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1.
Disparities in Kidney Stone Disease: A Scoping Review.
Crivelli, JJ, Maalouf, NM, Paiste, HJ, Wood, KD, Hughes, AE, Oates, GR, Assimos, DG
The Journal of urology. 2021;(3):517-525
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Abstract
PURPOSE We reviewed the available evidence regarding health disparities in kidney stone disease to identify knowledge gaps in this area. MATERIALS AND METHODS A literature search was conducted using PubMed®, Embase® and Scopus® limited to articles published in English from 1971 to 2020. Articles were selected based on their relevance to disparities in kidney stone disease among adults in the United States. RESULTS Several large epidemiological studies suggest disproportionate increases in incidence and prevalence of kidney stone disease among women as well as Black and Hispanic individuals in the United States, whereas other studies of comparable size do not report racial and ethnic demographics. Numerous articles describe disparities in imaging utilization, metabolic workup completion, analgesia, surgical intervention, stone burden at presentation, surgical complications, followup, and quality of life based on race, ethnicity, socioeconomic status and place of residence. Differences in urinary parameters based on race, ethnicity and socioeconomic status may be explained by both dietary and physiological factors. All articles assessed had substantial risk of selection bias and confounding. CONCLUSIONS Health disparities are present in many aspects of kidney stone disease. Further research should focus not only on characterization of these disparities but also on interventions to reduce or eliminate them.
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Evaluation of a child with suspected nephrolithiasis.
Reusz, GS, Hosszu, A, Kis, E
Current opinion in pediatrics. 2020;(2):265-272
Abstract
PURPOSE OF REVIEW As the incidence of nephrolithiasis in children doubles every 10 years it is becoming a common disease associated with significant morbidity along with considerable economic burden worldwide. The aim of this review is to summarize current data on the epidemiology and causes of renal stones in children and to provide a frame for the first clinical evaluation of a child with suspected nephrolithiasis. RECENT FINDINGS Dietary and environmental factors are the driving force of changing epidemiology. Diagnosis should be based on medical history, presenting signs, examination, first laboratory and radiological workup. Ultrasound should be the initial diagnostic imaging performed in pediatric patients while low-dose computed tomography is rarely necessary for management. Metabolic factors including hypercalciuria, hypocitraturia, low fluid intake as well as specific genetic diseases should be explored after the resolution of initial signs and symptoms. SUMMARY Appropriate initial evaluation, imaging technique, identification of risk factors and other abnormalities are essential for early diagnosis and prevention of stone-related morbidity in children with suspected nephrolithiasis.
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The use of antibiotics and risk of kidney stones.
Joshi, S, Goldfarb, DS
Current opinion in nephrology and hypertension. 2019;(4):311-315
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Abstract
PURPOSE OF REVIEW The effect of the intestinal microbiome on urine chemistry and lithogenicity has been a popular topic. Here we review the evidence for exposure to antibiotics increasing the risk of nephrolithiasis. RECENT FINDINGS Studies of the intestinal microbiome have focused on Oxalobacter formigenes, an anaerobe that frequently colonizes the human colon. As a degrader of fecal oxalate its presence is associated with lower urinary oxalate, which would be protective against calcium oxalate stone formation. It also appears capable of stimulating colonic oxalate secretion. A recent study showed that antibiotics can eliminate colonization with O. formigenes. In a case-control study, exposure to sulfa drugs, cephalosporins, fluoroquinolones, nitrofurantoin/methenamine, and broad spectrum penicillins prospectively increased the odds of nephrolithiasis. The effect was greatest for those exposed at younger ages and 3-6 months before being diagnosed with nephrolithiasis. SUMMARY Recent evidence suggests a possible, causal role of antibiotics in the development of kidney stones. A possible explanation for this finding includes alterations in the microbiome, especially effects on oxalate-degrading bacteria like O. formigenes. Ample reasons to encourage antibiotic stewardship already exist, but the possible role of antibiotic exposure in contributing to the increasing prevalence of kidney stones in children and adults is another rationale.
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[Genetic aspects of primary hyperoxaluria: diagnostics and treatment].
Filippova, TV, Svetlichnaya, DV, Rudenko, VI, Alyaev, YG, Shumikhina, MV, Azova, MM, Subbotina, TI, Gadzhieva, ZK, Asanov, AY, Litvinova, MM
Urologiia (Moscow, Russia : 1999). 2019;(5):140-143
Abstract
Primary hyperoxaluria is a group of inherited metabolic diseases characterized by increased formation of calcium-oxalate stones in kidneys with development of nephrolithiasis and chronic kidney disease. The article summarizes the modern information on the diagnostics and treatment of the disorder depending on genotype of the patient (AGXT, GRHPR, HOGA1 genes). The evaluation of the molecular genetic aetiology of the kidney stone disease contributes to the personalized treatment and prevention of the pathology in the patients and their relatives.
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Protective roles of flavonoids and flavonoid-rich plant extracts against urolithiasis: A review.
Zeng, X, Xi, Y, Jiang, W
Critical reviews in food science and nutrition. 2019;(13):2125-2135
Abstract
In the urinary system, urolithiasis is the third prevalent disorder which causes severe pain in individuals. Urinary stones are composed of calcium oxalate (CaOx) and calcium phosphate in approximately 80% of patients. Although various drugs and surgery operations are used to treat the disease, side effects of drugs and the high recurrence after therapy in patients cannot be ignored. Flavonoids are a large group of plant polyphenols with presumed beneficial effects on several common diseases. Whereas, a very few have reached clinical use. The results of recent studies have shown that the plant flavonoids could effectively inhibit the formation of CaOx stones in vitro and in vivo, correlating with their diuretic, antioxidant, anti-inflammatory, antibacterial properties and other protective effects. Thus, the flavonoids or flavonoid-rich plant extracts endowed with anti-urolithiasis activities and probable mechanisms of actions were reviewed. In addition, we also put forward some issues needed to be concerned in future investigations as well as offered prospects and challenges for developing the plant flavonoids into drugs for stone prevention.
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Progress and prospects in the management of kidney stones and developments in phyto-therapeutic modalities.
Akram, M, Idrees, M
International journal of immunopathology and pharmacology. 2019;:2058738419848220
Abstract
The aim of this article was to review some of the new and commonly used medicinal plants in the treatment of kidney stones, emphasizing medicinal uses, pharmacological activity, and research study of medicinal plants. Renal stones are a common problem worldwide with substantial morbidities and economic costs. The high economic burden associated with kidney stones is linked mainly with healthcare costs. In vitro and in vivo studies on alternative treatment of kidney stones have been searched by using words such as phytotherapy of kidney stones, medicinal plants used in kidney stones, and lithotriptic activity of plants. Articles reviewed showed that medicinal plants have lithotriptic potential. Medicinal plants may be useful in treatment of kidney stones. This study was aimed to explore and elaborate the efficacy and availability of alternative treatment for kidney stones and to provide safe, cost effective, and efficacious management options as well as reduce the burden of disease. Cost effectiveness may enable improvements in treatment efficiency that can benefit patients and the healthcare system. Further randomized clinical trials should be conducted to evaluate the safety and efficacy of medicinal plants.
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7.
Genetics of common complex kidney stone disease: insights from genome-wide association studies.
Palsson, R, Indridason, OS, Edvardsson, VO, Oddsson, A
Urolithiasis. 2019;(1):11-21
Abstract
Kidney stone disease is a common disorder in Western countries that is associated with significant suffering, morbidity, and cost for the healthcare system. Numerous studies have demonstrated familial aggregation of nephrolithiasis and a twin study estimated the heritability to be 56%. Over the past decade, genome-wide association studies have uncovered several sequence variants that confer increased risk of common complex kidney stone disease. The first reported variants were observed at the CLDN14 locus in the Icelandic population. This finding has since been replicated in other populations. The CLDN14 gene is expressed in tight junctions of the thick ascending limb of the loop of Henle, where the protein is believed to play a role in regulation of calcium transport. More recent studies have uncovered variants at the ALPL, SLC34A1, CASR, and TRPV5 loci, the first two genes playing a role in renal handling of phosphate, while the latter two are involved in calcium homeostasis. Although genetic data have provided insights into the molecular basis of kidney stone disease, much remains to be learned about the contribution of genetic factors to stone formation. Nevertheless, the progress made in recent years indicates that exciting times lie ahead in genetic research on kidney stone disease.
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Phosphaturia in kidney stone formers: Still an enigma.
Walker, V
Advances in clinical chemistry. 2019;:133-196
Abstract
Calcium kidney stones are common worldwide. Most are idiopathic and composed of calcium oxalate. Calcium phosphate is present in around 80% and may initiate stone formation. Stone production is multifactorial with a polygenic genetic contribution. Phosphaturia is found frequently among stone formers but until recently received scant attention. This review examines possible mechanisms for the phosphaturia and its relevance to stone formation from a wide angle. There is a striking lack of clinical data. Phosphaturia is associated, but not correlated, with hypercalciuria, increased 1,25 dihydroxy-vitamin D [1,25 (OH)2D], and sometimes evidence of disturbances in proximal renal tubular function. Phosphate reabsorption in the proximal renal tubules requires tightly regulated interaction of many proteins. Paracellular flow through intercellular tight junctions is the major route of phosphate absorption from the intestine and can be reduced therapeutically in hyperphosphatemic patients. In monogenic defects stones develop when phosphaturia is associated with hypercalciuria, generally explained by increased 1,25 (OH)2D production in response to hypophosphatemia. Calcification does not occur in disorders with increased FGF23 when phosphaturia occurs in isolation and 1,25 (OH)2D is suppressed. Candidate gene studies have identified mutations in the phosphate transporters, but in few individuals. One genome-wide study identified a polymorphism of the phosphate transporter gene SLC34A4 associated with stones. Others did not find mutations obviously linked to phosphate reabsorption. Future genetic studies should have a wide trawl and should focus initially on groups of patients with clearly defined phenotypes. The global data should be pooled.
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9.
Idiopathic hypercalciuria: Can we prevent stones and protect bones?
Ryan, LE, Ing, SW
Cleveland Clinic journal of medicine. 2018;(1):47-54
Abstract
Idiopathic hypercalciuria increases the risk of urinary stones and osteoporosis. The aim of this review is to delineate our current understanding of idiopathic hypercalciuria in the context of bone health, specifically its definition, causes, epidemiology, laboratory evaluation, and potential treatments.
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The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health.
Li, K, Wang, XF, Li, DY, Chen, YC, Zhao, LJ, Liu, XG, Guo, YF, Shen, J, Lin, X, Deng, J, et al
Clinical interventions in aging. 2018;:2443-2452
Abstract
Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, costs, and consequences of calcium supplementation on osteoporosis/osteoporotic fractures, cardiovascular events, kidney stones, gastrointestinal diseases, and other important diseases. In the end, we suggest that calcium supplementation should be prescribed and taken cautiously, accounting for individual patients' risks and benefits. Clearly, further studies are needed to examine the health effects of calcium supplementation to make any solid recommendations for people of different genders, ages, and ethnicities.