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Calcium Nephrolithiasis

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1. Kidney stone formers have more renal parenchymal crystals than non-stone formers, particularly in the papilla region. (Full text)

Kidney stone formers have more renal parenchymal crystals than non-stone formers, particularly in the papilla region. We investigated the renoprotective ability of healthy people against kidney stone formation. To clarify intratubular crystal kinetics and processing in human kidneys, we performed a quantitative and morphological observation of nephrectomized renal parenchyma tissues.Clinical data and pathological samples from 60 patients who underwent radical nephrectomy for renal cancer were (...) collected from June 2004 to June 2010. The patients were retrospectively classified as stone formers (SFs; n = 30, kidney stones detected by preoperative computed tomography) and non-stone formers (NSFs; n = 30, no kidney stone history). The morphology of parenchymal intratubular crystals and kidney stone-related gene and protein expression levels were examined in noncancerous renal sections from both groups.SFs had a higher smoking rate (P = 0.0097); lower red blood cell, hemoglobin, and hematocrit

2018 BMC Urology PubMed abstract

2. Autosomal Dominant Polycystic Kidney Disease - Management of Renal Stone Disease

infections compared to those that have not developed stones. 7 There may also be a relationship between nephrolithiasis and an increased number and size of renal cysts in ADPKD patients. 8 Further, such patients have been observed to have lower levels of renal function, suggesting that progression of ADPKD with resultant intrarenal ana- tomic obstruction is associated with a predisposition to nephrolithiasis. 8 In contrast to the general population (where calcium-containing stones are most prevalent (...) ), renal stones in ADPKD are most commonly composed of urate (56%-47%), and to a lesser degree, calcium oxalate. 6,9 The most common urine metabolic abnor- malities predisposing to stone formation in ADPKD are hypocitraturia, aciduria and hypomagesuria, as well as low urine volume. 6,8 In the ADPKD subgroup with preserved renal function, other risk factors predispos- ing to nephrolithiasis include hyperuricosuria, hyper- oxaluria,andhypercalcuria. 6 Giventhelatter,emphasis should be placed not just

2015 KHA-CARI Guidelines

3. Renal and ureteric stones: assessment and management

and impact. 1.6 Stenting after ureteroscopy for adults with ureteric stones less than 20 mm 1.6.1 Do not routinely offer post-treatment stenting to adults who have had ureteroscopy for ureteric stones less than 20 mm. T o find out why the committee made the recommendation on stenting after ureteroscopy and how it might affect practice, see rationale and impact. 1.7 Metabolic testing 1.7.1 Consider stone analysis for adults with ureteric or renal stones. 1.7.2 Measure serum calcium for adults (...) and lifestyle advice. 1.8.3 Consider potassium citrate [2] for adults with a recurrence of stones that are predominantly (more than 50%) calcium oxalate. 1.8.4 Consider potassium citrate for children and young people with a recurrence of stones that are predominantly (more than 50%) calcium oxalate, and with hypercalciuria or hypocitraturia. Renal and ureteric stones: assessment and management (NG118) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

4. Citrate salts for preventing and treating calcium containing kidney stones in adults. (Full text)

Citrate salts for preventing and treating calcium containing kidney stones in adults. Kidney stones affect people worldwide and have a high rate of recurrence even with treatment. Recurrences are particularly prevalent in people with low urinary citrate levels. These people have a higher incidence of calcium phosphate and calcium oxalate stones. Oral citrate therapy increases the urinary citrate levels, which in turn binds with calcium and inhibits the crystallisation thus reduces stone (...) formation. Despite the widespread use of oral citrate therapy for prevention and treatment of calcium oxalate stones, the evidence to support its clinical efficacy remains uncertain.The objective of this review was to determine the efficacy and adverse events associated with citrate salts for the treatment and prevention of calcium containing kidney stones.We searched the Cochrane Kidney and Transplant Specialised Register to 29 July 2015 through contact with the Trials' Search Co-ordinator using search

2015 Cochrane PubMed abstract

5. Guideline on the evaluation and medical management of the kidney stone patient - 2016 update

excretion and the risk of kidney stones. Kidney Int 2008;73:489-96. http://dx.doi.org/10.1038/sj.ki.5002708 110. Ettinger B, Tang A, Citron JT, et al. Randomized trial of allopurinol in the prevention of calcium oxalate calculi. N Engl J Med 1986;315:1386-9. http://dx.doi.org/10.1056/NEJM198611273152204 111. Smith MJ. Placebo vs. allopurinol for renal calculi. J Urol 1977;117:690-2. 112. Pearle MS, Roehrborn CG, Pak CY. Meta-analysis of randomized trials for medical prevention of calcium oxalate (...) , Sakhaee K, Skurla C, et al. Prevention of recurrent calcium stone formation with potassium citrate therapy in patients with distal renal tubular acidosis. J Urol 1985;134:20-3. 123. Fabris A, Lupo A, Bernich P, et al. Long-term treatment with potassium citrate and renal stones in medullary sponge kidney. Clin J Am Soc Nephrol 2010;5:1663-8. http://dx.doi.org/10.2215/CJN.00220110 124. Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am 2007;34:335-46. http://dx.doi. org/10.1016/j.ucl

2017 CPG Infobase

6. Citrate salts for preventing kidney stones

Media Releases 2013 Media Releases 2012 Media Releases Search Citrate salts for preventing kidney stones Citrate salts for preventing kidney stones Introduction Kidney stones are one of the most common disorders of the urinary tract and have a high rate of recurrence. Intervention Citrate salts to inhibit the crystallisation of calcium salt in urine. Citrate salts include potassium citrate, potassium-sodium citrate and potassium-magnesium citrate. Indication Citrate salts to inhibit (...) the crystallisation of calcium salt in urine. Citrate salts include potassium citrate, potassium-sodium citrate and potassium-magnesium citrate. A history of kidney stones containing calcium. Kidney stones are common, typically affecting people aged between 40 and 60 years. They are more common in men. Most (60–80%) kidney stones are composed of calcium salts, which occur in two forms: calcium oxalate and calcium phosphate. Additionally, up to 60% of people with kidney stones have hypocitraturia. Citrate salts

2017 Handbook of Non-Drug interventions (HANDI)

7. Genetic variants of calcium and vitamin D metabolism in kidney stone disease. (Full text)

Genetic variants of calcium and vitamin D metabolism in kidney stone disease. Kidney stone disease (nephrolithiasis) is a major clinical and economic health burden with a heritability of ~45-60%. We present genome-wide association studies in British and Japanese populations and a trans-ethnic meta-analysis that include 12,123 cases and 417,378 controls, and identify 20 nephrolithiasis-associated loci, seven of which are previously unreported. A CYP24A1 locus is predicted to affect vitamin D (...) metabolism and five loci, DGKD, DGKH, WDR72, GPIC1, and BCR, are predicted to influence calcium-sensing receptor (CaSR) signaling. In a validation cohort of only nephrolithiasis patients, the CYP24A1-associated locus correlates with serum calcium concentration and a number of nephrolithiasis episodes while the DGKD-associated locus correlates with urinary calcium excretion. In vitro, DGKD knockdown impairs CaSR-signal transduction, an effect rectified with the calcimimetic cinacalcet. Our findings

2020 Nature communications PubMed abstract

8. Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones. (Full text)

. Infrared (IR) spectroscopes, X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to confirm the bulk mineral composition in the thin section stones. Observations revealed differences in the micro-morphology of the kidney stones with similar composition in the internal 3-D structure. Calcium oxalate monohydrate stones showed well-organised layering patterns, while uric acid stones showed lower absorption signals with homogenous inner structure. Distinct mineral phases in the mixed (...) Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones. Understanding the mechanisms of kidney stone formation, development patterns and associated pathological features are gaining importance due to an increase in the prevalence of the disease and diversity in the presentation of the stone composition. Based on the microstructural characteristics of kidney stones, it may

2019 PLoS ONE PubMed abstract

9. Understanding the gut-kidney axis in nephrolithiasis: an analysis of the gut microbiota composition and functionality of stone formers. (Abstract)

Understanding the gut-kidney axis in nephrolithiasis: an analysis of the gut microbiota composition and functionality of stone formers. The involvement of the gut microbiota in the pathogenesis of calcium nephrolithiasis has been hypothesised since the discovery of the oxalate-degrading activity of Oxalobacter formigenes, but never comprehensively studied with metagenomics. The aim of this case-control study was to compare the faecal microbiota composition and functionality between recurrent (...) idiopathic calcium stone formers (SFs) and controls.Faecal samples were collected from 52 SFs and 48 controls (mean age 48±11). The microbiota composition was analysed through 16S rRNA microbial profiling approach. Ten samples (five SFs, five controls) were also analysed with deep shotgun metagenomics sequencing, with focus on oxalate-degrading microbial metabolic pathways. Dietary habits, assessed through a food-frequency questionnaire, and 24-hour urinary excretion of prolithogenic and antilithogenic

2018 Gut

10. Calcium Tartrate Tetrahydrate, Case Report of a Novel Human Kidney Stone (Full text)

Calcium Tartrate Tetrahydrate, Case Report of a Novel Human Kidney Stone Background: Calcium tartrate tetrahydrate has been reported as the main mineral in urinary stones in rats that have significant tartrate in their diet, but in humans, there has been only one mention of calcium tartrate stones in the form of bladder stone, and that case was in Africa. Case Presentation: Patient is a 34-year-old Caucasian male who presented with typical symptoms of nephrolithiasis. CT abd/pelvis (renal stone (...) protocol) revealed a 2 cm nonobstructing stone of the right renal pelvis. Patient underwent an uncomplicated right percutaneous nephrolithotomy and was noted to be stone free after surgery. Stone analysis was difficult with regard to determining composition, but was finally identified as calcium tartrate tetrahydrate. Conclusion: This was an unusual case, as this is the first recorded case of a calcium tartrate tetrahydrate outside of Africa. This type of stone had only been mainly described in rat

2017 Journal of endourology case reports PubMed abstract

11. Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial. (Abstract)

Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial. A growing number of randomized controlled trials (RCTs) are investigating the potential health benefits of high-dose vitamin D supplementation. However, there are limited RCT data on the safety of calcium-related adverse effects.We investigated the incidence of kidney stone and hypercalcemia events in a large, population-based RCT of vitamin D (...) for kidney stones were collected from health authorities. Serum calcium was measured in an 8% subsample of participants who returned annually for blood tests. HRs of time to the first kidney stone event were calculated by Cox regression.During a median follow-up of 3.3 y, 158 participants reported a kidney stone event (76 vitamin D, 82 placebo). The HR of reporting the first kidney stone event was 0.90 (95% CI: 0.66, 1.23; P = 0.51) for participants in the vitamin D arm compared with the placebo arm

2019 American Journal of Clinical Nutrition Controlled trial quality: predicted high

12. The association of the intestinal oxalate degrading bacteria with recurrent calcium kidney stone formation and hyperoxaluria: a case-control study. (Full text)

The association of the intestinal oxalate degrading bacteria with recurrent calcium kidney stone formation and hyperoxaluria: a case-control study. To investigate the potential oxalate degrading bacteria, including Oxalobacter formigenes (O.f), Lactobacillus (Lac) and Bifidobacterium (Bif) genera, and Oxalyl-CoA decarboxylase (oxc) encoding Lac (LX) and Bif (BX) species in recurrent calcium kidney stone patients and their correlation with 24-hour urine oxalate.Stool and 24-hour urine samples (...) . However, the relative abundance of O.f in stone-formers was lower than healthy controls (p= 0.035). More healthy controls were O.f positive compared with stone formers (p= 0.052). The results of linear regression model, including all study participants, showed that O.f presence could decrease 24-h urine oxalate (β = -8.4, p= 0.047). Neither Lac and Bif genera nor LX and BX species had correlation with calcium stone or urine oxalate.These results emphasize the role of O.f in kidney stone formation

2019 BJU international PubMed abstract

13. Activities of Calcium-Related Ion Channels during the Formation of Kidney Stones in an Infection-Induced Urolithiasis Rat Model. (Abstract)

of the kidney stone. Bacteria may play important roles by influencing renal calcium-related ion channel activities, resulting in chronic inflammation of the kidney along with the rapid aggregation of stones. We examined the correlation among infection-promoted CaOx kidney stones and alterations in calcium-related ion channels in an animal model with experimentally induced Proteus mirabilis and foreign-body infection. After infecting the bladder for 7 days, the data demonstrated that the stones were (...) Activities of Calcium-Related Ion Channels during the Formation of Kidney Stones in an Infection-Induced Urolithiasis Rat Model. Bacterial infection has long been recognized to contribute to struvite urinary stone deposition; however, its contribution to the development of chronic kidney stones has not been extensively investigated. In this study, we hypothesized another possible method of bacteria contributing to the formation of calcium oxalate (CaOx) that accounts for the biggest part

2019 American Journal of Physiology. Renal physiology

14. Paracellular calcium transport in the proximal tubule and the formation of kidney stones. (Abstract)

Paracellular calcium transport in the proximal tubule and the formation of kidney stones. The proximal tubule (PT) is responsible for the majority of calcium reabsorption by the kidney. Most PT calcium transport appears to be passive, although the molecular facilitators have not been well-established. Emerging evidence supports a major role for PT calcium transport in idiopathic hypercalciuria and the development of kidney stones. This review will cover recent developments in our understanding (...) of PT calcium transport and the role of the PT in kidney stone formation.

2019 American Journal of Physiology. Renal physiology

15. Prevalence of distal renal tubular acidosis in patients with calcium phosphate stones. (Abstract)

Prevalence of distal renal tubular acidosis in patients with calcium phosphate stones. Distal renal tubular acidosis (DRTA) is a metabolic disorder that associates urolithiasis and urinary pH > 6. The prevalence of DRTA in patients with calcium phosphate stones is not well known. The objective is to determine the prevalence of DRTA in patients with calcium phosphate stones and urinary pH above 6 based on the furosemide test.A total of 54 patients with calcium phosphate stones and urinary pH (...) stones (p < 0.04), a lower plasma potassium level (p < 0.001), a higher urinary Ca level (p ≤ 0.05), and a lower urinary citrate level (p < 0.001). None of the patients reported adverse effects from the furosemide test.There was a high prevalence of DTRA in patients with urinary pH above 6 and calcium phosphate stones. Young age, bilateral stones, stone recurrence, hypercalciuria, hypocitraturia, and plasma hypokalemia were associated with DRTA. None of the patients reported adverse effects

2019 World journal of urology

16. Urinary stone risk factors in the descendants of patients with kidney stone disease. (Abstract)

Urinary stone risk factors in the descendants of patients with kidney stone disease. Evidence has indicated that immediate family members of nephrolithiasis patients had high opportunity to develop stones. However, they are usually not regarded to be at risk, since it is unclear if there are any lithogenic abnormalities found in non-stone-forming nephrolithiasis relatives. Our aim was to investigate urinary metabolic abnormalities in the children of nephrolithiasis patients, compared (...) with the general population.The 24-h urinary metabolic profile was studied for 28 calcium oxalate nephrolithiasis patients (NL) and 46 of their descendants (ND), as well as 40 non-stone-forming volunteers (V) and 34 of their descendants (VD).There was no difference between age, gender, and serum creatinine between NL vs. V (parental groups) and ND vs. VD (descendant groups). High urinary oxalate in nephrolithiasis and urinary calcium in their descendants was detected. In addition, an elevated urinary excretion

2018 Pediatric Nephrology

17. The relationship between serum and urinary Fetuin-A levels and kidney stone formation among kidney stone patients (Full text)

The relationship between serum and urinary Fetuin-A levels and kidney stone formation among kidney stone patients Mineralization inhibitors are required to prevent the precipitation of minerals and inhibit the formation of kidney stones and other ectopic calcifications. In laboratory studies, Fetuin-A as a glycoprotein has inhibited hydroxyapatite precipitation in calcium and phosphate supersaturated solutions; however, information about patients with kidney stones is limited. The aim (...) of this study was to investigate the association of serum and urinary Fetuin-A levels with calcium oxalate kidney stones.In this case-control study, 30 patients with kidney stones and 30 healthy individuals without any history of urolithiasis who were referred to the urology ward of Sina Hospital of Tehran, Iran, in 2015 were entered into the study. All patients underwent computerized tomography scans. After collecting demographic information, serum and urine levels of Fetuin-A and some other calcification

2017 Central European journal of urology PubMed abstract

18. Losartan Ameliorates Calcium Oxalate-Induced Elevation of Stone-Related Proteins in Renal Tubular Cells by Inhibiting NADPH Oxidase and Oxidative Stress (Full text)

Losartan Ameliorates Calcium Oxalate-Induced Elevation of Stone-Related Proteins in Renal Tubular Cells by Inhibiting NADPH Oxidase and Oxidative Stress Calcium oxalate (CaOx) is the most common type of urinary stone. Increase of ROS and NADPH oxidase gives rise to inflammation and injury of renal tubular cells, which promotes CaOx stone formation. Recent studies have revealed that the renin-angiotensin system might play a role in kidney crystallization and ROS production. Here, we investigated (...) . The results revealed upregulation of Ang II/AT1R by CaOx treatment. CaOx-induced ROS and stone-related protein upregulation were mediated by the Ang II/AT1R signaling pathway. Losartan ameliorated renal tubular cell expression of stone-related proteins and renal crystallization by inhibiting NADPH oxidase and oxidative stress. We conclude that losartan might be a promising preventive and therapeutic candidate for hyperoxaluria nephrolithiasis.

2018 Oxidative medicine and cellular longevity PubMed abstract

19. The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis. (Full text)

The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis. To determine the influence of serum uric acid (UA) levels on renal impairment in patients with UA stone.We retrospectively analyzed 463 patients with calcium oxalate and/or calcium phosphate stones (CaOx/CaP), and 139 patients with UA stones. The subjects were divided into the serum UA-high (UA ≥ 7.0 mg/dL) or the UA-low group (UA < 7.0 mg/dL). The control group comprised (...) 3082 community-dwelling individuals that were pair-matched according to age, sex, body mass index, comorbidities, hemoglobin, serum albumin, and serum UA using propensity score matching. We compared renal function between controls and patients with UA stone (analysis 1), and between patients with CaOx/CaP and with UA stone (analysis 2). Logistic regression analysis was used to evaluate the impact of the hyperuricemia on the development of stage 3 and 3B chronic kidney disease (CKD) (analysis 3

2017 PLoS ONE PubMed abstract

20. Changes in renal papillary density after hydration therapy in calcium stone formers. (Full text)

Changes in renal papillary density after hydration therapy in calcium stone formers. Previous studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan. The effect of increased hydration on such papillary density in idiopathic calcium stone formers is not known.Patients with recurrent calcium oxalate stones undergoing endourological procedures for renal stones at our Institution from June 2013 to June 2014 (...) ).Increased fluid intake in patients with recurrent calcium oxalate stones was associated with a significant reduction in renal papillary density.NCT03343743 , 15/11/2017 (Retrospectively registered).

2018 BMC Urology PubMed abstract

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