additional steps during stone pathogenesis where medications could moderate stone risk.Idiopathic calcium oxalate stones grow attached to Randall’s plaques or plugs.Results of clinical and experimental studies suggest involvement of reactive oxygen species and oxidative stress in the formation of both the plaques and plugs.The renin-angiotensin-aldosterone system(RAAS),nicotinamide adenine dinucleotide phosphate(NADPH)oxidase,mitochondria,and NOD-like receptor pyrin domain containing-3(NLRP3)inflammasome have all been implicated at specific steps during stone pathogenesis in animal models.Conclusion: In addition to supersaturation-reducing therapies,the use of anti-oxidants,free radical scavengers,and inhibitors of NADPH oxidase,NLRP3 inflammasome,and RAAS may prove beneficial for stone prevention.Compounds such as statins and angiotensin converting enzyme inhibitors are already in use as therapeutics for hypertension and cardio-vascular disease and have previously shown to reduce calcium oxalate nephrolithiasis in rats.Although clinical evidence for their use in stone prevention in humans is limited,experimental data support they be considered along with standard evidence-based medications and clinical expertise when patients are being counselled for stone prevention.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.:82070723,82270797)Nature Science Foundation of Hubei Province,China(Grant No.:2022CFC020).
文摘Oxalate is an organic dicarboxylic acid that is a common component of plant foods.The kidneys are essential organs for oxalate excretion,but excessive oxalates may induce kidney stones.Jupiter microtubule associated homolog 2(JPT2)is a critical molecule in Ca^(2+)mobilization,and its intrinsic mechanism in oxalate exposure and kidney stones remains unclear.This study aimed to reveal the mechanism of JPT2 in oxalate exposure and kidney stones.Genetic approaches were used to control JPT2 expression in cells and mice,and the JPT2 mechanism of action was analyzed using transcriptomics and untargeted metabolomics.The results showed that oxalate exposure triggered the upregulation of JPT2,which is involved in nicotinic acid adenine dinucleotide phosphate(NAADP)-mediated Ca^(2+)mobilization.Transcriptomic analysis revealed that cell adhesion and macrophage inflammatory polarization were inhibited by JPT2 knockdown,and these were dominated by phosphatidylinositol 3-kinase(PI3K)/AKT signaling,respectively.Untargeted metabolomics indicated that JPT2 knockdown inhibited the production of succinic acid semialdehyde(SSA)in macrophages.Furthermore,JPT2 deficiency in mice inhibited kidney stones mineralization.In conclusion,this study demonstrates that oxalate exposure facilitates kidney stones by promoting crystal-cell adhesion,and modulating macrophage metabolism and inflammatory polarization via JPT2/PI3K/AKT signaling.
基金the Clinical Research Ethics Committees of Wuxi Taihu Hospital(Approval Number THH-YXLL-2021-0103).
文摘BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.
文摘Objectives: To assess the efficiency in terms of cost-effectiveness (CE) of oral Renalof® treatment versus extracorporeal shockwave lithotripsy (ESWL) in the treatment of kidney stones ≤ 1 cm in Nicaragua. Methods: A cost-effectiveness economic evaluation was carried out based on the results obtained in the randomised, prospective, observational, single-blind, prospective, phase 2 clinical trial. Cost-effectiveness and the incremental cost-effectiveness ratio (ICER) were calculated. Economic data were obtained from the Economics Department of Clínica Senior in Managua, Nicaragua. The monetary cost was expressed in US dollars (USD). Results: Treatment with Renalof® yielded a CE of $1,323.08/% remission, while ESWL was $9,498.54/% remission. The ICER shows that, in order to achieve a high percentage of kidney stone remission with ESWL, an extra $4,734.70 per patient must be invested. Conclusions: The use of Renalof® is shown to be a more cost-effective option than ESWL. It is recommended for the treatment of kidney stones ≤ 1 cm in size.
文摘The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.
文摘Objective:To observe the clinical efficacy and complication rates of different stone fragmentation techniques in the treatment of kidney stones.Methods:This study selected 100 patients with urinary stones treated at the Third Division General Hospital from 2021 to November 2023 as subjects.The control group(n=50)received conventional percutaneous nephrolithotomy(PCNL)for stone fragmentation,while the research group(n=50)received super-mini percutaneous nephrolithotomy(SMP)treatment.Surgical parameters,stone clearance rates,recurrence rates,and complication rates were compared between the two groups.Results:After treatment,the surgical parameters in the research group were significantly better than those in the control group.The research group had a higher stone clearance rate and lower rates of stone recurrence and complications(P<0.05).Conclusion:Compared with conventional PCNL,SMP shows better clinical outcomes for patients with kidney stones.It improves surgical parameters,increases stone clearance rates,and reduces both stone recurrence and complication rates,making it a valuable technique for clinical reference.
基金supported by the Medical Science and Technology Project of Zhejiang Province[2014KYA231]
文摘Kidney stones are a common urinary system condition that can progress to kidney disease. Previous studies on the association between tea consumption and kidney stones are inconsistent. A cross-sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078 northern Chinese adults. A total of 8,807 participants were included in the final analysis. Participants＇ prevalence of kidney stones was 1.07%, 1.73%, and 2.25% based on their tea consumption frecluencv of never, occasionally,
文摘Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018.The adherence to drug treatment was measured 6 months after its initiation,and the numerical values of the metabolic studies were compared.Wilcoxon tests were performed to compare the difference before and after treatment.Results:Ninety patients were evaluated,with 73.3% of adherence.The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs.There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients(p=0.031 vs.p=0.528).Conclusions:Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation;the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.
文摘<b><span>Background</span></b><b><span>: </span></b><span>In view of the high recurrence of kidney stones in patients, the search for less aggressive, preventive treatments has become increasingly essential. Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> offers a phytotherapy alternative. Due to its diuretic and kidney stone demineralisation properties, it has been widely used in this patient population, disintegrating and eliminating calcium oxalate and struvite kidney stones painlessly in the genitourinary system. </span><b><span>Methods</span></b><b><span>: </span></b><span>A Phase II, randomised, prospective, observational, single-blind study with two treatment arms was conducted in order to determine the efficacy of this alternative therapy: a total of 155 patients were enrolled, 120 were assigned to a Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> treatment group and 35 to the placebo group. All were over 18 years of age, of both genders, diagnosed with kidney stones of under 10 mm in diameter, present along the entire renal-ureteral-vesicular tract, diagnosed by ultrasound and renal CAT scan. Divided into two study arms, 120 were administered a dosage of a single 325 mg capsule of the Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span> product half an hour before the two main meals for 3 months. The presence of kidney stones in any part of the renal-ureteral tract was assessed at monthly consultations using one of the above-mentioned diagnostic tools. </span><b><span>Results</span></b><b><span>: </span></b><span>Study results show a high rate of effectiveness with Renalof</span><sup><span style="vertical-align:super;"><span style="white-space:nowrap;">®</span></span></sup><span>, finding up to a 65% expulsion rate (78 patients) in the first 8 weeks of treatment, compared to 11.4% (4 patients) in the placebo control group, P < 0.001. It is likely a longer follow-up period would be necessary in patients with kidney stones of 10 mm in diameter or larger than the period applied in the study.</span><span> </span><b><span>Discussion</span></b><b><span>: </span></b><span>We strongly recommend the inclusion of this product in kidney stone disease management protocols, especially for patients with kidney stones under 10 mm in diameter, where high response and effectiveness have been observed. Thus, it should be evaluated to reduce surgical treatment costs, as well as those for possible colic episodes and other associated complications.</span>
文摘<strong>Background:</strong> Kidney stone disease, also termed nephrolithiasis is associated with significant morbidities such as severe colicky flank pain, haematuria, urinary tract infection and kidney failure. Kidney stone disease was perceived as uncommon in developing countries;however, the global prevalence has been rising over the past two decades due to lifestyle changes. There is very limited literature on kidney stone composition in Africa, including Ghana and South Africa. It was based on this evidence that this study was undertaken. <strong>Aim:</strong> The primary aim of this study was to describe and compare the composition of kidney stone in patients receiving treatment at the Korle-Bu Teaching Hospital (KBTH), Accra (Ghana) and Groote Schuur Hospital (GSH), Cape Town (South Africa). <strong>Methods:</strong> The study was a retrospective folder review of patients treated for nephrolithiasis at the Korle-Bu Teaching Hospital in Accra (Ghana) and Groote Schuur Hospital in Cape Town (South Africa). Patients who were treated for kidney stone disease between 1<sup>st</sup> June 2016 and 31<sup>st</sup> May 2018 were recruited, and their folder numbers were retrieved from theatre logbooks. A total of hundred and sixty-three (n = 163) folders (n = 30 KBTH;n = 133 GSH) were subsequently retrieved from the two facilities’ records department. Demographic data and kidney stone analysis results were analyzed using the <em>R</em> statistical software. <strong>Results:</strong> The age of KBTH patients ranged from 24 to 75 years and age of 45 years, while that of GSH ranged 19 to 77 years and median age 48 years respectively. Males were the majority stone formers for both hospitals [56.7% KBTH;59.4% GSH]. There was no statistical difference in gender (<em>p</em> = 0.9447) and age (<em>p</em> = 0.2612) between the two groups. Calcium oxalate (86.7%) and uric acid (90.0%) were the commonest components of the kidney stones analyzed from the KBTH. Calcium oxalate (66.2%) and carbonate apatite (40.6%) were the most common components stones from GSH. Brushite (3.0%), cystine (3.8%) and struvite (19.6%) stones were only found in GSH patients. All kidney stones from the KBTH were mixed stones. Pure kidney stones were only found among the GSH dataset constituting 48.9%, also female patients from GSH formed more mixed stones than their male counterparts (M:F = 40.5%:66.67%) and infection kidney stones were also predominantly found among female patients. <strong>Conclusion:</strong> The findings indicate that the two facilities’ participants are not different in terms of gender and age. However, the composition of stones was found to be different between participants from both hospitals. This suggests that kidney stone composition may be influenced by patients’ geographical location and or cultural background.
文摘<strong>Background: </strong>The formation of kidney stones is considered a complicated process. Consequently, there are many questions about the link between kidney stones formation and level of salivary uric acid and calculus formation on the teeth surfaces. <strong>Objectives:</strong> To evaluate the correlation between the level of salivary uric acid and kidney stones formation and their influence on dental calculus and periodontal status among Saudi patients aged 25 - 70 years. <strong>Materials and Methods:</strong> 120 Saudi male patients were examined (60 of Kidney stones patients and 60 patients of non-kidney stones patients) for clinical evaluation of plaque index (PLI), gingival index (GI), calculus index of oral hygiene (CI) and clinical attachment loss (CAL). Moreover, lab assessment of uric acid level in the collected salivary samples was done. The findings were analyzed using of ANOVA test and Tukey’s test. <strong>Results:</strong> There were statistically significant differences in clinical parameters among kidney stones patients and non-kidney stones patients (p < 0.05), but these differences were highly statistically significant in the correlation between calculus index (CI), plaque index (PLI) and gingival index (GI) among kidney stone patients in group II, moreover, PLI and clinical attachment loss (CAL) among kidney stone patients in group III (p < 0.001). The statistical analyses revealed statistically significant differences in the level of salivary uric acid (mg/dl) in the comparison between kidney stones patients and non-kidney stones patients in group I and group III, whereas there were highly statistically significant in the comparison between kidney stones patients and non-kidney stones patients in group III. <strong>Conclusion:</strong> At the end of this study, we concluded that there was a relationship between dental calculus formation, kidney stones formation, and an increase in the level of salivary uric acid.
文摘Purpose: As patients with transfusion-dependent thalassemia (TDT) are living longer, novel morbidities are being recognized. The purpose of this review is to summarize the current knowledge regarding the prevalence and risk factors of nephrolithiasis in patients with TDT. Methods: A non-systematic, narrative review of the current literature published up to August 2021 was conducted. Results: Nephrolithiasis has been reported in 18% - 59% of patients with TDT, which is at least twice the prevalence in the general US population. The risk factors for nephrolithiasis can be classified into behavioral (dietary and lifestyle), environmental, metabolic, disease-specific, and genetic factors. While clarifying the true prevalence of nephrolithiasis in different age groups and diagnostic categories of TDT requires further research, prevention, and management of nephrolithiasis is a growing clinical concern. Physicians should be aware of the potential increased risk of stone disease in splenectomized and diabetic patients as well as those treated with certain chelation regimens. Conclusions: The etiology of nephrolithiasis and potential TDT-specific risk factors that may put patients at greater risk are highlighted. There is insufficient evidence at this time to recommend universal screening for nephrolithiasis using ultrasound. Evidence-based recommendations on monitoring, prevention, and management of nephrolithiasis in TDT are provided.
文摘The incidence of urolithiasis(UL)is increasing,and it has become more common in children and adolescents over the past few decades.Hypercalciuria is the leading metabolic risk factor of pediatric UL,and it has high morbidity,with or without lithiasis as hematuria and impairment of bone mass.The reduction in bone mineral density has already been described in pediatric idiopathic hypercalciuria(IH),and the precise mechanisms of bone loss or failure to achieve adequate bone mass gain remain unknown.A current understanding is that hypercalciuria throughout life can be considered a risk of change in bone structure and low bone mass throughout life.However,it is still not entirely known whether hypercalciuria throughout life can compromise the quality of the mass.The peak bone mass is achieved by late adolescence,peaking at the end of the second decade of life.This accumulation should occur without interference in order to achieve the peak of optimal bone mass.The bone mass acquired during childhood and adolescence is a major determinant of adult bone health,and its accumulation should occur without interference.This raises the critical question of whether adult osteoporosis and the risk of fractures are initiated during childhood.Pediatricians should be aware of this pediatric problem and investigate their patients.They should have the knowledge and ability to diagnose and initially manage patients with IH,with or without UL.
文摘Objective:To investigate the effect of allicin on the formation of kidney stones in rats by regulating the expression of osteopontin(OPN)and nuclear factor-κB(NF-κB)signaling pathway.Methods:A total of 50 healthy adult male SD rats with SPF grade were selected and divided into five groups by random number and computer random combination,with 10 rats in each group.Except the blank group,the other four groups were given 2 m L/d mixed solution of 1%ethylene glycol+2%ammonium chloride to construct the nephrolith model.During the modeling process,the blank group and the model group were given normal saline by gavage.The positive group was given 600 mg/(kg·d)of potassium sodium hydrogen citrate granules by gavage,the low-dose group was given 7.5 mg/(kg·d)of allicin by gavage,and the high-dose group was given 15 mg/(kg·d)of allicin by gavage.After administration,renal function,urine related indicators,calcium oxalate crystallization score,OPN protein expression and NF-κB signaling pathwayrelated protein expression were observed and compared among the five groups of rats.Results:There were significant differences in kidney index,urea nitrogen(BUN)and blood creatinine(Cr)levels among the five groups(P<0.05).There were no differences in kidney index,BUN and Cr levels between the high-dose group and the positive group(P>0.05),and were all lower than those in the model group and low-dose group(P<0.05).There were significant differences in the levels of oxalic acid(OA),calcium(Ca),magnesium(Mg),and phosphorus(P)in the urine of five groups of rats(P<0.05).The high-dose group showed no difference in the levels of OA,Ca,Mg,and P compared to the positive control group(P>0.05),and all were lower than the model group and low-dose group(P<0.05).There were significant differences in the scores of calcium oxalate crystallization and the expression of OPN protein in the five groups(P<0.05).There was no difference in the scores of calcium oxalate crystallization between the high-dose group and the positive group(P>0.05).The expression of OPN protein was higher than that in the positive group(P<0.05),and both were lower than that in the model group and low-dose group(P<0.05).There were significant differences in the expression levels of NF-κB inhibitory protein-α(IκB-α)and NF-κB in five groups(P<0.05),and the expression levels of IκB-αand NF-κB in the high-dose group were lower than those in the model group,positive control group,and low-dose group(P<0.05).Conclusion:Allicin may inhibit the formation of kidney stones in rats by down-regulating the expression levels of OPN and NF-κB signaling pathway-related proteins,and a high dose of allicin can obtain a similar effect of kidney stones inhibition as that of potassium sodium hydrogen citrate granules.
基金This study was supported by the PXE International,NIH/NIAMS grants R01AR028450(JU)and R01AR072695(JU and QL)The authors thank our patients for their participation in our studies.Carol Kelly assisted in manuscript preparation.
文摘Objective:Pseudoxanthoma elasticum(PXE)is a rare genetic disorder caused by loss-of-function mutations in the ABCC6 gene.While PXE is characterized by ectopic mineralization of connective tissues clinically affecting the skin,eyes,and cardiovascular system,kidney stones were reported in some individuals with PXE.The aim of this study is to determine whether kidney stones are an incidental finding or a frequent manifestation of PXE.Methods:We first investigated the genetic basis of two siblings diagnosed with PXE.The younger patient presented with recurrent kidney stones since 8 years old.Secondly,to address whether kidney stones are associated with PXE,the prevalence of kidney stones in a survey cohort of 563 respondents with PXE was compared to that of a general U.S.population survey,National Health and Nutrition Examination Survey,with 28,629 participants.Results:Genetic analysis in both patients identified compound heterozygous mutations in ABCC6,c.2787+1G>T,and c.3774_3775insC.The analysis of participants 20 years old and older revealed that 23.4%of PXE patients had previously had a kidney stone,a significant increase compared to 9.2%in the general population(P<0.01).In addition,17.8%of PXE patients reported their first kidney stone episode before age of 18 years old.Conclusions:PXE correlates with an increased risk of developing kidney stones with considerable morbidity and health-care cost.
文摘Renal calculi are inhomogenous, heterogeneous and complex in nature. There is a large variation in their chemical composition due to food habits of patients and hence geography of the inhabitants in different parts of the world. Ultrasonic studies are made to investigate various physical and other constants of such renal calculi. A double-probe through transmission technique is used to study various propagation parameters. The ultrasonic waves displayed on cathode-ray oscilloscope are complex and complicated in nature. Complete analysis of such wave patterns is given in the present study. The data reported would help in the design of an u ltrasonic lithotripter.
文摘Stone formation is induced by an increased level of urine crystallization promoters and reduced levels of its inhibitors.Crystallization inhibitors include citrate,magnesium,zinc,and organic compounds such as glycosaminoglycans.In the urine,there are various proteins,such as uromodulin(Tamm-Horsfall protein),calgranulin,osteopontin,bikunin,and nephrocalcin,that are present in the stone matrix.The presence of several carboxyl groups in these macromolecules reduces calcium oxalate monohydrate crystal adhesion to the urinary epithelium and could potentially protect against lithiasis.Proteins are the most abundant component of kidney stone matrix,and their presence may reflect the process of stone formation.Many recent studies have explored the proteomics of urinary stones.Among the stone matrix proteins,the most frequently identified were uromodulin,S100 proteins(calgranulins A and B),osteopontin,and several other proteins typically engaged in inflammation and immune response.The normal level and structure of these macromolecules may constitute protection against calcium salt formation.Paradoxically,most of them may act as both promoters and inhibitors depending on circumstances.Many of these proteins have other functions in modulating oxidative stress,immune function,and inflammation that could also influence stone formation.Yet,the role of these kidney stone matrix proteins needs to be established through more studies comparing urinary stone proteomics between stone formers and non-stone formers.
文摘The kidney is an important organ of humans to purify the blood.The healthy function of the kidney is always essential to balance the salt,potassium and pH levels in the blood.Recently,the failure of kidneys happens easily to human beings due to their lifestyle,eating habits and diabetes diseases.Early pre-diction of kidney stones is compulsory for timely treatment.Image processing-based diagnosis approaches provide a greater success rate than other detection approaches.In this work,proposed a kidney stone classification method based on optimized Transfer Learning(TL).The Deep Convolutional Neural Network(DCNN)models of DenseNet169,MobileNetv2 and GoogleNet applied for clas-sification.The combined classification results are processed by ensemble learning to increase classification performance.The hyperparameters of the DCNN model are adjusted by the metaheuristic algorithm of Gorilla Troops Optimizer(GTO).The proposed TL model outperforms in terms of all the parameters compared to other DCNN models.
文摘Medicinal plants have been valued for millennia as a rich source of therapeutic compounds for the prevention of various ailments all throughout the world.Kidney stones and urinary calculi affect a huge percentage of the population nowadays.Stone sickness has become more prevalent as a result of changes in living conditions,such as industrialization and hunger.The most common stone recorded in India is calcium oxalate kidney stones.Changes in prevalence and incidence,the occurrence of stone kinds and stone position,and stone removal treatment are all discussed.Medicinal herbs have been utilised for centuries because they are safer,more effective,culturally acceptable,and have less adverse effects than manufactured medications.Patients are advised to consume a low-fat diet,as well as fibres from naturally occurring plants and herbal treatments.The current article discusses the steps that should be taken to maximise the potential of medicinal plants for stone dissolving action.Combining herbal remedies with allopathic treatment is an excellent way to eliminate all issues associated with kidney stones.The purpose of this article is to emphasise the use of herbs as a treatment for urinary stones.
基金2019 Dongguan social science and technology development（key）project（201950715002195）Guangdong provincial science and technology department fund project（507204531040）
文摘Vitamin C is an essential vitamin for people,but it possibly linked to an increased risk of kidney stones.This view is controversial.The purpose of this assess was to illuminate the relationship between vitamin C intake and kidney stones.This paper reviewed relevant articles in the past 40 years from pubmed,analyzed the correlation between vitamin C intake and kidney stones,and pointed out the problems in the research process,which is of great reference significance.
文摘Objective:Prevalence of kidney stone disease continues to increase globally with recurrence rates between 30%and 50%despite technological and scientific advances.Reduction in recurrence would improve patient outcomes and reduce cost and stone morbidities.Our objective was to review results of experimental studies performed to determine the efficacy of readily available compounds that can be used to prevent recurrence.Methods: All relevant literature up to October 2020,listed in PubMed is reviewed.Results: Clinical guidelines endorse the use of evidence-based medications,such as alkaline agents and thiazides,to reduce urinary mineral supersaturation and recurrence.However,there may be additional steps during stone pathogenesis where medications could moderate stone risk.Idiopathic calcium oxalate stones grow attached to Randall’s plaques or plugs.Results of clinical and experimental studies suggest involvement of reactive oxygen species and oxidative stress in the formation of both the plaques and plugs.The renin-angiotensin-aldosterone system(RAAS),nicotinamide adenine dinucleotide phosphate(NADPH)oxidase,mitochondria,and NOD-like receptor pyrin domain containing-3(NLRP3)inflammasome have all been implicated at specific steps during stone pathogenesis in animal models.Conclusion: In addition to supersaturation-reducing therapies,the use of anti-oxidants,free radical scavengers,and inhibitors of NADPH oxidase,NLRP3 inflammasome,and RAAS may prove beneficial for stone prevention.Compounds such as statins and angiotensin converting enzyme inhibitors are already in use as therapeutics for hypertension and cardio-vascular disease and have previously shown to reduce calcium oxalate nephrolithiasis in rats.Although clinical evidence for their use in stone prevention in humans is limited,experimental data support they be considered along with standard evidence-based medications and clinical expertise when patients are being counselled for stone prevention.
