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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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The Relationship between Modern Fad Diets and Kidney Stone Disease: A Systematic Review of Literature.
Barghouthy, Y, Corrales, M, Somani, B
Nutrients. 2021;(12)
Abstract
OBJECTIVES Kidney stone disease (KSD) has a strong association with diet metabolic syndrome. This review aims at exploring the lithogenic risk posed by the current most popular diets. Our approach was to search for the effect of each diet type on the major urinary risk factors, to try to draw conclusions regarding the association of a specific diet type and KSD. METHODS This systematic review searched for the available literature exploring the association between the existing popular fad diets and KSD. Articles in English, French and Spanish were included, without restriction of the search period with the final search done in August 2021. RESULTS Total number of studies and studies for each diet type was as follows: 22 articles for the low carbohydrate diet, 20 articles for high protein diets, 26 articles for vegetarian and vegan diets. There exists a substantial variability in different low carbohydrate and high protein diets, and considerable overlap between modern popular fad diets. High carbohydrate intake might increase urine uric acid, calcium and oxalate levels. High protein diets increase urine calcium and uric acid and lower urine pH and citrate. Consumption of fruits and vegetables increases the urinary volume and urinary citrate. In vegan diets, sufficient daily calcium intake is important to avoid possible secondary hyperoxaluria. CONCLUSIONS Few studies evaluated the direct relationship between modern fad diets and KSD. In general, the reduction of carbohydrate in the diet, and counterbalancing protein rich diets with sufficient intake of fruits and vegetables, seem to play a protective role against KSD formation. Maintaining sufficient calcium intake in vegan and vegetarian diets is important. Additional research is needed to directly evaluate the link between KSD and each diet type.
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3.
Effect of Phaseolus Vulgaris on Urinary Biochemical Parameters among Patients with Kidney Stones in Saudi Arabia.
Jalal, SM, Alsultan, AA, Alotaibi, HH, Mary, E, Alabdullatif, AAI
Nutrients. 2020;(11)
Abstract
The study purpose was to investigate the effect of Phaseolus Vulgaris (PV) on urinary biochemical parameters among patients with kidney stones. We conducted a randomized controlled study among 60 patients with kidney stones (size < 10 mm) in the nephrology unit of both government and private hospitals, Al-Ahsa. Urinary volume, calcium, magnesium, potassium, oxalate, uric acid, and power of hydrogen (pH) were assessed before and after the intervention of giving 250 g of PV consumption as an extract thrice weekly (2.2 L to 2.5 L per week) for 6 weeks, which was compared with control. A 't' test was used with the significance at 5%. Mean score of age was 44.5 ± 10.16 in PV group and 43.73 ± 9.79 in control. Four (13.3%) and two (6.7%) had family history of kidney stones. Body mass Index (BMI) mean was 26.44 ± 2.7 and 26.36 ± 2.65 in pre and post-test, respectively, which were significant (p = 0.01017). There were significant changes (p = 0.000) in urine volume from 1962 ± 152.8 to 2005 ± 148.8, calcium 205.4 ± 11.99 to 198.4 ± 12.52, potassium 44.07 ± 3.66 to 52.15 ± 4.37, oxalate 37.12 ± 5.38 to 33.02 ± 5.71, and uric acid 6.88 ± 0.7 to 6.31 ± 0.58. In conclusion, PV is effective management for the patients with kidney stones as it increases the urinary volume and enhances the elimination of small kidney stones.
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The gut microbiota profile of adults with kidney disease and kidney stones: a systematic review of the literature.
Stanford, J, Charlton, K, Stefoska-Needham, A, Ibrahim, R, Lambert, K
BMC nephrology. 2020;(1):215
Abstract
BACKGROUND There is mounting evidence that individuals with kidney disease and kidney stones have an abnormal gut microbiota composition. No studies to date have summarised the evidence to categorise how the gut microbiota profile of these individuals may differ from controls. Synthesis of this evidence is essential to inform future clinical trials. This systematic review aims to characterise differences of the gut microbial community in adults with kidney disease and kidney stones, as well as to describe the functional capacity of the gut microbiota and reporting of diet as a confounder in these studies. METHODS Included studies were those that investigated the gut microbial community in adults with kidney disease or kidney stones and compared this to the profile of controls. Six scientific databases (CINHAL, Medline, PubMed, Scopus, Web of Science and Cochrane Library), as well as selected grey literature sources, were searched. Quality assessment was undertaken independently by three authors. The system of evidence level criteria was employed to quantitatively evaluate the alteration of microbiota by strictly considering the number, methodological quality and consistency of the findings. Additional findings relating to altered functions of the gut microbiota, dietary intakes and dietary methodologies used were qualitatively summarised. RESULTS Twenty-five articles met the eligibility criteria and included data from a total of 892 adults with kidney disease or kidney stones and 1400 controls. Compared to controls, adults with kidney disease had increased abundances of several microbes including Enterobacteriaceae, Streptococcaceae, Streptococcus and decreased abundances of Prevotellaceae, Prevotella, Prevotella 9 and Roseburia among other taxa. Adults with kidney stones also had an altered microbial composition with variations to Bacteroides, Lachnospiraceae NK4A136 group, Ruminiclostridium 5 group, Dorea, Enterobacter, Christensenellaceae and its genus Christensenellaceae R7 group. Differences in the functional potential of the microbial community between controls and adults with kidney disease or kidney stones were also identified. Only three of the 25 articles presented dietary data, and of these studies, only two used a valid dietary assessment method. CONCLUSIONS The gut microbiota profile of adults with kidney disease and kidney stones differs from controls. Future study designs should include adequate reporting of important confounders such as dietary intake to assist with interpretation of findings.
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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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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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Changes in separate renal function in patients who underwent minimally invasive renal stone surgery according to the preoperative functional deterioration.
Choo, MS, Park, J, Cho, MC, Son, H, Jeong, H, Cho, SY
Scientific reports. 2019;(1):3610
Abstract
The significant predictors for the postoperative deterioration of separate renal function after minimally invasive stone surgery were investigated in the present prospective and observational study. A total of 117 consecutive patients who underwent retrograde intrarenal surgery or mini-percutaneous nephrolithotomy for renal calculi >10 mm were included in the present study. Perioperative changes in separate renal function were evaluated with Technetium-99m-Diethylene TriaminePenta acetic acid scan prior to intervention and at postoperative 3 months. Based on the functional differences between bilateral renal units, deterioration of separate renal function was graded into the following three groups: normal deterioration (<10%), moderate deterioration (10-20%), and severe deterioration (>20%). A total of 46 patients had a normal separate renal function, while 71 (60.7%) showed abnormal separate function in the involved side, including 29 (24.8%) moderate and 42 (35.9%) severe deterioration. Postoperatively, 48 patients (41.0%) showed aggravation or no recovery of separate renal function. Of the 46 patients with normal separate function, only 9 patients (19.5%) showed postoperative aggravation. Patients with moderate and severe deterioration showed aggravation (n = 7, 24.1%) or no recovery of separate renal function (n = 32, 76.1%, P < 0.001). Preoperative severe deterioration of separate renal function was an independent significant predictor for the postoperative deterioration of renal function (OR: 9.09, 95% CI: 4.007-20.624, P < 0.001). Lower preoperative deterioration of separate renal function showed a high probability of functional recovery. Therefore, it is hypothesized that early intervention might be necessary in cases where the patient exhibits severe aggravation of renal function.
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[Evaluation of protocols on the use of analgesics for pain management in patients with extracorporeal shock wave lithotripsy (ESWL)].
Daly, KM, Chaker, K, Rhouma, SB, Chehida, MAB, Ouanes, Y, Sellami, A, Nouira, Y
The Pan African medical journal. 2019;:109
Abstract
Extracorporeal shock wave lithotripsy-related pain is the largest limiting factor in this technique. Our study aimed to compare the effectiveness of different types of analgesics for pain management used during ESWL sessions. We conducted a prospective study of 300 patients with urinary lithiasis justifying ESWL treatment. The patients were randomized to three groups: group I, included 100 patients who received intramuscular injection of 2cc of physiological saline solution (placebo), group II included 100 patients who received intramuscular injection of ketoprofen 100mg while group III included 100 patients who received lidocaine and prilocaine topical cream. Visual Analog Scale (VAS) was used to assess pain 10 minutes after and at the end of the session. Mean VAS score 10 minutes after and at the end of ESWL session was 3.7 and 4.91 respectively. There was no significant difference among the three groups with respect to: epidemiological data (age, sex, BMI, patient's history) and the characteristics of the renal stone (side, size, location, presence or not of double-J ureteral catheter). Eleven patients in the Group I terminated treatment early, with a significant difference compared to the other groups (p=0.003). VAS score 10 minutes after and at the end of ESWL session was statistically higher in Group I compared to Groups II and III (p < 0.001). Moreover, ESWL session was significantly more effective in Groups (II and III) compared to Group I (p<0.001). Pain treatment is necessary during ESWL sessions. Two painkillers molecules were assessed, which showed good pain control as well as an increase in the effectiveness of lithotripsy.
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The tolerability of Potassium Citrate Tablet in patients with intolerance to Potassium Citrate Powder form.
Basiri, A, Taheri, F, Taheri, M
Urology journal. 2018;(1):16-20
Abstract
PURPOSE To assess the tolerability of Potassium Citrate (KCit) tablet in patients with kidney stones that were not able to use the powder form of this drug due to unfavorable salty taste and gastrointestinal complications. MATERIALS AND METHODS Twenty-three stone formers, with intolerance to potassium citrate powder form, which had referred to Labbafinejad stone preventive clinic (2015), have been included in this study. All of the patients took two Potassium citrate tablets (10 meq), three times a day for two weeks. Spot urine sample and the 24-hour urine collections were performed before and after KCit therapy. In addition, a visual analog taste scale was completed to gauge the taste and palatability of the KCit tablet in comparing with the powder form. RESULTS All of the patients claimed that they consumed the tablets as prescribed. The urine pH and the 24-hour citrate and potassium were significantly higher after the treatment. In addition, the mean visual analog scale score was significantly improved in KCit therapy with tablet form versus to powder type (good vs. terrible score). CONCLUSION Oral tolerance of KCit therapy is improved with the use of Potassium Citrate tablet, with beneficial effects on 24-hour urine citrate, potassium, and pH.
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10.
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.