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Sample records for preventing kidney stone

  1. Diet for Kidney Stone Prevention

    MedlinePlus

    ... specific type of kidney stone include the following: Calcium Oxalate Stones reducing sodium reducing animal protein, such as ... with increased daily sodium consumption. People who form calcium oxalate or calcium phosphate stones should limit their intake ...

  2. Medical and dietary therapy for kidney stone prevention.

    PubMed

    Gul, Zeynep; Monga, Manoj

    2014-12-01

    The prevalence of kidney stone disease is increasing, and newer research is finding that stones are associated with several serious morbidities. These facts suggest that emphasis needs to be placed not only on stone treatment but also stone prevention. However, there is a relative dearth of information on dietary and medical therapies to treat and avoid nephrolithiasis. In addition, studies have shown that there are many misconceptions among both the general community and physicians about how stones should be managed. This article is meant to serve as a review of the current literature on dietary and drug therapies for stone prevention. PMID:25512810

  3. Medical and Dietary Therapy for Kidney Stone Prevention

    PubMed Central

    Gul, Zeynep

    2014-01-01

    The prevalence of kidney stone disease is increasing, and newer research is finding that stones are associated with several serious morbidities. These facts suggest that emphasis needs to be placed not only on stone treatment but also stone prevention. However, there is a relative dearth of information on dietary and medical therapies to treat and avoid nephrolithiasis. In addition, studies have shown that there are many misconceptions among both the general community and physicians about how stones should be managed. This article is meant to serve as a review of the current literature on dietary and drug therapies for stone prevention. PMID:25512810

  4. Kidney stones

    MedlinePlus

    ... dissolved in the urine can crystallize, forming a kidney stone (renal calculus). Usually the calculus is the size ... painful. Often, people may not know they have kidney stones until they feel the painful symptoms resulting from ...

  5. Kidney Stones

    MedlinePlus

    ... when you urinate Your doctor will diagnose a kidney stone with urine, blood, and imaging tests. If you have a stone that won't pass on its own, you may need treatment. It can be done with shock waves; with ...

  6. Kidney Stones

    PubMed Central

    Kleeman, Charles R.; Coburn, Jack W.; Brickman, Arnold S.; Lee, David B. N.; Narins, Robert G.; Ehrlich, Richard M.

    1980-01-01

    The prevalence of kidney stones has steadily risen during this century; passage of a calculus and a positive family history increase the probability of recurrence. Findings from recent studies on the cause of renal calculi have stressed crystallization and crystal aggregation of stone minerals from supersaturated urine, rather than excessive organic matrix. Absence of normal urine inhibitors of calcium salts is also stressed. Formation of calcium oxalate stones is the major problem. Therapy with decreased calcium and oxalate intake, thiazides, phosphate salts and allopurinol in various combinations has substantially decreased the prevalence of recurrent stones. The rationale for the use of allopurinol is that uric acid salts enhance the tendency for calcium oxalate to crystallize from supersaturated urine. The hypercalciuria seen in 30 percent to 40 percent of patients with oxalate stones is usually caused by intestinal hyperabsorption of calcium. Although patients with uric acid calculi constitute only a small fraction of those in whom stones form, they represent a group in whom good medical therapy, based on sound physiologic principles, has proved extremely successful. Renal tubular syndromes lead to nephrocalcinosis and lithiasis through hypercalciuria, alkaline urine and hypocitraturia, the latter an inhibitor of calcium salt precipitation. Recent advances in surgical techniques are discussed, including the rationale for removing staghorn calculi. The ileal ureter and coagulum pyelolithotomy deserve special emphasis. ImagesFigure 2.Figure 4.Figure 5.Figure 7. PMID:7385835

  7. What I Need to Know about Kidney Stones

    MedlinePlus

    ... Alternate Language URL Español What I need to know about Kidney Stones Page Content On this page: ... stones? To prevent kidney stones, you need to know what caused your kidney stone. Your doctor may ...

  8. Nutritional Management of Kidney Stones (Nephrolithiasis)

    PubMed Central

    Segal, Adam M.; Seifter, Julian L.; Dwyer, Johanna T.

    2015-01-01

    The incidence of kidney stones is common in the United States and treatments for them are very costly. This review article provides information about epidemiology, mechanism, diagnosis, and pathophysiology of kidney stone formation, and methods for the evaluation of stone risks for new and follow-up patients. Adequate evaluation and management can prevent recurrence of stones. Kidney stone prevention should be individualized in both its medical and dietary management, keeping in mind the specific risks involved for each type of stones. Recognition of these risk factors and development of long-term management strategies for dealing with them are the most effective ways to prevent recurrence of kidney stones. PMID:26251832

  9. The exposome for kidney stones.

    PubMed

    Goldfarb, David S

    2016-02-01

    The exposome is the assembly and measure of all the exposures of an individual in a lifetime. An individual's exposures begin before birth and include insults from environmental and occupational sources. The associated field is called exposomics, which relies on the application of internal and external exposure assessment methods. Exposomics has not yet been thoroughly applied to the study of kidney stones although much is known about how diet and fluid intake affect nephrolithiasis. Some other novel exposures that may contribute to kidney stones are discussed including use of antibiotics, urbanization and migration to urban heat islands, and occupation. People whose school and jobs limit their access to fluids and adequate bathroom facilities may have higher prevalence of stones. Examples include athletes, teachers, heathcare workers, and cab drivers. Occupational kidney stones have received scant attention and may represent a neglected, and preventable, type of stone. An exposomic-oriented history would include a careful delineation of occupation and activities. PMID:26615595

  10. Keep Your Kidneys Clear: Kicking Kidney Stones

    MedlinePlus

    ... Your Kidneys Clear Keep Your Kidneys Clear Kicking Kidney Stones Some say that passing a kidney stone is like delivering a baby made of razor ... is that, although they can be excruciatingly painful, kidney stones rarely cause permanent damage, and you may be ...

  11. Kidney Stones in Adults

    MedlinePlus

    ... specific type of kidney stone include the following: Calcium Oxalate Stones reducing sodium reducing animal protein, such as ... fish getting enough calcium from food or taking calcium supplements with food avoiding foods high in oxalate, such as spinach, rhubarb, nuts, and wheat bran ...

  12. Crystal Growth Inhibitors for the Prevention of L-Cystine Kidney Stones Through Molecular Design

    SciTech Connect

    Rimer, Jeffrey D.; An, Zhihua; Zhu, Zina; Lee, Michael H.; Goldfarb, David S.; Wesson, Jeffrey A.; Ward, Michael D.

    2010-11-12

    Crystallization of L-cystine is a critical step in the pathogenesis of cystine kidney stones. Treatments for this disease are somewhat effective but often lead to adverse side effects. Real-time in situ atomic force microscopy (AFM) reveals that L-cystine dimethylester (L-CDME) and L-cystine methylester (L-CME) dramatically reduce the growth velocity of the six symmetry-equivalent {l_brace}100{r_brace} steps because of specific binding at the crystal surface, which frustrates the attachment of L-cystine molecules. L-CDME and L-CME produce L-cystine crystals with different habits that reveal distinct binding modes at the crystal surfaces. The AFM observations are mirrored by reduced crystal yield and crystal size in the presence of L-CDME and L-CME, collectively suggesting a new pathway to the prevention of L-cystine stones by rational design of crystal growth inhibitors.

  13. KIDNEY STONE INCIDENCE AND METABOLIC URINARY CHANGES AFTER MODERN BARIATRIC SURGERY: REVIEW OF CLINICAL STUDIES, EXPERIMENTAL MODELS, AND PREVENTION STRATEGIES

    PubMed Central

    Canales, Benjamin K.; Hatch, Marguerite

    2014-01-01

    Bariatric surgery has been associated with increased metabolic kidney stone risk and post-operative stone formation. A MEDLINE search, performed for articles published between January 2005 and November 2013, identified 24 pertinent studies containing 683 bariatric patients with 24-hour urine profiles, 6,777 bariatric patients with kidney stone incidence, and 7,089 non-stone forming controls. Of all procedures reviewed, only Roux-en-Y gastric bypass (RYGB) was linked to post-operative kidney stone development, increasing stone incidence two-fold in non-stone formers (8.5%) and four-fold in patients with previous stone history (16.7%). High quality evidence from 7 studies (n=277 patients) before and after RYGB identified the following post-RYGB urinary lithogenic risk factors: 30% reduction in urine volume (the main driver of urinary crystal saturation), 40% reduction in urinary citrate (a potent stone inhibitor), and 50% increase in urinary oxalate (a stone promotor). Based on this, a summary of strategies to reduce calcium oxalate stone risk following RYGB is provided. Furthermore, recent experimental RYGB studies are assessed for insights into the pathophysiology of oxalate handling, and the literature in gut anion (oxalate) transport is reviewed. Finally, as a potential probiotic therapy for hyperoxaluria, primary data from our laboratory is presented, demonstrating a 70% reduction in urinary oxalate levels in four experimental RYGB animals after colonization with Oxalobacter formigines, a non-pathogenic gut commensal that uses oxalate as an energy source. Overall, urine profiles and kidney stone risk following bariatric surgery appear modifiable by dietary adjustments, appropriate supplementation, and lifestyle changes. For hyperoxaluria resistant to dietary oxalate restriction and calcium binding, well-designed human investigations are needed to identify additional means of lowering urinary oxalate, such as Oxalobacter colonization or empiric pyridoxine therapy. Further investigations are also needed to determine tolerability and compliance of stone prevention strategies, such as citrate supplementation and hydration, in this population. PMID:24969092

  14. Kidney Stone Treatment with Lithotripsy

    MedlinePlus Videos and Cool Tools

    Kidney Stone Treatment with Lithotripsy Broward Health Medical Center Fort Lauderdale, FL November 11, 2011 I'm ... got at least three stones in his left kidney. He's been having pain and blood in his ...

  15. Kidney Stones in Children and Teens

    MedlinePlus

    ... Issues Listen Español Text Size Email Print Share Kidney Stones in Children and Teens Page Content Article Body ​ ... teen girls having the highest incidence. Types of Kidney Stones There are many different types of kidney stones ...

  16. [MICROBIAL COMMUNITIES ON KIDNEY STONES].

    PubMed

    Romanova, Yu M; Mulabaev, N S; Tolordava, E R; Seregin, A V; Seregin, I V; Alexeeva, N V; Stepanova, T V; Levina, G A; Barhatova, O I; Gamova, N A; Goncharova, S A; Didenko, L V; Rakovskaya, I V

    2015-01-01

    The clinical material obtained surgically in patients with kidney stone disease (KSD) was tested for content of the stone microflora using PCR and standard microbiological methods. It was demonstrated that about 50% of stones in patients with KSD were infected with various infection agents as observed using standard microbiological and molecular genetic methods. The percentage of detection of the Mycoplasma hominis using cultural method is lower than the percentage detected using PCR, which is due to difficult isolation and cultivation, as well as DNA fragments of mycoplasma observed after antibiotic therapy. Studies based on modern microscopy methods showed that microorganisms on the surface of the kidney stone formed multispecies biofilms. PMID:26182663

  17. Ultrasonic propulsion of kidney stones

    PubMed Central

    May, Philip C.; Bailey, Michael R.; Harper, Jonathan D.

    2016-01-01

    Purpose of review Ultrasonic propulsion is a novel technique that uses short bursts of focused ultrasonic pulses to reposition stones transcutaneously within the renal collecting system and ureter. The purpose of this review is to discuss the initial testing of effectiveness and safety, directions for refinement of technique and technology, and opinions on clinical application. Recent findings Preclinical studies with a range of probes, interfaces, and outputs have demonstrated feasibility and consistent safety of ultrasonic propulsion with room for increased outputs and refinement toward specific applications. Ultrasonic propulsion was used painlessly and without adverse events to reposition stones in 14 of 15 human study participants without restrictions on patient size, stone size, or stone location. The initial feasibility study showed applicability in a range of clinically relevant situations, including facilitating passage of residual fragments following ureteroscopy or shock wave lithotripsy, moving a large stone at the UPJ with relief of pain, and differentiating large stones from a collection of small fragments. Summary Ultrasonic propulsion shows promise as an office-based system for transcutaneously repositioning kidney stones. Potential applications include facilitating expulsion of residual fragments following ureteroscopy or shock wave lithotripsy, repositioning stones prior to treatment, and repositioning obstructing UPJ stones into the kidney to alleviate acute renal colic. PMID:26845428

  18. Kidney stones - lithotripsy - discharge

    MedlinePlus

    ... days after this procedure. Drink a lot of water in the weeks after treatment. This helps pass any pieces of stone that still remain. Your health care provider may give you a medicine ... take and drink a lot of water if you have pain. You may need to ...

  19. Kidney Stones (For Parents)

    MedlinePlus

    ... as urine (pee). Urine contains substances — such as calcium, oxalate, phosphate, carbonate, cystine, and uric acid — that in ... high in sodium can increase the risk of calcium stones. Obesity can ... lead to concentrated levels of oxalate (a substance made in the body and found ...

  20. Kidney Stones in Children

    MedlinePlus

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two ... kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water ...

  1. Self-Fluid Management in Prevention of Kidney Stones: A PRISMA-Compliant Systematic Review and Dose-Response Meta-Analysis of Observational Studies.

    PubMed

    Xu, Chang; Zhang, Chao; Wang, Xiao-Long; Liu, Tong-Zu; Zeng, Xian-Tao; Li, Shen; Duan, Xiao-Wen

    2015-07-01

    Epidemiologic studies have suggested that daily fluid intake that achieves at least 2.5 L of urine output per day is protective against kidney stones. However, the precise quantitative nature of the association between fluid intake and kidney stone risk, as well as the effect of specific types of fluids on such risk, are not entirely clear.We conducted a systematic review and dose-response meta-analysis to quantitatively assess the association between fluid intake and kidney stone risk. Based on a literature search of the PubMed, Embase, and Cochrane Library databases, 15 relevant studies (10 cohort and 5 case-control studies) were selected for inclusion in the meta-analysis with 9601 cases and 351,081 total participants.In the dose-response meta-analysis, we found that each 500 mL increase in water intake was associated with a significantly reduced risk of kidney stone formation (relative risk (RR) = 0.93; 95% CI: 0.87, 0.98; P < 0.01). Protective associations were also found for an increasing intake of tea (RR = 0.96; 95% CI: 0.93, 0.99; P = 0.02) and alcohol (RR = 0.80, 95% CI: 0.75, 0.85; P < 0.01). A borderline reverse association were observed on coffee intake and risk of kidney stone (RR = 0.88; 95% CI: 0.76, 1.00; P = 0.05). The risk of kidney stones was not significantly related to intake of juice (RR = 1.02, 95% CI: 0.95, 1.10; P = 0.64), soda (RR = 1.03; 95% CI: 0.90, 1.17; P = 0.65), or milk (RR = 0.96; 95% CI: 0.88, 1.03; P = 0.21). Subgroup analysis and sensitivity analyses showed inconsistent results on coffee, alcohol, and milk intake.Increased water intake is associated with a reduced risk of kidney stones; increased consumption of tea and alcohol may reduce kidney stone risk. An average daily water intake was recommended for kidney stone prevention. PMID:26166074

  2. Treatment Effect, Adherence, and Safety of High Fluid Intake for the Prevention of Incident and Recurrent Kidney Stones: a Systematic Review and Meta-Analysis

    PubMed Central

    Cheungpasitporn, Wisit; Rossetti, Sandro; Friend, Keith; Erickson, Stephen B.; Lieske, John C.

    2016-01-01

    BACKGROUND The objective of this systematic review and meta-analysis were to evaluate the effectiveness of high fluid intake for the prevention of incident and recurrent kidney stones, as well as its adherence and safety. METHODS A literature search was performed encompassing 1980 through July 2014. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of kidney stone events in patients with high vs inadequate fluid intake were included. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method. RESULTS Nine studies (2 randomized controlled trials [RCTs] with 269 patients; 7 observational studies with 273,685 individuals) were included in the meta-analysis. Pooled RRs of kidney stones in individuals with high-fluid intake were 0.40 (95% CI 0.20–0.79) and 0.49 (0.34–0.71) in RCTs and observational studies, respectively. High fluid intake was significantly associated with reduced risk of recurrent kidney stones: RRs 0.40 (95% CI 0.20–0.79) and 0.20 (0.09–0.44) in RCTs and observational studies, respectively. Adherence and safety data on high fluid intake treatment were limited; 1 RCT reported no withdrawals due to adverse events. CONCLUSION This analysis demonstrated a significantly reduced risk of incident kidney stones among individuals with high fluid consumption. High fluid consumption also reduced the risk of recurrent kidney stones. Furthermore, the magnitude of risk reduction was high. Although increased water intake appears to be safe, future studies on its safety in patients with high risk of volume overload or hyponatremia may be indicated. PMID:26022722

  3. Ultrasonic Destruction of Kidney Stones

    PubMed Central

    Brannen, George E.; Bush, William H.

    1984-01-01

    Kidney stones may be removed without using a surgical incision by a combination of techniques and skills recently developed in the fields of urology and radiology. Percutaneous access to the kidney is established under fluoroscopic control. A guide wire placed into the renal pelvis allows a nephroscope to be inserted and the collecting system visualized. A long hollow metal probe is advanced through the nephroscope and placed in contact with the stone. This probe conducts the ultrasonic energy. The stone absorbs the energy and breaks into fine granules, which are evacuated by suction. Twenty-three consecutively seen patients presenting with 27 upper urinary tract calculi for which removal was indicated underwent successful percutaneous ultrasonic lithotripsy. Fifteen stones were located in the renal pelvis, eight in a calix, three at the ureteropelvic junction and one in the upper ureter. One infected staghorn calculus was removed. Two complications resulted in extended hospital stays, but in no patients were surgical incisions required. Of the 23 patients, 9 had previously had a surgical lithotomy. The authors believe that most renal and upper ureteral calculi for which removal is indicated may be extracted percutaneously with the aid of the ultrasonic lithotriptor. The patients may expect a rapid convalescence with diminished pain. Images PMID:6730470

  4. Hereditary Causes of Kidney Stones and Chronic Kidney Disease

    PubMed Central

    Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

    2013-01-01

    Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

  5. Protecting Space Travelers from Kidney Stones: Renal Stone Risk During Space Flight

    NASA Technical Reports Server (NTRS)

    Whitson, Peggy; Bloomberg, Jacob; Lee, Angie (Technical Monitor)

    2002-01-01

    Renal stones, popularly known as kidney or bladder stones, are small rock-like objects formed in the kidneys or urinary tract by deposits of calcium and other minerals. The problem arises when the stones block the drainage of the kidney, resulting in urinary obstruction and pain. Passing these stones can be one of the most painful experiences a person will endure so doctors often prescribe pain relievers to ease the experience. Drinking plenty of fluids, which help flush waste out of the body, and eating a well-balanced diet are the first steps to preventing stones. For individuals at risk, this may not be enough, and a doctor may recommend a special diet and medications. Unfortunately, approximately 60 percent of people who have had a renal stone will experience a recurrence. This is particularly true of men, who are four to five times more likely to develop stones than women. Renal stones do not discriminate based on age; even children are at risk. Astronauts are particularly at risk of developing renal stones because they lose bone and muscle mass; calcium, other minerals, and protein normally used for bone and muscle end up in the bloodstream and then in the kidneys. Without plenty of fluid to wash them away, crystals can form and then grow into stones. This factor compounds the risk for astronauts, since they also perceive that they are less thirsty in space and will drink less than normal during the mission. To minimize all of these factors, doctors must instead treat the stone-forming compounds with medication. This study will use potassium citrate to reduce the risk of stone formation. Renal stones are never convenient, but they are a particular concern for astronauts who have limited access to treatment during flight. Researchers are examining how earthbound preventions for renal stone formation work in flight, ensuring missions are not ended prematurely due to this medical condition. During STS-107, earthbound preventions and treatments become astronauts' gain.

  6. Mechanisms of human kidney stone formation.

    PubMed

    Evan, Andrew P; Worcester, Elaine M; Coe, Fredric L; Williams, James; Lingeman, James E

    2015-01-01

    The precise mechanisms of kidney stone formation and growth are not completely known, even though human stone disease appears to be one of the oldest diseases known to medicine. With the advent of the new digital endoscope and detailed renal physiological studies performed on well phenotyped stone formers, substantial advances have been made in our knowledge of the pathogenesis of the most common type of stone former, the idiopathic calcium oxalate stone former as well as nine other stone forming groups. The observations from our group on human stone formers and those of others on model systems have suggested four entirely different pathways for kidney stone formation. Calcium oxalate stone growth over sites of Randall's plaque appear to be the primary mode of stone formation for those patients with hypercalciuria. Overgrowths off the ends of Bellini duct plugs have been noted in most stone phenotypes, do they result in a clinical stone? Micro-lith formation does occur within the lumens of dilated inner medullary collecting ducts of cystinuric stone formers and appear to be confined to this space. Lastly, cystinuric stone formers also have numerous small, oval, smooth yellow appearing calyceal stones suggestive of formation in free solution. The scientific basis for each of these four modes of stone formation are reviewed and used to explore novel research opportunities. PMID:25108546

  7. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. PMID:26378390

  8. Apparatus for disintegrating kidney stones

    NASA Technical Reports Server (NTRS)

    Angulo, E. D. (Inventor)

    1984-01-01

    The useful life of the wire probe in an ultrasonic kidney stone disintegration instrument is enhanced and prolonged by attaching the wire of the wire probe to the tip of an ultrasonic transducer by means of a clamping arrangement. Additionally, damping material is applied to the wire probe in the form of a damper tube through which the wire probe passes in the region adjacent the transducer tip. The damper tube extends outwardly from the transducer tip a predetermined distance, terminating in a resilient soft rubber joint. Also, the damper tube is supported intermediate its length by a support member. The damper system thus acts to inhibit lateral vibrations of the wire in the region of the transducer tip while providing little or no damping to the linear vibrations imparted to the wire by the transducer.

  9. Epidemiologic insights into pediatric kidney stone disease.

    PubMed

    Matlaga, Brian R; Schaeffer, Anthony J; Novak, Thomas E; Trock, Bruce J

    2010-12-01

    The epidemiology of pediatric kidney stone has not yet been as rigorously defined as that of adult kidney stone disease. Herein, we review our recent epidemiologic works characterizing pediatric stone disease using the Kids' Inpatient Database (KID). Specifically we investigated the age and gender distribution of pediatric kidney stone disease, changes in disease prevalence over time, and medical comorbidities associated with this disorder. We identified patients by International Classification of Disease 9th Edition (ICD-9) codes for renal and ureteral calculi as the primary diagnosis. Medical comorbidities were identified using specific comorbidity software. Statistical comparisons between children with and without stone disease were performed. In the first decade of life, stone disease was more prevalent among males than females; however, in the second decade of life females were more commonly affected. Of note, there was a significant increase in treated stone disease across both genders between 1997 and 2003. We also found that the risk of kidney stone diagnosis in children younger than 6 years of age was significantly associated with hypertension and diabetes mellitus. The gender distribution among pediatric stone formers varies significantly by age, although overall females have a greater prevalence than males. There is also a strong association of stone disease and both diabetes and hypertension, although this was only observed in children less than 6 years of age. Taken all together, these findings suggest that urolithiasis in the young child is a complex systemic disease process. PMID:20967433

  10. Kidney stones in anorexia nervosa: a case report and review of the literature.

    PubMed

    Jonat, L M; Birmingham, C L

    2003-12-01

    Nephrolithiasis (kidney stones) is a recognized complication of anorexia nervosa (AN). We present the case of a 41-year-old woman with a 25-year history of AN. Between 1978 and 1986, she had two episodes of calcium oxalate kidney stones. Proper management of kidney stones in AN requires collection of the stone, laboratory analysis of the stone to determine its composition, and laboratory evaluation of the urine and blood to determine what treatment is necessary to prevent recurrent kidney stone formation. PMID:15018386

  11. Do Kidney Stone Formers Have A Kidney Disease?

    PubMed Central

    Zisman, Anna L.; Evan, Andrew P.; Coe, Fredric L.; Worcester, Elaine M.

    2015-01-01

    Nephrolithiasis is a highly prevalent disorder affecting approximately one in eleven people and is associated with multiple complications including hypertension, cardiovascular disease, and chronic kidney disease. Significant epidemiologic associations with chronic kidney disease and ESRD have been noted and are reviewed herein, but debate persists in the literature as to whether kidney stone formation is a pathogenic process contributing to kidney disease. Corroborating evidence supporting the presence of kidney disease in stone formers includes the variability of renal function by stone type, the positive association of stone size with renal dysfunction, the presence of markers of renal injury in the urine of even asymptomatic stone formers, and direct evidence of renal tissue injury on histopathology. Proposed pathogenic mechanisms include recurrent obstruction and comorbid conditions such as recurrent urinary tract infections and structural abnormalities. Recent work evaluating the renal histopathology of different groups of stone formers adds further granularity, suggesting variability in mechanisms of renal injury by stone type and confirming the pathogenic effects of crystal formation. Genetic abnormalities leading to stone formation including cystinuria and primary hyperoxaluria, among others, contribute to the burden of disease in the stone-forming population. PMID:26376133

  12. Kidney stone risk following modern bariatric surgery.

    PubMed

    Gonzalez, Ricardo D; Canales, Benjamin K

    2014-05-01

    Over the past 10 years, a variety of reports have linked bariatric surgery to metabolic changes that alter kidney stone risk. Most of these studies were retrospective, lacked appropriate controls, or involved bariatric patients with a variety of inclusion criteria. Despite these limitations, recent clinical and experimental research has contributed to our understanding of the pathophysiology of stone disease in this high-risk population. This review summarizes the urinary chemistry profiles that may be responsible for the increased kidney stone incidence seen in contemporary epidemiological bariatric studies, outlines the mechanisms of hyperoxaluria and potential therapies through a newly described experimental bariatric animal model, and provides a focused appraisal of recommendations for reducing stone risk in bariatric stone formers. PMID:24658828

  13. Kidney Stones in Primary Hyperoxaluria: New Lessons Learnt

    PubMed Central

    Jacob, Dorrit E.; Grohe, Bernd; Gener, Michaela; Beck, Bodo B.; Hoppe, Bernd

    2013-01-01

    To investigate potential differences in stone composition with regard to the type of Primary Hyperoxaluria (PH), and in relation to the patients medical therapy (treatment nave patients versus those on preventive medication) we examined twelve kidney stones from ten PH I and six stones from four PH III patients. Unfortunately, no PH II stones were available for analysis. The study on this set of stones indicates a more diverse composition of PH stones than previously reported and a potential dynamic response of morphology and composition of calculi to treatment with crystallization inhibitors (citrate, magnesium) in PH I. Stones formed by PH I patients under treatment are more compact and consist predominantly of calcium-oxalate monohydrate (COM, whewellite), while calcium-oxalate dihydrate (COD, weddellite) is only rarely present. In contrast, the single stone available from a treatment nave PH I patient as well as stones from PH III patients prior to and under treatment with alkali citrate contained a wide size range of aggregated COD crystals. No significant effects of the treatment were noted in PH III stones. In disagreement with findings from previous studies, stones from patients with primary hyperoxaluria did not exclusively consist of COM. Progressive replacement of COD by small COM crystals could be caused by prolonged stone growth and residence times in the urinary tract, eventually resulting in complete replacement of calcium-oxalate dihydrate by the monohydrate form. The noted difference to the nave PH I stone may reflect a reduced growth rate in response to treatment. This pilot study highlights the importance of detailed stone diagnostics and could be of therapeutic relevance in calcium-oxalates urolithiasis, provided that the effects of treatment can be reproduced in subsequent larger studies. PMID:23940605

  14. Kidney stone erosion by micro scale hydrodynamic cavitation and consequent kidney stone treatment.

    PubMed

    Perk, Osman Yavuz; Şeşen, Muhsincan; Gozuacik, Devrim; Koşar, Ali

    2012-09-01

    The objective of this study is to reveal the potential of micro scale hydrodynamic bubbly cavitation for the use of kidney stone treatment. Hydrodynamically generated cavitating bubbles were targeted to the surfaces of 18 kidney stone samples made of calcium oxalate, and their destructive effects were exploited in order to remove kidney stones in in vitro experiments. Phosphate buffered saline (PBS) solution was used as the working fluid under bubbly cavitating conditions in a 0.75 cm long micro probe of 147 μm inner diameter at 9790 kPa pressure. The surface of calcium oxalate type kidney stones were exposed to bubbly cavitation at room temperature for 5 to 30 min. The eroded kidney stones were visually analyzed with a high speed CCD camera and using SEM (scanning electron microscopy) techniques. The experiments showed that at a cavitation number of 0.017, hydrodynamic bubbly cavitation device could successfully erode stones with an erosion rate of 0.31 mg/min. It was also observed that the targeted application of the erosion with micro scale hydrodynamic cavitation may even cause the fracture of the kidney stones within a short time of 30 min. The proposed treatment method has proven to be an efficient instrument for destroying kidney stones. PMID:22476893

  15. Kidney stones - self-care

    MedlinePlus

    ... stones: Eat less salt. Chinese and Mexican food, tomato juice, regular canned foods, and processed foods are ... beets, leeks, summer squash, sweet potatoes, spinach, and tomato soup Drinks: tea and instant coffee Other foods: ...

  16. Kidney stones are common after bariatric surgery

    PubMed Central

    Lieske, John C.; Mehta, Ramila A.; Milliner, Dawn S.; Rule, Andrew D; Bergstralh, Eric J.; Sarr, Michael G.

    2014-01-01

    Obesity, a risk factor for kidney stones and chronic kidney disease (CKD), is effectively treated with bariatric surgery. However, it is unclear if surgery alters stone or CKD risk. To determine this we studied 762 Olmsted County, Minnesota residents who underwent bariatric surgery and matched them with equally obese control individuals who did not undergo surgery. The majority of bariatric patients underwent standard Roux-en-Y gastric bypass (RYGB) (78%), with the remainder having more malabsorptive procedures (very long limb RYGB or biliopancreatic diversion/duodenal switch; 14%), or restrictive procedures (laparoscopic banding or sleeve gastrectomy; 7%). Mean age was 45 years with 80% female. The mean preoperative BMI was 46.7 kg/m2 for both cohorts. Rates of kidney stones were similar between surgery patients and controls at baseline, but new stone formation significantly increased in surgery patients (11.0%) compared to controls (4.3%) during 6.0 years of follow up. After malabsorptive and standard surgery, the comorbidity-adjusted hazard ratio of incident stones was significantly increased to 4.15 and 2.13, respectively but not significantly changed for restrictive surgery. The risk of CKD significantly increased after the malabsorptive procedures (adjusted hazard ratio of 1.96). Thus, while RYGB and malabsorptive procedures are more effective for weight loss, both are associated with increased risk of stones, while malabsorptive procedures also increase CKD risk. PMID:25354237

  17. Focused ultrasound guided relocation of kidney stones

    PubMed Central

    Abrol, Nitin; Kekre, Nitin S.

    2015-01-01

    Purpose: Complete removal of all fragments is the goal of any intervention for urinary stones. This is more important in lower pole stones where gravity and spatial orientation of lower pole infundibulum may hinder spontaneous passage of fragments. Various adjuvant therapies (inversion, diuresis, percussion, oral citrate, etc.) are described to enhance stone-free rate but are not widely accepted. Focused ultrasound-guided relocation of fragments is a recently described technique aimed at improving results of intervention for stone disease. Purpose of this review is to discuss development of this technology and its potential clinical applications. Materials and Methods: Pubmed search was made using key words “Focused ultrasound” and “kidney stone”. All English language articles were reviewed by title. Relevant studies describing development and application of focused ultrasound in renal stones were selected for review. Results: Focused ultrasound has proven its efficacy in successfully relocating up to 8 mm stone fragments in vitro and in pigs. Relocation is independent of stone composition. The latest model allows imaging and therapy with a single handheld probe facilitating its use by single operator. The acoustic energy delivered by the new prototype is even less than that used for extracorporeal shock wave lithotripsy. Therapeutic exposure has not caused thermal injury in pig kidneys. Conclusion: Focused ultrasound-guided relocation of stones is feasible. Though it is safe in application in pigs, technology is awaiting approval for clinical testing in human beings. This technology has many potential clinical applications in the management of stone disease. PMID:25624572

  18. Kidney Stones - Multiple Languages: MedlinePlus

    MedlinePlus

    ... List of All Topics All Kidney Stones - Multiple Languages To use the sharing features on this page, please enable JavaScript. Chinese - Simplified (简体中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) ...

  19. Transducer Joint for Kidney-Stone Ultrasonics

    NASA Technical Reports Server (NTRS)

    Angulo, E. D.

    1983-01-01

    Ultrasonic therapy for kidney stones improved by new way of connecting wire-probe ultrasonic waveguide to transducer. Improved mounting allows joint to last long enough for effective treatment. Sheath and rubber dampers constrain lateral vibration of wire waveguide. Combination of V-shaped mounting groove, sheath, and rubber dampers increases life expectancy of wire 15 times or more.

  20. Kidney Stones: What You Need to Know

    MedlinePlus

    ... Kidney stones are caused by high levels of calcium, oxalate, and phosphorus in the urine. Some foods may ... consume of the following: • liquids • sodium • animal protein • calcium • oxalate Drinking enough liquids each day is the best ...

  1. Determination of minor and trace elements in kidney stones by x-ray fluorescence analysis

    NASA Astrophysics Data System (ADS)

    Srivastava, Anjali; Heisinger, Brianne J.; Sinha, Vaibhav; Lee, Hyong-Koo; Liu, Xin; Qu, Mingliang; Duan, Xinhui; Leng, Shuai; McCollough, Cynthia H.

    2014-03-01

    The determination of accurate material composition of a kidney stone is crucial for understanding the formation of the kidney stone as well as for preventive therapeutic strategies. Radiations probing instrumental activation analysis techniques are excellent tools for identification of involved materials present in the kidney stone. In particular, x-ray fluorescence (XRF) can be very useful for the determination of minor and trace materials in the kidney stone. The X-ray fluorescence measurements were performed at the Radiation Measurements and Spectroscopy Laboratory (RMSL) of department of nuclear engineering of Missouri University of Science and Technology and different kidney stones were acquired from the Mayo Clinic, Rochester, Minnesota. Presently, experimental studies in conjunction with analytical techniques were used to determine the exact composition of the kidney stone. A new type of experimental set-up was developed and utilized for XRF analysis of the kidney stone. The correlation of applied radiation source intensity, emission of X-ray spectrum from involving elements and absorption coefficient characteristics were analyzed. To verify the experimental results with analytical calculation, several sets of kidney stones were analyzed using XRF technique. The elements which were identified from this techniques are Silver (Ag), Arsenic (As), Bromine (Br), Chromium (Cr), Copper (Cu), Gallium (Ga), Germanium (Ge), Molybdenum (Mo), Niobium (Nb), Rubidium (Rb), Selenium (Se), Strontium (Sr), Yttrium (Y), Zirconium (Zr). This paper presents a new approach for exact detection of accurate material composition of kidney stone materials using XRF instrumental activation analysis technique.

  2. A Drosophila model identifies a critical role for zinc in mineralization for kidney stone disease.

    PubMed

    Chi, Thomas; Kim, Man Su; Lang, Sven; Bose, Neelanjan; Kahn, Arnold; Flechner, Lawrence; Blaschko, Sarah D; Zee, Tiffany; Muteliefu, Gulinuer; Bond, Nichole; Kolipinski, Marysia; Fakra, Sirine C; Mandel, Neil; Miller, Joe; Ramanathan, Arvind; Killilea, David W; Brückner, Katja; Kapahi, Pankaj; Stoller, Marshall L

    2015-01-01

    Ectopic calcification is a driving force for a variety of diseases, including kidney stones and atherosclerosis, but initiating factors remain largely unknown. Given its importance in seemingly divergent disease processes, identifying fundamental principal actors for ectopic calcification may have broad translational significance. Here we establish a Drosophila melanogaster model for ectopic calcification by inhibiting xanthine dehydrogenase whose deficiency leads to kidney stones in humans and dogs. Micro X-ray absorption near edge spectroscopy (μXANES) synchrotron analyses revealed high enrichment of zinc in the Drosophila equivalent of kidney stones, which was also observed in human kidney stones and Randall's plaques (early calcifications seen in human kidneys thought to be the precursor for renal stones). To further test the role of zinc in driving mineralization, we inhibited zinc transporter genes in the ZnT family and observed suppression of Drosophila stone formation. Taken together, genetic, dietary, and pharmacologic interventions to lower zinc confirm a critical role for zinc in driving the process of heterogeneous nucleation that eventually leads to stone formation. Our findings open a novel perspective on the etiology of urinary stones and related diseases, which may lead to the identification of new preventive and therapeutic approaches. PMID:25970330

  3. A Drosophila Model Identifies a Critical Role for Zinc in Mineralization for Kidney Stone Disease

    PubMed Central

    Lang, Sven; Bose, Neelanjan; Kahn, Arnold; Flechner, Lawrence; Blaschko, Sarah D.; Zee, Tiffany; Muteliefu, Gulinuer; Bond, Nichole; Kolipinski, Marysia; Fakra, Sirine C.; Mandel, Neil; Miller, Joe; Ramanathan, Arvind; Killilea, David W.; Brückner, Katja; Kapahi, Pankaj; Stoller, Marshall L.

    2015-01-01

    Ectopic calcification is a driving force for a variety of diseases, including kidney stones and atherosclerosis, but initiating factors remain largely unknown. Given its importance in seemingly divergent disease processes, identifying fundamental principal actors for ectopic calcification may have broad translational significance. Here we establish a Drosophila melanogaster model for ectopic calcification by inhibiting xanthine dehydrogenase whose deficiency leads to kidney stones in humans and dogs. Micro X-ray absorption near edge spectroscopy (μXANES) synchrotron analyses revealed high enrichment of zinc in the Drosophila equivalent of kidney stones, which was also observed in human kidney stones and Randall’s plaques (early calcifications seen in human kidneys thought to be the precursor for renal stones). To further test the role of zinc in driving mineralization, we inhibited zinc transporter genes in the ZnT family and observed suppression of Drosophila stone formation. Taken together, genetic, dietary, and pharmacologic interventions to lower zinc confirm a critical role for zinc in driving the process of heterogeneous nucleation that eventually leads to stone formation. Our findings open a novel perspective on the etiology of urinary stones and related diseases, which may lead to the identification of new preventive and therapeutic approaches. PMID:25970330

  4. Prevalence of Kidney Stones in the United States

    PubMed Central

    Scales, Charles D.; Smith, Alexandria C.; Hanley, Janet M.; Saigal, Christopher S.

    2012-01-01

    Background The last nationally representative assessment of kidney stone prevalence in the United States occurred in 1994. After a 13-yr hiatus, the National Health and Nutrition Examination Survey (NHANES) reinitiated data collection regarding kidney stone history. Objective Describe the current prevalence of stone disease in the United States, and identify factors associated with a history of kidney stones. Design, setting, and participants A cross-sectional analysis of responses to the 2007–2010 NHANES (n = 12 110). Outcome measurements and statistical analysis Self-reported history of kidney stones. Percent prevalence was calculated and multivariable models were used to identify factors associated with a history of kidney stones. Results and limitations The prevalence of kidney stones was 8.8% (95% confidence interval [CI], 8.1–9.5). Among men, the prevalence of stones was 10.6% (95% CI, 9.4–11.9), compared with 7.1% (95% CI, 6.4–7.8) among women. Kidney stones were more common among obese than normal-weight individuals (11.2% [95% CI, 10.0–12.3] compared with 6.1% [95% CI, 4.8–7.4], respectively; p < 0.001). Black, non-Hispanic and Hispanic individuals were less likely to report a history of stone disease than were white, non-Hispanic individuals (black, non-Hispanic: odds ratio [OR]: 0.37 [95% CI, 0.28–0.49], p < 0.001; Hispanic: OR: 0.60 [95% CI, 0.49–0.73], p < 0.001). Obesity and diabetes were strongly associated with a history of kidney stones in multivariable models. The cross-sectional survey design limits causal inference regarding potential risk factors for kidney stones. Conclusions Kidney stones affect approximately 1 in 11 people in the United States. These data represent a marked increase in stone disease compared with the NHANES III cohort, particularly in black, non-Hispanic and Hispanic individuals. Diet and lifestyle factors likely play an important role in the changing epidemiology of kidney stones. PMID:22498635

  5. Kidney Stones and Cardiovascular Events: A Cohort Study

    PubMed Central

    Alexander, R. Todd; Hemmelgarn, Brenda R.; Wiebe, Natasha; Bello, Aminu; Samuel, Susan; Klarenbach, Scott W.; Curhan, Gary C.

    2014-01-01

    Background and objectives Kidney stones are common in general clinical practice, and their prevalence is increasing. Kidney stone formers often have risk factors associated with atherosclerosis, but it is uncertain whether having a kidney stone is associated with higher risk of cardiovascular events. This study sought to assess the association between one or more kidney stones and the subsequent risk of cardiovascular events. Design, setting, participants, & measurements Cohort study of 3,195,452 people aged≥18 years registered in the universal health care system in Alberta, Canada, between 1997 and 2009 (median follow-up of 11 years). People undergoing dialysis or with a kidney transplant at baseline were excluded. The primary outcome was the first acute myocardial infarction (AMI) during follow-up. We also considered other cardiovascular events, including death due to coronary heart disease, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass grafting (CABG), and stroke. Results In total, 25,532 (0.8%) participants had at least one kidney stone, and 91,465 (3%) individuals had at least one cardiovascular event during follow-up. Compared with people without kidney stones and after adjustment for cardiovascular risk factors and other potential confounders, people who had at least one kidney stone had a higher risk of subsequent AMI (adjusted hazard ratio [HR], 1.40; 95% confidence interval [95% CI], 1.30 to 1.51), PTCA/CABG (HR, 1.63; 95% CI, 1.51 to 1.76), and stroke (HR, 1.26; 95% CI, 1.12 to 1.42). The magnitude of the excess risk associated with a kidney stone appeared more pronounced for younger people than for older people (P<0.001) and for women than men (P=0.01). Conclusions The occurrence of a kidney stone is associated with a higher risk of cardiovascular events, including AMI, PTCA/CABG, and stroke. PMID:24311706

  6. Determination of minor and trace elements concentration in kidney stones using elemental analysis techniques

    NASA Astrophysics Data System (ADS)

    Srivastava, Anjali

    The determination of accurate material composition of a kidney stone is crucial for understanding the formation of the kidney stone as well as for preventive therapeutic strategies. Radiations probing instrumental activation analysis techniques are excellent tools for identification of involved materials present in the kidney stone. The X-ray fluorescence (XRF) and neutron activation analysis (NAA) experiments were performed and different kidney stones were analyzed. The interactions of X-ray photons and neutrons with matter are complementary in nature, resulting in distinctly different materials detection. This is the first approach to utilize combined X-ray fluorescence and neutron activation analysis for a comprehensive analysis of the kideny stones. Presently, experimental studies in conjunction with analytical techniques were used to determine the exact composition of the kidney stone. The use of open source program Python Multi-Channel Analyzer was utilized to unfold the XRF spectrum. A new type of experimental set-up was developed and utilized for XRF and NAA analysis of the kidney stone. To verify the experimental results with analytical calculation, several sets of kidney stones were analyzed using XRF and NAA technique. The elements which were identified from XRF technique are Br, Cu, Ga, Ge, Mo, Nb, Ni, Rb, Se, Sr, Y, Zr. And, by using Neutron Activation Analysis (NAA) are Au, Br, Ca, Er, Hg, I, K, Na, Pm, Sb, Sc, Sm, Tb, Yb, Zn. This thesis presents a new approach for exact detection of accurate material composition of kidney stone materials using XRF and NAA instrumental activation analysis techniques.

  7. Low voltage scanning electron microscopy of uncoated kidney stones.

    PubMed

    Cheng, P T; Reid, A D

    1985-01-01

    Some organic kidney stone components are easily damaged by a 10-30 kV electron beam used in conventional scanning electron microscopy. To avoid beam damage and reduce charging, it is desirable to study kidney stones by low voltage (1-5 kV) scanning electron microscopy (LVSEM) even though image resolution will suffer and X-ray microanalysis will not be available. If one is proficient in crystal morphology one can analyze gold-coated kidney stones by LVSEM without much difficulty. Stone components examined include calcium oxalate monohydrate, calcium oxalate dihydrate, struvite, calcium apatite, brushite, whitlockite, cystine, uric acid, uric acid dihydrate and ammonium acid urate. For all these components with the exception of the very small whitlockite and ammonium acid urate crystals, uncoated kidney stones can be examined with a 1 kV electron beam. PMID:4095500

  8. Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review

    PubMed Central

    Alok, Shashi; Jain, Sanjay Kumar; Verma, Amita; Kumar, Mayank; Sabharwal, Monika

    2013-01-01

    Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

  9. Introduction: Kidney Stone Research, Lessons From Human Studies

    NASA Astrophysics Data System (ADS)

    Coe, Fredric L.

    2007-04-01

    About 5% of American women and 12% of men will develop a kidney stone at some time in their life, the prevalence has been rising in both sexes. Approximately 80% of stones are composed of calcium oxalate, and calcium phosphate; 10% of struvite; 9% of uric acid; and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stone. Stones ultimately arise because of an unwanted phase change of these substances from liquid to solid state. In this introduction, I have outlined our current thinking of the possible mechanisms involved in stone formation based on our biopsy data collected from a series of human kidney stone formers. In addition, I have presented a set of questions as a means of focusing future research in this field.

  10. Tracking kidney stones with sound during shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Kracht, Jonathan M.

    The prevalence of kidney stones has increased significantly over the past decades. One of the primary treatments for kidney stones is shock wave lithotripsy which focuses acoustic shock waves onto the stone in order to fragment it into pieces that are small enough to pass naturally. This typically requires a few thousand shock waves delivered at a rate of about 2 Hz. Although lithotripsy is the only non-invasive treatment option for kidney stories, both acute and chronic complications have been identified which could be reduced if fewer shock waves were used. One factor that could be used to reduce the number of shock waves is accounting for the motion of the stone which causes a portion of the delivered shock waves to miss the stone, yielding no therapeutic benefit. Therefore identifying when the stone is not in focus would allow tissue to be spared without affecting fragmentation. The goal of this thesis is to investigate acoustic methods to track the stone in real-time during lithotripsy in order to minimize poorly-targeted shock waves. A relatively small number of low frequency ultrasound transducers were used in pulse-echo mode and a novel optimization routine based on time-of-flight triangulation is used to determine stone location. It was shown that the accuracy of the localization may be estimated without knowing the true stone location. This method performed well in preliminary experiments but the inclusion of tissue-like aberrating layers reduced the accuracy of the localization. Therefore a hybrid imaging technique employing DORT (Decomposition of the Time Reversal Operator) and the MUSIC (Multiple Signal Classification) algorithm was developed. This method was able to localize kidney stories to within a few millimeters even in the presence of an aberrating layer. This would be sufficient accuracy for targeting lithotripter shock waves. The conclusion of this work is that tracking kidney stones with low frequency ultrasound should be effective clinically.

  11. Stone orientation affects the mechanism of failure in artificial kidney stones subject to shock waves

    NASA Astrophysics Data System (ADS)

    van Cauwelaert, Javier; Cleveland, Robin O.

    2003-10-01

    Micro computed tomography (CT) imaging was used to follow the progressive development of cracks in artificial kidney stones. The artificial stones were made from U30 cement with a cylindrical shape (6.5 mm diameter and 8.5 mm long). The stones were held within a polypropylene vial in one of three orientations: vertical, horizontal, and angled at 45 deg. The stones were treated with an electromagnetic lithotripter and the initiation and growth of cracks was observed using microCT. The images show that the orientation of the stones with respect to the shock changes the dominant mechanism for fragmentation. Vertical stones developed a spall-like crack near the distal surface, which propagated from the surface to the interior of the stone. Initiation of a secondary spall-like crack was observed proximal to the first crack. Little surface damage was observed. Horizontal stones presented pitting in the proximal surface and erosion in lateral faces, indicating the action of cavitation. Angled stones presented both spall-like fracture in either the leading or the distal corners and surface damage (pitting) in the proximal surface. Experiments are being performed to follow the development of cracks in human kidney stones. [Work supported by the Whitaker Foundation.

  12. Risk of kidney stones with surgical intervention in living kidney donors.

    PubMed

    Thomas, S M; Lam, N N; Welk, B K; Nguan, C; Huang, A; Nash, D M; Prasad, G V R; Knoll, G A; Koval, J J; Lentine, K L; Kim, S J; Lok, C E; Garg, A X

    2013-11-01

    A kidney stone in a person with a solitary kidney requires urgent attention, which may result in surgical and/or hospital attention. We conducted a matched retrospective cohort study to determine if living kidney donors compared to healthy nondonors have a higher risk of: (i) kidney stones with surgical intervention, and (ii) hospital encounters for kidney stones. We reviewed all predonation charts for living kidney donations from 1992 to 2009 at five major transplant centers in Ontario, Canada, and linked this information to healthcare databases. We selected nondonors from the healthiest segment of the general population and matched 10 nondonors to every donor. Of the 2019 donors and 20 190 nondonors, none had evidence of kidney stones prior to cohort entry. Median follow-up time was 8.4 years (maximum 19.7 years; loss to follow-up <7%). There was no difference in the rate of kidney stones with surgical intervention in donors compared to nondonors (8.3 vs. 9.7 events/10 000 person-years; rate ratio 0.85; 95% confidence interval [CI] 0.47-1.53). Similarly there was no difference in the rate of hospital encounters for kidney stones (12.1 vs. 16.1 events/10 000 person-years; rate ratio 0.75; 95% CI 0.45-1.24). These interim results are reassuring for the safety of living kidney donation. PMID:24102981

  13. Rise in Kidney Stones in Teens a Cause for Concern: Study

    MedlinePlus

    ... than among males in the same age group. After age 25, kidney stones were more common in men, the study authors said. Kidney stone incidence rose 15 percent more in blacks than in whites during each five-year period ...

  14. The Development of Kidney Stone Dietary Plans for Patient Education

    ERIC Educational Resources Information Center

    Dennison, Darwin; Mayo, M. Leah; Abraham, Victor E.

    2011-01-01

    Currently patient education programs and urology practices provide individuals with "lists of foods to avoid" for dietary management of kidney stones. However, "planned diets" that include daily meal plans and recipes provide structure and specificity for diet management and are preferred by many individuals. This article describes the development…

  15. ECONOMIC IMPACT OF KIDNEY STONES IN WHITE MALE ADULTS

    EPA Science Inventory

    A large survey of patients hospitalized for kidney stones in the Carolinas and the Rocky Mountains states yielded information that can be translated into conservative estimates of cost of this disease. Hospital costs were estimated by considering number of surgeries, the approxim...

  16. Long-Term Treatment with Potassium Citrate and Renal Stones in Medullary Sponge Kidney

    PubMed Central

    Fabris, Antonia; Lupo, Antonio; Bernich, Patrizia; Abaterusso, Cataldo; Marchionna, Nicola; Nouvenne, Antonio

    2010-01-01

    Background and objectives: Medullary sponge kidney (MSK) is a renal malformation typically associated with nephrocalcinosis and recurrent calcium stones. Incomplete distal renal tubular acidosis, hypocitraturia, and hypercalciuria are common. For stone prevention, patients with MSK generally receive the standard “stone clinic” recommendations and often receive potassium citrate (KC). However, the effect on stone recurrence of citrate treatment in these patients has never been studied. Design, setting, participants, & measurements: The issue was retrospectively analyzed on an outpatient basis in 97 patients with a radiologic diagnosis of MSK: 65 had at least one stone risk factor (SRF; hypercalciuria, hypocitraturia, hyperuricosuria, hyperoxaluria) and received KC [29 ± 8 (SD) mEq/d]; 10 patients with SRF and 22 without received only general stone clinic suggestions. Follow-up was 78 ± 13, 72 ± 15, and 83 ± 14 months, respectively. The 24-hour urinary excretion of calcium, oxalate, uric acid, citrate, and morning urine pH were investigated at baseline and at the end of follow-up. Results: Parallel to a significant rise in urinary citrate and decreased urinary calcium (all P < 0.001), KC led to a dramatic reduction in the stone event rate (from 0.58 to 0.10 stones/yr per patient). The existence of a group of patients with MSK, those without SRF, with a very low stone rate and no SRF was recognized. Conclusions: Treatment with KC is effective in preventing renal stones in the typical patient with MSK. It seems that two clinical phenotypes among patients showing typical MSK features during radiologic study exist. PMID:20576821

  17. An Unusual Type of Kidney Stone.

    PubMed

    De Koninck, Anne-Sophie; Groen, Luitzen-Albert; Maes, Heleen; Verstraete, Alain Gaston; Stove, Veronique; Delanghe, Joris Richard

    2016-01-01

    A very rare case of acetylsulfapyridine nephrolithiasis is presented in a 54-year-old female patient who had been prescribed sulfasalazine (6 x 500 mg/day) because of psoriatic arthritis for the last 9 years. The patient's renal function was only slightly impaired. Reflectance infrared spectroscopy and gas chromatography-mass spectrometry allowed the identification of the chemical nature of the stone. As acetylsulfapyridine is a metabolite of sulfasalazine, administration of the latter drug was the cause of the nephrolithiasis. PMID:27012055

  18. Bone Genes in the Kidney of Stone Formers

    NASA Astrophysics Data System (ADS)

    Evan, Andrew P.; Bledsoe, Sharon B.

    2008-09-01

    Intraoperative papillary biopsies from kidneys of idiopathic-calcium oxalate stone formers (ICSF) have revealed a distinct pattern of mineral deposition in the interstitium of the renal papilla. The earliest sites of these deposits, termed Randall's plaque, are found in the basement membrane of thin loops of Henle and appear to spread into the surrounding interstitium down to the papillary epithelium. Recent studies show kidney stones of ICSF patients grow attached to the renal papilla and at sites of Randall's plaque. Together these observations suggest that plaque formation may be the critical step in stone formation. In order to control plaque formation and thereby reduce future kidney stone development, the mechanism of plaque deposition must be understood. Because the renal papilla has unique anatomical features similar to bone and the fact that the interstitial deposits of ICSF patients are formed of biological apatite, this paper tests the hypothesis that sites of interstitial plaque form as a result of cell-mediated osteoblast-like activity.

  19. A model for damage of microheterogeneous kidney stones

    NASA Astrophysics Data System (ADS)

    Szeri, Andrew J.; Zohdi, Tarek I.; Blake, John R.

    2005-04-01

    In this paper, a theoretical framework is developed for the mechanics of kidney stones with an isotropic, random microstructure-such as those comprised of cystine or struvite. The approach is based on a micromechanical description of kidney stones comprised of crystals in a binding matrix. Stress concentration functions are developed to determine load sharing of the particle phase and the binding matrix phase. As an illustration of the theory, the fatigue of kidney stones subject to shock wave lithotripsy is considered. Stress concentration functions are used to construct fatigue life estimates for each phase, as a function of the volume fraction and of the mechanical properties of the constituents, as well as the loading from SWL. The failure of the binding matrix is determined explicitly in a model for the accumulation of distributed damage. Also considered is the amount of material damaged in a representative non-spherical collapse of a cavitation bubble near the stone surface. The theory can be used to assess the importance of microscale heterogeneity on the comminution of renal calculi and to estimate the number of cycles to failure in terms of measurable material properties.

  20. An in vitro ultrastructural study of infectious kidney stone genesis.

    PubMed

    McLean, R J; Nickel, J C; Noakes, V C; Costerton, J W

    1985-09-01

    A ureolytic strain of Proteus mirabilis, isolated from a patient with infectious kidney stones, produced struvite (MgNH4PO4 X 6 H2O) and apatite [Ca10(PO4)6CO3] crystals in vitro when grown in artificial urine. Surface-attached crystals were encased in a slime-like layer. Scanning electron microscopy revealed that surfaces submerged in the artificial urine were colonized by P. mirabilis. Bacteria-associated crystals appeared soon after colonization and eventually became coated with an amorphous substance. Energy-dispersive X-ray analysis of these crystals revealed the presence of Mg, Ca, and P which are major components of struvite and apatite. Transmission electron microscopy of surface scrapings revealed that the glycocalyx of P. mirabilis contained a large number of crystals. Based on these observations and previous work, a theory for infectious renal calculogenesis is proposed. The kidney is initially colonized by invading ureolytic pathogens. These pathogens secrete copious amounts of glycocalyx which facilitates adhesion of the organisms to the kidney, provides protection for these bacteria, and serves to bind struvite and apatite crystals that result from bacterial urease activity. Growth of these calcified microcolonies into mature stones is characterized by continued bacterial growth, incorporation of urinary mucoproteins into the matrix along with bacterial glycocalyx, and a continued deposition of struvite and apatite crystals due to the high pH. The mature stone, in effect, represents an enlarged "fossilized" bacterial microcolony. PMID:3897064

  1. Biochemical diagnosis in 3040 kidney stone formers in Argentina.

    PubMed

    Spivacow, Francisco Rodolfo; del Valle, Elisa Elena; Negri, Armando Luis; Fradinger, Erich; Abib, Anabella; Rey, Paula

    2015-08-01

    Nephrolithiasis is a frequent condition in urology that has an important recurrence and high impact in health economy. Knowing the biochemical abnormalities implicated in its pathogenesis is mandatory to establish therapeutic aims. Our objectives are to present the results in 3040 kidney stone formers in Argentina. All patients were selected after completing an ambulatory metabolic protocol with diagnostic purposes. There were 1717 men, (56.48%), with a mean age of 45±12 years, and 1323 women, (43.52%), mean age 44±12 years. 2781 patients had biochemical abnormalities, (91.49%), and were arbitrarily divided in two groups: those who had only one (single) biochemical abnormality (n=2156) and those who had associated abnormalities (n=625). No biochemical abnormalities were found in 259 patients (8.51%). The abnormalities present, single and associated, in order of frequency, were idiopathic hypercalciuria, (56.88%), hyperuricosuria (21.08%), unduly acidic urine (10.95%), hypocitraturia (10.55%), hypomagnesuria (7.9%), primary hyperparathyroidism (3.01%), hyperoxaluria (2.6%), and cystinuria (0.32%). We performed in 484 patient's stone composition and found calcium oxalate stones related to idiopathic hypercalciuria predominantly while uric acid stones to unduly acidic urine. In conclusion, the biochemical abnormalities described are similar to those found in a previous series of our own and to those reported in the literature. Its diagnosis is important to therapeutic purposes to avoid eventual recurrence. PMID:25958053

  2. Appropriate kidney stone size for ureteroscopic lithotripsy: When to switch to a percutaneous approach.

    PubMed

    Takazawa, Ryoji; Kitayama, Sachi; Tsujii, Toshihiko

    2015-02-01

    Flexible ureteroscopy (fURS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy (PNL) is currently the first-line recommended treatment for large kidney stones ≥ 20 mm and it has an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible considering its major complication rates. Staged fURS is a practical treatment for such large kidney stones because fURS has a minimal blood transfusion risk, short hospitalization and few restrictions on daily routines. However, as the stone size becomes larger, the stone-free rate decreases, and the number of operations required increases. Therefore, in our opinion, staged fURS is a practical option for kidney stones 20 to 40 mm. Miniaturized PNL combined with fURS should be considered to be a preferred option for stones larger than 40 mm. Moreover, URS is an effective treatment for multiple upper urinary tract stones. Especially for patients with a stone burden < 20 mm, URS is a favorable option that promises a high stone-free rate after a single session either unilaterally or bilaterally. However, for patients with a stone burden ≥ 20 mm, a staged operation should be considered to achieve stone-free status. PMID:25664253

  3. Appropriate kidney stone size for ureteroscopic lithotripsy: When to switch to a percutaneous approach

    PubMed Central

    Takazawa, Ryoji; Kitayama, Sachi; Tsujii, Toshihiko

    2015-01-01

    Flexible ureteroscopy (fURS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy (PNL) is currently the first-line recommended treatment for large kidney stones ≥ 20 mm and it has an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible considering its major complication rates. Staged fURS is a practical treatment for such large kidney stones because fURS has a minimal blood transfusion risk, short hospitalization and few restrictions on daily routines. However, as the stone size becomes larger, the stone-free rate decreases, and the number of operations required increases. Therefore, in our opinion, staged fURS is a practical option for kidney stones 20 to 40 mm. Miniaturized PNL combined with fURS should be considered to be a preferred option for stones larger than 40 mm. Moreover, URS is an effective treatment for multiple upper urinary tract stones. Especially for patients with a stone burden < 20 mm, URS is a favorable option that promises a high stone-free rate after a single session either unilaterally or bilaterally. However, for patients with a stone burden ≥ 20 mm, a staged operation should be considered to achieve stone-free status. PMID:25664253

  4. Risk factors for chronic kidney disease in persons with kidney stones: Case-control study in Olmsted County, Minnesota

    PubMed Central

    Saucier, Nathan A.; Sinha, M. K.; Liang, Kelly V.; Krambeck, Amy E.; Weaver, Amy L.; Bergstralh, Eric J.; Li, Xujian; Rule, Andrew D.; Lieske, John C.

    2010-01-01

    Background Kidney stones are associated with an increased risk for chronic kidney disease but risk factors in the general community are poorly defined. Study Design A nested case-control study was performed among Olmsted County, Minnesota residents who presented with a kidney stone at the Mayo Clinic between 1980 and 1994 to contrast kidney stone patients who developed chronic kidney disease to a group who did not. Setting and Participants Subjects were selected from the Rochester Epidemiology Project, an electronic linkage system between health care providers in Olmsted County, Minnesota. Cases were identified by diagnostic code for chronic kidney disease and confirmed to have an estimated glomerular filtration rate <60 ml/min/1.73 m2. Controls were matched 2:1 to cases on age, sex, date of first kidney stone, and length of medical record. Predictor Charts were abstracted to characterize stone disease, hypertension, diabetes, obesity, tobacco use, ileal conduit, symptomatic stones, type and number of stones, urinary tract infections, number and type of surgical procedures, and medical therapy. Outcomes and Measurements Kidney stone patients with CKD were compared to matched stone patients without CKD. Results There were 53 cases and 106 controls with a mean age of 57 years at first stone event and 59% were men. Among kidney stone patients, cases with CKD were significantly more likely (P<0.05) than controls to have had a history of diabetes (41.5% vs 17.0%), hypertension (71.7% vs 49.1%), frequent urinary tract infections (22.6% vs 6.6%), struvite stones (7.5% vs 0%), and allopurinol use (32.1% vs 4.7%) based on univariate analysis. Limitations Potential limitations include limited statistical power to detect associations, incomplete data from 24 hour urine studies, and that stone composition was not always available. Conclusion As in the general population, hypertension and diabetes are associated with an increased risk of chronic kidney disease amongst patients with kidney stones. However, other unique predictors were identified in kidney stone patients that increased the possibility of chronic kidney disease. Further studies are warranted to elucidate the nature of these associations. PMID:19853335

  5. Kidney Allograft Stone after Kidney Transplantation and its Association with Graft Survival

    PubMed Central

    Rezaee-Zavareh, M. S.; Ajudani, R.; Ramezani Binabaj, M.; Heydari, F.; Einollahi, B.

    2015-01-01

    Background: It is said that renal transplantation lithiasis is rare. However, literature has some different frequencies in this field and most of the studies related to this issue are case reports. Also the exact effect of this complication on the graft survival rate is not clear. Objectives: To determine the prevalence of nephrolithiasis among kidney transplant recipients and evaluate its association with the graft survival. Methods: We conducted a retrospective study to determine the prevalence of renal stone among 574 kidney transplant patients aged ≥18 years who had undergone renal transplantation in Baqiyatallah Transplant Center between 1990 and 2010. Cox regression analysis was used to determine the effect of renal stone on the graft survival. Results: The mean±SD follow-up time was 55±53 months. Kidney stones were diagnosed in 31 (4.4%) of all 574 kidney transplants studied. Cox regression analysis revealed that nephrolithiasis after transplantation had no significant effects on the survival of the transplanted kidney (OR 1.04, CI: 0.708–1.54). Conclusion: For the first time, we showed that nephrolithiasis in recipients does not have a significant effect on the transplant survival. PMID:26306157

  6. Bilateral ureteric stones: an unusual cause of acute kidney injury.

    PubMed

    Sumner, Daniel; Rehnberg, Lucas; Kler, Aaron

    2016-01-01

    A 49-year-old man presented to the accident and emergency department, with a short history of vague abdominal pain, abdominal distension and two episodes of frank haematuria. A plain chest film showed dilated loops of large bowel and blood results on admission showed an acute kidney injury (stage 3). A diagnosis of bowel obstruction was made initially but a CT scan of the abdomen showed bilateral obstructing calculi. After initial resuscitation, the patient had bilateral ultrasound-guided nephrostomies and haemofiltration. He later underwent bilateral antegrade ureteric stenting. A decision will later be made on whether or not he is fit enough to undergo ureteroscopy and laser stone fragmentation. PMID:27030462

  7. Assessment of the role of general, biochemical and family history characteristics in kidney stone formation

    PubMed Central

    Jabbar, Faiza; Asif, Muhammad; Dutani, Hajirah; Hussain, Abrar; Malik, Arif; Kamal, Mohammad Amjad; Rasool, Mahmood

    2014-01-01

    Aim The main objective of the study was to determine the urinary risk factors involved in kidney stone formation. Method In this study a total number of 101 patients (64 males and 37 females) between the age group 2 and 70 years were selected. Personal characteristics like age, family history, clinical sign and symptoms, education, monthly income, living style, smoking or tobacco chewing habit, dietary intake and daily amount of drinking water were recorded. Results The study showed that the risk of kidney stone formation was high in the median age group (16–25 years) both in male and female population. The most important factors associated with this were lack of drinking clean water, over weight and obesity as well as family history (37.5% and 27.02% in men and women, respectively). Conclusion Our study has confirmed that lack of drinking sufficient amount of water, increasing weight and obesity and family history are some major factors contributing to the increased risk of kidney stone formation. Therefore it is very important to live a healthy life, drink clean water and control weight to prevent such diseases. PMID:25561886

  8. Combined studies of chemical composition of urine sediments and kidney stones by means of infrared microspectroscopy

    NASA Astrophysics Data System (ADS)

    Tamošaitytė, Sandra; Hendrixson, Vaiva; Želvys, Arūnas; Tyla, Ramūnas; Kučinskienė, Zita A.; Jankevičius, Feliksas; Pučetaitė, Milda; Jablonskienė, Valerija; Šablinskas, Valdas

    2013-02-01

    Results of the structural analysis of urinary sediments by means of infrared spectral microscopy are presented. The results are in good agreement with the results of standard optical microscopy in the case of single-component and crystalline urinary sediments. It is found that for noncrystalline or multicomponent sediments, the suggested spectroscopic method is superior to optical microscopy. The chemical structure of sediments of any molecular origin can be elucidated by this spectroscopic method. The method is sensitive enough to identify solid particles of drugs present in urine. Sulfamethoxazole and traces of other medicines are revealed in this study among the other sediments. We also show that a rather good correlation exists between the type of urinary sediments and the renal stones removed from the same patient. Spectroscopic studies of urinary stones and corresponding sediments from 76 patients suffering from renal stone disease reveal that in 73% of cases such correlation exists. This finding is a strong argument for the use of infrared spectral microscopy to prevent kidney stone disease because stones can be found in an early stage of formation by using the nonintrusive spectroscopic investigation of urinary sediments. Some medical recommendations concerning the overdosing of certain pharmaceuticals can also be derived from the spectroscopic studies of urinary sediments.

  9. Crystal aggregation in kidney stones; a polymer aggregation problem?

    NASA Astrophysics Data System (ADS)

    Wesson, J.; Beshensky, A.; Viswanathan, P.; Zachowicz, W.; Kleinman, J.

    2008-03-01

    Kidney stones most frequently form as aggregates of calcium oxalate monohydrate (COM) crystals with organic layers between them, and the organic layers contain principally proteins. The pathway leading to the formation of these crystal aggregates in affected people has not been identified, but stone forming patients are thought to have a defect in the structure or distribution of urinary proteins, which normally protect against stone formation. We have developed two polyelectrolyte models that will induce COM crystal aggregation in vitro, and both are consistent with possible urinary protein compositions. The first model was based on mixing polyanionic and polycationic proteins, in portions such that the combined protein charge is near zero. The second model was based on reducing the charge density on partially charged polyanionic proteins, specifically Tamm-Horsfall protein, the second most abundant protein in urine. Both models demonstrated polymer phase separation at solution conditions where COM crystal aggregation was observed. Correlation with data from other bulk crystallization measurements suggest that the anionic side chains form critical binding interactions with COM surfaces that are necessary along with the phase separation process to induce COM crystal aggregation.

  10. Measurement of kidney stone formation in the rat model using micro-computed tomography

    NASA Astrophysics Data System (ADS)

    Umoh, Joseph U.; Pitelka, Vasek; Goldberg, Harvey A.; Holdsworth, David W.

    2012-03-01

    Kidney stones were induced in 5 rats by treating them with 1% ethylene glycol and 1% ammonium chloride through free drinking water for six weeks. The animals were anesthetized and imaged in vivo before the treatment at week 0, to obtain baseline data, then at weeks 2 and 6 to monitor the kidney stone formation. Micro-CT imaging was performed with x-ray tube voltage of 90 kV and a current of 40 mA. At week 2, kidney stone formation was observed. A micro-computed tomography methodology of estimating the volume and hydroxyapatite-equivalent mineral content of the kidney stone is presented. It determines the threshold CT number (390 HU) that separates the kidney stone from the tissue. The mean volume of the stones in the 10 kidneys significantly increased from 3.81+/-0.72 mm3 at week 2 to 23.96+/-9.12 mm3 at week 6 (p<0.05, r2=0.34). Measurement precision error was about 4%. This method allows analysis of the kidney stone formation to be carried out in vivo, with fewer experimental animals compared with other ex vivo methods, in which animals are sacrificed. It is precise, accurate, non-destructive, and could be used in pre-clinical research to study the formation of kidney stones in live small animals.

  11. Effective atomic number accuracy for kidney stone characterization using spectral CT

    NASA Astrophysics Data System (ADS)

    Joshi, M.; Langan, D. A.; Sahani, D. S.; Kambadakone, A.; Aluri, S.; Procknow, K.; Wu, X.; Bhotika, R.; Okerlund, D.; Kulkarni, N.; Xu, D.

    2010-04-01

    The clinical application of Gemstone Spectral ImagingTM, a fast kV switching dual energy acquisition, is explored in the context of noninvasive kidney stone characterization. Utilizing projection-based material decomposition, effective atomic number and monochromatic images are generated for kidney stone characterization. Analytical and experimental measurements are reported and contrasted. Phantoms were constructed using stone specimens extracted from patients. This allowed for imaging of the different stone types under similar conditions. The stone specimens comprised of Uric Acid, Cystine, Struvite and Calcium-based compositions. Collectively, these stone types span an effective atomic number range of approximately 7 to 14. While Uric Acid and Calcium based stones are generally distinguishable in conventional CT, stone compositions like Cystine and Struvite are difficult to distinguish resulting in treatment uncertainty. Experimental phantom measurements, made under increasingly complex imaging conditions, illustrate the impact of various factors on measurement accuracy. Preliminary clinical studies are reported.

  12. Targeted microbubbles: a novel application for the treatment of kidney stones

    PubMed Central

    Ramaswamy, Krishna; Marx, Vanessa; Laser, Daniel; Kenny, Thomas; Chi, Thomas; Bailey, Michael; Sorensen, Mathew D.; Grubbs, Robert H.; Stoller, Marshall L.

    2015-01-01

    Kidney stone disease is endemic. Extracorporeal shockwave lithotripsy was the first major technological breakthrough where focused shockwaves were used to fragment stones in the kidney or ureter. The shockwaves induced the formation of cavitation bubbles, whose collapse released energy at the stone, and the energy fragmented the kidney stones into pieces small enough to be passed spontaneously. Can the concept of microbubbles be used without the bulky machine? The logical progression was to manufacture these powerful microbubbles ex vivo and inject these bubbles directly into the collecting system. An external source can be used to induce cavitation once the microbubbles are at their target; the key is targeting these microbubbles to specifically bind to kidney stones. Two important observations have been established: (i) bisphosphonates attach to hydroxyapatite crystals with high affinity; and (ii) there is substantial hydroxyapatite in most kidney stones. The microbubbles can be equipped with bisphosphonate tags to specifically target kidney stones. These bubbles will preferentially bind to the stone and not surrounding tissue, reducing collateral damage. Ultrasound or another suitable form of energy is then applied causing the microbubbles to induce cavitation and fragment the stones. This can be used as an adjunct to ureteroscopy or percutaneous lithotripsy to aid in fragmentation. Randall’s plaques, which also contain hydroxyapatite crystals, can also be targeted to pre-emptively destroy these stone precursors. Additionally, targeted microbubbles can aid in kidney stone diagnostics by virtue of being used as an adjunct to traditional imaging methods, especially useful in high-risk patient populations. This novel application of targeted microbubble technology not only represents the next frontier in minimally invasive stone surgery, but a platform technology for other areas of medicine. PMID:25402588

  13. Quantification of asymptomatic kidney stone burden by computed tomography for predicting future symptomatic stone events

    PubMed Central

    Selby, Michael G.; Vrtiska, Terri J.; Krambeck, Amy E.; McCollough, Cynthia H.; Elsherbiny, Hisham; Bergstralh, Eric J.; Lieske, John C.; Rule, Andrew D.

    2014-01-01

    Objective To find the optimal characterization of asymptomatic radiographic stone burden on computed tomographic (CT) scans. Methods A survey was sent to stone formers who underwent a CT scan while asymptomatic during a stone clinic evaluation. Symptomatic stone passage events after CT scan were detected by survey and medical record review. Radiographic stone burden was quantified by number of stones, largest stone diameter, automated total stone volume (TSV), and bilateral stones and then compared as predictors of stone events. Results There were 550 stone formers; 43% had a stone event a median 4.7 years after the CT scan. Stone burden by quartiles was 0–1, 2–3, 4–6, ≥7 for number of stones; 0–2, 3–4, 5–7, ≥8 mm for largest stone diameter; and 0–8, 9–78, 79–280, and ≥ 281 mm3 for TSV; 48% had bilateral stones. The hazard ratios (HRs) for symptomatic event was 1.30 (p<0.001) for the number of stones per quartile, 1.26 (p<0.001) for largest stone diameter per quartile, 1.38 (p<0.001) for TSV per quartile, and 1.80 (p<0.001) for bilateral stones. On multivariable analysis, only TSV was an independent predictor of symptomatic events (HR=1.35 per quartile, p=0.01). This risk of events with TSV was also independent of demographics, urine chemistries, and stone composition. Among the 53 patients with interim events between CT scans, a rapid increase in TSV between CT scans (>570 mm3/year) predicted subsequent events (HR=2.8, p=0.05). Conclusions Automated TSV is more predictive of symptomatic events than manual methods for quantifying stone burden on CT scan. PMID:25440821

  14. Common and rare variants associated with kidney stones and biochemical traits

    PubMed Central

    Oddsson, Asmundur; Sulem, Patrick; Helgason, Hannes; Edvardsson, Vidar O.; Thorleifsson, Gudmar; Sveinbjörnsson, Gardar; Haraldsdottir, Eik; Eyjolfsson, Gudmundur I.; Sigurdardottir, Olof; Olafsson, Isleifur; Masson, Gisli; Holm, Hilma; Gudbjartsson, Daniel F.; Thorsteinsdottir, Unnur; Indridason, Olafur S.; Palsson, Runolfur; Stefansson, Kari

    2015-01-01

    Kidney stone disease is a complex disorder with a strong genetic component. We conducted a genome-wide association study of 28.3 million sequence variants detected through whole-genome sequencing of 2,636 Icelanders that were imputed into 5,419 kidney stone cases, including 2,172 cases with a history of recurrent kidney stones, and 279,870 controls. We identify sequence variants associating with kidney stones at ALPL (rs1256328[T], odds ratio (OR)=1.21, P=5.8 × 10−10) and a suggestive association at CASR (rs7627468[A], OR=1.16, P=2.0 × 10−8). Focusing our analysis on coding sequence variants in 63 genes with preferential kidney expression we identify two rare missense variants SLC34A1 p.Tyr489Cys (OR=2.38, P=2.8 × 10−5) and TRPV5 p.Leu530Arg (OR=3.62, P=4.1 × 10−5) associating with recurrent kidney stones. We also observe associations of the identified kidney stone variants with biochemical traits in a large population set, indicating potential biological mechanism. PMID:26272126

  15. Common and rare variants associated with kidney stones and biochemical traits.

    PubMed

    Oddsson, Asmundur; Sulem, Patrick; Helgason, Hannes; Edvardsson, Vidar O; Thorleifsson, Gudmar; Sveinbjörnsson, Gardar; Haraldsdottir, Eik; Eyjolfsson, Gudmundur I; Sigurdardottir, Olof; Olafsson, Isleifur; Masson, Gisli; Holm, Hilma; Gudbjartsson, Daniel F; Thorsteinsdottir, Unnur; Indridason, Olafur S; Palsson, Runolfur; Stefansson, Kari

    2015-01-01

    Kidney stone disease is a complex disorder with a strong genetic component. We conducted a genome-wide association study of 28.3 million sequence variants detected through whole-genome sequencing of 2,636 Icelanders that were imputed into 5,419 kidney stone cases, including 2,172 cases with a history of recurrent kidney stones, and 279,870 controls. We identify sequence variants associating with kidney stones at ALPL (rs1256328[T], odds ratio (OR)=1.21, P=5.8 × 10(-10)) and a suggestive association at CASR (rs7627468[A], OR=1.16, P=2.0 × 10(-8)). Focusing our analysis on coding sequence variants in 63 genes with preferential kidney expression we identify two rare missense variants SLC34A1 p.Tyr489Cys (OR=2.38, P=2.8 × 10(-5)) and TRPV5 p.Leu530Arg (OR=3.62, P=4.1 × 10(-5)) associating with recurrent kidney stones. We also observe associations of the identified kidney stone variants with biochemical traits in a large population set, indicating potential biological mechanism. PMID:26272126

  16. Kidney stone risk following Roux-en-Y gastric bypass surgery

    PubMed Central

    Gonzalez, Ricardo D.

    2014-01-01

    Since the first report in 2005, Roux-en-Y gastric bypass (RYGB) surgery has been linked to a variety of metabolic changes that alter kidney stone risk. The studies with the highest level of evidence, performed in non-stone forming patients before and after RYGB, cite a number of kidney stone risk factors, including a 25% increase in urinary oxalate, a 30% decrease in urinary citrate, and reduction in urine volume by half a liter. In addition to these, recent clinical and experimental studies have contributed to our understanding of the pathophysiology of stone disease in this unique population. This review summarizes the current RYGB urinary chemistry profiles and epidemiological studies, outlines known and theoretical mechanisms of hyperoxaluria and hypocitrituria, and provides some standard recommendations for reducing stone risk in RYGB stone formers as well as some novel ones, including correction of metabolic acidosis and use of probiotics. PMID:25473624

  17. Preclinical safety and effectiveness studies of ultrasonic propulsion of kidney stones

    PubMed Central

    Harper, Jonathan D.; Dunmire, Barbrina; Wang, Yak-Nam; Simon, Julianna C.; Liggitt, H. Denny; Paun, Marla; Cunitz, Bryan W.; Starr, Frank; Bailey, Michael R.; Penniston, Kristina; Lee, Franklin Chong-Ho; Hsi, Ryan S.; Sorensen, Mathew D.

    2014-01-01

    Objective To provide an update on a research device to ultrasonically reposition kidney stones transcutaneously. This paper reports preclinical safety and effectiveness studies, survival data, modifications of the system, and testing in a stone-forming porcine model. These data formed the basis for regulatory approval to test the device in humans. Materials and Methods The ultrasound burst was shortened to 50ms from previous investigations with 1s bursts. Focused ultrasound was used to expel 2–5mm calcium oxalate monohydrate stones placed ureteroscopically in five pigs. Additionally, de novo stones were imaged and repositioned in a stone-forming porcine model. Acute safety studies were performed targeting two kidneys (6 sites) and three pancreases (8 sites). Survival studies followed 10 animals for one week after simulated treatment. Serum and urine analyses were performed and tissues were evaluated histologically. Results All ureteroscopically-implanted stones (6/6) were repositioned out of the kidney in 14 ± 8 minutes with 13 ± 6 bursts. On average, three bursts moved a stone more than 4mm and collectively accounted for the majority of relocation. Stones (3mm) were detected and repositioned in the 200-kg stone-forming model. No injury was detected in the acute or survival studies. Conclusions Ultrasonic propulsion is safe and effective in the porcine model. Stones were expelled from the kidney. De novo stones formed in a large porcine model were repositioned. No adverse effects were identified with the acute studies directly targeting kidney or pancreatic tissue or during the survival studies indicating no evidence of delayed tissue injury. PMID:24975708

  18. Prevent Diabetes Problems: Keep Your Kidneys Healthy

    MedlinePlus

    ... Fund National Kidney Foundation American Diabetes Association JDRF Diabetes Disease Organizations Many organizations provide support to patients ... PDF, 293 KB). Alternate Language URL Español Prevent diabetes problems: Keep your kidneys healthy Page Content On ...

  19. Do You Have Symptoms of a Kidney Stone?

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  20. The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis.

    PubMed

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Vijayvargiya, Priya; Anthanont, Pimjai; Erickson, Stephen B

    2016-04-01

    Background With rising prevalence of morbid obesity, the number of bariatric surgeries performed each year has been increasing worldwide. The objective of this meta-analysis was to assess the risk of kidney stones following bariatric surgery. Methods A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through July 2015. Only studies reporting relative risks, odd ratios or hazard ratios (HRs) to compare risk of kidney stones in patients who underwent bariatric surgery versus no surgery were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results Four studies (One randomized controlled trial and three cohort studies) with 11,348 patients were included in analysis to assess the risk of kidney stones following bariatric surgery. The pooled RR of kidney stones in patients undergoing bariatric surgery was 1.22 (95% CI, 0.63-2.35). The type of bariatric surgery subgroup analysis demonstrated an increased risk of kidney stones in patients following Roux-en-Y gastric bypass (RYGB) with the pooled RR of 1.73 (95% CI, 1.30-2.30) and a decreased risk of kidney stones in patients following restrictive procedures including laparoscopic banding or sleeve gastrectomy with the pooled RR of 0.37 (95% CI, 0.16-0.85). Conclusions Our meta-analysis demonstrates an association between RYGB and increased risk of kidney stones. Restrictive bariatric surgery, on the other hand, may decrease kidney stone risk. Future study with long-term follow-up data is needed to confirm this potential benefit of restrictive bariatric surgery. PMID:26803902

  1. Body Mass Index and Kidney Stones: A Cohort Study of Japanese Men

    PubMed Central

    Yoshimura, Eiichi; Sawada, Susumu S.; Lee, I-Min; Gando, Yuko; Kamada, Masamitsu; Matsushita, Munehiro; Kawakami, Ryoko; Ando, Ryosuke; Okamoto, Takashi; Tsukamoto, Koji; Miyachi, Motohiko; Blair, Steven N.

    2016-01-01

    Background In Japan, the incidence of kidney stones has increased markedly in recent decades. Major causes of kidney stones remain unclear, and limited data are available on the relationship between overweight/obesity and the incidence of kidney stones. We therefore evaluated body mass index (BMI) and the incidence of kidney stones in Japanese men. Methods Of the workers at a gas company, 5984 males aged 20–40 years underwent a medical examination in 1985 (baseline). This study includes 4074 of the men, who were free of kidney stones at baseline and underwent a second medical examination performed between April 2004 and March 2005. BMI was calculated from measured height and weight in 1985, and men were categorized into tertiles. The development of kidney stones during follow-up was based on self-reports from questionnaires at the second medical examination. Results The average duration of follow-up was 19 years, with 258 participants developing kidney stones during this period. Using the lowest BMI (1st tertile) group as a reference, the hazard ratios (95% confidence intervals [CIs]) for the 2nd and 3rd BMI tertiles were: 1.26 (95% CI, 0.92–1.73) and 1.44 (95% CI, 1.06–1.96), respectively (P for trend = 0.019). After additionally adjusting for potential confounders, such as age, systolic blood pressure, cardiorespiratory fitness, cigarette smoking, and alcohol consumption, the hazard ratios were 1.28 (95% CI, 0.93–1.76) and 1.41 (95% CI, 1.02–1.97), respectively (P for trend = 0.041). Conclusions These results suggest that increased BMI is a risk factor for kidney stones in Japanese men. PMID:26616396

  2. Ceftriaxone crystallization and its potential role in kidney stone formation.

    PubMed

    Chutipongtanate, Somchai; Thongboonkerd, Visith

    2011-03-18

    Drug-induced nephrolithiasis contributes to 1-2% of the incidence of renal calculi. We examined whether ceftriaxone at therapeutic doses could be crystallized in the urine and also explored its role in kidney stone formation. Crystallization was induced by mixing ceftriaxone sodium at therapeutic urinary excretion levels (0.5-4.0 mg/ml) to calcium chloride at physiologic urinary concentration (5mM) in deionized (dI) water or artificial urine (AU). The results showed that ceftriaxone was crystallized with free calcium in dose- and time-dependent manner. These ceftriaxone/calcium crystals showed birefringence property under polarized microscope. Individual crystals had needle-shape (5-100 μm in length), whereas the aggregated form had star-burst and irregular-plate shape (40-200 μm in diameter) (note that the crystal sizes were much larger than renal tubular lumens). Calcium-depletion assay revealed that crystallization required free calcium as a substrate. In AU, crystallization remained although it was partially inhibited when compared to that in dI water. Finally, these crystals could tightly adhere onto renal tubular cell surface. Our data demonstrated that ceftriaxone at therapeutic levels could be crystallized with free calcium in the urine under physiologic condition. We hypothesize that tubular occlusion and crystal-cell adhesion may play important role in pathogenic mechanisms of ceftriaxone-induced nephrolithiasis. PMID:21329669

  3. Minimally invasive surgical treatment for kidney stone disease.

    PubMed

    Rodríguez, Dayron; Sacco, Dianne E

    2015-07-01

    Minimally invasive interventions for stone disease in the United States are mainly founded on 3 surgical procedures: extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, and percutaneous nephrolithotomy. With the advancement of technology, treatment has shifted toward less invasive strategies and away from open or laparoscopic surgery. The treatment chosen for a patient with stones is based on the stone and patient characteristics. Each of the minimally invasive techniques uses an imaging source, either fluoroscopy or ultrasound, to localize the stone and an energy source to fragment the stone. Extracorporeal shock wave lithotripsy uses a shock wave energy source generated outside the body to fragment the stone. In contrast, with ureteroscopy, laser energy is placed directly on the stone using a ureteroscope that visualizes the stone. Percutaneous nephrolithotomy requires dilation of a tract through the back into the renal pelvis so that instruments can be inserted directly onto the stone to fragment or pulverize it. The success of the surgical intervention relies on performing the least invasive technique with the highest success of stone removal. PMID:26088070

  4. Non-invasive Differentiation of Kidney Stone Types using X-ray Dark-Field Radiography

    PubMed Central

    Scherer, Kai; Braig, Eva; Willer, Konstantin; Willner, Marian; Fingerle, Alexander A.; Chabior, Michael; Herzen, Julia; Eiber, Matthias; Haller, Bernhard; Straub, Michael; Schneider, Heike; Rummeny, Ernst J.; Noël, Peter B.; Pfeiffer, Franz

    2015-01-01

    Treatment of renal calculi is highly dependent on the chemical composition of the stone in question, which is difficult to determine using standard imaging techniques. The objective of this study is to evaluate the potential of scatter-sensitive X-ray dark-field radiography to differentiate between the most common types of kidney stones in clinical practice. Here, we examine the absorption-to-scattering ratio of 118 extracted kidney stones with a laboratory Talbot-Lau Interferometer. Depending on their chemical composition, microscopic growth structure and morphology the various types of kidney stones show strongly varying, partially opposite contrasts in absorption and dark-field imaging. By assessing the microscopic calculi morphology with high resolution micro-computed tomography measurements, we illustrate the dependence of dark-field signal strength on the respective stone type. Finally, we utilize X-ray dark-field radiography as a non-invasive, highly sensitive (100%) and specific (97%) tool for the differentiation of calcium oxalate, uric acid and mixed types of stones, while additionally improving the detectability of radio-lucent calculi. We prove clinical feasibility of the here proposed method by accurately classifying renal stones, embedded within a fresh pig kidney, using dose-compatible measurements and a quick and simple visual inspection. PMID:25873414

  5. Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy

    NASA Astrophysics Data System (ADS)

    Cleveland, Robin O.; Sapozhnikov, Oleg A.

    2005-10-01

    A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones.

  6. Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy.

    PubMed

    Cleveland, Robin O; Sapozhnikov, Oleg A

    2005-10-01

    A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones. PMID:16266186

  7. Spontaneous retrograde migration of ureterovesical junction stone to the kidney; first ever reported case in the English literature in human

    PubMed Central

    Khan, Ziauddin; Yaqoob, Alaeddin A.; Bhatty, Tanweer A.

    2016-01-01

    We present a case of spontaneous retrograde migration of ureterovesical junction stone to the kidney. A 26-year-old Bahraini male, diagnosed with left lower ureteric stone 7 months before this presentation. On his recent presentation, the stone has migrated down but not passed, confirmed on imaging. Operative removal was planned. X-ray kidney ureter bladder (KUB) in the morning of surgery did not reveal stone in the ureter, but the same shadow was seen in the kidney. An urgent computerized tomography-KUB was done, and this confirms the stone has migrated to the kidney. Surgery was canceled, and the stone was dealt with extracorporeal shockwave lithotripsy and was fragmented in the first session. This retrograde migration of lower ureteric stone to the kidney is not reported in the English literature in human before. PMID:27141199

  8. Outcomes of ureteroscopy for patients with stones in a solitary kidney: evidence from a systematic review

    PubMed Central

    Rai, Bhavan Prasad; Somani, Bhaskar K.

    2016-01-01

    Introduction Management of urolithiasis in a solitary functioning kidney can be clinically challenging. The aim of this article was to review the outcomes of URS for patients with stone disease in a solitary kidney and critically appraise the existing evidence and outcome reporting standards. Material and methods We conducted a systematic review in line with PRISMA checklist and Cochrane guidelines between January 1980 and February 2015. Our inclusion criteria were all English language articles reporting on a minimum of 10 patients with a solitary kidney undergoing ureteroscopy for stone disease. Results A total of 116 patients (mean age 50 years) underwent URS for stones in solitary kidney. For a mean stone size of 16.8 mm (range: 5–60 mm) and 1.23 procedures/patient, the mean stone free rate was 87%. No significant change in renal function was recorded in any of the studies although a transient elevation in creatinine was reported in 10 (8.6%) patients. A total of 33 (28%) complications were recorded a majority (n = 21) of which were Clavien grade I. The Clavien grade II/III complications as reported by authors were urosepsis, steinstrasse and renal colic. None of the procedures required conversion to open surgery with no cases of renal haematoma or ureteric perforation. Conclusions This contemporary review highlights URS as a viable treatment option for stone disease in patients with a solitary kidney. It is associated with superior clearance rates to SWL and fewer high-risk complications compared to PCNL. PMID:27123332

  9. Progression of crack formation in artificial kidney stones subject to shock waves

    NASA Astrophysics Data System (ADS)

    Van Cauwelaert, Javier; Cleveland, Robin

    2002-11-01

    We used micro computed tomography (CT) imaging to follow the progressive development of cracks in artificial kidney stones. The artificial stones were made from U30 cement with a cylindrical shape (6.5 mm diameter and 7.5 mm long). The stones were held within a polypropylene vial in one of three different orientations: vertical, horizontal, and angled at 45 deg. The stones were treated with an electromagnetic lithotripter using between 50 and 150 shock waves. The initiation and growth of cracks was observed using microCT. We found that crack formation in the U30 stones was influenced by the orientation of the stone with respect to the shock wave (SW) propagation direction. Vertical stones developed a spall-like crack near the distal surface; horizontal stones had little internal damage for the number of shock waves applied; and angled stones were damaged primarily in the vicinity of the leading corner. The position of the cracks were in qualitative agreement with the numerical solutions of the pressure field inside the stones. The elastic properties of the U30 stones are being measured which will alow a quantitative analysis of crack growth to be performed and compared to the experimental data. [Work supported by the Whitaker Foundation.

  10. Cavitation Bubble Cluster Activity in the Breakage of Kidney Stones by Lithotripter Shock Waves

    PubMed Central

    Pishchalnikov, Yuriy A.; Sapozhnikov, Oleg A.; Bailey, Michael R.; Williams, James C.; Cleveland, Robin O.; Colonius, Tim; Crum, Lawrence A.; Evan, Andrew P.; McAteer, James A.

    2008-01-01

    High-speed photography was used to analyze cavitation bubble activity at the surface of artificial and natural kidney stones during exposure to lithotripter shock waves in vitro. Numerous individual bubbles formed at the surface of stones, but these bubbles did not remain independent and combined with one another to form bubble clusters. Bubble clusters formed at the proximal end, the distal end, and at the sides of stones. Each cluster collapsed to a narrow point of impact. Collapse of the proximal cluster caused erosion at the leading face of the stone and the collapse of clusters at the sides of stones appeared to contribute to the growth of cracks. Collapse of the distal cluster caused minimal damage. We conclude that cavitation-mediated damage to stones was due not to the action of solitary bubbles, but to the growth and collapse of bubble clusters. PMID:14565872

  11. Treatment of Kidney Stone in a Kidney-Transplanted Patient with Mini-Percutaneous Laser Lithotripsy: A Case Report

    PubMed Central

    Markić, Dean; Krpina, Kristian; Ahel, Juraj; Gršković, Antun; Španjol, Josip; Rubinić, Nino; Materljan, Mauro; Mikolašević, Ivana; Orlić, Lidija; Rački, Sanjin

    2016-01-01

    We report a case of a kidney-transplanted patient with urolithiasis treated with mini-percutaneous laser lithotripsy. The patient presented with renal dysfunction and graft hydronephrosis. Diagnostic procedures revealed ureterolithiasis as a cause of obstruction, and percutaneous nephrostomy was inserted as a temporary solution. Before surgery, the stone migrated to the renal pelvis. Mini-percutaneous laser lithotripsy was successfully performed, and during surgery, all stone fragments were removed. Six months after successful treatment, the patient has good functioning and stone-free graft. PMID:27066492

  12. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound

    PubMed Central

    Dunmire, Barbrina; Harper, Jonathan D.; Cunitz, Bryan W.; Lee, Franklin C.; Hsi, Ryan; Liu, Ziyue; Bailey, Michael R.; Sorensen, Mathew D.

    2016-01-01

    Purpose Ultrasound is known to overestimate kidney stone size. We explored measuring the acoustic shadow behind kidney stones combined with different ultrasound imaging modalities to improve stone sizing accuracy. Materials and Methods A total of 45 calcium oxalate monohydrate stones were imaged in vitro at 3 different depths with the 3 different ultrasound imaging modalities of conventional ray line, spatial compound and harmonic imaging. The width of the stone and the width of the acoustic shadow were measured by 4 operators blinded to the true size of the stone. Results Average error between the measured and true stone width was 1.4 ± 0.8 mm, 1.7 ± 0.9 mm, 0.9 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Average error between the shadow width and true stone width was 0.2 ± 0.7 mm, 0.4 ± 0.7 mm and 0.0 ± 0.8 mm for ray line, spatial compound and harmonic imaging, respectively. Sizing error based on the stone width worsened with greater depth (p <0.001) while the sizing error based on the shadow width was independent of depth. Conclusions Shadow width was a more accurate measure of true stone size than a direct measurement of the stone in the ultrasound image (p <0.0001). The ultrasound imaging modality also impacted the measurement accuracy. All methods performed similarly for shadow size while harmonic imaging was the most accurate stone size modality. Overall 78% of the shadow sizes were accurate to within 1 mm, which is similar to the resolution obtained with clinical computerized tomography. PMID:26301788

  13. Chronic trimethyltin chloride exposure and the development of kidney stones in rats.

    PubMed

    Ren, Xuefeng; Wu, Xin; Sui, Gang; Gong, Zhihong; Yawson, Emmanuel; Wu, Banghua; Lai, Guanchao; Ruan, Xiaolin; Gao, Hongbin; Zhou, Feng; Su, Bing; Olson, James R; Tang, Xiaojiang

    2015-05-01

    We recently reported that occupational exposure to trimethyltin (TMT) is a risk factor for developing kidney stones. To further examine the association between TMT exposure and the formation of kidney stones, we conducted a 180-day animal study and exposed the randomly grouped Sprague-Dawley (SD) rats to TMT in the drinking water at doses of 0, 8.2, 32.8 and 131.3 µg kg(-1) day(-1). Transient behavioral changes were observed in the high-dose group during the first 2 weeks of exposure. TMT exposure led to a significant dose-dependent inhibition of renal H(+)/K(+)-ATPase and an increase in urinary pH. In comparison to no kidney stones being identified in the control and the lowest dose group, 1 rat in the 32.8 µg kg(-1) day(-1) dose group and 3 out of 9 rats in the 131.3 µg kg(-1) day(-1) dose group were found to have stones in the kidney/urinary tract. Pathological analysis showed that more wide spread calcium disposition was observed in kidneys of rats with TMT exposure compared with the rats in the control group. However, X-ray diffraction (XRD) analysis found that the kidney stones were mainly composed of struvite with the formula: NH4MgPO4 6H2O, while calcium-containing components were also detected. Together, this study further demonstrates through animal studies that chronic exposure to a relatively low level of TMT induces nephrotoxicity and increases the risk for developing kidney stones. PMID:25224689

  14. [Kidney stone formation during space flight and long-term bed rest].

    PubMed

    Okada, Atsushi; Ichikawa, Jun; Tozawa, Keiichi

    2011-10-01

    Microgravity environment like space flight or a condition requiring long-term bed-rest increase bone resorption and decrease bone formation, inducing the rapid decrease of bone minerals to osteoporosis. Bone mineral loss increases urinary calcium excretion and the risk of urinary stone formation. To clarify the influence of the conditions on renal stone formation, a 90-day bed rest test was performed to analyze the mechanism of microgravity or bed rest-induced stone formation and prevention by bisphosphonate medication and bed-rest exercise. As the results, renal stone formation was observed in control and exercise groups and no stone was seen in the medication group. In the medication group, urinary calcium excretion and relative supersaturation of calcium oxalate were lower than in the control group throughout the bed-rest and recovery period. Bisphosphonate is useful for the prevention of renal stone formation during space flight and long-term bed-rest. PMID:21960236

  15. From crystalluria to kidney stones, some physicochemical aspects of calcium nephrolithiasis

    PubMed Central

    Baumann, Johannes M; Affolter, Beat

    2014-01-01

    Nephrolithiasis seems to be the result of crystal formation, aggregation and retention in the kidney during crystalluria. These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes. Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics, metabolism and morphology. In this review we try to provide some quantitative information on urinary supersaturation with respect to stone minerals, especially Ca oxalate (CaOx), on the formation and aggregation of CaOx crystals and on crystal retention in the kidney. The paper is centered on idiopathic Ca nephrolithiasis being the most frequent stone disease with only partially known pathogenesis. New aspects of the role of urinary macromolecules in stone formation and of the mechanism of crystal aggregation are provided. PMID:25374820

  16. Treatment of Symptomatic Lower Pole Stones of a Kidney with Partial Nephrectomy Using Micropercutaneous Nephrolithotomy Technique

    PubMed Central

    Karatag, Tuna; Buldu, Ibrahim; Kaynar, Mehmet; Taskapu, Hakan; Tekinarslan, Erdem; Istanbulluoglu, Mustafa Okan

    2015-01-01

    We present the treatment of lower pole stones of a 62-year-old male patient with a history of open partial nephrectomy due to renal angiomyolipoma and renal stones. He was successfully treated with micropercutaneous nephrolithotomy technique under spinal anesthesia in spite of fibrotic and scar tissue due to previous open surgery. The patient was stone-free and was discharged after a 24-hour hospitalization period. There is not any published report of micropercutaneous nephrolithotomy in a partial nephrectomized kidney before. In this report, we suggest that microperc technique may be considered for challenging conditions in case of failed retrograde intrarenal surgery. PMID:25918666

  17. Impact of Nutritional Factors on Incident Kidney Stone Formation: A Report From the WHI OS

    PubMed Central

    Sorensen, Mathew D.; Kahn, Arnold J.; Reiner, Alex P.; Tseng, Timothy Y.; Shikany, James M.; Wallace, Robert B.; Chi, Thomas; Wactawski-Wende, Jean; Jackson, Rebecca D.; O’Sullivan, Mary Jo; Sadetsky, Natalia; Stoller, Marshall L.

    2014-01-01

    Purpose Increased fluid intake, and decreased dietary sodium and animal protein intake are thought to reduce the risk of kidney stones but the role of calcium intake is controversial. We evaluated the relationship between dietary factors and incident kidney stone formation. Materials and Methods Secondary analysis was done of 78,293 women from the prospective WHI OS (Women’s Health Initiative Observational Study) with no history of nephrolithiasis who completed the validated food frequency questionnaire. Multivariate logistic regression was used to determine demographic and dietary factors, and supplement use independently associated with incident kidney stones. Results Overall 1,952 women (2.5%) reported an incident kidney stone in 573,575 person-years of followup. The risk of incident kidney stones was decreased by 5% to 28% (p = 0.01) with higher dietary calcium intake and by 13% to 31% (p = 0.002) with higher water intake after adjusting for nephrolithiasis risk factors. Conversely higher dietary sodium intake increased the risk of nephrolithiasis by 11% to 61% (p <0.001) after adjustment with the most pronounced effect in women with the highest intake. Higher body mass index independently increased the risk of incident nephrolithiasis (adjusted OR 1.19–2.01, p <0.001). Animal protein intake was not associated with nephrolithiasis on multivariate analysis. Conclusions This study adds to the growing evidence underscoring the importance of maintaining adequate fluid and dietary calcium intake. Greater dietary calcium intake significantly decreased the risk of incident kidney stones. In contrast, excess sodium intake increased the risk of incident nephrolithiasis, especially in women with the highest intake. Animal protein intake was not independently associated with nephrolithiasis. PMID:22425103

  18. Hypothesis: Urbanization and exposure to urban heat islands contribute to increasing prevalence of kidney stones.

    PubMed

    Goldfarb, David S; Hirsch, Jacqueline

    2015-12-01

    The prevalence of kidney stones is increasing worldwide. Various etiologies may in part explain this observation including increased prevalence of diabetes, obesity and the metabolic syndrome, increased dietary protein and salt content, and decreased dietary dairy products. We hypothesize an additional and novel potential contributor to increasing kidney stone prevalence: migration to urban settings, or urbanization, and resultant exposure of the population to the higher temperatures of urban heat islands (UHIs). Both urbanization and exposure to UHIs are worldwide, continuous trends. Because the difference in temperature between rural and urban settings is greater than the increase in temperature caused by global warming, the potential effect of urbanization on stone prevalence may be of greater magnitude. However, demonstration of a convincing link between urbanization and kidney stones is confounded by many variables simultaneously affected by migration to cities, such as changes in occupation, income, and diet. No data have yet been published supporting this proposed association. We explore the plausibility and limitations of this possible etiology of increasing kidney stone prevalence. PMID:26372336

  19. Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors

    PubMed Central

    Romero, Victoriano; Akpinar, Haluk; Assimos, Dean G

    2010-01-01

    The prevalence and incidence of nephrolithiasis is reported to be increasing across the world. Herein, we review information regarding stone incidence and prevalence from a global perspective. A literature search using PubMed and Ovid was performed to identify peer-reviewed journal articles containing information on the incidence and prevalence of kidney stones. Key words used included kidney stone prevalence, incidence, and epidemiology. Data were collected from the identified literature and sorted by demographic factors and time period. A total of 75 articles were identified containing kidney stone-related incidence or prevalence data from 20 countries; 34 provided suitable information for review. Data regarding overall prevalence or incidence for more than a single time period were found for 7 countries (incidence data for 4 countries; prevalence data for 5 countries). These included 5 European countries (Italy, Germany, Scotland, Spain, and Sweden), Japan, and the United States. The body of evidence suggests that the incidence and prevalence of kidney stones is increasing globally. These increases are seen across sex, race, and age. Changes in dietary practices may be a key driving force. In addition, global warming may influence these trends. PMID:20811557

  20. Correlates of kidney stone disease differ by race in a multi-ethnic middle aged population: The ARIC Study

    PubMed Central

    Akoudad, Saloua; Szklo, Moyses; McAdams, Mara A.; Fulop, Tibor; Anderson, Cheryl A.M.; Coresh, Josef; Köttgen, Anna

    2010-01-01

    Objective To identify correlates of kidney stone disease in white and African American men and women in a population-based longitudinal study starting in four US communities, and to assess differences in correlates across racial groups. Methods 12,161 middle-aged participants of the ARIC Study provided information on history of kidney stone disease between 1993–1995. Information on incident kidney stone-related hospitalizations was obtained from ICD-codes on hospital discharge records. Results Kidney stone disease was reported by 12.0% of men and 4.8% of women. After multivariable adjustment, prevalent kidney stone disease was significantly (p<0.05) associated with male gender (PR=2.50), increased serum triglycerides (PR=1.07 per SD increase), diabetes (PR=1.27), gallstone disease (PR=1.54), white race (PR= 1.67), and region of residence. Male gender (HR=1.70), diabetes (HR=1.98) and hypertension (HR=1.69) were significantly associated (p<0.05) with incident kidney stone-related hospitalizations (n=94). Race-stratified analyses showed stronger associations of prevalent kidney stone disease with increased triglycerides, older age, and gallstone disease in African Americans compared to whites, whereas male gender showed stronger association in whites (all p-interaction<0.05). Conclusion We identified novel correlates of kidney stone disease (triglycerides, gallstone disease) and risk factor interactions by race (age, male gender, triglycerides, gallstone disease). PMID:20801154

  1. A review of Thulium fiber laser ablation of kidney stones

    NASA Astrophysics Data System (ADS)

    Fried, Nathaniel M.; Blackmon, Richard L.; Irby, Pierce B.

    2011-02-01

    The clinical solid-state Holmium:YAG laser lithotripter (λ=2120 nm) is capable of operating at high pulse energies, but its efficient operation is limited to low pulse rates during lithotripsy. The diode-pumped experimental Thulium Fiber Laser (λ=1908 nm) is limited to low pulse energies, but can operate at high pulse rates. This review compares stone ablation threshold, ablation rate, and retropulsion effects for Ho:YAG and TFL. Laser lithotripsy complications also include optical fiber bending failure resulting in endoscope damage and low irrigation rates leading to poor visibility. Both problems are related to fiber diameter and limited by Ho:YAG laser multimode spatial beam profile. This study exploits TFL spatial beam profile for higher power transmission through smaller fibers. A short taper is also studied for expanding TFL beam at the distal tip of a small-core fiber. Stone mass loss, stone crater depths, fiber transmission losses, fiber burn-back, irrigation rates, and deflection through a flexible ureteroscope were measured for tapered fiber and compared with conventional fibers. The stone ablation threshold for TFL was four times lower than for Ho:YAG. Stone retropulsion with Ho:YAG increased linearly with pulse energy. Retropulsion with TFL was minimal at pulse rates < 150 Hz, then rapidly increased at higher pulse rates. TFL beam profile provides higher laser power through smaller fibers than Ho:YAG laser, potentially reducing fiber failure and endoscope damage and allowing greater irrigation rates for improved visibility and safety. Use of a short tapered distal fiber tip also allows expansion of the laser beam, resulting in decreased fiber tip damage compared to conventional fibers, without compromising fiber bending, stone ablation efficiency, or irrigation rates.

  2. Carbohydrate intolerance and kidney stones in children in the Goldfields.

    PubMed

    Baldwin, D N; Spencer, J L; Jeffries-Stokes, C A

    2003-07-01

    Renal stones have been reported as a common finding in Australian Aboriginal children. The stones are predominantly urate in composition. We report on five children with nephrolithiasis from the Goldfields region of Western Australia. All were diagnosed when under 5 years of age, the majority being under 3 years. All five children also had lactose intolerance, and we postulate that carbohydrate malabsorption, together with the ensuing chronic diarrhoea and intraluminal breakdown of sugars by enteric bacteria may result in a situation of chronic metabolic acidosis. Chronic metabolic acidosis can lead to protein catabolism, increased urate excretion and the formation of renal stones. Carbohydrate intolerance may be an aetiological factor in the development of renal stones and possibly chronic renal disease, particularly in Aboriginal Australians. Renal disease represents one of the most significant factors affecting the health of Australian Aboriginal people. The incidence of end stage renal failure in this population exceeds that of non-Aboriginals by a factor of 13:1, and this disproportionate figure is increasing. It is likely that chronic renal damage is multifactorial; however, it is probable that at least some aetiological factors have their onset during childhood. PMID:12887672

  3. High precision mapping of kidney stones using μ-IR spectroscopy to determine urinary lithogenesis.

    PubMed

    Blanco, Francisco; Ortiz-Alías, Pilar; López-Mesas, Montserrat; Valiente, Manuel

    2015-06-01

    Evolution of urinary lithiasis is determined by the metabolism and life-style of the related patient. The appropriate classification of the stone is mandatory for the identification of the lithogenic process. In this study, cros-sections from a single stone of each of the most frequent urolithiasis types (calcium oxalate mono and dihydrate and carbonate apatite) have been selected and imaged using IR microspectroscopy. Moreover, the use of high definition sFTIR (synchrotron source) has revealed hidden information to the conventional FTIR. This work has demonstrated that minor components become key factors on the description of the stages of stone formation. Intensity map for COM (1630 cm(-1) peak). The high spatial definition achieved is key for the precise description of the kidney stone history. PMID:25091212

  4. Association Between Kidney Stones and Risk of Stroke

    PubMed Central

    Lin, Shih-Yi; Lin, Cheng-Li; Chang, Yen-Jung; Hsu, Wu-Huei; Lin, Cheng-Chieh; Wang, I-Kuan; Chang, Chiz-Tzung; Chang, Chao-Hsiang; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract Nephrolithiasis is highly prevalent and has been associated with vascular diseases such as cardiovascular events. Few studies have comprehensively associated renal stones with stroke. This study explored whether patients with renal stones were at a higher stroke risk than those without renal stones. A national insurance claim dataset of 22 million enrollees in Taiwan was used to identify 53,659 patients with renal stones, and 214,107 were selected as age-, sex-, and comorbidity-matched controls for a 13-year follow-up. The relative stroke risk for the RS cohort was 1.06-fold higher than that for the non-RS group (95% confidence interval [CI] = 1.01–1.11). Age-specific analysis revealed that the adjusted stroke risk for the RS cohort increased as age decreased, with the highest risk of 1.47-fold (95% CI = 1.10–1.96) in patients aged 20 to 34 years, followed by a 1.12-fold risk (95% CI = 1.00–1.25) in patients aged 35 to 50 years. Sex-specific analysis clarified that women in the RS group had a 1.12-fold stroke risk compared with women in the non-RS group (95% CI = 1.03–1.21). Patients who had undergone >4 surgeries had up to 42.5-fold higher risk of stroke (95% CI = 33.8–53.4). The study utilized the national database and demonstrated that patients, particularly women and the younger population, with nephrolithiasis have an increased risk of ischemic stroke development. Patients treated with medication or through surgery for RSs showed steady and higher risks of stroke than those without surgical or medical intervention. PMID:26937915

  5. Prevention of nephrolithiasis by Lactobacillus in stone-forming rats: a preliminary study.

    PubMed

    Kwak, Cheol; Jeong, Byong Chang; Ku, Ja Hyeon; Kim, Hyeon Hoe; Lee, Jeong Jun; Huh, Chul Sung; Baek, Young Jin; Lee, Sang Eun

    2006-08-01

    Hyperoxaluria is a risk factor for renal stones. It appears to be sustained by increased dietary load or increased intestinal absorption. The aim of this study was to evaluate whether oral administration of lactobacilli could prevent urolithiasis in stone-forming rats. Oxalate-degrading activities of lactobacilli were evaluated by measuring the oxalate level in a culture medium after inoculation with lactobacilli. Only the strains of Lactobacillus having oxalate-degrading activity were used. Sprague-Dawley rats were fed a powdered standard diet containing 3% sodium oxalate and/or received 100 mg/kg of celecoxib for the first 8 days by gavage, before or after the beginning of this experiment (groups with previous treatment or with co-treatment). Rats were sacrificed after 4 weeks and kidneys were harvested for the assay of crystal formation under a dissecting microscope. Twenty-four-hour urine collections were performed before kidney harvest. Only two strains, Lactobacillus casei HY2743 and L. casei HY7201 out of 31 strains of Lactobacillus were able to degrade oxalate. In both groups of co-treatment and previous treatment with L. casei HY2743 and L. casei HY7201, urine oxalate excretion decreased compared to the group without lactobacilli. The dissecting microscope examination of kidneys in the rats in two previous treatment groups and the co-treatment group with L. casei HY7201 showed less abundant crystals than control groups. Our results show that lactobacilli may be used as a potential therapeutic strategy in the prevention of urinary stones. PMID:16633809

  6. Percutaneous nephrolithotomy for complex caliceal and staghorn stones in patients with solitary kidney.

    PubMed

    Resorlu, Berkan; Kara, Cengiz; Oguz, Ural; Bayindir, Mirze; Unsal, Ali

    2011-06-01

    Treatment of patients with solitary kidney having complex stones is one of the most challenging problem in urology. We present our experience with percutaneous nephrolithotomy (PCNL) in treating 16 patients with staghorn stones in a solitary kidney to determine long-term renal functional results. We retrospectively reviewed the records of 16 patients with complex caliceal or staghorn stones in a solitary kidney treated with PCNL. Demographic data, number and location of accesses, hemoglobin values, stone analyses, and complications were studied. Serum creatinine, glomerular filtration rate (GFR), systolic and diastolic blood pressure, new onset hypertension, and kidney morphology were determined preoperatively and postoperatively at 1 month and 1 year. Male to female ratio was 14:2 and mean age was 49.6 years (range 31-55). Of these, 10 (62.5%) patients required a single tract, while 6 (37.5%) required multiple tracts. The calculi were extracted or fragmented successfully in 13 (81.3%) patients and complete stone clearance was achieved after the first stage. In two patients with residual calculi, a double-J catheter was inserted and extracorporeal shock wave lithotripsy (SWL) was performed. There were no significant intraoperative problems except in one patient, who had bleeding from an infundibular tear attributable to torquing. During the 1-year study period, none of the patients progressed to end-stage renal disease requiring dialysis. We demonstrated a significant improvement in creatinine and GFR levels from preoperatively to 1-year follow-up. The number of patients with hypertension before PCNL was 5 and by the end of follow-up there was no new onset hypertension. The demonstrated effectiveness, small number of complications at short-term, not any poorly effect on renal function and blood pressure at the long-term follow-up confirm that PCNL is not only effective but is also safe in the solitary kidney with staghorn calculi. PMID:20967435

  7. Kidney stone imaging with 3D ultra-short echo time (UTE) magnetic resonance imaging. A phantom study.

    PubMed

    Ibrahim, El-Sayed H; Pooley, Robert A; Bridges, Mellena D; Cernigliaro, Joseph G; Haley, William E

    2014-01-01

    Computed tomography (CT) is the current gold standard for imaging kidney stones, albeit at the cost of radiation exposure. Conventional magnetic resonance imaging (MRI) sequences are insensitive to detecting the stones because of their appearance as a signal void. With the development of 2D ultra-short echo-time (UTE) MRI sequences, it becomes possible to image kidney stones in vitro. In this work, we optimize and implement a modified 3D UTE MRI sequence for imaging kidney stones embedded in agarose phantoms mimicking the kidney tissue and in urine phantoms at 3.0T. The proposed technique is capable of imaging the stones with high spatial resolution in a short scan time. PMID:25570462

  8. Biochemical changes in kidneys of normal and stone forming rats with sodium pentosan polysulphate.

    PubMed

    Subha, K; Baskar, R; Varalakshmi, P

    1992-02-01

    The influence of sodium pentosan polysulphate was studied on the deposition of stone forming constituents along with certain enzymes in the renal tissue of experimentally induced urolithiatic rats. Calcium, oxalate and phosphorus levels were elevated in kidneys of lithogenic rats, while SPP administration reduced these levels to near control values. The elevation in kidney LDH was significant in the stone forming groups and SPP had minimal effect. Increases in the activities of Na+, K(+)-and Ca(2+)-ATPases in the calculogenic groups was lowered considerably with SPP treatment. Inorganic pyrophosphatase activity was reduced significantly in the calculogenic as well as in the drug treated groups. Leucine aminopeptidase was decreased in the calculogenic group. SPP treatment elevated the enzyme activity in the treated groups. Reduction in kidney oxalate with SPP may prove useful in the medical management of urolithiasis. PMID:1373054

  9. Hyperspectral imaging based method for fast characterization of kidney stone types

    NASA Astrophysics Data System (ADS)

    Blanco, Francisco; López-Mesas, Montserrat; Serranti, Silvia; Bonifazi, Giuseppe; Havel, Josef; Valiente, Manuel

    2012-07-01

    The formation of kidney stones is a common and highly studied disease, which causes intense pain and presents a high recidivism. In order to find the causes of this problem, the characterization of the main compounds is of great importance. In this sense, the analysis of the composition and structure of the stone can give key information about the urine parameters during the crystal growth. But the usual methods employed are slow, analyst dependent and the information obtained is poor. In the present work, the near infrared (NIR)-hyperspectral imaging technique was used for the analysis of 215 samples of kidney stones, including the main types usually found and their mixtures. The NIR reflectance spectra of the analyzed stones showed significant differences that were used for their classification. To do so, a method was created by the use of artificial neural networks, which showed a probability higher than 90% for right classification of the stones. The promising results, robust methodology, and the fast analytical process, without the need of an expert assistance, lead to an easy implementation at the clinical laboratories, offering the urologist a rapid diagnosis that shall contribute to minimize urolithiasis recidivism.

  10. Quantification of the Range of Motion of Kidney and Ureteral Stones During Shockwave Lithotripsy in Conscious Patients.

    PubMed

    Harrogate, Suzanne R; Yick, L M Shirley; Williams, James C; Cleveland, Robin O; Turney, Benjamin W

    2016-04-01

    Effective shockwave lithotripsy requires accurate targeting of the stone throughout the course of treatment. Stone movement secondary to respiratory movement can make this more difficult. In vitro work has shown that stone motion outside the focal region reduces the efficacy of stone fragmentation; however, there are few clinical data on the degree of stone movement in patients during treatment. To investigate this, X-ray fluoroscopic images of the kidney and ureteral stones at the upper and lower limits of the normal respiratory cycle were acquired during shock wave lithotripsy of 58 conscious patients, and stone excursion was calculated from these images. In addition, the respiration rate and patient perceived pain were recorded during the course of the treatment. It was found that stone motion secondary to respiration was 7.7 ± 2.9 mm for kidney stones and 3.6 ± 2.1 mm for ureteral stones-less than has been reported in studies with anesthetized patients. There was no significant change of motion over the course of treatment although pain was found to increase. These data suggest that stone motion in conscious patients is less than in anesthetized patients. Furthermore, it suggests that lithotripters with focal regions of 8 mm or greater should not suffer from a marked drop in fragmentation efficiency due to stone motion. PMID:26756226

  11. Detection of carcinogenic metals in kidney stones using ultraviolet laser-induced breakdown spectroscopy.

    PubMed

    Khalil, Ahmed Asaad I; Gondal, Mohammed A; Shemis, Mohamed; Khan, Irfan S

    2015-03-10

    The UV single-pulsed (SP) laser-induced breakdown spectroscopy (LIBS) system was developed to detect the carcinogenic metals in human kidney stones extracted through the surgical operation. A neodymium yttrium aluminium garnet laser operating at 266 nm wavelength and 20 Hz repetition rate along with a spectrometer interfaced with an intensified CCD (ICCD) was applied for spectral analysis of kidney stones. The ICCD camera shutter was synchronized with the laser-trigger pulse and the effect of laser energy and delay time on LIBS signal intensity was investigated. The experimental parameters were optimized to obtain the LIBS plasma in local thermodynamic equilibrium. Laser energy was varied from 25 to 50 mJ in order to enhance the LIBS signal intensity and attain the best signal to noise ratio. The parametric dependence studies were important to improve the limit of detection of trace amounts of toxic elements present inside stones. The carcinogenic metals detected in kidney stones were chromium, cadmium, lead, zinc, phosphate, and vanadium. The results achieved from LIBS system were also compared with the inductively coupled plasma-mass spectrometry analysis and the concentration detected with both techniques was in very good agreement. The plasma parameters (electron temperature and density) for SP-LIBS system were also studied and their dependence on incident laser energy and delay time was investigated as well. PMID:25968393

  12. Features of gallstone and kidney stone fragmentation by IR-pulsed Nd:YAG laser radiation

    NASA Astrophysics Data System (ADS)

    Batishche, Sergei A.

    1995-05-01

    It is shown that infra-red ((lambda) equals 1064 nm) long pulse (approximately 100 microsecond(s) ) radiation of YAG:Nd laser, operating in free generation regime, effectively fragments gallstones, urinary calculus and kidney stones. The features of the mechanism of this process are investigated. Laser lithotripsy is nowadays a method widely used for fragmentation of gallstones, urinary calculus and kidney stones. Flashlamp pumped dye lasers of microsecond duration are most often used for such purposes. Nevertheless, there are some reports on lithotripsies with nanosecond duration laser pulses (for example, Q-switched YAG:Nd laser). The mechanism of the laser fragmentation of such stones was supposed to be the next. The laser powerful radiation, delivered through the optical fiber, is absorbed by the material of the stone. As a result of such highly localized energy absorption, dense plasma is formed, which expands. Such plasma and vapor, liquid confined, forms a cavitation bubble. This bubble grows, reaches its most dimension and then collapses on itself in some hundreds of micro seconds. Shock waves generated during the growth and the collapse of these bubbles are the origin of fragmentation of the stone. It is necessary to say that there are rather confined data on the hundreds microsecond laser pulse fragmentation especially what concerns the usage of infra-red (IR) YAG:Nd lasers with long laser pulses. Clearing this problem would result in better understanding of the fragmentation mechanism and it could favor development of simple and more reliable laser systems for lithotripsy. In this work we report about investigation of features of an effective fragmentation of gallstones, urinary calculus and kidney stones under exposure of IR ((lambda) equals 1064 nm) radiation of repetitive YAG:Nd laser working in free generation regime.

  13. Rapid vaporization of kidney stones, ex vivo, using a Thulium fiber laser at pulse rates up to 500 Hz with a stone basket

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-03-01

    The Holmium:YAG laser (λ = 2120 nm) is currently the preferred laser for fragmenting kidney stones in the clinic. However, this laser has some limitations, including operation at low pulse rates and a multimode spatial beam profile which prohibits its use with smaller, more flexible optical fibers. Our laboratory is studying the Thulium fiber laser (λ = 1908 nm) as an alternative lithotripter. The TFL has several advantages, including lower stone ablation thresholds, use with smaller and more flexible fibers, and operation at arbitrary pulse lengths and pulse rates. Previous studies have reported increased stone ablation rates with TFL operation at higher pulse rates, however, stone retropulsion remains an obstacle to even more efficient stone ablation. This study explores TFL operation at high pulse rates in combination with a stone stabilization device (e.g. stone basket) for improved efficiency. A TFL beam with pulse energy of 35 mJ, pulse duration of 500-μs, and pulse rates of 10-500 Hz was coupled into 100-μm-core, low-OH, silica fibers, in contact mode with uric acid and calcium oxalate monohydrate stones, ex vivo. TFL operation at 500 Hz produced UA and COM stone ablation rates up to 5.0 mg/s and 1.3 mg/s, respectively. High TFL pulse rates produced increased stone ablation rates sufficient for use in the clinic.

  14. Vascular Calcification and Bone Mineral Density in Recurrent Kidney Stone Formers

    PubMed Central

    Girfoglio, Daniela; Vijay, Vivek; Goldsmith, David; Ferraro, Pietro Manuel; Moochhala, Shabbir H.; Unwin, Robert

    2015-01-01

    Background and objectives Recent epidemiologic studies have provided evidence for an association between nephrolithiasis and cardiovascular disease, although the underlying mechanism is still unclear. Vascular calcification (VC) is a strong predictor of cardiovascular morbidity and the hypothesis explored in this study is that VC is more prevalent in calcium kidney stone formers (KSFs). The aims of this study were to determine (1) whether recurrent calcium KSFs have more VC and osteoporosis compared with controls and (2) whether hypercalciuria is related to VC in KSFs. Design, setting, participants, & measurements This is a retrospective, matched case-control study that included KSFs attending an outpatient nephrology clinic of the Royal Free Hospital (London, UK) from 2011 to 2014. Age- and sex-matched non-stone formers were drawn from a list of potential living kidney donors from the same hospital. A total of 111 patients were investigated, of which 57 were KSFs and 54 were healthy controls. Abdominal aortic calcification (AAC) and vertebral bone mineral density (BMD) were assessed using available computed tomography (CT) imaging. The prevalence, severity, and associations of AAC and CT BMD between KSFs and non-stone formers were compared. Results Mean age was 47±14 years in KSFs and 47±13 in non-stone formers. Men represented 56% and 57% of KSFs and non-stone formers, respectively. The prevalence of AAC was similar in both groups (38% in KSFs versus 35% in controls, P=0.69). However, the AAC severity score (median [25th percentile, 75th percentile]) was significantly higher in KSFs compared with the control group (0 [0, 43] versus 0 [0, 10], P<0.001). In addition, the average CT BMD was significantly lower in KSFs (159±53 versus 194 ±48 Hounsfield units, P<0.001). A multivariate model adjusted for age, sex, high BP, diabetes, smoking status, and eGFR confirmed that KSFs have higher AAC scores and lower CT BMD compared with non-stone formers (P<0.001 for both). Among stone formers, the association between AAC score and hypercalciuria was not statistically significant (P=0.86). Conclusions This study demonstrates that patients with calcium kidney stones suffer from significantly higher degrees of aortic calcification than age- and sex-matched non-stone formers, suggesting that VC may be an underlying mechanism explaining reported associations between nephrolithiasis and cardiovascular disease. Moreover, bone demineralization is more prominent in KSFs. However, more data are needed to confirm the possibility of potentially common underlying mechanisms leading to extraosseous calcium deposition and osteoporosis in KSFs. PMID:25635036

  15. Temporal Trends in the Incidence of Kidney Stones among Children: A 25-Year Population-Based Study

    PubMed Central

    Dwyer, Moira E.; Krambeck, Amy E.; Bergstralh, Eric J.; Milliner, Dawn S.; Lieske, John C.; Rule, Andrew D.

    2012-01-01

    PURPOSE We conducted a population-based pediatric study to determine the incidence of symptomatic kidney stones over a 25-year period and to identify factors related to variation in stone incidence during this time period. MATERIALS AND METHODS The Rochester Epidemiology Project was used to identify all children (ages <18 years) diagnosed with kidney stones in Olmsted County, Minnesota from 1984–2008. Medical records were reviewed to validate first time symptomatic stone-formers with identification of age-appropriate symptoms plus stone confirmation by imaging or passage. The incidence of symptomatic stones by age, gender, and time period was compared. Clinical characteristics of incident stone-formers were described. RESULTS There were 207 children who received a diagnostic code for kidney stones, 84 (41%) of whom were validated as incident stone-formers. The incidence rate increased 4% per calendar year (p=0.01) throughout the 25-year period. This was due to a 6% per year rise of incidence in children aged 12–17 years (p=0.02 for age x calendar year interaction) with an increase from 13 per 100,000 person-years in 1984–1990 to 36 per 100,000 person-years in 2003–2008. Computed tomography (CT) identified the stone in 6% (1/18) of adolescent stone-formers from 1984–1996 versus 76% (34/45) from 1997–2008. The incidence of spontaneous stone passage in adolescents did not increase significantly between these two time periods (16 versus 18 per 100,000 person-years, p=0.30) CONCLUSIONS The incidence of kidney stones increased dramatically among adolescents in the general population over a 25-year period. The exact cause of this finding remains to be determined. PMID:22595060

  16. Molecular mechanisms of crystal-related kidney inflammation and injury. Implications for cholesterol embolism, crystalline nephropathies and kidney stone disease.

    PubMed

    Mulay, Shrikant R; Evan, Andrew; Anders, Hans-Joachim

    2014-03-01

    Crystals are particles of endogenous inorganic or organic composition that can trigger kidney injury when deposited or formed inside the kidney. While decades of research have focused on the molecular mechanisms of solute supersaturation and crystal formation, the pathomechanisms of crystal-induced renal inflammation remain largely unknown. The recent discovery of the intracellular NLRP3 inflammasome as a pattern recognition platform that translates crystal uptake into innate immune activation via secretion of IL-1β and IL-18 revised the pathogenesis of gout, silicosis, asbestosis, atherosclerosis and other crystal-related disorders. As a proof of concept, the NLRP3 inflammasome was now shown to trigger inflammation and acute kidney injury (AKI) in oxalate nephropathy. It seems likely that this and potentially other innate immunity mechanisms drive crystalline nephropathies (CNs) that are associated with crystals of calcium phosphate, uric acid, cysteine, adenine, certain drugs or contrast media, and potentially of myoglobin during rhabdomyolysis and of light chains in myeloma. Here, we discuss the proven and potential mechanisms of renal inflammation and kidney injury in crystal-related kidney disorders. In addition, we list topics for further research in that field. This perspective may also provide novel therapeutic options that can help to avoid progressive tissue remodeling and chronic kidney disease in patients with kidney stone disease or other CNs. PMID:24163269

  17. Calcium and Phosphorus Regulatory Hormones and Risk of Incident Symptomatic Kidney Stones

    PubMed Central

    Hoofnagle, Andrew N.; Curhan, Gary C.

    2015-01-01

    Background and objectives Calcium and phosphorus regulatory hormones may contribute to the pathogenesis of calcium nephrolithiasis. However, there has been no prospective study to date of plasma hormone levels and risk of kidney stones. This study aimed to examine independent associations between plasma levels of 1,25-dihydroxyvitamin D (1,25[OH]2D), 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, fibroblast growth factor 23 (FGF23), parathyroid hormone, calcium, phosphate, and creatinine and the subsequent risk of incident kidney stones. Design, setting, participants, & measurements This study was a prospective, nested case-control study of men in the Health Professionals Follow-Up Study who were free of diagnosed nephrolithiasis at blood draw. During 12 years of follow-up, 356 men developed an incident symptomatic kidney stone. Using risk set sampling, controls were selected in a 2:1 ratio (n=712 controls) and matched for age, race, and year, month, and time of day of blood collection. Results Baseline plasma levels of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, parathyroid hormone, calcium, phosphate, and creatinine were similar in cases and controls. Mean 1,25(OH)2D and median FGF23 levels were higher in cases than controls but differences were small and statistically nonsignificant (45.7 versus 44.2 pg/ml, P=0.07 for 1,25[OH]2D; 47.6 versus 45.1 pg/ml, P=0.08 for FGF23). However, after adjusting for body mass index, diet, plasma factors, and other covariates, the odds ratios of incident symptomatic kidney stones in the highest compared with lowest quartiles were 1.73 (95% confidence interval, 1.11 to 2.71; P for trend 0.01) for 1,25(OH)2D and 1.45 (95% confidence interval, 0.96 to 2.19; P for trend 0.03) for FGF23. There were no significant associations between other plasma factors and kidney stone risk. Conclusions Higher plasma 1,25(OH)2D, even in ranges considered normal, is independently associated with higher risk of symptomatic kidney stones. Although of borderline statistical significance, these findings also suggest that higher FGF23 may be associated with risk. PMID:25623233

  18. Ex vivo pyelotomy, nephroscopy and holmium laser lithotripsy of a staghorn stone in a donor kidney prior to renal transplant.

    PubMed

    Janczak, Dariusz; Bolanowska, Barbara; Jankowski, Paweł; Dorobisz, Tadeusz; Dorobisz, Karolina; Chabowski, Mariusz; Janczak, Dawid; Szydelko, Tomasz

    2015-07-01

    This case report presents the diagnostic and treatment procedures of stone removal from the kidney of a 67-year-old donor, the transplantation of the kidney to a 65-year-old recipient, and the postoperative course until the end of hospitalization. Computed tomography performed before collecting the organ showed a staghorn stone in the renal pelvis and lower calyces in the right donor kidney. The stones were removed ex-vivo using a rigid ureteroscope and a holmium laser prior to transplantation. Then the organ was transplanted to the left iliac fossa of a 65-year-old man with end-stage renal failure. The authors think there is a possibility of increasing the kidney pool, by using organs containing large calculi. In such cases stones should be removed before the operation and the patient should be monitored regularly, especially in the first months after the transplant. PMID:26240630

  19. After urgent drainage of an obstructed kidney by internal ureteric stenting; is ureteroscopic stone extraction always needed?

    PubMed Central

    Taha, Diaa-Eldin; Elshal, Ahmed M.; Zahran, Mohamed H.; Harraz, Ahmed M.; El-Nahas, Ahmed R.; Shokeir, Ahmed A.

    2015-01-01

    Objectives To assess the probability of spontaneous stone passage and its predictors after drainage of obstructed kidney by JJ stent, as insertion of an internal ureteric stent is often used for renal drainage in cases of calcular ureteric obstruction. Patients and methods Between January 2011 and June 2013, patients for whom emergent drainage by ureteric stents were identified. The patients’ demographics, presentation, and stone characteristics were reviewed. The primary endpoint for this study was stone-free status at the time of stent removal, where all patients underwent non-contrast spiral computed tomography (NCCT) before stent removal. Ureteroscopic stone extraction was performed for CT detectable ureteric stones at the time of stent removal. Potential factors affecting the need for ureteroscopic stone extraction at the time of stent removal were assessed using univariate and multivariate statistical analyses. Results Emergent ureteric stents were undertaken in 196 patients (112 males, 84 females) with a mean (SD) age of 53.7 (16.2) years, for renal obstruction drainage. At the time of stent removal, 83 patients (42.3%) were stone free; with the remaining 113 patients (57.7%) undergoing ureteroscopic stone extraction. On multivariate analysis, stone width [odds ratio (OR) 15.849, 95% confidence interval (CI) 2.83; P = 0.002) and radio-opaque stones (OR 12.035, 95% CI 4.65; P < 0.001) were independent predictors of the need for ureteroscopic stone extraction at the time of stent removal. Conclusion Spontaneous ureteric stone passage is possible after emergent drainage of an obstructed kidney by ureteric stenting. Stone opacity, larger stone width, and positive preoperative urine culture are associated with a greater probability of requiring ureteroscopic stone extraction after emergent drainage by ureteric stenting. PMID:26609444

  20. Generation of shear waves as an effective mechanism of dynamic load of the lithotripter shock wave on the kidney stone

    NASA Astrophysics Data System (ADS)

    Sapozhnikov, Oleg A.; Cleveland, Robin O.; Bailey, Michael R.; Crum, Lawrence A.

    2003-10-01

    A number of stone comminution mechanisms have been studied in lithotripsy. Except cavitation erosion, these mechanisms (namely, spallation, dynamic fatigue, shear, and circumferential compression) are associated with stresses generated in the stone by the shock wave. The mechanical load on the stone depends on the waveform and stone structure, size, and shape. We modeled the propagation of lithotripter shock waves through a cylindrical stone with a finite differences simulation based on Lame's equation. The stone parameters were similar to those of natural kidney stones. A new mechanism of tensile stress generation is predicted that may be 5-10 times more efficient than spalling. Shear elasticity of the stone gave rise to the peak tensile strain in the bulk of the stone; this strain occurs near the stone axis due to coherent arrival of shear waves from the front edges of the stone. The position of the region of maximum strain and direction of corresponding tensile forces is similar to those predicted by the spalling mechanism. The modeling also showed that circumferential compression is not activated by the dynamic load produced by a short shock wave typical for lithotripsy. [Work supported by NIH PO1 DK43881, RO1 DK55674 and FOGARTY, CDRF, ONRIFO, and NSBRI.

  1. A potential cause for kidney stone formation during space flights: enhanced growth of nanobacteria in microgravity

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Haddad, Ruwaida S.; Golden, D. C.; Morrison, Dennis R.; McKay, David S.

    2005-01-01

    BACKGROUND: Although some information is available regarding the cellular/molecular changes in immune system exposed to microgravity, little is known about the reasons of the increase in the kidney stone formation in astronauts during and/or after long duration missions at zero gravity (0 g). In our earlier studies, we have assessed a unique agent, nanobacteria (NB), in kidney stones and hypothesized that NB have an active role in calcium phosphate-carbonate deposition in kidney. In this research we studied effect of microgravity on multiplication and calcification of NB in vitro. METHODS: We examined NB cultures in High Aspect Rotating Vessels (HARVs) designed at the NASA's Johnson Space Center, which are designed to stimulate some aspects of microgravity. Multiplication rate and calcium phosphate composition of those NB were compared with NB cultured on stationary and shaker flasks. Collected aliquots of the cultures from different incubation periods were analyzed using spectrophotometer, SEM, TEM, EDX, and x-ray diffraction techniques. RESULTS: The results showed that NB multiplied 4.6x faster in HARVs compared to stationary cultures, and 3.2x faster than shaker flask conditions. X-ray diffraction and EDX analysis showed that the degree of apatite crystal formation and the properties of the apatite depend on the specific culture conditions used. CONCLUSION: We now report an increased multiplication rate of NB in microgravity-simulated conditions. Thus, NB infection may have a potential role in kidney stone formation in crew members during space flights. For further proof to this hypothesis, screening of the NB antigen and antibody level in flight crew before and after flight would be necessary.

  2. Metals in Human Gall, Bladder, and Kidney Stones Based on an Electron Microprobe Investigation.

    PubMed

    Moser, Reinhard; Zaccarini, Federica; Moser, Waltraud; Schrittwieser, Rudolf; Kerbl, Reinhold

    2015-10-01

    Several particles of copper accompanied by a few particles of nickel, lead, and a compound composed of selenium containing minor Ni, Si, Cu, and Co were found in human gall, kidney, and bladder stones. The investigated particles occur as tiny grains, <10 µm in size, that are irregularly dispersed in the stones. Therefore, they were studied by scanning electron microscopy and qualitatively analyzed by energy dispersive system. One grain of copper contained a small amount of Ni and Zn, and some grains of nickel proved to contain Cr as trace element. Most of the discovered metals formed a single-phase grain. However, a few grains found in two gallstones were associated with inclusions of calcium and apatite. Based on the results presented in this contribution, we argue that most of the studied metals can be classified as endogenous particles, i.e., directly precipitated from the same fluids that formed their host human stones. This observation suggests that the precipitation and accumulation of metals in some human stones can be considered an efficient way to eliminate them from the human body. PMID:26016509

  3. H+, Water and Urea Transport in the Inner Medullary Collecting Duct and Their Role in the Prevention and Pathogenesis of Renal Stone Disease

    NASA Astrophysics Data System (ADS)

    Wall, Susan M.; Klein, Janet D.

    2008-09-01

    The inner medullary collecting duct (IMCD) is the final site within the kidney for the reabsorption of urea, water and electrolytes and for the secretion of H+ before the luminal fluid becomes the final urine. Transporters expressed in the IMCD contribute to the generation of the large ion gradients that exist between the interstitium and the collecting duct lumen. Thus, the luminal fluid within the human IMCD can reach an osmolality of 1200 mOsm/kg H2O and a pH of 4. This ability of the human nephron to concentrate and acidify the urine might predispose to stone formation. However, under treatment conditions that predispose to stone formation, such as during hypercalciuria, the kidney mitigates stone formation by reducing solute concentration by reducing H2O reabsorption. Moreover, the kidney attenuates stone formation by tightly controlling acid-base balance, which prevents the bone loss, hypocitraturia and hypercalciuria observed during metabolic acidosis by augmenting net H+ excretion by tightly regulating H+ transporter function and through luminal buffering, particularly with NH3. This article will review the ion transporters present in the mammalian IMCD and their role in the prevention and in the pathogenesis of renal stone formation.

  4. Kidney stones and subclinical atherosclerosis in young adults: Coronary Artery Risk Development in Young Adults (CARDIA) study

    PubMed Central

    Reiner, Alexander P.; Kahn, Arnold; Eisner, Brian H.; Pletcher, Mark J.; Sadetsky, Natalia; Williams, O. Dale; Polak, Joseph F.; Jacobs, David R.; Stoller, Marshall L.

    2013-01-01

    Purpose Recent reports suggest that nephrolithiasis and atherosclerosis share a number of risk factors. There has been no previous examination of the relationship between kidney stones and subclinical atherosclerotic disease Here we assessed the relationship between nephrolithiasis and carotid wall thickness and carotid stenosis assessed by B-mode ultrasound in the general community using data from The Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods CARDIA is a U.S. population-based, observational study of 5,115 white and African-American men and women between the ages of 18 and 30 years at recruitment in 1985-1986. Results By the year 20 exam, 200 (3.9%) of CARDIA participants had reported ever having kidney stones. Symptomatic kidney stones were associated with greater carotid wall thickness measured at the year 20 exam, particularly of the internal carotid/bulb region. Using a composite dichotomous endpoint of carotid stenosis and/or upper quartile of internal carotid/bulb wall thickness, the association of kidney stones with carotid atherosclerosis was significant (odds ratio=1.6; 95% confidence interval 1.1-2.3; p=0.01) even after adjusting for major atherosclerotic risk factors. Conclusions The association between a history of kidney stones and subclinical carotid atherosclerosis in young adults adds further support to the notion that nephrolithiasis and atherosclerosis share common systemic risk factors and/or pathophysiology. PMID:21251678

  5. A new compound in kidney stones? Powder X-ray diffraction study of calcium glycinate trihydrate.

    PubMed

    Le Bail, Armel; Daudon, Michel; Bazin, Dominique

    2013-07-01

    The present identification of a new compound in kidney stones is relevant in clinical practice. Here, poly[[di-μ-aqua-bis(glycinato-κ(2)N,O)calcium(II)] monohydrate], {[Ca(C2H4NO2)2(H2O)2]·H2O}n, has been identified in a possible kidney concretion, although it could be a 'false calculus' associated with Munchausen syndrome. The crystal packing is characterized by an infinite zigzag chain of Ca atoms in [Ca(OW)4O2N2] (OW is a water O atom) square antiprisms, sharing edges formed by water molecules. An uncoordinated water molecule interconnects the parallel chains in a three-dimensional hydrogen-bonding scheme. Similarities between the trihydrate and the monohydrate are described. PMID:23832032

  6. Kidney stones

    MedlinePlus

    ... PA: Elsevier Saunders; 2012:chap 46. Fink HA, Wilt TJ, Eidman KE, et al. Medical management to ... ncbi.nlm.nih.gov/pubmed/23546565 . Fink HA, Wilt TJ, Eidman KE, et al. Recurrent nephrolithiasis in ...

  7. Medical management of renal stones.

    PubMed

    Morgan, Monica S C; Pearle, Margaret S

    2016-01-01

    The prevalence of kidney stones is increasing in industrialized nations, resulting in a corresponding rise in economic burden. Nephrolithiasis is now recognized as both a chronic and systemic condition, which further underscores the impact of the disease. Diet and environment play an important role in stone disease, presumably by modulating urine composition. Dietary modification as a preventive treatment to decrease lithogenic risk factors and prevent stone recurrence has gained interest because of its potential to be safer and more economical than drug treatment. However, not all abnormalities are likely to be amenable to dietary therapy, and in some cases drugs are necessary to reduce the risk of stone formation. Unfortunately, no new drugs have been developed for stone prevention since the 1980s when potassium citrate was introduced, perhaps because the long observation period needed to demonstrate efficacy discourages investigators from embarking on clinical trials. Nonetheless, effective established treatment regimens are currently available for stone prevention. PMID:26977089

  8. Cholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stones in Korea

    PubMed Central

    Song, Myung Eun; Lee, Dong-Jun; Oh, Tak Geun; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2016-01-01

    Purpose Cholecystectomy in patients with an intact gallbladder after endoscopic removal of stones from the common bile duct (CBD) remains controversial. We conducted a case-control study to determine the risk of recurrent CBD stones and the benefit of cholecystectomy for prevention of recurrence after endoscopic removal of stones from the CBD in Korean patients. Materials and Methods A total of 317 patients who underwent endoscopic CBD stone extraction between 2006 and 2012 were included. Possible risk factors for the recurrence of CBD stones including previous cholecystectomy history, bile duct diameter, stone size, number of stones, stone composition, and the presence of a periampullary diverticulum were analyzed. Results The mean duration of follow-up after CBD stone extraction was 25.4±22.0 months. A CBD diameter of 15 mm or larger [odds ratio (OR), 1.930; 95% confidence interval (CI), 1.098 to 3.391; p=0.022] and the presence of a periampullary diverticulum (OR, 1.859; 95% CI, 1.014 to 3.408; p=0.045) were independent predictive factors for CBD stone recurrence. Seventeen patients (26.6%) in the recurrence group underwent elective cholecystectomy soon after endoscopic extraction of CBD stones, compared to 88 (34.8%) in the non-recurrence group; the difference was not statistically significant (p=0.212). Conclusion A CBD diameter of 15 mm or larger and the presence of a periampullary diverticulum were found to be potential predictive factors for recurrence after endoscopic extraction of CBD stones. Elective cholecystectomy after clearance of CBD stones did not reduce the incidence of recurrent CBD stones in Korean patients. PMID:26632393

  9. Altered Calcium and Vitamin D Homeostasis in First-Time Calcium Kidney Stone-Formers

    PubMed Central

    Ketha, Hemamalini; Singh, Ravinder J.; Grebe, Stefan K.; Bergstralh, Eric J.; Rule, Andrew D.; Lieske, John C.; Kumar, Rajiv

    2015-01-01

    Background Elevated serum 1,25-dihydroxyvitamin D (1,25(OH)2D) concentrations have been reported among cohorts of recurrent calcium (Ca) kidney stone-formers and implicated in the pathogenesis of hypercalciuria. Variations in Ca and vitamin D metabolism, and excretion of urinary solutes among first-time male and female Ca stone-formers in the community, however, have not been defined. Methods In a 4-year community-based study we measured serum Ca, phosphorus (P), 25-hydroxyvitamin D (25(OH)D), 1,25(OH)2D, 24,25-dihydroxyvitamin D (24,25(OH)2D), parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF-23) concentrations in first-time Ca stone-formers and age- and gender frequency-matched controls. Results Serum Ca and 1,25(OH)2D were increased in Ca stone-formers compared to controls (P = 0.01 and P = 0.001). Stone-formers had a lower serum 24,25(OH)2D/25(OH)D ratio compared to controls (P = 0.008). Serum PTH and FGF-23 concentrations were similar in the groups. Urine Ca excretion was similar in the two groups (P = 0.82). In controls, positive associations between serum 25(OH)D and 24,25(OH)2D, FGF-23 and fractional phosphate excretion, and negative associations between serum Ca and PTH, and FGF-23 and 1,25(OH)2D were observed. In SF associations between FGF-23 and fractional phosphate excretion, and FGF-23 and 1,25(OH)2D, were not observed. 1,25(OH)2D concentrations associated more weakly with FGF-23 in SF compared with C (P <0.05). Conclusions Quantitative differences in serum Ca and 1,25(OH)2D and reductions in 24-hydroxylation of vitamin D metabolites are present in first-time SF and might contribute to first-time stone risk. PMID:26332888

  10. Mutations in SLC34A3/NPT2c Are Associated with Kidney Stones and Nephrocalcinosis

    PubMed Central

    Dasgupta, Debayan; Wee, Mark J.; Reyes, Monica; Li, Yuwen; Simm, Peter J.; Sharma, Amita; Schlingmann, Karl-Peter; Janner, Marco; Biggin, Andrew; Lazier, Joanna; Gessner, Michaela; Chrysis, Dionisios; Tuchman, Shamir; Baluarte, H. Jorge; Levine, Michael A.; Tiosano, Dov; Insogna, Karl; Hanley, David A.; Carpenter, Thomas O.; Ichikawa, Shoji; Hoppe, Bernd; Konrad, Martin; Sävendahl, Lars; Munns, Craig F.; Lee, Hang; Jüppner, Harald

    2014-01-01

    Compound heterozygous and homozygous (comp/hom) mutations in solute carrier family 34, member 3 (SLC34A3), the gene encoding the sodium (Na+)-dependent phosphate cotransporter 2c (NPT2c), cause hereditary hypophosphatemic rickets with hypercalciuria (HHRH), a disorder characterized by renal phosphate wasting resulting in hypophosphatemia, correspondingly elevated 1,25(OH)2 vitamin D levels, hypercalciuria, and rickets/osteomalacia. Similar, albeit less severe, biochemical changes are observed in heterozygous (het) carriers and indistinguishable from those changes encountered in idiopathic hypercalciuria (IH). Here, we report a review of clinical and laboratory records of 133 individuals from 27 kindreds, including 5 previously unreported HHRH kindreds and two cases with IH, in which known and novel SLC34A3 mutations (c.1357delTTC [p.F453del]; c.G1369A [p.G457S]; c.367delC) were identified. Individuals with mutations affecting both SLC34A3 alleles had a significantly increased risk of kidney stone formation or medullary nephrocalcinosis, namely 46% compared with 6% observed in healthy family members carrying only the wild-type SLC34A3 allele (P=0.005) or 5.64% in the general population (P<0.001). Renal calcifications were also more frequent in het carriers (16%; P=0.003 compared with the general population) and were more likely to occur in comp/hom and het individuals with decreased serum phosphate (odds ratio [OR], 0.75, 95% confidence interval [95% CI], 0.59 to 0.96; P=0.02), decreased tubular reabsorption of phosphate (OR, 0.41; 95% CI, 0.23 to 0.72; P=0.002), and increased serum 1,25(OH)2 vitamin D (OR, 1.22; 95% CI, 1.05 to 1.41; P=0.008). Additional studies are needed to determine whether these biochemical parameters are independent of genotype and can guide therapy to prevent nephrocalcinosis, nephrolithiasis, and potentially, CKD. PMID:24700880

  11. Dietary Intake of Fiber, Fruit, and Vegetables Decrease the Risk of Incident Kidney Stones in Women: A Women's Health Initiative (WHI) Report

    PubMed Central

    Sorensen, Mathew D.; Hsi, Ryan S.; Chi, Thomas; Shara, Nawar; Wactawski-Wende, Jean; Kahn, Arnold J.; Wang, Hong; Hou, Lifang; Stoller, Marshall L.

    2014-01-01

    Purpose We evaluated the relationship between dietary fiber, fruit, and vegetable intake, and the risk of kidney stone formation. Methods Overall, 83,922 postmenopausal women from the WHI Observational Study were included and followed prospectively. Cox proportional hazards regression analyses evaluated the associations between total dietary fiber, fruits, and vegetable intake, and the risk of incident kidney stone formation adjusting for nephrolithiasis risk factors (age, race/ethnicity, geographic region, diabetes mellitus, calcium supplementation, hormone therapy use, body mass index, calibrated caloric intake, and dietary water, sodium, animal protein, and calcium intake). Women with a prior history of kidney stones (3,471 women) were analyzed separately. Results Mean age was 64±7 years, 85% of women were Caucasian and 2,937 women (3.5%) experienced a kidney stone occurrence in 8 years median follow-up. In women with no history of kidney stones, higher total dietary fiber (6-26% decreased risk, p<0.001), higher fruit intake (12-25% decreased risk, p<0.001), and higher vegetable intake (9-22% decreased risk, p=0.002) were associated with a decreased risk of incident kidney stone formation in separate adjusted models. In women with a history of stones, there were no significant protective effects of fiber, fruits, or vegetable intake on the risk of kidney stone recurrence. Conclusions Greater dietary intake of fiber, fruits and vegetables were each associated with a reduced risk of incident kidney stones in postmenopausal women. The protective effects were independent of other known risk factors for kidney stones. In contrast, there was no reduction in risk in women with a history of stones. PMID:24859445

  12. The reliability of national videos related to the kidney stones on YouTube

    PubMed Central

    Serinken, Mustafa; Eken, Cenker; Erdemir, Fikret; Eliçabuk, Hayri; Başer, Aykut

    2016-01-01

    Objective Kidney stones are one of the most common disorders of the urinary tract. With increasing awareness, a larger proportion of patients are seeking medical knowledge from the Internet. In present study, the features, reliability and efficacy of videos on YouTube related to the treatment of kidney stones were evaluated. Material and methods In December 2014, YouTube was searched using keywords “nephrolithiasis”; “renal calculi”; “renal stones”; and “kidney stones” for videos uploaded containing relevant information about the disease. Only videos in Turkish were included in the study. Two physician viewers watched each video and classified them as useful, partially useful and useless according to European Association of Urology (EAU) Guidelines. The source, length, number of views, number of favourable opinions, and days since uploaded date of the all videos were evaluated. Results A total of 600 videos were analysed The median length of videos was 6.7±10.4 (median: 3, IQR: 0.03–58) minutes. Each video was viewed at an average of 2368 (min: 11, max: 97133) times. Most of the videos (32.8%) were created by academicians and physicians. Nearly half (47.4%) of the videos were uploaded in 2014. The majority of the videos (62.5%) contained information for treatment. Percutaneous nephrolithotomy and ureterorenoscopy were the most common treatment modalities (32.8% and 28.0%, respectively ) in these videos. A statistically significant difference was not detected between view numbers and source of videos (p=0.87). However, there was a statistically significant difference between usefulness to the viewers and source of videos. Hospital -based videos were detected to be more useful (p=0.000). Conclusion As a result, videos that would be prepared in internet environment by professional individuals or organizations in a way which would attract attention and be easily comprehended by the public could contribute to the knowledge and education of our society about the stone disease which is commonly seen in our country. PMID:27011874

  13. Non-Invasive Measurement of the Temperature Rise in Tissue Surrounding a Kidney Stone Subjected to Ultrasonic Propulsion*

    PubMed Central

    Oweis, Ghanem F.; Dunmire, Barbrina L.; Cunitz, Bryan W.; Bailey, Michael R.

    2016-01-01

    Transcutaneous focused ultrasound (US) is used to propel kidney stones using acoustic radiation force. It is important to estimate the level of heating generated at the stone/tissue interface for safety assessment. An in-vitro experiment is conducted to measure the temperature rise in a tissue-mimicking phantom with an embedded artificial stone and subjected to a focused beam from an imaging US array. A novel optical-imaging-based thermometry method is described using an optically clear tissue phantom. Measurements are compared to the output from a fine wire thermocouple placed on the stone surface. The optical method has good sensitivity, and it does not suffer from artificial viscous heating typically observed with invasive probes and thermocouples. PMID:26736818

  14. Non-invasive measurement of the temperature rise in tissue surrounding a kidney stone subjected to ultrasonic propulsion.

    PubMed

    Oweis, Ghanem F; Dunmire, Barbrina L; Cunitz, Bryan W; Bailey, Michael R

    2015-08-01

    Transcutaneous focused ultrasound (US) is used to propel kidney stones using acoustic radiation force. It is important to estimate the level of heating generated at the stone/tissue interface for safety assessment. An in-vitro experiment is conducted to measure the temperature rise in a tissue-mimicking phantom with an embedded artificial stone and subjected to a focused beam from an imaging US array. A novel optical-imaging-based thermometry method is described using an optically clear tissue phantom. Measurements are compared to the output from a fine wire thermocouple placed on the stone surface. The optical method has good sensitivity, and it does not suffer from artificial viscous heating typically observed with invasive probes and thermocouples. PMID:26736818

  15. Stones and urinary tract infections.

    PubMed

    Miano, Roberto; Germani, Stefano; Vespasiani, Giuseppe

    2007-01-01

    The term infection stones refers to calculi that occur following urinary tract infections (UTIs) caused by urease-producing gram-negative organisms. They consist of magnesium ammonium phosphate, carbonate apatite and monoammonium urate. Alkaline urine is most favorable to their formation. Urinary tract obstruction, neurogenic bladder, voiding dysfunction, temporary or indwelling urinary catheters, distal renal tubular acidosis and medullary sponge kidney are considered the main risk factors for developing infection stones. Urinalysis and urine culture are essential for diagnosis. A typical finding on imaging is a moderately radiopaque, staghorn or branched stone. Curative treatment is possible only by eliminating all of the stone fragments and by eradicating UTI. A variety of operative and pharmaceutical approaches is available. Metaphylactic treatment is mandatory to prevent recurrences. The relationship between urinary stones and UTIs is well known and shows two different clinical pictures: (1) stones that develop following UTIs (infection stones) which play a key role in stone pathogenesis, and (2) stones complicated by UTIs (stones with infection) which are metabolic stones that passively trap bacteria from coexistent UTIs and may consist of calcium or non-calcium. This article presents an overview of infection stones, analyzing the epidemiology, composition, pathogenesis, diagnosis, treatment and prevention of this type of calculi. PMID:17726350

  16. GENETIC BASIS OF RENAL CELLULAR DYSFUNCTION AND THE FORMATION OF KIDNEY STONES

    PubMed Central

    Khan, Saeed R.; Canales, Benjamin K.

    2013-01-01

    Nephrolithiasis is a result of formation and retention of crystals within the kidneys. The driving force behind crystal formation is urinary supersaturation with respect to the stone forming salts, which means that crystals form when the concentrations of participating ions are higher than the thermodynamic solubility for that salt. Levels of supersaturation are kept low and under control by proper functioning of a variety of cells including those that line the renal tubules. It is our hypothesis that crystal deposition i.e. formation and retention in the kidneys, is a result of impaired cellular function, which may be intrinsic and inherent or triggered by external stimuli and challenges. Cellular impairment or dysfunction affects the supersaturation, by influencing the excretion of participating ions such as calcium, oxalate and citrate and causing hypercalciuria, hyperoxaluria or hypocitraturia. The production and excretion of macromolecular promoters and inhibitors of crystallization is also dependent upon proper functioning of the renal epithelial cells. Insufficient or ineffective crystallization modulators such as osteopontin (OPN), Tamm Horsfall protein (THP), bikunin (BK) etc are most likely produced by the impaired cells. PMID:19517103

  17. The role of shear and longitudinal waves in the kidney stone comminution by a lithotripter shock pulse

    NASA Astrophysics Data System (ADS)

    Sapozhnikov, Oleg A.; Cleveland, Robin O.; Bailey, Michael R.

    2001-05-01

    Shock wave lithotripsy has been in clinical use for 20 years but there is no consensus as to the main mechanism of kidney stone comminution. Experiments show that several mechanisms might be involved, including cavitation, spallation, and dynamic fatigue. Until recently, little attention was paid to shear elasticity of the stone material, i.e., mechanical load was mainly attributed to the longitudinal waves. In a previous numerical study, we found that shear elasticity resulted in tremendous change in the stress pattern inside cylindrical stones. The numerical model has been extended to study elastic waves in asymmetric inhomogeneous stones. Strains and stresses in the stone are calculated based on the Lamé equation for an isotropic elastic medium. Lithotripter shock waves of various temporal and spatial profiles were considered according to several clinical models of lithotripters. Maximum compression, tensile and shear stresses are predicted as a function of stone dimension and shape. The model predicts that both shear and longitudinal waves play an important role in creating the regions of excess stresses where cracks can be formed. The results of modeling are compared with the experimental observations. [Work supported by ONRIFO, CRDF, NIH-Fogarty, RFBR, NIH, and Whitaker Foundation.

  18. Chinese Minimally Invasive Percutaneous Nephrolithotomy for Intrarenal Stones in Patients with Solitary Kidney: A Single-Center Experience

    PubMed Central

    Huang, Zhichao; Fu, Fajun; Zhong, Zhaohui; Zhang, Lei; Xu, Ran; Zhao, Xiaokun

    2012-01-01

    Objective To report our experience with Chinese minimally invasive percutaneous nephrolithotomy (Chinese MPCNL) to manage patients with intrarenal stones in solitary kidney, and evaluate the safety, efficiency and feasibility of this technique. Methods Forty-one patients with intrarenal stones in solitary kidney underwent Chinese MPCNL in our department from March 2009 to February 2011. Demographic characteristics, operative parameters, number of tracts, stone-free rates (SFRs), stone analyses, hemoglobin levels, nephrostomy tube removal time, hospitalization time, and complications were evaluated. Serum creatinine (Scr) and glomerular filtration rate (GFR) were measured preoperatively, postoperatively at 1 month, and each follow-up visit. The 5-stage classification of chronic kidney disease (CKD) was used according to the National Kidney Foundation guidelines. Results The initial stone-free status was achieved in 35 (85.4%) patients after Chinese MPCNL. The mean follow-up time was 16.9±4.7 months (range: 12–24), and the final SFR improved to 97.6% after auxiliary procedures. Among all patients, complex stones were detected in 26 (63.4%) patients, and 9 (22.0%) required multiple tracts. The mean operative time and mean hospitalization time were 71.3±23.5 min (range: 40–139) and 6.1±0.5 days (range: 5–11), respectively. During preoperative period and postoperative period (1 month), Scr were 132.1±41.3 umol/L (range: 78.2–231.4) and 108.9±30.7 umol/L (range: 71.6–136.9), respectively (P<0.05), while GFR were 74.9±24.2 ml/min (range: 35–110) and 83.9±27.4 ml/min (range: 65–110), respectively (P<0.05). According to CKD classification, the renal function was stable, improved, and worse in 29 (70.7%), 11 (26.8%), and 1 (2.5%) patients, compared with the preoperative levels. No patient progressed to end-stage renal disease requiring dialysis. Conclusions Our experience with Chinese MPCNL demonstrates that it is safe, feasible and efficient for managing the intrarenal calculi in solitary kidney with a low complication rate. At long-term follow-up, renal function stabilized or even improved in the majority of patients with solitary kidney. PMID:22808197

  19. Evaluation of calcium and magnesium in scalp hair samples of population consuming different drinking water: risk of kidney stone.

    PubMed

    Panhwar, Abdul Haleem; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shaikh, Haffeezur Rehman; Arain, Salma Aslam; Arain, Sadaf Sadia; Brahman, Kapil Dev

    2013-12-01

    The objective of this study was to examine the relationship between calcium (Ca) and magnesium (Mg) in underground water (UGW), bottled mineral water (BMW), and domestic treated water (DTW) with related to risk of kidney stones. The water samples were collected from different areas of Sindh, Pakistan. The scalp hair samples of both genders, age ranged 30-60 years, consuming different types of water, have or have not kidney disorders, were selected. The Ca and Mg concentrations were determined in scalp hair of study subjects and water by flame atomic absorption spectroscopy. The Ca and Mg contents in different types of drinking water, UGW, DTW, and BMW, were found in the range of 79.1-466, 23.7-140, and 45-270 mg/L and 4.43-125, 5.23-39.6, and 7.16-51.3 mg/L, respectively. It was observed that Ca concentration in the scalp hair samples of kidney stone patients consuming different types of drinking water was found to be higher (2,895-4721 μg/g) while Mg level (84.3-101 μg/g) was lower as compare to referents subjects (2,490-2,730 μg/g for Ca, 107-128 μg/g for Mg) in both genders. The positive correlation was found between Ca and Mg levels in water with related to kidney stone formations in population, especially who consumed underground water. A relative risk and odd ratio were calculated; the relative risk had a strong positive association with incidence of kidney stone which depends on types of drinking water. PMID:24218227

  20. Effect of Cystone on Urinary Composition and Stone Formation Over a One Year Period

    PubMed Central

    Erickson, S. B.; Vrtiska, T. J.; Lieske, J. C.

    2014-01-01

    Kidney stones are a common problem for which inadequate prevention exists. We recruited ten recurrent kidney stone formers with documented calcium oxalate stones into a two phased study to assess safety and effectiveness of Cystone, an herbal treatment for prevention of kidney stones. The first phase was a randomized double-blinded 12 week cross over study assessing the effect of Cystone vs. placebo on urinary supersaturation. The second phase was an open label one year study of Cystone to determine if renal stone burden decreased, as assessed by quantitative and subjective assessment of CT. Results revealed no statistically significant effect of Cystone on urinary composition short (6 weeks) or long (52 weeks) term. Average renal stone burden increased rather than decreased on Cystone. Therefore, this study does not support the efficacy of Cystone to treat calcium oxalate stone formers. Future studies will be needed to assess effects on stone passage, or on other stone types. PMID:21419609

  1. Evaluation of a system for classification of stones and their sites in kidneys treated with extracorporeal shock wave lithotripsy.

    PubMed

    Pettersson, B; Tiselius, H G; Rahmqvist, M

    1990-01-01

    The results of treatment with extracorporeal shock wave lithotripsy (ESWL) were recorded in 1067 patients with renal calculi during their first admission to hospital. All treatments were performed in an unmodified Dornier HM3 lithotripter according to the original recommendations whereby the generator voltage was usually set between 18 and 23 kV. The stones in kidneys treated with ESWL alone were first classified into four different types (A. B. C. D) and after which a further subgrouping was carried out according to the number and sites of stones in the renal pelvis or calyces. The number of shock-waves. the energy index. the duration of treatment, and length of hospital stay as well as the therapeutic results after four weeks and six months were recorded for the different subgroups. An approximate estimate of the stone volume was calculated from measurements on a plain abdominal radiograph. The mean stone volume, number of shock waves, energy index, duration of treatment, and length of hospital stay increased progressively and significantly from group A to group D. The stone volumes and the energy indexes in the different subgroups within each type were distributed around levels that clearly differed between the types. Although minor variations were observed similar patterns also were recorded for the retreatment rate, the total duration of treatment, and the length of hospital stay. The therapeutic result, expressed as satisfactory disintegration, showed roughly similar results within each group but, as expected, the success rate decreased when more complicated stones were treated. Although stones located in the renal pelvis were often bigger than calyceal stones, the former seemed to disintegrate more easily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2274754

  2. Differentiation of tissue and kidney stones for laser lithotripsy using different spectroscopic approaches

    NASA Astrophysics Data System (ADS)

    Lange, Birgit; Cordes, Jens; Brinkmann, Ralf

    2015-07-01

    Holmium lasers are nowadays the gold standard for endoscopic laser lithotripsy. However, there is a risk of damaging or perforating the ureter or kidney tissue when the vision is poor. An automatic tissue/stone differentiation would improve the handling and safety of the procedure. To achieve this objective, an easy and robust real-time discrimination method has to be found which can be used to realize a feedback loop to control the laser system. Two possible approaches have been evaluated: White light reflectance and fluorescence spectroscopy. In both cases, we use the treatment fiber for detection and evaluate the possibility to decide whether the fiber is placed in front of tissue or calculus by the signal that is delivered by the surface in front of it. White light reflectance spectroscopy uses the standard light source for endourologic surgeries: Radiation of a Xenon light source is coupled to the ureteroscope via a liquid light guide. The part of the white light that is reflected back into the fiber is spectroscopically analyzed. In a clinical proof of concept study reflection signals were measured in vivo in 8 patients. For differentiation of stone and tissue via autofluorescence, excitation as well as detection was done via the treatment fiber. A suitable excitation wavelength was chosen with in vitro measurements (UV / visible) on several human renal calculi and porcine tissues. For verification of the positive results with green excitation in a clinical proof of concept study, a measurement set-up was realized which allows the recording of fluorescence signals during an endourological intervention.

  3. The potential role of salt abuse on the risk for kidney stone formation.

    PubMed

    Sakhaee, K; Harvey, J A; Padalino, P K; Whitson, P; Pak, C Y

    1993-08-01

    The kidney stone-forming risk of a high sodium diet was evaluated by assessing the effect of such a diet on the crystallization of stone-forming salts in urine. Fourteen normal subjects participated in 2 phases of study of 10 days duration each, comprising a low sodium phase (basal metabolic diet containing 50 mmol. sodium per day) and a high sodium phase (basal diet plus 250 mmol. sodium chloride per day). The high sodium intake significantly increased urinary sodium (34 +/- 12 to 267 +/- 56 mmol. per day), calcium (2.73 +/- 1.03 to 3.93 +/- 1.51 mmol. per day) and pH (5.79 +/- 0.44 to 6.15 +/- 0.25), and significantly decreased urinary citrate (3.14 +/- 1.19 to 2.52 +/- 0.83 mmol. per day). Arterialized venous blood bicarbonate and total serum carbon dioxide concentrations decreased significantly during the high sodium diet, whereas serum chloride concentration increased. However, no change in arterialized venous pH was detected. Thus, a high sodium intake not only increased calcium excretion, but also increased urinary pH and decreased citrate excretion. The latter effects are probably due to sodium-induced bicarbonaturia and a significant decrease in serum bicarbonate concentration, respectively. Commensurate with these changes, the urinary saturation of calcium phosphate (brushite) and monosodium urate increased, and the inhibitor activity against calcium oxalate crystallization (formation product) decreased. The net effect of a high sodium diet was an increased propensity for the crystallization of calcium salts in urine. PMID:8326549

  4. The potential role of salt abuse on the risk for kidney stone formation

    NASA Technical Reports Server (NTRS)

    Sakhaee, K.; Harvey, J. A.; Padalino, P. K.; Whitson, P.; Pak, C. Y.

    1993-01-01

    The kidney stone-forming risk of a high sodium diet was evaluated by assessing the effect of such a diet on the crystallization of stone-forming salts in urine. Fourteen normal subjects participated in 2 phases of study of 10 days duration each, comprising a low sodium phase (basal metabolic diet containing 50 mmol. sodium per day) and a high sodium phase (basal diet plus 250 mmol. sodium chloride per day). The high sodium intake significantly increased urinary sodium (34 +/- 12 to 267 +/- 56 mmol. per day), calcium (2.73 +/- 1.03 to 3.93 +/- 1.51 mmol. per day) and pH (5.79 +/- 0.44 to 6.15 +/- 0.25), and significantly decreased urinary citrate (3.14 +/- 1.19 to 2.52 +/- 0.83 mmol. per day). Arterialized venous blood bicarbonate and total serum carbon dioxide concentrations decreased significantly during the high sodium diet, whereas serum chloride concentration increased. However, no change in arterialized venous pH was detected. Thus, a high sodium intake not only increased calcium excretion, but also increased urinary pH and decreased citrate excretion. The latter effects are probably due to sodium-induced bicarbonaturia and a significant decrease in serum bicarbonate concentration, respectively. Commensurate with these changes, the urinary saturation of calcium phosphate (brushite) and monosodium urate increased, and the inhibitor activity against calcium oxalate crystallization (formation product) decreased. The net effect of a high sodium diet was an increased propensity for the crystallization of calcium salts in urine.

  5. Knowledge, attitudes, and practice patterns of recurrent urinary stones prevention in Saudi Arabia.

    PubMed

    Binsaleh, Saleh; Habous, Mohamad; Madbouly, Khaled

    2016-04-01

    The purpose of this study is to assess the knowledge, attitudes, and practice patterns of urologists in Saudi Arabia regarding prevention of recurrent stone formation and how much they follow preventive stone disease management guidelines. A questionnaire about knowledge, attitudes, and practice patterns of urologists in Saudi Arabia regarding prevention of recurrent stone formation was used. The survey comprised three domains: knowledge, attitudes, and practice patterns. Data about gender, duration of experience and health care sector were also collected. Individual responses were recorded, tabulated and compared using descriptive statistics. The overall response rate was 38.8 %. All respondents were male urologists. Most of them (62, 71.3 %) had an experience of 5-20 years in management of stone disease patients and the majority (74, 85.1 %) belonged to the governmental health care sector. A total of 51 % of the respondents answered in concordance with the best practice guidelines in at least half of the questions and 40 % in all of the questions. Overall, practice patterns of 58 % of the respondents were in concordance with the best practice guidelines in all the questions except for the question of practices regarding stone analysis. As regards to attitude domain, a total of 58.7 % respondents expressed their agreement or strong agreement with the questions. Urologists' knowledge of stone recurrence preventive programs is suboptimal. They do not apply effectively the best stone prevention practice guidelines in their daily practice as well. Efforts to increase knowledge and enforce its application in daily practice are strongly warranted. PMID:26296383

  6. Integrative microRNA-gene expression network analysis in genetic hypercalciuric stone-forming rat kidney

    PubMed Central

    Lu, Yuchao; Qin, Baolong; Hu, Henglong; Zhang, Jiaqiao; Wang, Yufeng; Wang, Qing

    2016-01-01

    Background. MicroRNAs (miRNAs) influence a variety of biological functions by regulating gene expression post-transcriptionally. Aberrant miRNA expression has been associated with many human diseases. Urolithiasis is a common disease, and idiopathic hypercalciuria (IH) is an important risk factor for calcium urolithiasis. However, miRNA expression patterns and their biological functions in urolithiasis remain unknown. Methods and Results. A multi-step approach combining microarray miRNA and mRNA expression profile and bioinformatics analysis was adopted to analyze dysregulated miRNAs and genes in genetic hypercalciuric stone-forming (GHS) rat kidneys, using normal Sprague-Dawley (SD) rats as controls. We identified 2418 mRNAs and 19 miRNAs as significantly differentially expressed, over 700 gene ontology (GO) terms and 83 KEGG pathways that were significantly enriched in GHS rats. In addition, we constructed an miRNA-gene network that suggested that rno-miR-674-5p, rno-miR-672-5p, rno-miR-138-5p and rno-miR-21-3p may play important roles in the regulatory network. Furthermore, signal-net analysis suggested that NF-kappa B likely plays a crucial role in hypercalciuria urolithiasis. Conclusions. This study presents a global view of mRNA and miRNA expression in GHS rat kidneys, and suggests that miRNAs may be important in the regulation of hypercalciuria. The data provide valuable insights for future research, which should aim at validating the role of the genes featured here in the pathophysiology of hypercalciuria. PMID:27069814

  7. Kidney pain (image)

    MedlinePlus

    A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size of sand or ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the ...

  8. [Michel de Montaigne (1533-1592). Writer philosopher, kidney stone patient and medical critic].

    PubMed

    Marx, F J

    2015-10-01

    Michel de Montaigne (1533-1592) was the most important representative of French Humanism in the sixteenth century. Fragmentarily scattered throughout his "essais" and in chronological order in the diary of his spa journeys to Italy, he extensively describes his suffering from kidney stones, which accompanied him from the age of 45 years up to his death. This urological self-report achieves additional weight due to the extraordinary personality of the patient, who reflects on his urolithiasis and the effect on his own life not only from a subjective viewpoint but also makes his disease experience a starting point for critical thoughts on the value and limitations of the medical possibilities in his epoch. With a clear knowledge of the difficulty of medical practice, he postulates a rational approach supported by experience. Particularly interesting is Montaigne's stance towards contemporary physicians. He sees the benefits of physician consultations for himself and for patients generally, as being rarely substantiated but, despite sometimes strong antimedical invectives, accuses the doctors themselves less than the, although rationally structured but still mostly speculative, medical teaching structure influenced by Hippocrates and Galenism. PMID:26350356

  9. Effect of supersaturation ratio and Khella extract on nucleation and morphology of kidney stones

    NASA Astrophysics Data System (ADS)

    Abdel-Aal, E. A.; Daosukho, S.; El-Shall, H.

    2009-04-01

    Induction times in supersaturated calcium oxalate (CaOx)-the major component of most kidney stones-solutions were determined at 37 °C using UV-vis spectrometry with and without Khella extract. The slope of the light absorbance measurement curve indicated the inhibition of calcium oxalate nucleation with Khella extract. The induction time was estimated from the time vs. absorbance curve. Khella seeds were obtained from two sources, one in Turkey and one in Egypt. High performance liquid chromatography (HPLC) results showed that only Turkish Khella extract contained khellin and visnagin that are believed to be the active components of the herb. Both extracts contained calcium, magnesium, and oxalate. It was found that both Khella extracts reduced the induction time at every supersaturation ratio. Using an equation that relates induction times and supersaturation ratios, free energy barrier, and critical nuclei radius were calculated. The results revealed that decrease of free energy barrier and critical nuclei radius as supersaturation ratio increased. In addition, the calculated surface energy of calcium oxalate crystals was decreased from 9.01 to 6.79 and 6.40 mJ/m2 with Egyptian Khella extract and Turkish Khella extract, respectively. Scanning electron microscopy (SEM) photomicrographs showed that the control supersaturated CaOx solutions produced CaOx monohydrate (COM) crystals. With the addition of Khella extract, the resulting crystals were modified to calcium oxalate dihydrate (COD) form.

  10. Experimental modelling of kidney stone destruction by spherical and focused shock waves in water

    NASA Astrophysics Data System (ADS)

    Filler, W. S.; Simenauer, R.; Wells, P. W.; Bezirdjian, L.

    1990-07-01

    A comparative study was made of damage to simulated kidney stones from spherical sector and focused hydrodynamic shock waves. Plaster cylinders of 40 bar static compressive strength were subjected to spherical shock waves with a time constant of 7 μsec generated by a conical shock tube. Near total destruction of the 2.5 cm by 2.5 cm cylinders to fine particles occurred with a single shock at a peak pressure of 0.85 kbar; onset of visible erosion at 0.5 kbar. Similar experiments performed in the diffraction region at a distance of 10 cm beyond the end of th shock tube with three repeated shocks of 0.34 kbar resulted in significant erosion. Similar targets located at the second focus of a semi-ellipsoid reflector were subjected to multiple shock waves generated by an underwater electric arc located at the first focus. Progressive target erosion to fine particles occurred at the second focus as several hundred shocks were provided at the high pressure singularity. These experiments offer empirical insight important to modelling the response of calculi imbedded in biological tissue; e.g., kidneystones and gallstones, to shock waves of varied characteristics. Sector shock waves appear to offer potential for much more efficient and less traumatic medical application than focused shocks.

  11. Treatment of Kidney Stones Using Extracorporeal Shock Wave Lithotripsy (ESWL) and Double-J Stent in Infants.

    PubMed

    Younesi Rostami, Mehdi; Taghipour-Gorgikolai, Mehrdad; Sharifian, Rayka

    2012-01-01

    Background. Extracorporeal shock wave lithotripsy (ESWL) has progressively acquired popularity as being the gold standard treatment for upper urinary tract lithiasis in infants since 1980. Our aim was to evaluate the outcome of ESWL for kidney stones and the use of double-J stent in infants. Material and Methods. A prospective clinical trial study performed on 50 infants with renal calculi at pelvic admitted in the Urology ward of Shafa Hospital, Sari, Iran, between 2001 and 2010. Main outcome measure of our study was clearing stones after one or more consecutive sessions of ESWL. Results. The study included 50 patients with renal calculi at pelvic. Among them, there were 35 (70%) boys and 15 (30%) girls with the age ranging from 1 to 13 months (mean of 7 month ± 3 days). All of them were treated by standard ESWL using Simons Lithostor plus machine. The stone sizes ranged from 6 mm to 22 mm. Double-J stents were placed in 11 infants (22%) with stones larger than 13 mm. Most of the patients required only one ESWL session. Conclusion. Since there were no complications following ESWL treatment, we can conclude that, in short term, ESWL is an effective and safe treatment modality for renal lithiasis in infants. In addition, we recommend double-J stent in infants with stones larger than 13 mm. PMID:22550483

  12. The effect of renal cortical thickness on the treatment outcomes of kidney stones treated with shockwave lithotripsy

    PubMed Central

    Luke, Sylvia; Chiu, Peter K.F.; Teoh, Jeremy Y.C.; Wong, Ka-Tak; Hou, Simon S.M.

    2015-01-01

    Purpose Because the shock wave passes through various body tissues before reaching the stone, stone composition may affect the treatment efficacy of shock wave lithotripsy (SWL). We investigated the effect of various tissue components along the shock wave path on the success of SWL. Materials and Methods From October 2008 to August 2010, a total of 206 patients with kidney stones sized 5 to 20 mm were prospectively recruited for a study of the factors that affect the outcome of treatment with a Sonolith Vision lithotripter. Successful SWL was defined as either stone-free status or residual fragments <4 mm at 12 weeks. Logistic regression analysis was performed to assess the factors that predicted treatment outcomes. Potential predictors included the patient's age, shock wave delivery rate, stone volume (SV), mean stone density (MSD), skin-to-stone distance (SSD), and the mean thickness of the three main components along the shock wave path: renal cortical thickness (KT), muscle thickness (MT), and soft-tissue thickness (ST). Results The mean age of the patients was 53.8 years (range, 25-82 years). The overall treatment success rate after one session of SWL was 43.2%. The mean KT, MT, and ST were 26.9, 16.6, and 40.8 mm, respectively. The logistic regression results showed that a slower shock wave delivery rate, smaller SV, a lower MSD, and a thicker KT were found to be significant predictors for successful SWL. SSD, MT, and ST were not predictors of successful treatment. Conclusions Among the main tissue components along the shock wave path, a thicker KT was a favorable factor for successful SWL after adjustment for SV, MSD, and the shock wave delivery rate. PMID:25964839

  13. The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode

    PubMed Central

    Lieske, John C.; Li, Xujian; Melton, L. Joseph; Krambeck, Amy E.; Bergstralh, Eric J.

    2014-01-01

    Most patients with first-time kidney stones undergo limited evaluations, and few receive preventive therapy. A prediction tool for the risk of a second kidney stone episode is needed to optimize treatment strategies. We identified adult first-time symptomatic stone formers residing in Olmsted County, Minnesota, from 1984 to 2003 and manually reviewed their linked comprehensive medical records through the Rochester Epidemiology Project. Clinical characteristics in the medical record before or up to 90 days after the first stone episode were evaluated as predictors for symptomatic recurrence. A nomogram was developed from a multivariable model based on these characteristics. There were 2239 first-time adult kidney stone formers with evidence of a passed, obstructing, or infected stone causing pain or gross hematuria. Symptomatic recurrence occurred in 707 of these stone formers through 2012 (recurrence rates at 2, 5, 10, and 15 years were 11%, 20%, 31%, and 39%, respectively). A parsimonious model had the following risk factors for recurrence: younger age, male sex, white race, family history of stones, prior asymptomatic stone on imaging, prior suspected stone episode, gross hematuria, nonobstructing (asymptomatic) stone on imaging, symptomatic renal pelvic or lower-pole stone on imaging, no ureterovesicular junction stone on imaging, and uric acid stone composition. Ten-year recurrence rates varied from 12% to 56% between the first and fifth quintiles of nomogram score. The Recurrence of Kidney Stone nomogram identifies kidney stone formers at greatest risk for a second symptomatic episode. Such individuals may benefit from medical intervention and be good candidates for prevention trials. PMID:25104803

  14. The ROKS nomogram for predicting a second symptomatic stone episode.

    PubMed

    Rule, Andrew D; Lieske, John C; Li, Xujian; Melton, L Joseph; Krambeck, Amy E; Bergstralh, Eric J

    2014-12-01

    Most patients with first-time kidney stones undergo limited evaluations, and few receive preventive therapy. A prediction tool for the risk of a second kidney stone episode is needed to optimize treatment strategies. We identified adult first-time symptomatic stone formers residing in Olmsted County, Minnesota, from 1984 to 2003 and manually reviewed their linked comprehensive medical records through the Rochester Epidemiology Project. Clinical characteristics in the medical record before or up to 90 days after the first stone episode were evaluated as predictors for symptomatic recurrence. A nomogram was developed from a multivariable model based on these characteristics. There were 2239 first-time adult kidney stone formers with evidence of a passed, obstructing, or infected stone causing pain or gross hematuria. Symptomatic recurrence occurred in 707 of these stone formers through 2012 (recurrence rates at 2, 5, 10, and 15 years were 11%, 20%, 31%, and 39%, respectively). A parsimonious model had the following risk factors for recurrence: younger age, male sex, white race, family history of stones, prior asymptomatic stone on imaging, prior suspected stone episode, gross hematuria, nonobstructing (asymptomatic) stone on imaging, symptomatic renal pelvic or lower-pole stone on imaging, no ureterovesicular junction stone on imaging, and uric acid stone composition. Ten-year recurrence rates varied from 12% to 56% between the first and fifth quintiles of nomogram score. The Recurrence of Kidney Stone nomogram identifies kidney stone formers at greatest risk for a second symptomatic episode. Such individuals may benefit from medical intervention and be good candidates for prevention trials. PMID:25104803

  15. Extraintestinal Complications: Kidney Disorders

    MedlinePlus

    ... but some less serious ones occur more frequently. Kidney stones These are probably the most commonly encountered kidney complications of IBD—particularly oxalate stones. Kidney stones are more common in Crohn's patients with disease ...

  16. Assessing the Mechanism of Kidney Stone Comminution by a Lithotripter Shock Pulse

    NASA Astrophysics Data System (ADS)

    Sapozhnikov, Oleg A.; Bailey, Michael R.; Maxwell, Adam D.; MacConaghy, Brian; Cleveland, Robin O.; Crum, Lawrence A.

    2005-03-01

    Comminution of axisymmetric stones by a lithotripter shock wave was studied experimentally and theoretically. In experiments, shock waves were generated by a research electrohydraulic lithotripter modeled after the Dornier HM-3, and stones were made from U-30 cement. Cylindrical stones of various length to diameter ratios, stones of conical shape, and stones with artificial cracks were studied. In other cases, baffles to block specific waves that contribute to spallation or squeezing were used, and glycerol was used to suppress cavitation. The theory was based on the elasticity equations for an isotropic medium. The equations were written in finite differences and integrated numerically. Maximum compression, tensile and shear stresses were predicted depending on the stone shape and side-surface condition in order to investigate the importance of the stone geometry. It is shown that the theoretical model used explains the observed position of a crack in a stone. The theory also predicts the efficiency of stone fragmentation depending on its shape and size, as well as on the presence of cracks on the stone surface and baffles near the stone.

  17. The optimal minimally invasive percutaneous nephrolithotomy strategy for the treatment of staghorn stones in a solitary kidney.

    PubMed

    Liu, Chenli; Cui, Zelin; Zeng, Guohua; Wan, Shaw P; Li, Jiasheng; Zhu, Wei; Zeng, Tao; Liu, Yang

    2016-04-01

    The objective of the study was to analyze the treatment outcomes for staghorn stones in patients with solitary kidney using either the single-tract or the multi-tract minimally invasive percutaneous nephrolithotomy (MPCNL). We retrospectively reviewed 105 patients who underwent MPCNL for staghorn calculi in solitary kidney from 2012 to 2014. The patients who underwent the single-tract approach (71 patients) were assigned to Group 1. The 34 patients who underwent the multi-tract approach (34 patients) were assigned to Group 2. We recorded and compared the patient's demographics, intraoperative parameters, and post-operative outcomes. We also analyzed any complications as a result of the particular procedure, as well as any resulting stone-free rates (SFRs). The mean number of access tracts was 2.38 ± 0.70 (range 2-4) for Group 2. The mean operative time was longer for Group 2, p = 0.01. The initial SFR was 52.1 % for Group 1 and 47.1 % for Group 2 after the one-session procedure, p = 0.63.The final SFR improved to 83.1 and 79.4 % for both groups following auxiliary treatment, p = 0.65. The mean hemoglobin drop was higher in Group 2 as compared to Group 1, p < 0.01. There was no significant difference in the change of mean serum creatinine in either group. There were fewer overall complications in Group 1 than in Group 2 (23.9 vs. 44.1 %). Almost half of the patients who underwent multi-tract MPCNL required an additional procedure to achieve satisfactory stone clearance. The results showed that single-tract MPCNL might be a better treatment option for staghorn stones in a solitary kidney with the same therapeutic outcome, but with less complications. PMID:26209008

  18. Differentiation of uric acid versus non-uric acid kidney stones in the presence of iodine using dual-energy CT

    NASA Astrophysics Data System (ADS)

    Wang, J.; Qu, M.; Leng, S.; McCollough, C. H.

    2010-04-01

    In this study, the feasibility of differentiating uric acid from non-uric acid kidney stones in the presence of iodinated contrast material was evaluated using dual-energy CT (DECT). Iodine subtraction was accomplished with a commercial three material decomposition algorithm to create a virtual non-contrast (VNC) image set. VNC images were then used to segment stone regions from tissue background. The DE ratio of each stone was calculated using the CT images acquired at two different energies with DECT using the stone map generated from the VNC images. The performance of DE ratio-based stone differentiation was evaluated at five different iodine concentrations (21, 42, 63, 84 and 105 mg/ml). The DE ratio of stones in iodine solution was found larger than those obtained in non-iodine cases. This is mainly caused by the partial volume effect around the boundary between the stone and iodine solution. The overestimation of the DE ratio leads to substantial overlap between different stone types. To address the partial volume effect, an expectation-maximization (EM) approach was implemented to estimate the contribution of iodine and stone within each image pixel in their mixture area. The DE ratio of each stone was corrected to maximally remove the influence of iodine solutions. The separation of uric-acid and non-uric-acid stone was improved in the presence of iodine solution.

  19. The Effect of Glycemic Status on Kidney Stone Disease in Patients with Prediabetes

    PubMed Central

    Lien, Tzu-Hsien; Wu, Jin-Shang; Sun, Zih-Jie

    2016-01-01

    Background While the evidence supporting a positive association between diabetes mellitus and kidney stone disease (KSD) is solid, studies examining the association between impaired fasting glucose (IFG) and KSD show inconsistent results. Currently, there are no studies examining the relationship between impaired glucose tolerance (IGT) and KSD. The objective of this study is to investigate the effects of different glycemic statuses on KSD. The results may help to motivate patients with diabetes to conform to treatment regimens. Methods We conducted a cross sectional study of a population that underwent health check-ups between January 2000 and August 2009 at the Health Evaluation Center of National Cheng Kung University Hospital. A total of 14,186 subjects were enrolled. The following categories of glycemic status were used according to the criteria of the 2009 American Diabetes Association: normal glucose tolerance, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes. The existence of KSD was evaluated using renal ultrasonography, and the presence of any hyperechoic structures causing acoustic shadowing was considered to be indicative of KSD. Results The prevalence of KSD was 7.4% (712/9,621), 9.3% (163/1,755), 10.8% (78/719), 12.0% (66/548), and 11.3% (174/1,543) in subjects with NGT, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes, respectively. Isolated IFG, combined IFG/IGT, and diabetes were associated with KSD after adjusting for other clinical variables, but isolated IGT was not. Age (41 to 64 years vs. ≤40 years, ≥65 years vs. ≤40 years), male gender, hypertension, and hyperuricemia were also independently associated with KSD. Conclusion Isolated IFG, combined IFG/IGT, and diabetes, but not isolated IGT, were associated with a higher risk of KSD. PMID:27126886

  20. Treatment of the Infected Stone.

    PubMed

    Marien, Tracy; Miller, Nicole L

    2015-11-01

    Infected kidney stones refer to stones that form because of urinary tract infections with urease-producing bacteria, secondarily infected stones of any composition, or stones obstructing the urinary tract leading to pyelonephritis. The mainstay of treatment of infection stones is complete stone removal. Kidney stones that obstruct the urinary tract and cause obstructive pyelonephritis are also frequently referred to as infected stones. Obstructive pyelonephritis is a urologic emergency as it can result in sepsis and even death. Infection stones and obstructive stones causing pyelonephritis are different disease processes, and their workup and management are described separately. PMID:26475943

  1. Polymorphisms in CaSR and CLDN14 Genes Associated with Increased Risk of Kidney Stone Disease in Patients from the Eastern Part of India.

    PubMed

    Guha, Manalee; Bankura, Biswabandhu; Ghosh, Sudakshina; Pattanayak, Arup Kumar; Ghosh, Saurabh; Pal, Dilip Kumar; Puri, Anurag; Kundu, Anup Kumar; Das, Madhusudan

    2015-01-01

    Kidney stone disease (KSD) is a major clinical problem imposing a large burden for both healthcare and economy globally. In India, the prevalence of kidney stone disease is rapidly increasing. This study aimed to evaluate the association between genetic defects in vitamin D receptor (VDR), calcium sensing receptor (CaSR) and claudin 14 (CLDN14) genes and kidney stone disease in patients from eastern India. We enrolled 200 consecutive kidney stone patients (age 18-60 years) (cases) and their corresponding sex and age matched 200 normal individuals (controls). To identify genetic variants responsible for KSD, we performed sequence analysis of VDR, CaSR and CLDN14 genes. Four non-synonymous (rs1801725, rs1042636, rs1801726 and rs2228570), one synonymous (rs219780) and three intronic single nucleotide polymorphisms (SNPs) (rs731236, rs219777 and rs219778) were identified. Genotype and allele frequency analysis of these SNPs revealed that, rs1801725 (Ala986Ser), rs1042636 (Arg990Gly) of CaSR gene and rs219778, rs219780 (Thr229Thr) of CLDN14 gene were significantly associated with KSD. Serum calcium levels were significantly higher in subjects carrying 986Ser allele and calcium excretion was higher in subjects bearing 990Gly allele. In conclusion, rs1801725, rs1042636, rs219778 and rs219780 SNPs were associated with kidney stone risk in patients from the eastern part of India. PMID:26107257

  2. Initial experiences with laparoscopy and flexible ureteroscopy combination pyeloplasty in management of ectopic pelvic kidney with stone and ureter-pelvic junction obstruction.

    PubMed

    Yin, Zhuo; Wei, Y B; Liang, B L; Zhou, K Q; Gao, Y L; Yan, B; Wang, Z; Yang, J R

    2015-06-01

    To demonstrate the safety and efficacy of combine laparoscopy and flexible ureteroscopy to treat ectopic pelvic kidneys with ureteropelvic junction obstruction (UPJO) and stones. 16 patients of ectopic pelvic kidneys with ureteropelvic junction obstruction and stones were treated with laparoscopy and flexible ureteroscopy (FURS). The operative time, required dose of tramadol, visual analog pain scale (VAPS), postoperative day, stone-free rates (SFRs), perioperative complications, and serum creatinine were evaluated. The SFRs were evaluated with noncontrasted renal computed tomography (CT). Intravenous pyelography (IVP) and CT scan were used to evaluate the UPJO. Stone-free status was defined as absence of stone fragments in kidney or the size of that is less than 3 mm. Operation time from 118 to 225 min, average time (171 ± 28) min; lithotomy time from 16 to 45 min, average time (32 ± 6) min. Average tramadol required at the first day postoperation was (118 ± 49.6) mg; at the second day was (78 ± 24.8) mg. VAPS score at 24 h (5.0 ± 0.7), VAPS score at 48 h (2.5 ± 0.8). Postoperative day (3.9 ± 0.6) days. Stone-free rate was 100%. Average serum creatinine was (88.7 ± 24.3) mol/L before surgery and (92.8 ± 21.6) mol/L after surgery. No major complication. No stone and obstruction recurrence in the follow-up of average 29.3 months. Combined FUR and LC is a good option for patient of ectopic pelvic kidney with renal stone and UPJO. From our initial experience, the SFRs and the effect of pyeloplasty are satisfactory and without major complication, the operative time is acceptable. PMID:25666341

  3. [Preventing chronic kidney disease in France: advantages, feasibility and concerns].

    PubMed

    Duranton, Flore; Brunet, Philippe; Laville, Maurice; Landais, Paul; Daurès, Jean-Pierre; Mourad, Georges; Bustins, Montserrat; Argilés, Angel

    2014-12-01

    Chronic kidney disease concerns 10 to 14 % of Western populations, and these people are at increased risk of mortality. Treating those patients who reach end-stage renal disease is socially and financially costly and requires considerable medical efforts. While the number of nephrologists per inhabitant in France seems to be preserved over time, the increasing prevalence of end-stage renal disease and improvement in early referral of chronic kidney disease patients results in increased workload for renal physicians. In order to reduce the consequences of chronic kidney disease at both, individual and societal levels, promoting primary prevention (elimination of risk factors), secondary prevention (early management of patients) or tertiary prevention (optimal treatment of functional disabilities related to chronic kidney disease) seems relevant. Some of these actions could narrow the gap between current medical practices and recommendations or prevent new end-stage renal disease cases with an acceptable cost-effectiveness ratio. New approaches might be necessary to better control the disease and overcome current limitations such as resistance to treatments. PMID:25457993

  4. Androgen Receptor Enhances Kidney Stone-CaOx Crystal Formation via Modulation of Oxalate Biosynthesis & Oxidative Stress

    PubMed Central

    Liang, Liang; Li, Lei; Tian, Jing; Lee, Soo Ok; Dang, Qiang; Huang, Chiung-Kuei; Yeh, Shuyuan; Erturk, Erdal; Bushinsky, David; Chang, Luke S.

    2014-01-01

    Males develop kidney stones far more frequently than females with a ratio of 2–3:1, suggesting that androgen receptor (AR) signaling might play a key role in the development of nephrolithiasis. Using the cre-loxP system to selectively knock out AR in glyoxylate-induced calcium oxalate (CaOx) crystal mouse models, we found that the mice lacking hepatic AR had less oxalate biosynthesis, which might lead to lower CaOx crystal formation, and that the mice lacking kidney proximal or distal epithelial AR also had lower CaOx crystal formation. We found that AR could directly up-regulate hepatic glycolate oxidase and kidney epithelial NADPH oxidase subunit p22-PHOX at the transcriptional level. This up-regulation might then increase oxalate biosynthesis and oxidative stress that resulted in induction of kidney tubular injury. Targeting AR with the AR degradation enhancer ASC-J9 led to suppression of CaOx crystal formation via modulation of oxalate biosynthesis and oxidative stress in both in vitro and in vivo studies. Taken together, these results established the roles of AR in CaOx crystal formation. PMID:24956378

  5. Androgen receptor enhances kidney stone-CaOx crystal formation via modulation of oxalate biosynthesis & oxidative stress.

    PubMed

    Liang, Liang; Li, Lei; Tian, Jing; Lee, Soo Ok; Dang, Qiang; Huang, Chiung-Kuei; Yeh, Shuyuan; Erturk, Erdal; Bushinsky, David; Chang, Luke S; He, Dalin; Chang, Chawnshang

    2014-08-01

    Males develop kidney stones far more frequently than females with a ratio of 2-3:1, suggesting that androgen receptor (AR) signaling might play a key role in the development of nephrolithiasis. Using the cre-loxP system to selectively knock out AR in glyoxylate-induced calcium oxalate (CaOx) crystal mouse models, we found that the mice lacking hepatic AR had less oxalate biosynthesis, which might lead to lower CaOx crystal formation, and that the mice lacking kidney proximal or distal epithelial AR also had lower CaOx crystal formation. We found that AR could directly up-regulate hepatic glycolate oxidase and kidney epithelial NADPH oxidase subunit p22-PHOX at the transcriptional level. This up-regulation might then increase oxalate biosynthesis and oxidative stress that resulted in induction of kidney tubular injury. Targeting AR with the AR degradation enhancer ASC-J9 led to suppression of CaOx crystal formation via modulation of oxalate biosynthesis and oxidative stress in both in vitro and in vivo studies. Taken together, these results established the roles of AR in CaOx crystal formation. PMID:24956378

  6. The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

    PubMed Central

    Gonzalez, Ricardo D.; Whiting, Bryant M.

    2012-01-01

    Abstract Background and Purpose Over the last 50 years, chemolysis as a primary or adjuvant treatment for urinary stones has fallen in and out of favor. We review the literature for a historical perspective on the origins and chronology of Renacidin therapy, focusing on landmark studies and impracticalities that have seemingly condemned it to history. Materials and Methods A MEDLINE search was performed on the topic of chemolysis of urinary calculi. Historical literature was reviewed with regard to stone composition, treatment modalities, outcomes, and complications. Results A total of 61 articles were reviewed, 40 of which were case series, representing a total of 817 patients studied. Mulvaney first introduced Renacidin in 1959 as a modification of Suby and Albright's 1943 solution. Because of an overabundance of nonstandardized irrigation protocols, six deaths were reported in the early 1960s resulting in a Food and Drug Administration ban on the practice of upper urinary tract stone dissolution. Over time, Renacidin returned to the urologist's arsenal, appearing first as an adjunct to dissolve catheter and bladder calculi and later (1990) as an approved agent for renal pelvis and ureter use. This feat was almost single-handedly the result of a successful hemiacidrin case series published in 1971 by Nemoy and Stamey. By using daily urine cultures, prophylactic antibiotics, and meticulous intrarenal pressure monitoring, Nemoy and Stamey virtually eliminated all major irrigation complications, paving the way for a flurry of studies. More importantly, they established the link between residual struvite stones, persistent infection, and recurrent staghorn stone formation. Conclusions Dissolution of urinary calculi by chemolysis has been shown to be safe and effective if performed with sterile urine cultures, prophylactic antibiotics, and low intrapelvic pressures. The pioneers of this therapy are remembered for their attempts to develop an alternative to open surgery, and, in the process, solidified the stone-free concept for infection-based stones. PMID:21999455

  7. Cystoman® and calculi: a good alternative to standard therapies in preventing stone recurrence.

    PubMed

    Proietti, S; Giannantoni, A; Luciani, L G; Sortino, G; Graziotti, P; Giusti, G

    2014-08-01

    To assess the efficacy and tolerability of D-mannose-containing product (Cystoman(®)) in preventing recurrence in patients who underwent surgical treatment for infection related urinary stones. From January 2011 to February 2013 we have enrolled all consecutive patients affected by staghorn calculi and recurrent urinary tract infections (UTIs). All patients recommended for surgery were scheduled for percutaneous nephrolithotomy. The study agent was administered daily for 5 months after surgical procedure. At baseline and 5-month follow-up all patients underwent abdominal Computed Tomography (CT) scan and they also completed Medical Outcomes Study short-form, 36-item questionnaire (SF-36). They performed urine and urine culture monthly. The primary endpoints were the assessment of the efficacy with regard to infection-related urinary stone recurrence and the tolerability of Cystoman(®). The secondary endpoint was the evaluation of quality-of-life symptoms. During the study period, a total of 27 patients were included in the study. The data from 25 patients were analyzable. Seventeen patients (68%) did not report UTIs during follow-up. Eight patients (32%) remained infected and the average number of UTIs was 2.6 ± 1.6 in 5 months. At 5-month follow-up 17 (68%) patients were free from stones recurrence; in 8 (32%) cases CT scan revealed stone recurrence with an average stone diameter of 1.1 ± 0.4 cm. In nonrecurring patients, 2 (11.7%) reported an average of 1.5 ± 0.7 UTIs episodes; in recurring patients, 6 (75%) showed 3 ± 1.67 of UTIs episodes. Statistically significant differences were seen in the occurrence of UTIs episodes were detected between nonrecurring stone patients and recurring patients (p < 0.05). Moreover, statistically significant changes were detected in SF-36 scores from baseline to month 5 in the categories of physical functioning and energy/fatigue (p < 0.05). Cystoman(®) is effective in preventing infection-related urinary stones. PMID:24972556

  8. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1year of age. A single-center experience.

    PubMed

    Da?glli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utan?a, Mehmet Mazhar; Bodaki, Mehmet Nuri; Penbegl, Necmettin; Hatipo?lu, Nam?k Kemal; akmak?, Sleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL. PMID:26002160

  9. Modern management of stone disease in patients with a solitary kidney

    PubMed Central

    Tkocz, Michał; Ziaja, Damian

    2011-01-01

    Analysing the data available in the literature, contemporary methods of treatment of nephrolithiasis are limited to the methods of minimally invasive percutaneous nephrolithotomy (PCNL) and ureterorenoscopic lithotripsy (URSL), not excluding their use in the presence of developmental abnormalities and kidney impairment only. Minimally invasive methods have become standard procedures. A complement to ineffective URSL and PCNL treatment is extracorporeal shock wave lithotripsy. This is confirmed by 30 years of observation in the only treatment of kidney calculi by Alken launched in 1981 and continued by Jones et al. Before the era of endoscopic procedures (PCNL and URSL) effectively removed the only deposits in the kidney in open operations. Minimally invasive treatments are recommended for patients with localized deposits in the pelvicalyceal system or solitary kidney ureter. They are recognized as safe and effective treatment in a solitary kidney in particular in patients who have already been operated on. PMID:23255993

  10. Impaired expression of an organic cation transporter, IMPT1, in a knockout mouse model for kidney stone disease.

    PubMed

    Tzortzaki, Eleni G; Yang, Min; Glass, Dayna; Deng, Li; Evan, Andrew P; Bledsoe, Sharon B; Stambrook, Peter J; Sahota, Amrik; Tischfield, Jay A

    2003-08-01

    The imprinted multimembrane-spanning polyspecific transporter-like gene 1 ( IMPT1) encodes a predicted protein with organic cation transport capabilities. As a first step in understanding the function of IMPT1, we identified the renal structures expressing this gene in knockout mice with adenine phosphoribosyltransferase (APRT) deficiency and 2,8-dihydroxyadenine (DHA) nephrolithiasis. IMPT1 mRNA was not detected using a standard in situ hybridization (ISH) protocol, but we observed intense staining in cortico-medullary tubules and glomeruli in wild-type mice using an improved reverse transcription-polymerase chain reaction (RT-PCR) ISH procedure. IMPT1 mRNA expression was significantly decreased in the cortical region in kidney sections from APRT-deficient male mice. APRT-deficient female mice are less severely affected by DHA-induced kidney stone disease, and we observed only a modest reduction in IMPT1 expression in kidneys from these mice. IMPT1 expression in APRT heterozygous mice was comparable to that in wild-type mice, suggesting imprinting of one of the parental alleles. These findings suggest that decreased IMPT1 mRNA expression may contribute to the impaired renal function in APRT-deficient male mice, and that RT-PCR ISH is a valuable tool for localizing the site of expression of transcripts that are not detectable using standard ISH procedures. PMID:12856169

  11. Qualification and application of an ELISA for the determination of Tamm Horsfall protein (THP) in human urine and its use for screening of kidney stone disease.

    PubMed

    Lau, Wai-Hoe; Leong, Wing-Seng; Ismail, Zhari; Gam, Lay-Harn

    2008-01-01

    Kidney stone disease affects 1 - 20% of the general population. At present, the diagnosis of a stone is done using radiography method when noticeable symptoms appeared. We developed a non-invasive quantitative assay for urinary THP, namely ELISA; whereby our previous study and other reports had shown the usefulness of THP as biomarker for kidney stone disease. Since urine is biological fluid that is easily obtainable, this method could be used as a screening assay for kidney stone prior to confirmation with radiography. The ELISA gave assay linearity r(2) > 0.999 within the range of 109 ng/mL to 945 ng/mL THP. Assay precisions were < 4% (C.V.) for repeatability and < 5% (C.V.) for reproducibility. Assay accuracy range from 97.7% to 101.2% at the various THP concentrations tested. Assay specificity and sensitivity were 80% and 86%, respectively. The cut-off points at P < 0.05 were 37.0 and 41.2 mug/mL for male and female, respectively. The assay is cost effective and rapid whereby the cost for assaying each urine sample in duplicate is approximately USD0.35 and within 5 hours, 37 samples can be assayed alongside full range of standards and 3 QC samples in each plate. Furthermore, sample preparation is relatively easy where urine sample was diluted 10 times in TEA buffer. The usability of the ELISA method for diagnosis of kidney stone disease is evaluated with 117 healthy subjects and 58 stone formers. PMID:18695745

  12. Urinary stone composition in Oman: with high incidence of cystinuria.

    PubMed

    Al-Marhoon, Mohammed S; Bayoumi, Riad; Al-Farsi, Yahya; Al-Hinai, Abdullhakeem; Al-Maskary, Sultan; Venkiteswaran, Krishna; Al-Busaidi, Qassim; Mathew, Josephkunju; Rhman, Khalid; Sharif, Omar; Aquil, Shahid; Al-Hashmi, Intisar

    2015-06-01

    Urinary stones are a common problem in Oman and their composition is unknown. The aim of this study is to analyze the components of urinary stones of Omani patients and use the obtained data for future studies of etiology, treatment, and prevention. Urinary stones of 255 consecutive patients were collected at the Sultan Qaboos University Hospital. Stones were analyzed by Fourier transform infrared spectrophotometer. The biochemical, metabolic, and radiological data relating to the patients and stones were collected. The mean age was 41 years, with M:F ratio of 3.7:1. The common comorbidities associated with stone formation were hypertension; diabetes, benign prostate hyperplasia; urinary tract infection; obesity; and atrophic kidney. The common presentation was renal colic and flank pain (96%). Stones were surgically retrieved in 70% of patients. Mean stone size was 9 ± 0.5 mm (range 1.3-80). Stone formers had a BMI ≥ 25 in 56% (P = 0.006) and positive family history of stones in 3.8%. The most common stones in Oman were as follows: Calcium Oxalates 45% (114/255); Mixed calcium phosphates & calcium oxalates 22% (55/255); Uric Acid 16% (40/255); and Cystine 4% (10/255). The most common urinary stones in Oman are Calcium Oxalates. Overweight is an important risk factor associated with stone formation. The hereditary Cystine stones are three times more common in Oman than what is reported in the literature that needs further genetic studies. PMID:25805105

  13. Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

    PubMed Central

    Tasanarong, Adis

    2014-01-01

    Contrast-induced acute kidney injury (CI-AKI) is the most common iatrogenic cause of acute kidney injury after intravenous contrast media administration. In general, the incidence of CI-AKI is low in patients with normal renal function. However, the rate is remarkably elevated in patients with preexisting chronic kidney disease, diabetes mellitus, old age, high volume of contrast agent, congestive heart failure, hypotension, anemia, use of nephrotoxic drug, and volume depletion. Consequently, CI-AKI particularly in high risk patients contributes to extended hospitalizations and increases long-term morbidity and mortality. The pathogenesis of CI-AKI involves at least three mechanisms; contrast agents induce renal vasoconstriction, increase of oxygen free radicals through oxidative stress, and direct tubular toxicity. Several strategies to prevent CI-AKI have been evaluated in experimental studies and clinical trials. At present, intravascular volume expansion with either isotonic saline or sodium bicarbonate solutions has provided more consistent positive results and was recommended in the prevention of CI-AKI. However, the proportion of patients with risk still develops CI-AKI. This review critically evaluated the current evidence for pharmacological strategies to prevent CI-AKI in patients with a risk of developing CI-AKI. PMID:24719848

  14. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial

    PubMed Central

    Moosanejad, N.; Firouzian, A.; Hashemi, S.A.; Bahari, M.; Fazli, M.

    2016-01-01

    This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques regarding their rates of success and complications in patients with kidney stones. Patients were randomly assigned to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years) received totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or ureteral catheter after PCNL) and 40 patients (18 men; mean age: 49.95±13.38 years) underwent standard PCNL (a nephrostomy catheter and ureteral catheter were used after PCNL). All surgeries were performed by one surgeon. Postoperative changes in hemoglobin, the blood transfusion rate, changes in creatinine levels, operation time, analgesic need, hospitalization time, and complication rate were compared between the groups. No significant differences were observed in age, gender, stone size, and surgery side between the groups (P<0.05). The operation time was significantly lower in the totally tubeless PCNL group than in the standard PCNL group (P=0.005). Pethidine requirements were significantly higher in the standard PCNL group than the totally tubeless PCNL group (P=0.007). Hospitalization time was significantly higher in the standard PCNL group than in the totally tubeless PCNL group (P<0.0001). The complication rate was 15% in the standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73). The totally tubeless PCNL technique is safe and effective, even for patients with staghorn stones. This technique is associated with decreased pain, analgesic needs, and operative and hospitalization time. We believe that a normal peristaltic ureter is the best drainage tube. PMID:27007650

  15. A wandering path toward prevention for acute kidney injury.

    PubMed

    Atkinson, Simon J

    2016-05-01

    Acute kidney injury (AKI) is a common cause of hospital-related mortality; therefore, strategies to either prevent or treat this complication are of great interest. In this issue of the JCI, Inoue, Abe, and colleagues have uncovered a targetable neuroimmunomodulatory mechanism that protects mice from ischemia-reperfusion injury (IRI) and subsequent AKI. Specifically, the authors demonstrate that vagus nerve stimulation (VNS) activates the cholinergic antiinflammatory pathway (CAP), resulting in activation of antiinflammatory effects via α7 nicotinic acetylcholine receptor-expressing splenic macrophages. Together, the results of this study have potential clinical implications in the prevention of AKI in at-risk individuals. PMID:27088799

  16. Association Between Kidney Stones and Risk of Stroke: A Nationwide Population-Based Cohort Study.

    PubMed

    Lin, Shih-Yi; Lin, Cheng-Li; Chang, Yen-Jung; Hsu, Wu-Huei; Lin, Cheng-Chieh; Wang, I-Kuan; Chang, Chiz-Tzung; Chang, Chao-Hsiang; Lin, Ming-Chia; Kao, Chia-Hung

    2016-02-01

    Nephrolithiasis is highly prevalent and has been associated with vascular diseases such as cardiovascular events. Few studies have comprehensively associated renal stones with stroke.This study explored whether patients with renal stones were at a higher stroke risk than those without renal stones. A national insurance claim dataset of 22 million enrollees in Taiwan was used to identify 53,659 patients with renal stones, and 214,107 were selected as age-, sex-, and comorbidity-matched controls for a 13-year follow-up.The relative stroke risk for the RS cohort was 1.06-fold higher than that for the non-RS group (95% confidence interval [CI] = 1.01-1.11). Age-specific analysis revealed that the adjusted stroke risk for the RS cohort increased as age decreased, with the highest risk of 1.47-fold (95% CI = 1.10-1.96) in patients aged 20 to 34 years, followed by a 1.12-fold risk (95% CI = 1.00-1.25) in patients aged 35 to 50 years. Sex-specific analysis clarified that women in the RS group had a 1.12-fold stroke risk compared with women in the non-RS group (95% CI = 1.03-1.21). Patients who had undergone >4 surgeries had up to 42.5-fold higher risk of stroke (95% CI = 33.8-53.4).The study utilized the national database and demonstrated that patients, particularly women and the younger population, with nephrolithiasis have an increased risk of ischemic stroke development. Patients treated with medication or through surgery for RSs showed steady and higher risks of stroke than those without surgical or medical intervention. PMID:26937915

  17. Prevention and conservative management of acute kidney injury.

    PubMed

    Vanmassenhove, Jill; Veys, Nic; VAN Biesen, Wim

    2016-02-01

    The incidence of acute kidney injury (AKI) is increasing steadily. This can be attributed to a growing prevalence of risk factors for AKI, such as aging, diabetes, underlying cardiovascular disease and the escalating application of more complex procedures. Currently, there is no treatment for established AKI, except for renal replacement therapy in case of life-threatening conditions. The focus should thus be shifted towards AKI prevention rather than treatment. Several promising pharmacological and non-pharmacological interventions for prevention of AKI in animal models did not fulfill the expectations when applied in humans. There are multiple reasons why these interventions prove to be disappointing. The pathophysiology of AKI in different settings has not been fully elucidated, the underlying cause of AKI in the clinical setting is often multifactorial, and animal AKI models often do not mimic human AKI very well. Ischemia-reperfusion models are representative for human AKI in the setting of aortic clamping or in case of delayed graft function after kidney transplantation, but are not suited to study AKI in many other conditions such as sepsis. Moreover, several drugs for AKI prevention are associated with deleterious adverse events in humans as they lack selectivity. In this review, an overview of the strategies that can be used in the clinical setting for AKI prevention will be presented. Potential preventive strategies in certain specific clinical conditions will also be reviewed. PMID:26583594

  18. Miniature ball-tip optical fibers for use in thulium fiber laser ablation of kidney stones

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Kennedy, Joshua D.; Irby, Pierce B.; Fried, Nathaniel M.

    2016-01-01

    Optical fibers, consisting of 240-μm-core trunk fibers with rounded, 450-μm-diameter ball tips, are currently used during Holmium:YAG laser lithotripsy to reduce mechanical damage to the inner lining of the ureteroscope working channel during fiber insertion and prolong ureteroscope lifetime. Similarly, this study tests a smaller, 100-μm-core fiber with 300-μm-diameter ball tip during thulium fiber laser (TFL) lithotripsy. TFL was operated at a wavelength of 1908 nm, with 35-mJ pulse energy, 500-μs pulse duration, and 300-Hz pulse rate. Calcium oxalate/phosphate stone samples were weighed, laser procedure times were measured, and ablation rates were calculated for ball tip fibers, with comparison to bare tip fibers. Photographs of ball tips were taken before and after each procedure to track ball tip degradation and determine number of procedures completed before need for replacement. A high speed camera also recorded the cavitation bubble dynamics during TFL lithotripsy. Additionally, saline irrigation rates and ureteroscope deflection were measured with and without the presence of TFL fiber. There was no statistical difference (P>0.05) between stone ablation rates for single-use ball tip fiber (1.3±0.4 mg/s) (n=10), multiple-use ball tip fiber (1.3±0.5 mg/s) (n=44), and conventional single-use bare tip fibers (1.3±0.2 mg/s) (n=10). Ball tip durability varied widely, but fibers averaged greater than four stone procedures before failure, defined by rapid decline in stone ablation rates. Mechanical damage at the front surface of the ball tip was the limiting factor in fiber lifetime. The small fiber diameter did not significantly impact ureteroscope deflection or saline flow rates. The miniature ball tip fiber may provide a cost-effective design for safe fiber insertion through the ureteroscope working channel and into the ureter without risk of instrument damage or tissue perforation, and without compromising stone ablation efficiency during TFL lithotripsy.

  19. Ambient temperature as a contributor to kidney stone formation: implications of global warming.

    PubMed

    Fakheri, Robert J; Goldfarb, David S

    2011-06-01

    Nephrolithiasis is a common disease across the world that is becoming more prevalent. Although the underlying cause for most stones is not known, a body of literature suggests a role of heat and climate as significant risk factors for lithogenesis. Recently, estimates from computer models predicted up to a 10% increase in the prevalence rate in the next half century secondary to the effects of global warming, with a coinciding 25% increase in health-care expenditures. Our aim here is to critically review the medical literature relating stones to ambient temperature. We have categorized the body of evidence by methodology, consisting of comparisons between geographic regions, comparisons over time, and comparisons between people in specialized environments. Although most studies are confounded by other factors like sunlight exposure and regional variation in diet that share some contribution, it appears that heat does play a role in pathogenesis in certain populations. Notably, the role of heat is much greater in men than in women. We also hypothesize that the role of a significant human migration (from rural areas to warmer, urban locales beginning in the last century and projected to continue) may have a greater impact than global warming on the observed worldwide increasing prevalence rate of nephrolithiasis. At this time the limited data available cannot substantiate this proposed mechanism but further studies to investigate this effect are warranted. PMID:21451456

  20. Hyaluronan and Stone Disease

    NASA Astrophysics Data System (ADS)

    Asselman, Marino

    2008-09-01

    Kidney stones cannot be formed as long as crystals are passed in the urine. However, when crystals are retained it becomes possible for them to aggregate and form a stone. Crystals are expected to be formed not earlier than the distal tubules and collecting ducts. Studies both in vitro and in vivo demonstrate that calcium oxalate monohydrate crystals do not adhere to intact distal epithelium, but only when the epithelium is proliferating or regenerating, so that it possesses dedifferentiated cells expressing hyaluronan, osteopontin (OPN) and their mutual receptor CD44 at the apical cell membrane. The polysaccharide hyaluronan is an excellent crystal binding molecule because of its negative ionic charge. We hypothesized that the risk for crystal retention in the human kidney would be increased when tubular cells express hyaluronan at their apical cell membrane. Two different patient categories in which nephrocalcinosis frequently occurs were studied to test this hypothesis (preterm neonates and kidney transplant patients). Hyaluronan (and OPN) expression at the luminal membrane of tubular cells indeed was observed, which preceded subsequent retention of crystals in the distal tubules. Tubular nephrocalcinosis has been reported to be associated with decline of renal function and thus further studies to extend our knowledge of the mechanisms of retention and accumulation of crystals in the kidney are warranted. Ultimately, this may allow the design of new strategies for the prevention and treatment of both nephrocalcinosis and nephrolithiasis in patients.

  1. Reprogramming: A Preventive Strategy in Hypertension Focusing on the Kidney

    PubMed Central

    Tain, You-Lin; Joles, Jaap A.

    2015-01-01

    Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent hypertension in adult life by administrating appropriate compounds during early development. We have termed this reprogramming. While the risk of hypertension has been assessed in many mother-child cohorts of human developmental programming, interventions necessary to prove causation and provide a reprogramming strategy are lacking. Since the developing kidney is particularly vulnerable to environmental insults and blood pressure is determined by kidney function, renal programming is considered key in developmental programming of hypertension. Common pathways, whereby both genetic and acquired developmental programming converge into the same phenotype, have been recognized. For instance, the same reprogramming interventions aimed at shifting nitric oxide (NO)-reactive oxygen species (ROS) balance, such as perinatal citrulline or melatonin supplements, can be protective in both genetic and developmentally programmed hypertension. Furthermore, a significantly increased expression of gene Ephx2 (soluble epoxide hydrolase) was noted in both genetic and acquired animal models of hypertension. Since a suboptimal environment is often multifactorial, such common reprogramming pathways are a practical finding for translation to the clinic. This review provides an overview of potential clinical applications of reprogramming strategies to prevent programmed hypertension. We emphasize the kidney in the following areas: mechanistic insights from human studies and animal models to interpret programmed hypertension; identified risk factors of human programmed hypertension from mother-child cohorts; and the impact of reprogramming strategies on programmed hypertension from animal models. It is critical that the observed effects on developmental reprogramming in animal models are replicated in human studies. PMID:26712746

  2. Acute kidney injury by radiographic contrast media: pathogenesis and prevention.

    PubMed

    Andreucci, Michele; Faga, Teresa; Pisani, Antonio; Sabbatini, Massimo; Michael, Ashour

    2014-01-01

    It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24-72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

  3. Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

    PubMed Central

    Faga, Teresa; Pisani, Antonio; Michael, Ashour

    2014-01-01

    It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

  4. Urinary polyaromatic hydrocarbons are associated with adult celiac disease and kidney stones: USA NHANES, 2011-2012.

    PubMed

    Shiue, Ivy

    2016-02-01

    Links between environmental chemicals and human health have emerged over the last few decades, but the effects from polyaromatic hydrocarbons (PAH) were less studied, compared to other commonly known environmental chemicals such as heavy metals, phthalates, arsenic, phenols, and pesticides. Therefore, it was aimed to study the relationships of urinary PAH and adult digestive conditions using a large human sample in a national and population-based study in recent years. Data was retrieved from the US National Health and Nutrition Examination Surveys, 2011-2012 including demographics, self-reported health conditions, and urinary PAH. Statistical analyses included chi-square test, t test, survey-weighted logistic regression modeling, and population attributable risk (PAR) estimation. Of 5560 American adults aged 20-80 and included in the statistical analysis, urinary 4-hydroxyphenanthrene was significantly associated with celiac disease (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.14-2.26, P?=?0.009). In addition, urinary 2-hydroxyfluorene (OR 1.35, 95% CI 1.02-1.78, P?=?0.038), 3-hydroxyfluorene (OR 1.35, 95% CI 1.07-1.70, P?=?0.015), 1-hydroxyphenanthrene (OR 1.48, 95% CI 1.08-2.03, P?=?0.017), 1-hydroxypyrene (OR 1.36, 95% CI 1.05-1.77, P?=?0.023), and 2-hydroxynapthalene (OR 1.25, 95% CI 1.00-1.58, P?=?0.054) were significantly associated with kidney stones, although not necessarily failing kidney. There were no statistically significant associations observed in the relationship of urinary PAH and liver problems, although higher levels of PAHs were observed. Urinary PAHs are associated with adult digestive conditions, although the causality cannot be established. From the research perspective, longitudinal monitoring from observational studies and experimental research understanding mechanism would be suggested. Regulation of minimizing PAHs exposure might need to be considered in future health and environmental policies. PMID:26728287

  5. Men and women in space: bone loss and kidney stone risk after long-duration spaceflight.

    PubMed

    Smith, Scott M; Zwart, Sara R; Heer, Martina; Hudson, Edgar K; Shackelford, Linda; Morgan, Jennifer Ll

    2014-07-01

    Bone loss, a key concern for long-duration space travelers, is typically considered a female issue. The number of women who have flown long-duration space missions is now great enough to allow a quantitative comparison of changes in bone and renal stone risk by sex. Participants were 42 astronauts (33 men and 9 women) on long-duration missions to the International Space Station. Bone mineral density (by dual-energy X-ray absorptiometry) and biochemical markers of bone metabolism (from blood and urine samples) were evaluated before and after flight. Data were analyzed in two groups, based on available resistance exercise equipment. Missions were 49 to 215 days in duration, flown between 2000 and 2012. The bone density response to spaceflight was the same for men and women in both exercise groups. The bone mineral density response to flight was the same for men and women, and the typical decrease in bone mineral density (whole body and/or regional) after flight was not observed for either sex for those using an advanced resistive exercise device. Biochemical markers of bone formation and resorption responded similarly in male and female astronauts. The response of urinary supersaturation risk to spaceflight was not significantly different between men and women, although risks were typically increased after flight in both groups, and risks were greater in men than in women before and after flight. The responses of men and women to spaceflight with respect to these measures of bone health were not different. PMID:24470067

  6. Catechin prevents the calcium oxalate monohydrate induced renal calcium crystallization in NRK-52E cells and the ethylene glycol induced renal stone formation in rat

    PubMed Central

    2013-01-01

    Background Reactive oxygen species play important roles in renal calcium crystallization. In this study, we examined the effects of catechin, which have been shown to have antioxidant properties on the renal calcium crystallization. Methods In the vitro experiment, the changes of the mitochondrial membrane potential, expression of superoxide dismutase (SOD), 4-hydroxynonenal (4-HNE), cytochrome c, and cleaved caspase 3 were measured to show the effects of catechin treatment on the NRK-52E cells induced by calcium oxalate monohydrate (COM). In the vivo study, Sprague–Dawley rats were administered 1% ethylene glycol (EG) to generate a rat kidney stone model and then treated with catechin (2.5 and 10 mg/kg/day) for 14 days. The urine and serum variables were dected on 7 and 14 days after EG administration. The expression of cytochrome c, cleaved caspase 3, SOD, osteopontin (OPN), malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHdG) in kidney were measured. Furthermore, the mitochondrial microstructure in the kidney was also examined by transmission electron microscopy. Results Catechin treatment could prevent the changes in mitochondrial membrane potential and expression of SOD, 4-HNE, cytochrome c, and cleaved caspase 3 in NRK-52E cells induced by the COM. For the in vivo experiments, the EG administration induced renal calcium crystallization was also prevented by the catechin. The expression of SOD, OPN, MDA, OPN and 8-OHdG, were increased after EG administration and this increase was diminished by catechin. Moreover, catechin also prevented EG induced mitochondrial collapse in rat. Conclusions Catechin has preventive effects on renal calcium crystallization both in vivo and in vitro, and provide a potential therapeutic treatment for this disease. PMID:24044655

  7. Preventive and therapeutic effects of sodium bicarbonate on melamine-induced bladder stones in mice.

    PubMed

    Ren, Shu-Ting; Du, Yun-Xia; Xu, Chang-Fu; Zhang, Jiao-Jiao; Mo, Li-Ping; Sun, Ying; Gao, Xiao-Li

    2014-10-01

    The actual preventive and therapeutic effects of alkalinizing urine on melamine-induced bladder stones (cystolith) are not completely known. Using an ideal model, two experiments were conducted in Balb/c mice. The mice were fed a normal diet in controls and a melamine diet in the other groups. The first day was set as experiment-day 1. In "Experiment 1", either low-/mid-/high-dose sodium bicarbonate (SB) or sterile water was administered by intragastric perfusion (once daily) to the mice for 14 days. Relative to the model group, the mean pH of the urine in the SB groups was significantly elevated at 3 h after SB administration, with a significant decrease in cystolith incidence on experiment-day 14. In "Experiment 2", on experiment-day 12, the melamine diet was replaced by a normal diet in 4 groups with melamine withdrawal (MW). Meanwhile, either mid-/high-dose SB or sterile water was administered by intragastric perfusion (once) to the mice in the corresponding groups. On experiment-day 12, after an additional 8 h, the cystolith incidence was significantly reduced in the high-SB, MW + mid-SB and MW + high-SB groups than in the model group. In conclusion, low urinary pH is one of the main determinants of the formation of melamine-associated stones, urinary alkalinization can be achieved by a proper dose of oral SB, and SB acts to prevent and treat melamine-induced cystoliths in mice. PMID:25092435

  8. Multielement analysis of human hair and kidney stones by instrumental neutron activation analysis with the k0-standardization method.

    PubMed

    Abugassa, I; Sarmani, S B; Samat, S B

    1999-06-01

    This paper focuses on the evaluation of the k0 method of instrumental neutron activation analysis in biological materials. The method has been applied in multielement analysis of human hair standard reference materials from IAEA, No. 085, No. 086 and from NIES (National Institute for Environmental Sciences) No. 5. Hair samples from people resident in different parts of Malaysia, in addition to a sample from Japan, were analyzed. In addition, human kidney stones from members of the Malaysian population have been analyzed for minor and trace elements. More than 25 elements have been determined. The samples were irradiated in the rotary rack (Lazy Susan) at the TRIGA Mark II reactor of the Malaysian Institute for Nuclear Technology and Research (MINT). The accuracy of the method was ascertained by analysis of other reference materials, including 1573 tomato leaves and 1572 citrus leaves. In this method the deviation of the 1/E1+ alpha epithermal neutron flux distribution from the 1/E law (P/T ratio) for true coincidence effects of the gamma-ray cascade and the HPGe detector efficiency were determined and corrected for. PMID:10355102

  9. Nonlinear effects in ultrasound fields of diagnostic-type transducers used for kidney stone propulsion: Characterization in water

    NASA Astrophysics Data System (ADS)

    Karzova, M.; Cunitz, B.; Yuldashev, P.; Andriyakhina, Y.; Kreider, W.; Sapozhnikov, O.; Bailey, M.; Khokhlova, V.

    2015-10-01

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher intensity at the focus to provide stronger pushing force; however, nonlinear acoustic saturation can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match the focal geometry of the beam as measured at a low power output. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging.

  10. Nonlinear Effects in Ultrasound Fields of Diagnostic-type Transducers Used for Kidney Stone Propulsion: Characterization in Water

    PubMed Central

    Karzova, M.; Cunitz, B.; Yuldashev, P.; Andriyakhina, Y.; Kreider, W.; Sapozhnikov, O.; Bailey, M.; Khokhlova, V.

    2016-01-01

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher transducer output to provide stronger pushing force; however, nonlinear acoustic saturation effect can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match low power pressure beam scans. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging.

  11. Aortic Stent-Graft Infection Following Septic Complications of a Kidney Stone

    SciTech Connect

    Berg, H. Rogier van den Leijdekkers, Vanessa J.; Vahl, Anco

    2006-06-15

    A 73-year-old man was treated because of a renal pelvis blowout of the left kidney for which he received a nephrostomy catheter without antibiotic prophylaxis. Almost a year previously this patient had undergone endovascular repair of a symptomatic infrarenal abdominal aorta aneurysm. Four weeks after the diagnosis and treatment of the ruptured renal pelvis, a new computed tomography scan and ultrasound-guided fine needle aspiration confirmed the diagnosis of infected aortic stent-graft. An extra-anatomic axillo-uniiliac bypass and graft excision was performed. Two weeks after discharge the patient returned to the hospital with an occlusion of his left renal artery and died of renal failure. This is the first time an infected aortic stent-graft after a renal pelvis blowout has been reported. Although infections of aortic stent-grafts occur rarely, one should be aware of the possibility in aortic stent-graft patients undergoing abdominal procedures without antibiotic prophylaxis.

  12. Lymphocytopenia may be a new indicator for infected obstructed kidneys secondary to urinary stone disease

    PubMed Central

    Ali, Ahmed; Farell, Liam; Somani, Bhaskar K.

    2015-01-01

    Objective: Infected obstructed kidney (IOK) is a urological emergency. We wanted to look at the role of serum inflammatory markers in these patients. Materials and Methods: Patients with IOK requiring percutaneous nephrostomy (PCN) at our university hospital were identified, and data were collected on lymphocyte count, C-reactive protein (CRP) and microbiology results. Results: Thirty-nine patients had PCN for IOK. Lymphocytopenia was seen in two-thirds of these patients. Severe lymphocytopenia was associated with a significant rise in CRP in all cases and following PCN, lymphocytopenia improved in the majority of cases. Conclusions: Lymphocytopenia seems to be associated with the severity of infection and could be a surrogate marker on its own or in conjunction with CRP for initial diagnosis and monitoring response to treatment in patients with IOKs. PMID:26692668

  13. Diagnosis and prevention of chronic kidney allograft loss.

    PubMed

    Nankivell, Brian J; Kuypers, Dirk R J

    2011-10-15

    Kidney transplantation is the best possible treatment for many patients with end-stage renal failure, but progressive dysfunction and eventual allograft loss with return to dialysis is associated with increased mortality and morbidity. Immune injury from acute or chronic rejection and non-immune causes, such as nephrotoxicity from calcineurin inhibitors, ischaemia-reperfusion injury, recurrent glomerular disease, and allograft BK viral infection, are potential threats. Serial monitoring of renal function enables early recognition of chronic allograft dysfunction, and investigations such as therapeutic drug concentrations, urinalysis, imaging, and a diagnostic biopsy should be undertaken before irreversible nephron loss has occurred. Specific interventions targeting the pathophysiological cause of dysfunction include strengthening of immunosuppression for chronic rejection, or calcineurin inhibitor minimisation, substitution, or elimination if nephrotoxicity dominates. Recommended proactive preventive measures are control of hypertension, proteinuria, dyslipidaemia, diabetes, smoking, and other comorbidities. Strategies to maintain transplant function and improve long-term graft survival are important goals of translational research. PMID:22000139

  14. Therapy for urolithiasis with hydroxamic acids. IV. Prevention of infected urinary stone formation with N-(pivaloyl)glycinohydroxamic acid.

    PubMed

    Satoh, M; Munakata, K; Kitoh, K; Seto, N; Kanazawa, T; Takeuchi, H; Yoshida, O

    1981-07-01

    With the aim of finding a prospective therapeutic compound with a promising potential for the treatment of urolithiasis, we evaluated the effectiveness of a new potent inhibitor of urease, N-(pivaloyl)glycinohydroxamic acid. The present study revealed that N-(pivaloyl)glycinohydroxamic acid effectively inhibited the alkalinization of urine and the stone formation in vitro and in vivo, due to its strong inhibitory potency against the ureolytic activity of intact Proteus mirabilis. The possibility of the clinical application of this compound in the prevention of struvite stone formation caused by infection of urea-splitting bacteria awaits evaluation of the safety of this compound. PMID:7028944

  15. [Prevention of infected urinary stones by urease inhibitor. IV. Treatment of infection stones in rats by a new hydroxamic acid and cefalexin].

    PubMed

    Takeuchi, H; Tomoyoshi, T; Okada, Y; Yoshida, O; Kobashi, K

    1983-03-01

    We investigated the combined effectiveness of a new urease inhibitor, N-( pivaroyl ) glycinohydroxamic acid, with Cefalexin in the treatment of infection stones in rats. Combination therapy with the hydroxamic acid and Cefalexin inhibited bladder stone formation, and dissolved the stone dose dependently, while separate therapy was not significantly effective against stone formation or bacterial growth. This compound may become a useful medicine for the treatment of infection stones. PMID:6375315

  16. Bariatric Surgery and Stone Disease

    NASA Astrophysics Data System (ADS)

    Lieske, John C.; Kumar, Rajiv

    2008-09-01

    Bariatric surgery is an effective treatment strategy for patients with morbid obesity that can result in effective weight loss, resolution of diabetes mellitus and other weight related complications, and even improved mortality. However, it also appears that hyperoxaluria is common after modern bariatric surgery, perhaps occurring in up to 50% of patients after Rouxen-Y gastric bypass. Although increasing numbers of patients are being seen with calcium oxalate kidney stones after bariatric surgery, and even a few with oxalosis and renal failure, the true risk of these outcomes remains unknown. The mechanisms that contribute to this enteric hyperoxaluria are also incompletely defined, although fat malabsorption may be an important component. Since increasing numbers of these procedures are likely to be performed in the coming years, further study regarding the prevalence and mechanisms of hyperoxaluria and kidney stones after bariatric surgery is needed to devise effective methods of treatment in order to prevent such complications.

  17. Pears and renal stones: possible weapon for prevention? A comprehensive narrative review.

    PubMed

    Manfredini, R; De Giorgi, A; Storari, A; Fabbian, F

    2016-02-01

    Urinary stones have been recognized as a human disease since dawn of history and treatment of this condition is reported by Egyptian medical writings. Also, pears have a very long history, being one of the earliest cultivated fruit trees and also known for medicinal use. Urinary tract stone formation represents a common condition and also a significant burden for health care service, due also to possible frequent relapses. Furthermore, urinary stones have been reported to have relationship with different metabolic derangements, and appropriate diet could contribute to avoid or reduce urinary stone formation. Citrate is an inhibitor of crystal growth in the urinary system, and hypocitraturia represents a main therapeutical target in stone formers. Pears contain a significant amount of malic acid, a precursor of citrate, and have antioxidant activity as well. A diet supplemented with pears, and associated with low consumption of meat and salt could impact positively cardiometabolic risk and urinary tract stone formation. However, very few studies evaluated the impact of pears utilization on health, and none on urinary tract stone formation in particular. High content in malate could warrant protection against stone formation, avoiding patients at high risk to be compelled to assume a considerable and expensive amount of pills. PMID:26914114

  18. [Preventive measures in stones due to infection, uric acid and cystine].

    PubMed

    Hess, B; Ackermann, D

    1992-01-01

    General prophylaxis of renal stone formation consists of 1. high fluid intake and 2. modest consumption of protein-rich foods. Specific prophylactic measures are based on pathophysiologic mechanisms of stone formation. In infection-induced renal stones, combined treatment with culture specific antibiotics and complete stone removal is of utmost importance. In all cases where stone fragments cannot be removed completely and/or partial obstruction remains, long-term antibiotics in combination with urine acidification by methionine (urine pH 5.6 to 6.2) are most appropriate. Prophylaxis of uric acid stones primarily consists of reducing purine intake and alkalizing the urine by potassium citrate. Only if this regimen failed or gout occurred, allopurinol should be administered. In patients with cystine stones, urine volume should be increased to greater than 3000 ml/die. Alkalizing the urine to a pH greater than 7.5 rises cystine solubility, whereas cystine excretion may be reduced by a diet low in sodium and/or low in methionine/cysteine. Thiols form mixed thiol-cysteine disulfides that are many times more soluble than cystine in urine; because of their high rate of adverse side-effects, however, these compounds are of lowest priority in the treatment of cystine stones. There is no convincing evidence for the efficacy of high dose ascorbic acid treatment in cystinuria. PMID:1736401

  19. Prevention, detection and management of acute kidney injury: concise guideline.

    PubMed

    Ftouh, Saoussen; Lewington, Andrew

    2014-02-01

    Acute kidney injury (AKI) is considered a silent disease that commonly occurs in patients with acute illness; however, given that it has few specific symptoms and signs in its early stages, detection can be delayed. AKI can also occur in patients with no obvious acute illness or secondary to more rare causes. In both these scenarios, patients are often under the care of specialists outside of nephrology, who might fail to detect that AKI is developing and might not be familiar with its optimum management. Therefore, there is a need to increase the awareness of AKI among many different healthcare specialists. In this article, we summarise the key recommendations from the National Institute for Health and Care Excellence (NICE) AKI guideline. The guideline provides recommendations for adult and paediatric patients on the prevention, early detection and management of AKI, as well as information on AKI and sources of support. Implementation of this guideline will contribute to improving patient safety and saving lives. PMID:24532748

  20. Comparison of shock wave lithotripsy (SWL) and retrograde intrarenal surgery (RIRS) for treatment of stone disease in horseshoe kidney patients

    PubMed Central

    Gokce, Mehmet Ilker; Tokatli, Zafer; Suer, Evren; Hajiyev, Parviz; Akinci, Aykut; Esen, Baris

    2016-01-01

    ABSTRACT Objectives In this study it is aimed to compare the success and complication rates of SWL and RIRS in treatment of HSK stone disease. Materials and methods In this retrospective study data of 67 patients treated with either SWL (n=44) or RIRS (n=23) for stone disease in HSK between May 2003 to August 2014 was investigated. age, gender, stone size and multiplicity, stone free status, renal colic episodes and complication rates of the SWL and RIRS groups were compared. Results Mean age of the population was 42.5±8.2 (range: 16-78) years and mean stone size was 16.9±4.1 mm. SWL and RIRS groups were similar with regard to demographic characteristics and stone related characteristics. SFR of the SWL and RIRS groups were 47.7%(21/44 patients) and 73.9% (17/23 patients) respectively (p=0.039).Renal colic episodes were observed in 3 and 16 patients in the RIRS and SWL groups respectively (p=0.024). No statistically significant complications were observed between the SWL (8/44 patients) and RIRS (4/23) groups (p=0.936). Conclusions In HSK patients with stone disease, both SWL and RIRS are effective and safe treatment modalities. However RIRS seems to maintain higher SFRs with comparable complication rates. PMID:27136473

  1. Can the manipulation of urinary pH by beverages assist with the prevention of stone recurrence?

    PubMed

    Siener, Roswitha

    2016-02-01

    The formation of various types of stones in the urinary tract is strongly influenced by urinary pH. An acidic urinary pH promotes the crystallization of uric acid and cystine, respectively. Moreover, changes in systemic acid-base homeostasis alter urinary excretion of citrate, an important inhibitor of calcium oxalate stone formation. The effect of beverages on urinary pH and citrate excretion is mainly determined by the presence of bicarbonate and citrate. The bicarbonate content of mineral water can replace alkalization therapy with potassium citrate and contribute to urine inhibitory power by increasing urinary pH and citrate excretion. Citrus juices are rich sources of citrate. Oral citrate is absorbed in the intestine and nearly completely metabolized to bicarbonate, providing an alkali load, which in turn increases urinary pH and citrate excretion. However, data from observational and interventional studies on the effect of different types of citrus juices on the risk of urinary stone formation are conflicting. In conclusion, favourable changes in urinary pH and citrate excretion can be attained by various beverages. However, the long-term efficacy of certain beverages for the recurrence prevention of different types of stones has yet to be determined. PMID:26614113

  2. Diet and Kidney Stones

    MedlinePlus

    ... vary due to differences in such things as soil quality and state of ripeness. There may be ... help/hurt me to take a vitamin or mineral supplement? The B vitamins (which include thiamine, riboflavin, ...

  3. Kidney stone ablation times and peak saline temperatures during Holmium:YAG and Thulium fiber laser lithotripsy, in vitro, in a ureteral model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-02-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental Thulium fiber laser (TFL) was studied and compared to clinical gold standard Holmium:YAG laser. The Holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. TFL (λ = 1908 nm) was operated with 35 mJ, 500 μs, 150-500 Hz, and 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate / 40% calcium phosphate), of uniform mass and diameter (4-5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 ml/min and 13.7 ml/min for the TFL and Holmium laser, respectively. The temperature 3 mm from tube's center and 1 mm above mesh sieve was measured by a thermocouple and recorded during experiments. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. Holmium laser time measured 167 +/- 41 s (n = 12). TFL times measured 111 +/- 49 s, 39 +/- 11 s, and 23 +/- 4 s, for pulse rates of 150, 300, and 500 Hz (n = 12 each). Mean peak saline irrigation temperatures reached 24 +/- 1 °C for Holmium, and 33 +/- 3 °C, 33 +/- 7 °C, and 39 +/- 6 °C, for TFL at pulse rates of 150, 300, and 500 Hz. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and reduced stone retropulsion, and may provide a clinical alternative to the conventional Holmium laser for lithotripsy.

  4. [Progression factors for chronic kidney disease. Secondary prevention].

    TOXLINE Toxicology Bibliographic Information

    García de Vinuesa S

    2008-01-01

    The natural history of most chronic kidney diseases (CKD) indicates that glomerular filtration gradually declines over time, progressing to more advanced stages of kidney failure. Since the publication of the first studies by the Modification of Diet in Renal Disease (MDRD) Study Group, numerous factors have been identified that can accelerate this progression. Some are dependent on the etiology, but other are common to all and may accelerate progression of kidney disease: Non-modifiable progression factors for CKD: - Etiology of kidney disease - Degree of initial kidney function - Gender - Age - Ethnicity/Other genetic factors - Birth weight Modifiable progression factors for CKD: - Proteinuria - High blood pressure - Poor glycemic control in diabetes - Smoking - Obesity - Metabolic syndrome/Insulin resistance - Dyslipidemia - Anemia - Metabolic factors (Ca/P, uric acid) - Use of nephrotoxic drugs. Therapeutic intervention on these factors has shown that it reduce the rate of progression of CKD (Strength of Recommendation A).There is no clear evidence that correction of these factors slows CKD (Strength of Recommendation C), although it has been shown to have a beneficial effect on cardiovascular risk at other levels.

  5. Urinary Stone Disease: Progress, Status, and Needs.

    PubMed

    Kirkali, Ziya; Rasooly, Rebekah; Star, Robert A; Rodgers, Griffin P

    2015-10-01

    Urinary stone disease (USD) is an important healthcare problem in the US affecting both adults and children, and costs $10 billion to the nation. Prevalence of USD has nearly doubled during the last 15 years in parallel to the obesity and type 2 diabetes epidemic. Despite the advances in the management of an acute episode, one of three stone formers experience recurrence. A better understanding of stone formation is necessary to develop secondary prevention strategies. There are many unanswered research questions that require a multidisciplinary approach. National Institute of Diabetes and Digestive and Kidney Diseases recently held a workshop on USD, and is committed to continue conducting and supporting research in this field. PMID:26190090

  6. An Additional Potential Factor for Kidney Stone Formation during Space Flights: Calcifying Nanoparticles (Nanobacteria): A Case Report

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Ciftcioglu, Neva; Schmid, Joseph; Griffith, Donald

    2007-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi due to skeletal calcium liberation and other undefined factors, resulting in stone disease in crewmembers during and after spaceflight. Calcifying nanoparticles, or nanobacteria, reproduce at a more rapid rate in simulated microgravity conditions and create external shells of calcium phosphate in the form of apatite. The questions arises whether calcifying nanoparticles are niduses for calculi and contribute to the development of clinical stone disease in humans, who possess environmental factors predisposing to the development of urinary calculi and potentially impaired immunological defenses during spaceflight. A case of a urinary calculus passed from an astronaut post-flight with morphological characteristics of calcifying nanoparticles and staining positive for a calcifying nanoparticle unique antigen, is presented.

  7. 2D elemental mapping of sections of human kidney stones using laser ablation inductively-coupled plasma-mass spectrometry: Possibilities and limitations

    NASA Astrophysics Data System (ADS)

    Vašinová Galiová, Michaela; Čopjaková, Renata; Škoda, Radek; Štěpánková, Kateřina; Vaňková, Michaela; Kuta, Jan; Prokeš, Lubomír; Kynický, Jindřich; Kanický, Viktor

    2014-10-01

    A 213 nm Nd:YAG-based laser ablation (LA) system coupled to quadrupole-based inductively coupled plasma-mass spectrometer and an ArF* excimer-based LA-system coupled to a double-focusing sector field inductively coupled plasma-mass spectrometer were employed to study the spatial distribution of various elements in kidney stones (uroliths). Sections of the surfaces of uroliths were ablated according to line patterns to investigate the elemental profiles for the different urolith growth zones. This exploratory study was mainly focused on the distinguishing of the main constituents of urinary calculus fragments by means of LA-ICP-mass spectrometry. Changes in the ablation rate for oxalate and phosphate phases related to matrix density and hardness are discussed. Elemental association was investigated on the basis of 2D mapping. The possibility of using NIST SRM 1486 Bone Meal as an external standard for calibration was tested. It is shown that LA-ICP-MS is helpful for determination of the mineralogical composition and size of all phases within the analyzed surface area, for tracing down elemental associations and for documenting the elemental content of urinary stones. LA-ICP-MS results (elemental contents and maps) are compared to those obtained with electron microprobe analysis and solution analysis ICP-MS.

  8. Thulium fiber laser ablation of kidney stones using a 50-μm-core silica optical fiber

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Hutchens, Thomas C.; Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-01-01

    Our laboratory is currently studying the experimental thulium fiber laser (TFL) as a potential alternative laser lithotripter to the gold standard, clinical Holmium:YAG laser. We have previously demonstrated the efficient coupling of TFL energy into fibers as small as 100-μm-core-diameter without damage to the proximal end. Although smaller fibers have a greater tendency to degrade at the distal tip during lithotripsy, fiber diameters (≤200 μm) have been shown to increase the saline irrigation rates through the working channel of a flexible ureteroscope, to maximize the ureteroscope deflection, and to reduce the stone retropulsion during laser lithotripsy. In this study, a 50-μm-core-diameter, 85-μm-outer-diameter, low-OH silica fiber is characterized for TFL ablation of human calcium oxalate monohydrate urinary stones, ex vivo. The 50-μm-core fiber consumes approximately 30 times less cross-sectional area inside the single working channel of a ureteroscope than the standard 270-μm-core fiber currently used in the clinic. The ureteroscope working channel flow rate, including the 50-μm fiber, decreased by only 10% with no impairment of ureteroscope deflection. The fiber delivered up to 15.4±5.9 W under extreme bending (5-mm-radius) conditions. The stone ablation rate measured 70±22 μg/s for 35-mJ-pulse-energy, 500-μs-pulse-duration, and 50-Hz-pulse-rate. Stone retropulsion and fiber burnback averaged 201±336 and 3000±2600 μm, respectively, after 2 min. With further development, thulium fiber laser lithotripsy using ultra-small, 50-μm-core fibers may introduce new integration and miniaturization possibilities and potentially provide an alternative to conventional Holmium:YAG laser lithotripsy using larger fibers.

  9. Preventing and Treating Acute Kidney Injury Among Hospitalized Patients with Cirrhosis and Ascites: A Narrative Review.

    PubMed

    Tapper, Elliot B; Bonder, Alan; Cardenas, Andres

    2016-05-01

    Acute kidney injury in the setting of ascites and cirrhosis is a medical emergency characterized by significant morbidity and mortality. Clinicians other than gastroenterologists are often the front line against acute kidney injury for patients with ascites. Owing to the specifics of cirrhotic physiology, the treatment and prevention of acute kidney injury in the setting of ascites has unique features, widespread knowledge of which will benefit our patients with cirrhosis. Early detection and treatment of infection, maximization of cardiac output, and avoidance of medications that limit cardiorenal adaptations to arterial underfilling are part of a multipronged strategy to protect the renal function of our patients with cirrhosis and ascites. PMID:26724589

  10. Prevention of recurrent nephrolithiasis.

    PubMed

    Goldfarb, D S; Coe, F L

    1999-11-15

    The first episode of nephrolithiasis provides an opportunity to advise patients about measures for preventing future stones. Low fluid intake and excessive intake of protein, salt and oxalate are important modifiable risk factors for kidney stones. Calcium restriction is not useful and may potentiate osteoporosis. Diseases such as hyperparathyroidism, sarcoidosis and renal tubular acidosis should be considered in patients with nephrolithiasis. A 24-hour urine collection with measurement of the important analytes is usually reserved for use in patients with recurrent stone formation. In these patients, the major urinary risk factors include hypercalciuria, hyperoxaluria, hypocitraturia and hyperuricosuria. Effective preventive and treatment measures include thiazide therapy to lower the urinary calcium level, citrate supplementation to increase the urinary citrate level and, sometimes, allopurinol therapy to lower uric acid excretion. Uric acid stones are most often treated with citrate supplementation. Data now support the cost-effectiveness of evaluation and treatment of patients with recurrent stones. PMID:10593318

  11. Challenging chronic kidney disease: experience from chronic kidney disease prevention programs in Shanghai, Japan, Taiwan and Australia.

    PubMed

    Chen, Nan; Hsu, Chih-Cheng; Yamagata, Kunihiro; Langham, Robyn

    2010-06-01

    Chronic kidney disease (CKD) is now a global health problem. One important strategy to prevent and manage CKD is to offer a prevention program which could detect CKD early as well as raise awareness of the disease. In Shanghai, a community-based study demonstrated that the prevalence of CKD was high while awareness was low. The results from Shanghai urged the necessity of a screening and prevention program of CKD. In Japan, the urinalysis screening system was established to early diagnose and prevent CKD. Due to modification of lifestyle and prevalence of diabetes, urine dip-stick test for microalbuminuria might be necessary in adults while screening for proteinuria and haematuria are necessary for students and young adults. In Taiwan, two CKD programs - a CKD care program and diabetic share care program - were initiated. The cost-effectiveness study indicated that both programs could reduce end-stage renal disease (ESRD) burden in Taiwan because integrated pre-ESRD care was important for patients with CKD stage 4 and stage 5 while a diabetic shared care program was cost-effective to prevent nephropathy to patients with diabetic mellitus. In Australia, studies demonstrated that screening of high-risk individuals as well as promoting awareness were cost-effective to early detection of CKD. Furthermore, opportunistic screening with emphasis on early detection was effective in CKD prevention. The studies from those regions share experiences on early prevention and management of CKD. PMID:20586945

  12. Prevention of hypercalciuria and stone-forming propensity during prolonged bedrest by alendronate

    NASA Technical Reports Server (NTRS)

    Ruml, L. A.; Dubois, S. K.; Roberts, M. L.; Pak, C. Y.

    1995-01-01

    The bone loss and hypercalciuria induced by immobilization or the decreased gravitational forces of space are well described. Using a model of bedrest immobilization, the ability of a potent aminobisphosphonate, alendronate, to avert hypercalciuria and stone-forming propensity was tested. Sixteen male subjects participated in a randomized, placebo-controlled trial in which they received either 20 mg of alendronate or placebo 2 weeks prior to and during 3 weeks of strict bedrest. Parameters of bone and calcium metabolism and urinary crystallization of stone-forming salts were measured before and at the end of bedrest. In the placebo group, bedrest increased urinary calcium (209 +/- 47 to 267 +/- 60 mg/day, p < 0.01) and the saturation of calcium phosphate. Before bedrest, the alendronate group had a significantly lower serum calcium (8.8 +/- 0.4 vs. 9.6 +/- 0.5 mg/dl, p < 0.01) and higher serum PTH (62.4 +/- 33.1 vs. 23.1 +/- 7.5 pg/ml, p < 0.01) compared with the placebo group. Moreover, the alendronate group had a lower urinary calcium (75 +/- 41 mg/day) and saturation of calcium oxalate and calcium phosphate. These effects of alendronate were sustained during bedrest. Following bedrest in the alendronate group, urinary calcium rose to 121 +/- 50 mg/day, a value less than that in the placebo group before or during bedrest. Similarly, urinary saturation of calcium oxalate and calcium phosphate rose with bedrest in the alendronate-treated patients but remained lower than values obtained in placebo-treated patients before or during bedrest. Alendronate inhibits bone mineral loss and averts the hypercalciuria and increased propensity for the crystallization of stone-forming calcium salts which occurs during 3 weeks of strict bedrest.

  13. Flexible Ureterorenoscopy versus Extracorporeal Shock Wave Lithotripsy for the treatment of upper/middle calyx kidney stones of 10-20 mm: a retrospective analysis of 174 patients.

    PubMed

    Cecen, Kursat; Karadag, Mert Ali; Demir, Aslan; Bagcioglu, Murat; Kocaaslan, Ramazan; Sofikerim, Mustafa

    2014-01-01

    To compare the outcomes of flexible ureterorenoscopy (F-URS) with extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper or mid calyx kidney stones of 10 to 20 mm. A total of 174 patients with radioopaque solitary upper or mid calyx stones who underwent ESWL or F-URS with holmium:YAG laser were enrolled in this study. Each group treated with ESWL and F-URS for upper or mid calyx kidney stones were retrospectively compared in terms of retreatment and stone free rates, and complications. 87% (n = 94) of patients who underwent ESWL therapy was stone free at the end of 3rd month. This rate was 92% (n = 61) for patients of F-URS group (p = 0.270 p > 0.05). Retreatment was required in 12.9% of patients (n = 14) who underwent ESWL and these patients were referred to F-URS procedure after 3rd month radiologic investigations. The retreatment rate of cases who were operated with F-URS was 7.5% (n = 5) (p = 0.270 p > 0.05). Ureteral perforation (Clavien grade 3B) was occured in 3 patients (4.5%) who underwent F-URS. Fever (Clavien grade 1) was noted in 7 and 5 patients from ESWL and F-URS group, respectively (6.4% vs 7.5%) (p = 0.78 p > 0.05). F-URS and ESWL have similar outcomes for the treatment of upper or mid calyx renal stones of 10-20 mm. ESWL has the superiority of minimal invasiveness and avoiding of general anethesia. F-URS should be kept as the second teratment alternative for patients with upper or mid caliceal stones of 10-20 mm and reserved for cases with failure in ESWL. PMID:25332859

  14. Men and Women in Space: Bone Loss and Kidney Stone Risk after Long-Duration Space Flight

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Zwart, Sara R.; Heer, Martina; Hudson, Edgar, K.; Shackelford, Linda; Morgan, Jennifer L. L.

    2014-01-01

    Bone loss on Earth is more prevalent in women than men, leading to the assumption that women may be at greater risk from bone loss during flight. Until recently, the number of women having flown long-duration missions was too small to allow any type of statistical analysis. We report here data from 42 astronauts on long-duration missions to the International Space Station, 33 men and 9 women. Bone mineral density (dual-energy X-ray absorptiometry), bone biochemistry (from blood and urine samples), and renal stone risk factors were evaluated before and after flight. Data were analyzed in two groups, based on available resistance exercise equipment. The response of bone mineral density to flight was the same for men and women, and the typical decrease in bone mineral density (whole body and/or regional) after flight was not observed for either sex for those using an Advanced Resistive Exercise Device. Bone biochemistry, specifically markers of formation and resorption, generally responded similarly in male and female astronauts. The response of urinary supersaturation risk to space flight was not significantly different between men and women, although risks were typically increased after flight in both groups and risks were generally greater in men than in women before and after flight. Overall, the bone and renal stone responses of men and women to space flight were not different.

  15. Drug-Induced Acute Kidney Injury: A Focus on Risk Assessment for Prevention.

    PubMed

    Kane-Gill, Sandra L; Goldstein, Stuart L

    2015-10-01

    Drugs are the third to fifth leading cause of acute kidney injury (AKI) in critically ill patients following sepsis and hypotension. Susceptibilities and exposures for development of AKI have been identified, and some are modifiable allowing for the possibility of AKI prevention or mitigation of AKI severity. Using drug therapies for prevention of AKI has been attempted but with little success in human studies, so we must rely on risk-assessment strategies for prevention. The purpose of this article is to review the risk factors, risk-assessment strategies, prevention, and management of drug-induced AKI with emphasis on risk assessment. PMID:26410137

  16. Farnesoid X Receptor Ligand Prevents Cisplatin-Induced Kidney Injury by Enhancing Small Heterodimer Partner

    PubMed Central

    Bae, Eun Hui; Choi, Hong Sang; Joo, Soo Yeon; Kim, In Jin; Kim, Chang Seong; Choi, Joon Seok; Ma, Seong Kwon; Lee, JongUn; Kim, Soo Wan

    2014-01-01

    The farnesoid X receptor (FXR) is mainly expressed in liver, intestine and kidney. We investigated whether 6-ethyl chenodeoxycholic acid (6ECDCA), a semisynthetic derivative of chenodeoxycholic aicd (CDCA, an FXR ligand), protects against kidney injury and modulates small heterodimer partner (SHP) in cisplatin-induced kidney injury. Cisplatin inhibited SHP protein expression in the kidney of cisplatin-treated mice and human proximal tubular (HK2) cells; this effect was counteracted by FXR ligand. Hematoxylin and eosin staining revealed the presence of tubular casts, obstructions and dilatations in cisplatin-induced kidney injury, which was attenuated by FXR ligand. FXR ligand also attenuated protein expression of transforming growth factor-β1 (TGF-β1), Smad signaling, and the epithelial-to-mesenchymal transition process, inflammatory markers and cytokines, and apoptotic markers in cisplatin-treated mice. Cisplatin induced NF-κB activation in HK2 cell; this effect was attenuated by pretreatment with FXR ligand. In SHP knockdown by small interfering RNA, cisplatin-induced activation of TGF-β1, p-JNK and Bax/Bcl-2 ratio was not attenuated, while SHP overexpression and FXR ligand inhibited expression of these proteins in cisplatin-pretreated HK2 cells. In conclusion, FXR ligand, 6ECDCA prevents cisplatin-induced kidney injury, the underlying mechanism of which may be associated with anti-fibrotic, anti-inflammatory, and anti-apoptotic effects through SHP induction. PMID:24475141

  17. Farnesoid X receptor ligand prevents cisplatin-induced kidney injury by enhancing small heterodimer partner.

    PubMed

    Bae, Eun Hui; Choi, Hong Sang; Joo, Soo Yeon; Kim, In Jin; Kim, Chang Seong; Choi, Joon Seok; Ma, Seong Kwon; Lee, Jongun; Kim, Soo Wan

    2014-01-01

    The farnesoid X receptor (FXR) is mainly expressed in liver, intestine and kidney. We investigated whether 6-ethyl chenodeoxycholic acid (6ECDCA), a semisynthetic derivative of chenodeoxycholic aicd (CDCA, an FXR ligand), protects against kidney injury and modulates small heterodimer partner (SHP) in cisplatin-induced kidney injury. Cisplatin inhibited SHP protein expression in the kidney of cisplatin-treated mice and human proximal tubular (HK2) cells; this effect was counteracted by FXR ligand. Hematoxylin and eosin staining revealed the presence of tubular casts, obstructions and dilatations in cisplatin-induced kidney injury, which was attenuated by FXR ligand. FXR ligand also attenuated protein expression of transforming growth factor-?1 (TGF-?1), Smad signaling, and the epithelial-to-mesenchymal transition process, inflammatory markers and cytokines, and apoptotic markers in cisplatin-treated mice. Cisplatin induced NF-?B activation in HK2 cell; this effect was attenuated by pretreatment with FXR ligand. In SHP knockdown by small interfering RNA, cisplatin-induced activation of TGF-?1, p-JNK and Bax/Bcl-2 ratio was not attenuated, while SHP overexpression and FXR ligand inhibited expression of these proteins in cisplatin-pretreated HK2 cells. In conclusion, FXR ligand, 6ECDCA prevents cisplatin-induced kidney injury, the underlying mechanism of which may be associated with anti-fibrotic, anti-inflammatory, and anti-apoptotic effects through SHP induction. PMID:24475141

  18. 10 Symptoms of Kidney Disease

    MedlinePlus

    ... the liver, can cause pain. Kidney infections and kidney stones can cause severe pain, often in spasms. Bladder infections can cause burning when you urinate. People who have medullary sponge kidney say it is painful. What patients said: "About ...

  19. Ultrasound: Renal (Kidneys, Ureters, Bladder) (For Parents)

    MedlinePlus

    ... present since birth the presence of blockages or kidney stones complications of a urinary tract infection (UTI) cysts ... and Related Conditions Urinary Tract Infections Wilms Tumor Kidney Stones Vesicoureteral Reflux (VUR) Glomerulonephritis Ultrasound: Abdomen Ultrasound: Bladder ...

  20. Histopathology Predicts the Mechanism of Stone Formation

    NASA Astrophysics Data System (ADS)

    Evan, Andrew P.

    2007-04-01

    About 5% of American women and 12% of men will develop a kidney stone at some time in their life and these numbers appear to be on the rise. Despite years of scientific research into the mechanisms of stone formation and growth, limited advances have been made until recently. Randall's original observations and thoughts on the mechanisms for kidney stone formation have been validated for idiopathic calcium oxalate stone formers (ICSF) but not for most other stone forming groups. Our current studies on selected groups of human stone formers using intraoperative papillary biopsies has shown overwhelming evidence for the presence of Randall's plaque in ICSF and that stone formation and growth are exclusively linked to its availability to urinary ions and proteins. Intense investigation of the plaque-stone junction is needed if we are to understand the factors leading to the overgrowth process on exposed regions of plaque. Such information should allow the development of treatment strategies to block stone formation in ICSF patients. Patients who form brushite stones, or who form apatite stones because of distal renal tubular acidosis (dRTA), or patients with calcium oxalate stones due to obesity bypass procedures, or patients with cystinuria, get plugged inner medullary collecting ducts (IMCD) which leads to total destruction of the lining cells and focal sites of interstitial fibrosis. These stone formers have plaque but at levels equal to or below non-stone formers, which would suggest that they form stones by a different mechanism than do ICSF patients.

  1. Remote ischaemic pre-conditioning for the prevention of acute kidney injury.

    PubMed

    Ho, Phoebe Wing-Lam; Pang, Wing-Fai; Szeto, Cheuk-Chun

    2016-04-01

    Acute kidney injury (AKI) is a common complication associated with high morbidity and mortality in hospitalized patients. One potential mechanism underlying renal injury is ischaemia/reperfusion injury (IRI), which attributed the organ damage to the inflammatory and oxidative stress responses induced by a period of renal ischaemia and subsequent reperfusion. Therapeutic strategies that aim at minimizing the effect of IRI on the kidneys may prevent AKI and improve clinical outcomes significantly. In this review, we examine the technique of remote ischaemic preconditioning (rIPC), which has been shown by several trials to confer organ protection by applying transient, brief episodes of ischaemia at a distant site before a larger ischaemic insult. We provide an overview of the current clinical evidence regarding the renoprotective effect of rIPC in the key clinical settings of cardiac or vascular surgery, contrast-induced AKI, pre-existing chronic kidney disease (CKD) and renal transplantation, and discuss key areas for future research. PMID:26370466

  2. Statins for the prevention of contrast-induced acute kidney injury.

    PubMed

    Ball, Timothy; McCullough, Peter A

    2014-01-01

    Acute kidney injury (AKI) is a common medical problem, especially in patients undergoing cardiovascular procedures. The risk of kidney damage has multiple determinants and is often related to or exacerbated by intravenous or intra-arterial iodinated contrast. Contrast-induced AKI (CI-AKI) has been associated with an increased risk of subsequent myocardial infarction, stroke, the development of heart failure, rehospitalization, progression of chronic kidney disease, end-stage renal disease, and death. Statins have been studied extensively in the setting of chronic kidney disease and they have been shown to reduce albuminuria, but they have had no effect on the progressive reduction of glomerular filtration or the need for renal replacement therapy. Several meta-analyses have shown a protective effect of short-term statin administration on CI-AKI and led to two large randomized controlled trials evaluating the role of rosuvastatin in the prevention of CI-AKI in high-risk patients with acute coronary syndrome and diabetes mellitus. Both trials showed a benefit of rosuvastatin prior to contrast administration in a statin-naive patient population. In aggregate, these studies support the short-term use of statins specifically for the prevention of CI-AKI in patients undergoing coronary angiography with or without percutaneous coronary intervention. PMID:25343843

  3. Management of Pneumocystis jirovecii Pneumonia in Kidney Transplantation to Prevent Further Outbreak

    PubMed Central

    Goto, Norihiko; Futamura, Kenta; Okada, Manabu; Yamamoto, Takayuki; Tsujita, Makoto; Hiramitsu, Takahisa; Narumi, Shunji; Watarai, Yoshihiko

    2015-01-01

    The outbreak of Pneumocystis jirovecii pneumonia (PJP) among kidney transplant recipients is emerging worldwide. It is important to control nosocomial PJP infection. A delay in diagnosis and treatment increases the number of reservoir patients and the number of cases of respiratory failure and death. Owing to the large number of kidney transplant recipients compared to other types of organ transplantation, there are greater opportunities for them to share the same time and space. Although the use of trimethoprim-sulfamethoxazole (TMP-SMX) as first choice in PJP prophylaxis is valuable for PJP that develops from infections by trophic forms, it cannot prevent or clear colonization, in which cysts are dominant. Colonization of P. jirovecii is cleared by macrophages. While recent immunosuppressive therapies have decreased the rate of rejection, over-suppressed macrophages caused by the higher levels of immunosuppression may decrease the eradication rate of colonization. Once a PJP cluster enters these populations, which are gathered in one place and uniformly undergoing immunosuppressive therapy for kidney transplantation, an outbreak can occur easily. Quick actions for PJP patients, other recipients, and medical staff of transplant centers are required. In future, lifelong prophylaxis may be required even in kidney transplant recipients. PMID:26609250

  4. Inhibition of glycogen synthase kinase 3β prevents NSAID-induced acute kidney injury

    PubMed Central

    Bao, Hao; Ge, Yan; Zhuang, Shougang; Dworkin, Lance D; Liu, Zhihong; Gong, Rujun

    2011-01-01

    Clinical use of non-steroidal anti-inflammatory drugs (NSAIDs) like diclofenac (DCLF) is limited by multiple adverse effects, including renal toxicity leading to acute kidney injury. In mice with DCLF-induced nephrotoxicity TDZD-8, a selective glycogen synthase kinase (GSK)3β inhibitor, improved acute kidney dysfunction, ameliorated tubular necrosis and apoptosis associated with induced cortical expression of cyclooxygenase-2 (COX-2) and prostaglandin E2. This renoprotective effect was blunted but still largely preserved in COX-2 null mice, suggesting that other GSK3β targets beyond COX-2 functioned in renal protection. Indeed, TDZD-8 diminished the mitochondrial permeability transition in DCLF-injured kidneys. In vitro, GSK3β inhibition reinstated viability and suppressed necrosis and apoptosis in DCLF-stimulated tubular epithelial cells. DCLF elicited oxidative stress, enhanced the activity of the redox-sensitive GSK3β and promoted a mitochondrial permeability transition by interacting with cyclophilin D, a key component of the mitochondrial permeability transition pore. TDZD-8 blocked GSK3β activity, prevented GSK3β mediated cyclophilin D phosphorylation and the ensuing mitochondrial permeability transition, concomitant with normalization of intracellular ATP. Conversely, ectopic expression of a constitutively active GSK3β abolished the effects of TDZD-8. Hence, inhibition of GSK3β ameliorates NSAID-induced acute kidney injury by induction of renal cortical COX-2 and direct inhibition of the mitochondrial permeability transition. PMID:22258319

  5. Analysis of Altered MicroRNA Expression Profiles in Proximal Renal Tubular Cells in Response to Calcium Oxalate Monohydrate Crystal Adhesion: Implications for Kidney Stone Disease

    PubMed Central

    Wang, Bohan; Wu, Bolin; Liu, Jun; Yao, Weimin; Xia, Ding; Li, Lu; Chen, Zhiqiang; Ye, Zhangqun; Yu, Xiao

    2014-01-01

    Background Calcium oxalate monohydrate (COM) is the major crystalline component in kidney stones and its adhesion to renal tubular cells leads to tubular injury. However, COM-induced toxic effects in renal tubular cells remain ambiguous. MicroRNAs (miRNAs) play an important role in gene regulation at the posttranscriptional levels. Objective The present study aimed to assess the potential changes in microRNAs of proximal renal tubular cells in response to the adhesion of calcium oxalate monohydrate (COM) crystals. Methodology Lactate dehydrogenase (LDH) activity and DAPI staining were used to measure the toxic effects of HK-2 cells exposed to COM crystals. MicroRNA microarray and mRNA microarray were applied to evaluate the expression of HK-2 cells exposed to COM crystals. Quantitative real-time PCR (qRT-PCR) technology was used to validate the microarray results. Target prediction, Gene Ontology (GO) analysis and pathway analysis were applied to predict the potential roles of microRNAs in biological processes. Principal Findings Our study showed that COM crystals significantly altered the global expression profile of miRNAs in vitro. After 24 h treatment with a dose (1 mmol/L), 25 miRNAs were differentially expressed with a more than 1.5-fold change, of these miRNAs, 16 were up-regulated and 9 were down-regulated. A majority of these differentially expressed miRNAs were associated with cell death, mitochondrion and metabolic process. Target prediction and GO analysis suggested that these differentially expressed miRNAs potentially targeted many genes which were related to apoptosis, regulation of metabolic process, intracellular signaling cascade, insulin signaling pathway and type 2 diabetes. Conclusion Our study provides new insights into the role of miRNAs in the pathogenesis associated with nephrolithiasis. PMID:24983625

  6. Complete staghorn calculus in polycystic kidney disease: infection is still the cause

    PubMed Central

    2013-01-01

    Background Kidney stones in patients with autosomal dominant polycystic kidney disease are common, regarded as the consequence of the combination of anatomic abnormality and metabolic risk factors. However, complete staghorn calculus is rare in polycystic kidney disease and predicts a gloomy prognosis of kidney. For general population, recent data showed metabolic factors were the dominant causes for staghorn calculus, but for polycystic kidney disease patients, the cause for staghorn calculus remained elusive. Case presentation We report a case of complete staghorm calculus in a polycystic kidney disease patient induced by repeatedly urinary tract infections. This 37-year-old autosomal dominant polycystic kidney disease female with positive family history was admitted in this hospital for repeatedly upper urinary tract infection for 3 years. CT scan revealed the existence of a complete staghorn calculus in her right kidney, while there was no kidney stone 3 years before, and the urinary stone component analysis showed the composition of calculus was magnesium ammonium phosphate. Conclusion UTI is an important complication for polycystic kidney disease and will facilitate the formation of staghorn calculi. As staghorn calculi are associated with kidney fibrosis and high long-term renal deterioration rate, prompt control of urinary tract infection in polycystic kidney disease patient will be beneficial in preventing staghorn calculus formation. PMID:24070202

  7. Bladder stones

    MedlinePlus

    Stones - bladder; Urinary tract stones; Bladder calculi ... Benway BM, Bhayani SM. Lower urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 89. Sharma R, Dill CE, Gelman DY. Urinary ...

  8. Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease.

    PubMed

    Robertson, W G

    2016-02-01

    This review describes the various dietary regimens that have been used to advise patients on how to prevent the recurrence of their calcium-containing kidney stones. The conclusion is that although there is some general advice that may be useful to many patients, it is more efficacious to screen each patient individually to identify his/her main urinary, metabolic, nutritional, environmental, and lifestyle risk factors for stone-formation and then tailor specific advice for that particular patient based on the findings from these investigations. If the patient can be motivated to adhere strictly to this conservative approach to the prophylactic management of their stone problem over a long time period, then it is possible to prevent them from forming further stones. This approach to stone management is considerably less expensive than any of the procedures currently available for stone removal or disintegration. In the UK, for each new stone episode prevented by this conservative approach to prophylaxis it is calculated to save the Health Authority concerned around £2000 for every patient treated successfully. In the long term, this accumulates to a major saving within each hospital budget if most stone patients can be prevented from forming further stones and when the savings are totalled up country-wide saves the National Exchequer considerable sums in unclaimed Sick Pay and industry a significant number of manpower days which would otherwise be lost from work. It is also of immense relief and benefit to the patients not to have to suffer the discomfort and inconvenience of further stone episodes. PMID:26645870

  9. Prevention and treatment of sepsis-induced acute kidney injury: an update.

    PubMed

    Honore, Patrick M; Jacobs, Rita; Hendrickx, Inne; Bagshaw, Sean M; Joannes-Boyau, Olivier; Boer, Willem; De Waele, Elisabeth; Van Gorp, Viola; Spapen, Herbert D

    2015-12-01

    Sepsis-induced acute kidney injury (SAKI) remains an important challenge in critical care medicine. We reviewed current available evidence on prevention and treatment of SAKI with focus on some recent advances and developments. Prevention of SAKI starts with early and ample fluid resuscitation preferentially with crystalloid solutions. Balanced crystalloids have no proven superior benefit. Renal function can be evaluated by measuring lactate clearance rate, renal Doppler, or central venous oxygenation monitoring. Assuring sufficiently high central venous oxygenation most optimally prevents SAKI, especially in the post-operative setting, whereas lactate clearance better assesses mortality risk when SAKI is present. Although the adverse effects of an excessive "kidney afterload" are increasingly recognized, there is actually no consensus regarding an optimal central venous pressure. Noradrenaline is the vasopressor of choice for preventing SAKI. Intra-abdominal hypertension, a potent trigger of AKI in post-operative and trauma patients, should not be neglected in sepsis. Early renal replacement therapy (RRT) is recommended in fluid-overloaded patients' refractory to diuretics but compelling evidence about its usefulness is still lacking. Continuous RRT (CRRT) is advocated, though not sustained by convincing data, as the preferred modality in hemodynamically unstable SAKI. Diuretics should be avoided in the absence of hypervolemia. Antimicrobial dosing during CRRT needs to be thoroughly reconsidered to assure adequate infection control. PMID:26690796

  10. Prevention programs for chronic kidney disease in low-income countries.

    PubMed

    Perico, Norberto; Remuzzi, Giuseppe

    2016-04-01

    Chronic kidney disease (CKD) is an important determinant of the poor health outcome for major noncommunicable diseases that are the leading cause of death worldwide. Early recognition with screening programs of CKD and co-morbid conditions, like hypertension, diabetes, or toxic environments, can potentially slow progression to renal failure, improve quality of life and reduce healthcare cost. Effective multimodal tools are available to prevent CKD by managing its risk factors, and to slow or even halt disease progression to end-stage renal failure (ESRF). They can be adapted even to poor-resource settings of low- and middle-income countries for individual at high risk of CKD. CKD is also linked to acute kidney injury (AKI), that in poorest part of Africa, Asia and Latin America is preventable, treatable and often reversible, if managed adequately and in timely manner as proposed by the program "AKI 0by25" launched by the international Society of Nephrology in 2013. In addition to saving lives, prevention programs will create major heath gains, eventually reducing the current health inequity that arises from unaffordable or unobtainable renal replacement therapies in many part of the developing world if ESRF is not prevented. PMID:26983956

  11. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  12. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  13. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  14. Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

    PubMed Central

    Penido, Maria Goretti Moreira Guimarães; Tavares, Marcelo de Sousa

    2015-01-01

    In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environmental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specific prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children. PMID:26380196

  15. Fad diets and their effect on urinary stone formation.

    PubMed

    Nouvenne, Antonio; Ticinesi, Andrea; Morelli, Ilaria; Guida, Loredana; Borghi, Loris; Meschi, Tiziana

    2014-09-01

    The influence of unhealthy dietary habits on urinary stone formation has been widely recognized in literature. Dietary advice is indeed the cornerstone prescription for prevention of nephrolithiasis as well. However, only a small amount of medical literature has addressed the influence of popular or fad diets, often self-prescribed for the management of obesity and overweight or for cultural beliefs, on the risk of kidney stones. Thereby in this paper we analyze the current knowledge on the effects of some popular diets on overall lithogenic risk. High-protein diets, like Dukan diet, raise some concerns, since animal proteins are able to increase urinary calcium and to decrease urinary citrate excretion, thus leading to a high overall lithogenic risk. Low-carbohydrate diets, like Atkins diet or zone diet, may have a protective role against kidney stone formation, but there are also evidences stating that this dietary approach may rise calciuria and decrease citraturia, since it is generally associated to a relatively high intake of animal proteins. Vegan diet can be harmful for urinary stone disease, especially for the risk of hyperuricemia and micronutrient deficiencies, even if only few studies have addressed this specific matter. On the other side, the benefits of a lacto-ovo-vegetarian diet on kidney stone prevention have been largely emphasized, provided that the intake of calcium and oxalate is balanced. Traditional Mediterranean diet should exert a protective effect on nephrolithiasis as well, even if specific studies have not been carried out yet. High phytate and antioxidant content of this diet have however demonstrated to be beneficial in preventing the formation of new or recurrent calculi. Anyway, at the current state of knowledge, the most effective dietary approach to prevent kidney stone disease is a mild animal protein restriction, a balanced intake of carbohydrates and fats and a high intake of fruit and vegetables. Other fundamental aspects, which are often neglected in fad diets, are a normal intake of milk and dairy products and salt restriction. All these nutritional aspects should be greatly taken into account when patients who are willing to undergo fad or commercial diets ask for dietary advice. PMID:26816783

  16. Fad diets and their effect on urinary stone formation

    PubMed Central

    Nouvenne, Antonio; Ticinesi, Andrea; Morelli, Ilaria; Guida, Loredana; Meschi, Tiziana

    2014-01-01

    The influence of unhealthy dietary habits on urinary stone formation has been widely recognized in literature. Dietary advice is indeed the cornerstone prescription for prevention of nephrolithiasis as well. However, only a small amount of medical literature has addressed the influence of popular or fad diets, often self-prescribed for the management of obesity and overweight or for cultural beliefs, on the risk of kidney stones. Thereby in this paper we analyze the current knowledge on the effects of some popular diets on overall lithogenic risk. High-protein diets, like Dukan diet, raise some concerns, since animal proteins are able to increase urinary calcium and to decrease urinary citrate excretion, thus leading to a high overall lithogenic risk. Low-carbohydrate diets, like Atkins diet or zone diet, may have a protective role against kidney stone formation, but there are also evidences stating that this dietary approach may rise calciuria and decrease citraturia, since it is generally associated to a relatively high intake of animal proteins. Vegan diet can be harmful for urinary stone disease, especially for the risk of hyperuricemia and micronutrient deficiencies, even if only few studies have addressed this specific matter. On the other side, the benefits of a lacto-ovo-vegetarian diet on kidney stone prevention have been largely emphasized, provided that the intake of calcium and oxalate is balanced. Traditional Mediterranean diet should exert a protective effect on nephrolithiasis as well, even if specific studies have not been carried out yet. High phytate and antioxidant content of this diet have however demonstrated to be beneficial in preventing the formation of new or recurrent calculi. Anyway, at the current state of knowledge, the most effective dietary approach to prevent kidney stone disease is a mild animal protein restriction, a balanced intake of carbohydrates and fats and a high intake of fruit and vegetables. Other fundamental aspects, which are often neglected in fad diets, are a normal intake of milk and dairy products and salt restriction. All these nutritional aspects should be greatly taken into account when patients who are willing to undergo fad or commercial diets ask for dietary advice. PMID:26816783

  17. CXCR₄antagonism as a therapeutic approach to prevent acute kidney injury.

    PubMed

    Zuk, A; Gershenovich, M; Ivanova, Y; MacFarland, R T; Fricker, S P; Ledbetter, S

    2014-10-01

    We examined whether antagonism of the CXCR₄receptor ameliorates the loss of renal function following ischemia-reperfusion. CXCR₄is ubiquitously expressed on leukocytes, known mediators of renal injury, and on bone marrow hematopoietic stem cells (HSCs). Plerixafor (AMD3100, Mozobil) is a small-molecule CXCR₄antagonist that mobilizes HSCs into the peripheral blood and also modulates the immune response in in vivo rodent models of asthma and rheumatoid arthritis. Treatment with plerixafor before and after ischemic clamping ameliorated kidney injury in a rat model of bilateral renal ischemia-reperfusion. Serum creatinine and blood urea nitrogen were significantly reduced 24 h after reperfusion, as were tissue injury and cell death. Plerixafor prevented the renal increase in the proinflammatory chemokines CXCL1 and CXCL5 and the cytokine IL-6. Flow cytometry of kidney homogenates confirmed the presence of significantly fewer leukocytes with plerixafor treatment; additionally, myeloperoxidase activity was reduced. AMD3465, a monocyclam analog of plerixafor, was similarly renoprotective. Four weeks postreperfusion, long-term effects included diminished fibrosis, inflammation, and ongoing renal injury. The mechanism by which CXCR₄inhibition ameliorates AKI is due to modulation of leukocyte infiltration and expression of proinflammatory chemokines/cytokines, rather than a HSC-mediated effect. The data suggest that CXCR₄antagonism with plerixafor may be a potential option to prevent AKI. PMID:25080523

  18. Prophylactic effects of quercetin and hyperoside in a calcium oxalate stone forming rat model.

    PubMed

    Zhu, Wei; Xu, Yun-fei; Feng, Yuan; Peng, Bo; Che, Jian-ping; Liu, Min; Zheng, Jun-hua

    2014-12-01

    Quercetin and hyperoside (QH) are the two main constituents of the total flavone glycosides of Flos Abelmoschus manihot, which has been prescribed for treating chronic kidney disease for decades. This study aimed to investigate the effect of QH on calcium oxalate (CaOx) formation in ethylene glycol (EG)-fed rats. Rats were divided into three groups: an untreated stone-forming group, a QH-treated stone-forming group (20 mg/kg/day) and a potassium citrate-treated stone-forming group (potassium citrate was a worldwide-recognized calculi-prophylactic medicine). Ethylene glycol (0.5 %) was administered to the rats during the last week, and vitamin D3 was force-fed to induce hyperoxaluria and kidney calcium oxalate crystal deposition. 24 h urine samples were collected before and after inducing crystal deposits. Rats were killed and both kidneys were harvested after 3 weeks. Bisected kidneys were examined under a polarized light microscope for semi-quantification of the crystal-formation. The renal tissue superoxide dismutase and catalase levels were measured by Western blot. QH and potassium citrate have the ability to alkalinize urine. The number of crystal deposits decreased significantly in the QH-treated stone-forming group as compared to the other groups. Superoxide dismutase and catalase levels also increased significantly in the QH-treated stone-forming group, as compared with the untreated stone-forming group. QH administration has an inhibitory effect on the deposition of CaOx crystal in EG-fed rats and may be effective for preventing stone-forming disease. PMID:25085199

  19. Dimension stone

    USGS Publications Warehouse

    Dolley, T.P.

    2003-01-01

    Dimension stone can be defined as natural rock material quarried to obtain blocks or slabs that meet specifications as to size (width, length and thickness) and shape for architectural or engineering purposes. Color, grain texture and pattern, and surface finish of the stone are also normal requirements. Other important selection criteria are durability (based on mineral composition, hardness and past performance), strength and the ability of the stone to take a polish.

  20. Kidney transplant

    MedlinePlus

    ... Side effects from medicines used to prevent transplant rejection Loss of transplanted kidney ... tries to destroy it. In order to avoid rejection, almost all kidney transplant recipients must take medicines ...

  1. Idiopathic calcium nephrolithiasis. 1. Differences in urine crystalloids, urine saturation with brushite and urine inhibitors of calcification between persons with and persons without recurrent kidney stone formation.

    PubMed Central

    Pylypchuk, G.; Ehrig, U.; Wilson, D. R.

    1979-01-01

    The propensity of urine to promote calcium stone formation was compared in 64 patients with recurrent idiopathic calcium nephrolithiasis and 30 healthy individuals without such a history. The rates of excretion of urine crystalloids, the urine saturation with brushite (CaHPO4-2H2O), the ability of the urine to calcify collagen in vitro, and the concentration of urine inhibitors of collagen calcification were measured. The patients had a reduced urine citrate excretion rate in addition to an increased urine calcium excretion rate, while the rates for urine magnesium, phosphate, uric acid and oxalate were not significantly different in the two groups of subjects. The urine concentration of magnesium, phosphate and uric acid was decreased in the patients because of the higher urine volume. The urine creatinine excretion rate correlated with the rates of excretion of urine calcium, magnesium, phosphate, uric acid and oxalate in both groups, which suggested that increased lean body mass, possibly associated with greater food intake, may be an important determinant of crystalloid excretion. The urine of the patients was significantly more saturated with brushite than the urine of the control subjects and resulted in greater collagen calcification when incubated in vitro. The urine concentration of inhibitors of collagen calcification, however, was not significantly different in the two groups. Thus, the urine of patients with recurrent idiopathic calcium nephrolithiasis is more highly saturated with brushite, largely as a result of an increased urine calcium excretion rate, and contains a lower concentration of magnesium and citrate, substances that tend to prevent the precipitation and growth of crystals in urine. PMID:436047

  2. A Radiographic Correlation between Renal and Pulp Stones

    PubMed Central

    Ertas, E Tarim; Inci, M; Demirtas, A; Ertas, H; Yengil, E; Sisman, Y; Gokce, C

    2014-01-01

    ABSTRACT Aim: The purpose of this study was to determine the correlation between pulp stones and renal stones. This study also aimed to report associations between the presence of pulp stone and gender, age, tooth type, dental arches and sides. Patients and Methods: Data were collected through examination of bitewing radiographs of 116 kidney stone patients and a similar number of age-matched controls, referred to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University. Two oral radiologists examined the radiographs to identify pulp stones. The Chi-squared and Mann Whitney U tests were used to investigate the correlations between the presence of pulp chamber calcification and age, gender, dental status and kidney stone. Results: Pulp chamber opacities were detected in 199 (19.3%) out of the 1031 examined teeth, and in 84 (72.4%) out of the 116 kidney stone patients. There was no statistically significant difference between the study and control group (p = 0.882). The occurrence of pulp stones was significantly higher in molars than premolars and similar prevalences were found between dental arches and sides. Conclusion: In this study, no correlation was found between the presence of pulp stones and kidney stones in the investigated group. Therefore, the presence of pulp stones does not seem to be correlated with that of kidney stones. PMID:25803378

  3. Stone chewing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Picking stones up into the mouth and chewing them has been commonly reported in pigs and also in dogs. It has variously been described as play behavior, redirected foraging behavior or a stereotypic behavior. In pigs, stone chewing is often observed in sows housed on paddocks, and most frequently o...

  4. Rosuvastatin Treatment Prevents Progressive Kidney Inflammation and Fibrosis in Stroke-Prone Rats

    PubMed Central

    Gianella, Anita; Nobili, Elena; Abbate, Mauro; Zoja, Carla; Gelosa, Paolo; Mussoni, Luciana; Bellosta, Stefano; Canavesi, Monica; Rottoli, Daniela; Guerrini, Uliano; Brioschi, Maura; Banfi, Cristina; Tremoli, Elena; Remuzzi, Giuseppe; Sironi, Luigi

    2007-01-01

    Salt-loaded, spontaneously hypertensive stroke-prone rats show progressive increases in blood pressure and proteinuria and accumulate acute-phase proteins in body fluids, modeling events during renal damage. The aim of this study was to assess the pathological events occurring in the kidney of spontaneously hypertensive stroke-prone rats over time and evaluate the effects of statin treatment, which is known to improve renal and cardiovascular outcomes. Kidneys of male spontaneously hypertensive stroke-prone rats euthanized at different stages of proteinuria showed progressive inflammatory cell infiltration, the accumulation of α-smooth muscle actin-positive cells, degenerative changes in podocytes, and severe fibrosis. These were accompanied by an imbalance in the plasminogen/plasmin and metalloprotease systems characterized by the increased renal expression of plasminogen activator inhibitor-1, tissue plasminogen activator, and urokinase plasminogen activator; the net result was an increase in plasmin and matrix metalloproteinase (MMP)-2 and a reduction in MMP-9 activity. Chronic treatment with the hydrophilic rosuvastatin had renoprotective effects in terms of morphology and inflammation and prevented the changes in plasmin, MMP-2, and MMP-9 activity. These effects were independent of the changes in blood pressure and plasma lipid levels. Treatment with the lipophilic simvastatin was not renoprotective. These data suggest that rosuvastatin may have potential utility as a therapeutic option in renal diseases that are characterized by inflammation and fibrosis. PMID:17392157

  5. Holmium:YAG (λ=2120nm) vs. Thulium fiber laser (λ=1908nm) ablation of kidney stones: thresholds, rates, and retropulsion

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2011-03-01

    The Holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but its efficient operation is limited to relatively low pulse rates (~10 Hz) during lithotripsy. On the contrary, the Thulium Fiber Laser (TFL) is limited to low pulse energies, but can operate at very high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion effects for different Ho:YAG and TFL operation modes. The TFL (λ=1908 nm) was operated with pulse energies of 5-35 mJ, 500-μs pulse duration, and pulse rates of 10-400 Hz. The Ho:YAG laser (λ=2120 nm) was operated with pulse energies of 30-550 mJ, 350-μs pulse duration, and pulse rate of 10 Hz. Laser energy was delivered through small-core (200-270-μm) optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 J/cm2and 20.8 J/cm2, respectively. Stone retropulsion with Ho:YAG laser increased linearly with pulse energy. Retropulsion with TFL was minimal at pulse rates < 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies < 175 mJ at 10 Hz, and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies (e.g. 100-200 mJ) and high pulse rates (100-150 Hz) may also provide higher ablation rates, when retropulsion is not the primary concern.

  6. Theoretical modeling of the urinary supersaturation of calcium salts in healthy individuals and kidney stone patients: Precursors, speciation and therapeutic protocols for decreasing its value

    NASA Astrophysics Data System (ADS)

    Rodgers, Allen L.; Allie-Hamdulay, Shameez; Jackson, Graham E.; Durbach, Ian

    2013-11-01

    BackgroundSupersaturation (SS) of urinary salts has been extensively invoked for assessing the risk of renal stone formation, but precursors have often been ignored. Our objectives were to establish by computer modeling, which urinary components are essential for calculating reliable SS values, to investigate whether unique equilibrium processes occur in the urine of stone formers (SF) which might account for their higher SS levels relative to healthy controls (N), to determine the relative efficacies of three different, widely-used protocols for lowering urinary SS of calcium salts and to examine the influence of precursors.

  7. Mesenchymal Stem Cell Therapy Prevents Interstitial Fibrosis and Tubular Atrophy in a Rat Kidney Allograft Model

    PubMed Central

    Herrero, Esther; Torras, Joan; Ripoll, Elia; Flaquer, Maria; Gomà, Montse; Lloberas, Nuria; Anegon, Ignacio; Cruzado, Josep M.; Grinyó, Josep M.; Herrero-Fresneda, Immaculada

    2012-01-01

    In solid organ transplantation, mesenchymal stem cell (MSC) therapy is strongly emerging among other cell therapies due to the positive results obtained in vitro and in vivo as an immunomodulatory agent and their potential regenerative role. We aimed at testing whether a single dose of MSCs, injected at 11 weeks after kidney transplantation for the prevention of chronic mechanisms, enhanced regeneration and provided protection against the inflammatory and fibrotic processes that finally lead to the characteristic features of chronic allograft nephropathy (CAN). Either bone marrow mononuclear cells (BMCs) injection or no-therapy (NT) were used as control treatments. A rat kidney transplantation model of CAN with 2.5 h of cold ischemia was used, and functional, histological, and molecular parameters were assessed at 12 and 24 weeks after transplantation. MSC and BMC cell therapy preserves renal function at 24 weeks and abrogates proteinuria, which is typical of this model (NT24w: 68.9±26.5 mg/24 h, MSC24w: 16.6±2.3 mg/24 h, BMC24w: 24.1±5.3 mg/24 h, P<0.03). Only MSC-treated animals showed a reduction in interstitial fibrosis and tubular atrophy (NT24w: 2.3±0.29, MSC24w: 0.4±0.2, P<0.03), less T cells (NT: 39.6±9.5, MSC: 8.1±0.9, P<0.03) and macrophages (NT: 20.9±4.7, MSC: 5.9±1.7, P<0.05) infiltrating the parenchyma and lowered expression of inflammatory cytokines while increasing the expression of anti-inflammatory factors. MSCs appear to serve as a protection from injury development rather than regenerate the damaged tissue, as no differences were observed in Ki67 expression, and kidney injury molecule-1, Clusterin, NGAL, and hepatocyte growth factor expression were only up-regulated in nontreated animals. Considering the results, a single delayed MSC injection is effective for the long-term protection of kidney allografts. PMID:22494435

  8. Preventive effect of pentoxifylline on contrast-induced acute kidney injury in hypercholesterolemic rats

    PubMed Central

    YANG, SHI-KUN; DUAN, SHAO-BIN; PAN, PENG; XU, XIANG-QING; LIU, NA; XU, JUN

    2015-01-01

    Oxidative stress is an important mechanism of contrast-induced acute kidney injury (CIAKI). The optimal strategy to prevent CIAKI remains unclear. The aim of the present study was to assess the effect of pentoxifylline, a nonspecific phosphodiesterase inhibitor, on the prevention of CIAKI. A total of 32 healthy male Sprague-Dawley rats were randomly divided into normal dietary group (NN; n=8) and a high cholesterol-supplemented dietary group (HN; 4% cholesterol and 1% cholic acid; n=24). At the end of eight weeks, the rats in the high cholesterol diet group were randomly divided into three subgroups (n=8 in each group). CIAKI was induced in two of the subgroups via intravenous injection of the radiocontrast media iohexol (10 ml/kg). Pentoxifylline (50 mg/kg) was administered to one of the iohexol-treated groups via intraperitoneal injection 12 h prior to and following contrast media (CM) injection. Kidney function parameters and oxidative stress markers were then measured. The renal pathological changes were evaluated using hematoxylin and eosin staining and scored semi-quantitatively. In iohexol-injected rats, serum creatinine (Scr), renal pathological scores, renal malondialdehyde (MDA) content, renal NADPH oxidase activity, fractional excretion of sodium (FENa%) and fractional excretion of potassium (FEK%) were significantly increased (P<0.01). The Scr, histologic scores, renal MDA content, NADPH oxidase activity, FENa% and FEK% in the rats treated with pentoxifylline prior to iohexol were observed to be reduced compared with those in rats treated with iohexol alone (P<0.01). This suggests that pentoxifylline significantly attenuates renal injuries, including tubular necrosis and proteinaceous casts induced by CM. It may be concluded that pentoxifylline protected the renal tissue from the nephrotoxicity induced by low-osmolar CM via an antioxidant effect. PMID:25574202

  9. Kidney (Renal) Failure

    MedlinePlus

    Advertisement Resize Text: Toggle navigation Find a Urologist Submit About Us What We Do Foundation History Leadership ... a kidney stone or scar tissue Share Symptoms Advertisement Patient Education Materials We provide free patient education ...

  10. Cost-Effectiveness of Statins for Primary Cardiovascular Prevention in Chronic Kidney Disease

    PubMed Central

    Erickson, Kevin F.; Japa, Sohan; Owens, Douglas K.; Chertow, Glenn M.; Garber, Alan M.; Goldhaber-Fiebert, Jeremy D.

    2013-01-01

    Objectives To evaluate the cost-effectiveness of statins for primary prevention of myocardial infarction (MI) and stroke in patients with chronic kidney disease (CKD). Background Patients with CKD have an elevated risk of MI and stroke. Although HMG Co-A reductase inhibitors (“statins”) may prevent cardiovascular events in patients with non-dialysis-requiring CKD, adverse drug effects and competing risks could materially influence net effects and clinical decision-making. Methods We developed a decision-analytic model of CKD and cardiovascular disease (CVD) to determine the cost-effectiveness of low-cost generic statins for primary CVD prevention in men and women with hypertension and mild-to-moderate CKD. Outcomes included MI and stroke rates, discounted quality adjusted life years (QALYs) and lifetime costs (2010 USD), and incremental cost-effectiveness ratios. Results For 65 year-old men with moderate hypertension and mild-to-moderate CKD, statins reduced the combined rate of MI and stroke, yielded 0.10 QALYs, and increased costs by $1,800 ($18,000 per QALY gained). For patients with lower baseline cardiovascular risks, health and economic benefits were smaller; for 65 year-old women, statins yielded 0.06 QALYs and increased costs by $1,900 ($33,400 per QALY gained). Results were sensitive to rates of rhabdomyolysis and drug costs. Statins are less cost-effective when obtained at average retail prices, particularly in patients at lower CVD risk. Conclusions While statins reduce absolute CVD risk in patients with CKD, increased risk of rhabdomyolysis, and competing risks associated with progressive CKD, partly offset these gains. Low-cost generic statins appear cost-effective for primary prevention of CVD in patients with mild-to-moderate CKD and hypertension. PMID:23500327

  11. A Case of Recurrent Renal Aluminum Hydroxide Stone

    PubMed Central

    Cakıroglu, Basri; Dogan, Akif Nuri; Tas, Tuncay; Gozukucuk, Ramazan; Uyanik, Bekir Sami

    2014-01-01

    Renal stone disease is characterized by the differences depending on the age, gender, and the geographic location of the patients. Seventy-five percent of the renal stone components is the calcium (Ca). The most common type of the stones is the Ca oxalate stones, while Ca phosphate, uric acid, struvite, and sistine stones are more rarely reported. Other than these types, triamterene, adenosine, silica, indinavir, and ephedrine stones are also reported in the literature as case reports. However, to the best of our knowledge, aluminum hydroxide stones was not reported reported before. Herein we will report a 38-years-old woman with the history of recurrent renal colic disease whose renal stone was determined as aluminum hydroxide stone in type. Aluminum mineral may be considered in the formation of kidney stones as it is widely used in the field of healthcare and cosmetics. PMID:25013740

  12. Protein-bound uremic toxins…new targets to prevent insulin resistance and dysmetabolism in patients with chronic kidney disease.

    PubMed

    Soulage, Christophe O; Koppe, Laetitia; Fouque, Denis

    2013-11-01

    The retention of p-cresyl sulfate (PCS), the prototype of protein-bound uremic toxins that is produced by the gut microbiota and normally excreted by the kidney, may contribute to the development of insulin resistance in patients with chronic kidney disease. In a recent study, we demonstrated in mice, as in cultured muscle cells, that PCS interferes with intracellular insulin signaling pathways and triggers insulin resistance. The treatment of CKD mice with a prebiotic that reduces the intestinal production and decreases blood levels of PCS prevented insulin resistance and lipid abnormalities, suggesting new opportunities to prevent metabolic disturbances in patients with CKD. This study highlights the uremic toxins as new actors in metabolic alterations associated with CKD and allows for the consideration of new therapeutic approaches (e.g., prebiotics, probiotics, adsorbents) to better prevent them. PMID:23938300

  13. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of water through a conduit. The device is used in the surgical removal of kidney stones. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Water jet renal stone dislodger system. 876.4650... stone dislodger system. (a) Identification. A water jet renal stone dislodger system is a device used...

  14. Cytomegalovirus prevention strategies in seropositive kidney transplant recipients: an insight into current clinical practice.

    PubMed

    Fernández-Ruiz, Mario; Arias, Manuel; Campistol, Josep M; Navarro, David; Gómez-Huertas, Ernesto; Gómez-Márquez, Gonzalo; Díaz, Juan Manuel; Hernández, Domingo; Bernal-Blanco, Gabriel; Cofan, Frederic; Jimeno, Luisa; Franco-Esteve, Antonio; González, Esther; Moreso, Francesc J; Gómez-Alamillo, Carlos; Mendiluce, Alicia; Luna-Huerta, Enrique; Aguado, José María

    2015-09-01

    There is notable heterogeneity in the implementation of cytomegalovirus (CMV) prevention practices among CMV-seropositive (R+) kidney transplant (KT) recipients. In this prospective observational study, we included 387 CMV R+ KT recipients from 25 Spanish centers. Prevention strategies (antiviral prophylaxis or preemptive therapy) were applied according to institutional protocols at each site. The impact on the 12-month incidence of CMV disease was assessed by Cox regression. Asymptomatic CMV infection, acute rejection, graft function, non-CMV infection, graft loss, and all-cause mortality were also analyzed (secondary outcomes). Models were adjusted for a propensity score (PS) analysis for receiving antiviral prophylaxis. Overall, 190 patients (49.1%) received preemptive therapy, 185 (47.8%) antiviral prophylaxis, and 12 (3.1%) no specific intervention. Twelve-month cumulative incidences of CMV disease and asymptomatic infection were 3.6% and 39.3%, respectively. Patients on prophylaxis had lower incidence of CMV disease [PS-adjusted HR (aHR): 0.10; 95% confidence interval (CI): 0.01-0.79] and asymptomatic infection (aHR: 0.46; 95% CI: 0.29-0.72) than those managed preemptively, with no significant differences according to the duration of prophylaxis. All cases of CMV disease in the prophylaxis group occurred after prophylaxis discontinuation. There were no differences in any of the secondary outcomes. In conclusion, antiviral prophylaxis was associated with a lower occurrence of CMV disease in CMV R+ KT recipients, although such benefit should be balanced with the risk of late-onset disease. PMID:25864986

  15. Intravascular Administration of Mannitol for Acute Kidney Injury Prevention: A Systematic Review and Meta-Analysis

    PubMed Central

    Xu, Fengying; Zou, Zui; Ye, Chaoyang; Mei, Changlin; Mao, Zhiguo

    2014-01-01

    Background The effects of mannitol administration on acute kidney injury (AKI) prevention remain uncertain, as the results from clinical studies were conflicting. Due to the lack of strong evidence, the KDIGO Guideline for AKI did not propose completely evidence-based recommendations on this issue. Methods We searched PubMed, EMBASE, clinicaltrials.gov and Cochrane Controlled Trials Register. Randomized controlled trials on adult patients at increased risk of AKI were considered on the condition that they compared the effects of intravascular administration of mannitol plus expansion of intravascular volume with expansion of intravascular volume alone. We calculated pooled risk ratios, numbers needed to treat and mean differences with 95% confidence intervals for dichotomous data and continuous data, respectively. Results Nine trials involving 626 patients were identified. Compared with expansion of intravascular volume alone, mannitol infusion for AKI prevention in high-risk patients can not reduce the serum creatinine level (MD 1.63, 95% CI −6.02 to 9.28). Subgroup analyses demonstrated that serum creatinine level is negatively affected by the use of mannitol in patients undergoing an injection of radiocontrast agents (MD 17.90, 95% CI 8.56 to 27.24). Mannitol administration may reduce the incidence of acute renal failure or the need of dialysis in recipients of renal transplantation (RR 0.34, 95% CI 0.21 to 0.57, NNT 3.03, 95% CI 2.17 to 5.00). But similar effects were not found in patients at high AKI risk, without receiving renal transplantation (RR 0.29, 95% CI 0.01 to 6.60). Conclusions Intravascular administration of mannitol does not convey additional beneficial effects beyond adequate hydration in the patients at increased risk of AKI. For contrast-induced nephropathy, the use of mannitol is even detrimental. Further research evaluating the efficiency of mannitol infusions in the recipients of renal allograft should be undertaken. PMID:24454783

  16. Mechanical thromboprophylaxis is sufficient to prevent the lower extremity deep vein thrombosis after kidney transplantation

    PubMed Central

    Jun, Kang-Woong; Park, Keun-Myoung; Kim, Mi-Hyeong; Hwang, Jeong-Kye; Park, Soon-Chul; Moon, In-Sung; Chung, Byung-Ha; Choi, Bum-Soon; Yang, Chul-Woo; Kim, Yong-Soo

    2014-01-01

    Purpose Deep vein thrombosis (DVT) is a severe and common complication that occurs after the major operation. Despite the commonality of DVT there is limited data on the incidence of DVT after kidney transplantation (KT). Furthermore, most studies have been retrospective in design and were conducted in western countries. The aim of this study was to evaluate the incidence of lower extremity DVT with mechanical thromboprophylaxis within 1 month of KT in Korea. Methods A total of 187 consecutive patients who underwent KT were included in this study. Patients used a graduated elastic stocking (n = 93) or an intermittent pneumatic compression device (n = 94) to prevent DVT. The frequency of DVT during the first month after KT was evaluated using serial color duplex ultrasound on postoperative days 7 ± 2, 14 ± 2, and 28 ± 3. All patients were tested for eight thrombophilic factors before KT. Results DVT occurred in four patients (2.1%) during the first month after KT. All DVT developed in the graduated elastic stocking group. Interestingly, none of the patients had the factor V Leiden mutation or the prothrombin gene 20210A mutation. Conclusion The incidence of DVT in this study was relatively lower than that of western populations. We did not encounter a factor V Leiden mutation or a prothrombin gene 20210A mutation in our study population. These findings suggest that inherited thrombophilic risk factors may be partially responsible for the difference in DVT incidence rates between different nationalities and/or ethnicities. PMID:25025024

  17. Management and prevention of post-transplant malignancies in kidney transplant recipients

    PubMed Central

    Stallone, Giovanni; Infante, Barbara; Grandaliano, Giuseppe

    2015-01-01

    The central issue in organ transplantation remains suppression of allograft rejection. Thus, the development of immunosuppressive drugs has been the key to successful allograft function. The increased immunosuppressive efficiency obtained in the last two decades in kidney transplantation dramatically reduced the incidence of acute rejection. However, the inevitable trade-off was an increased rate of post-transplant infections and malignancies. Since the incidence of cancer in immunosuppressed transplant recipients becomes greater over time, and the introduction of new immunosuppressive strategies are expected to extend significantly allograft survival, the problem might grow exponentially in the near future. Thus, cancer is becoming a major cause of morbidity and mortality in patients otherwise successfully treated by organ transplantation. There are at least four distinct areas requiring consideration, which have a potentially serious impact on recipient outcome after transplantation: (i) the risk of transmitting a malignancy to the recipient within the donor organ; (ii) the problems of previously diagnosed and treated malignancy in the recipient; (iii) the prevention of de novo post-transplant malignant diseases and (iv) the management of these complex and often life-threatening clinical problems. In this scenario, the direct and indirect oncogenic potential of immunosuppressive therapy should be always carefully considered. PMID:26413294

  18. Translational research in nephrology: chronic kidney disease prevention and public health

    PubMed Central

    Brück, Katharina; Stel, Vianda S.; Fraser, Simon; De Goeij, Moniek C.M.; Caskey, Fergus; Abu-Hanna, Ameen; Jager, Kitty J.

    2015-01-01

    This narrative review evaluates translational research with respect to five important risk factors for chronic kidney disease (CKD): physical inactivity, high salt intake, smoking, diabetes and hypertension. We discuss the translational research around prevention of CKD and its complications both at the level of the general population, and at the level of those at high risk, i.e. people at increased risk for CKD or CKD complications. At the population level, all three lifestyle risk factors (physical inactivity, high salt intake and smoking) have been translated into implemented measures and clear population health improvements have been observed. At the ‘high-risk’ level, the lifestyle studies reviewed have tended to focus on the individual impact of specific interventions, and their wider implementation and impact on CKD practice are more difficult to establish. The treatment of both diabetes and hypertension appears to have improved, however the impact on CKD and CKD complications was not always clear. Future studies need to investigate the most effective translational interventions in low and middle income countries. PMID:26613019

  19. Management and prevention of post-transplant malignancies in kidney transplant recipients.

    PubMed

    Stallone, Giovanni; Infante, Barbara; Grandaliano, Giuseppe

    2015-10-01

    The central issue in organ transplantation remains suppression of allograft rejection. Thus, the development of immunosuppressive drugs has been the key to successful allograft function. The increased immunosuppressive efficiency obtained in the last two decades in kidney transplantation dramatically reduced the incidence of acute rejection. However, the inevitable trade-off was an increased rate of post-transplant infections and malignancies. Since the incidence of cancer in immunosuppressed transplant recipients becomes greater over time, and the introduction of new immunosuppressive strategies are expected to extend significantly allograft survival, the problem might grow exponentially in the near future. Thus, cancer is becoming a major cause of morbidity and mortality in patients otherwise successfully treated by organ transplantation. There are at least four distinct areas requiring consideration, which have a potentially serious impact on recipient outcome after transplantation: (i) the risk of transmitting a malignancy to the recipient within the donor organ; (ii) the problems of previously diagnosed and treated malignancy in the recipient; (iii) the prevention of de novo post-transplant malignant diseases and (iv) the management of these complex and often life-threatening clinical problems. In this scenario, the direct and indirect oncogenic potential of immunosuppressive therapy should be always carefully considered. PMID:26413294

  20. Nephropathy in dietary hyperoxaluria: A potentially preventable acute or chronic kidney disease

    PubMed Central

    Glew, Robert H; Sun, Yijuan; Horowitz, Bruce L; Konstantinov, Konstantin N; Barry, Marc; Fair, Joanna R; Massie, Larry; Tzamaloukas, Antonios H

    2014-01-01

    Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis, but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma, profound tubular damage and interstitial inflammation and fibrosis. Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to end-stage renal disease (ESRD). This sequence of events, well recognized in the past in primary and enteric hyperoxalurias, has also been documented in a few cases of dietary hyperoxaluria. Estimates of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide, thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these regions. Studies addressing this question have the potential of improving population health and should be undertaken, alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate, and into the mechanisms of development of oxalate-induced renal parenchymal disease. Novel preventive and therapeutic strategies for treating all types of hyperoxaluria are expected to develop from these studies. PMID:25374807

  1. U.S. Centers for Disease Control and Prevention launches new chronic kidney disease surveillance system website.

    PubMed

    Johns, Tanya; Jaar, Bernard G

    2013-01-01

    The burden of chronic kidney disease (CKD) is substantial and is associated with poor health outcomes including increase hospitalizations and premature deaths, as well as considerable health care cost. In recognition of this mounting public health problem, the U.S. Centers for Disease Control and Prevention and their collaborators created a national CKD surveillance system. This commentary introduces the national CKD surveillance system and discusses some of its potential uses. PMID:24034342

  2. Effects of calcium carbonate, magnesium oxide and sodium citrate bicarbonate health supplements on the urinary risk factors for kidney stone formation.

    PubMed

    Allie, Shameez; Rodgers, Allen

    2003-01-01

    We describe a model to illustrate different chemical interactions that can occur in urine following ingestion of individual and combined health supplements. Two types of interactions are defined: synergism and addition. The model was applied to eight healthy males who participated in a study to investigate the chemical interactions between calcium carbonate, magnesium oxide and sodium citrate-bicarbonate health supplements on calcium oxalate urinary stone risk factors. Subjects ingested these components individually and in combination for 7 days. Twenty-four-hour urines were collected at baseline and during the final day of supplementation. These were analysed using standard laboratory techniques. Three different chemical interactions, all involving citrate, were identified: magnesium and citrate exerted a synergistic effect on lowering the relative superaturation (RS) of brushite; the same two components produced a synergistic effect on raising pH; finally, calcium and citrate exerted an additive effect on lowering the RS of uric acid. We propose that the novel approach described in this paper allows for the evaluation of individual, additive and synergistic interactions in the assessment of the efficacy of stone-risk reducing preparations. PMID:12636048

  3. Stone Composition as a Function of Age and Sex

    PubMed Central

    Rule, Andrew D.; Krambeck, Amy E.; Williams, James C.; Bergstralh, Eric J.; Mehta, Ramila A.; Moyer, Thomas P.

    2014-01-01

    Background and objectives Kidney stones are heterogeneous but often grouped together. The potential effects of patient demographics and calendar month (season) on stone composition are not widely appreciated. Design, setting, participants, & measurements The first stone submitted by patients for analysis to the Mayo Clinic Metals Laboratory during 2010 was studied (n=43,545). Stones were classified in the following order: any struvite, any cystine, any uric acid, any brushite, majority (?50%) calcium oxalate, or majority (?50%) hydroxyapatite. Results Calcium oxalate (67%) was the most common followed by hydroxyapatite (16%), uric acid (8%), struvite (3%), brushite (0.9%), and cystine (0.35%). Men accounted for more stone submissions (58%) than women. However, women submitted more stones than men between the ages of 1019 (63%) and 2029 (62%) years. Women submitted the majority of hydroxyapatite (65%) and struvite (65%) stones, whereas men submitted the majority of calcium oxalate (64%) and uric acid (72%) stones (P<0.001). Although calcium oxalate stones were the most common type of stone overall, hydroxyapatite stones were the second most common before age 55 years, whereas uric acid stones were the second most common after age 55 years. More calcium oxalate and uric acid stones were submitted in the summer months (July and August; P<0.001), whereas the season did not influence other stone types. Conclusions It is well known that calcium oxalate stones are the most common stone type. However, age and sex have a marked influence on the type of stone formed. The higher number of stones submitted by women compared with men between the ages of 10 and 29 years old and the change in composition among the elderly favoring uric acid have not been widely appreciated. These data also suggest increases in stone risk during the summer, although this is restricted to calcium oxalate and uric acid stones. PMID:25278549

  4. Prolonging nephrogenesis in preterm infants: a new approach for prevention of kidney disease in adulthood?

    PubMed

    Fanos, Vassilios; Castagnola, Massimo; Faa, Gavino

    2015-05-01

    Chronic kidney disease represents a dramatic worldwide resource-consuming problem. This problem is of increasing importance even in preterm infants, since nephrogenesis may go on only for a few weeks (4 to 6 weeks) after birth. Recent literature focusing on traditional regenerative medicine does not take into account the presence of a high number of active endogenous stem cells in the preterm kidney, which represents a unique opportunity for starting regenerative medicine in the perinatal period. Pluripotent cells of the blue strip have the capacity to generate new nephrons, improving kidney function in neonates and potentially protecting them from developing chronic kidney disease and end-stage renal disease in adulthood. There is a marked interindividual neonatal variability of nephron numbers. Moreover, the renal stem/progenitor cells appear as densely-packed small cells with scant cytoplasm, giving rise to a blue-appearing strip in hematoxylin-eosin-stained kidney sections ("the blue strip"). There are questions concerning renal regenerative medicine: among preliminary data, the simultaneous expression of Wilms tumor 1 and thymosin ?4 in stem/progenitor cells of the neonatal kidney may bring new prospects for renal regeneration applied to renal stem cells that reside in the kidney itself. A potential approach could be to prolong the 6 weeks of postnatal renal growth of nephrons or to accelerate the growth of nephrons during the 6 weeks or both. Considering what we know today about perinatal programming, this could be an important step for the future to reduce the incidence and global health impact of chronic kidney disease. PMID:25957420

  5. 18C. Chinese Herbs Cured a Kidney Calculus—A Retrospective Case Report

    PubMed Central

    2013-01-01

    Focus Areas: Integrative Approaches to Care Objective: Traditional Chinese medicine (TCM) is referred to as holistic or complementary and alternative medicine. Herbal remedy plays the main role of TCM. It has been widely used in preventive measures and treatment modalities for all stages of illness. Here is a retrospective case report about herb healing the kidney stone and improving type II diabetes and hypertension. Patient, Method and Result: A male, 46 years old, chief complaint: intermittent lumbago 6 years. The other symptoms were fatigue and slight thirst. He had been diagnosed with type II diabetes, hypertension of 2 years, and a small kidney stone (6 years). His blood pressure (BP) was between 140/85mmHg to 150/95mmHg; fasting plasma glucose was around 7mmol/L to 8 mmol/L. PE: BP 145/95 mmHg. Lab: 2hPG: 15.1mmol/L. Urinalysis: RBC: 5-6/HP, WBC: 2-4/ HP, GLU. Ultrasound: kidney stone, 0.3x 0.2 cm, at the inferior pole of the left kidney. This patient irregularly took Metformin, refused to control diet or use antihypertensives, but was open to using an herbal formula, 1 dose per day. After 1 year's treatment, his back pain, fatigue, and thirst gradually disappeared. BP was around130-120/85-75mmHg, 2h PG: 7.3mmol/L. FPG: 6mmol/L. Urinalysis: RBC: 0-2/HP, WBC: negative, Glu. Ultrasound: normal, no stone found. Discussion: Generally, there is no method to remove a small stone in the renal parenchyma. In this case, Chinese herbal tea achieved a dramatic curing result. At retrospective review after 8 years, no stone recurred. From the TCM theory, the stone is the result of heat congealing turbid dampness; the diabetes is Yin-deficient heat. The basic function of this formula is to tonify Qi and Yin, invigorate blood, clear heat, and resolve the stone. In conjunction with Metformin, the patient's diabetes and hypertension were improved. Conclusion: This Chinese herb formula dissolved the kidney stone and prevented a new stone from recurring. There is no obvious contraindication with Metformin.

  6. Pulsed focused ultrasound pretreatment improves mesenchymal stem cell efficacy in preventing and rescuing established acute kidney injury in mice

    PubMed Central

    Burks, Scott R.; Nguyen, Ben A.; Tebebi, Pamela A.; Kim, Saejeong J.; Bresler, Michele N.; Ziadloo, Ali; Street, Jonathan M.; Yuen, Peter S. T.; Star, Robert A.; Frank, Joseph A.

    2014-01-01

    Animal studies have shown that mesenchymal stem cell (MSC) infusions improve acute kidney injury (AKI) outcomes when administered early after ischemic/reperfusion injury or within 24hr after cisplatin administration. These findings have spurred several human clinical trials to prevent AKI. However, no specific therapy effectively treats clinically obvious AKI or rescues renal function once advanced injury is established. We investigated if noninvasive image-guided pulsed focused ultrasound (pFUS) could alter the kidney microenvironment to enhance homing of subsequently infused MSC. To examine the efficacy of pFUS-enhanced cell homing in disease, we targeted pFUS to kidneys to enhance MSC homing after cisplatin-induced AKI. We found that pFUS enhanced MSC homing at 1 day post-cisplatin, prior to renal functional deficits, and that enhanced homing improved outcomes of renal function, tubular cell death, and regeneration at 5 days post-cisplatin compared to MSC alone. We then investigated whether pFUS+MSC therapy could rescue established AKI. MSC alone at 3 days post-cisplatin, after renal functional deficits were obvious, significantly improved 7-day survival of animals. Survival was further improved using pFUS+MSC. MSC, alone or with pFUS, changed kidney macrophage phenotypes from M1 to M2. This study shows pFUS is a neoadjuvant approach to improve MSC homing to diseased organs. pFUS with MSC better prevents AKI than MSC alone and allows rescue therapy in established AKI, which currently has no meaningful therapeutic options. PMID:25640064

  7. Pharmacological GLI2 inhibition prevents myofibroblast cell-cycle progression and reduces kidney fibrosis.

    PubMed

    Kramann, Rafael; Fleig, Susanne V; Schneider, Rebekka K; Fabian, Steven L; DiRocco, Derek P; Maarouf, Omar; Wongboonsin, Janewit; Ikeda, Yoichiro; Heckl, Dirk; Chang, Steven L; Rennke, Helmut G; Waikar, Sushrut S; Humphreys, Benjamin D

    2015-08-01

    Chronic kidney disease is characterized by interstitial fibrosis and proliferation of scar-secreting myofibroblasts, ultimately leading to end-stage renal disease. The hedgehog (Hh) pathway transcriptional effectors GLI1 and GLI2 are expressed in myofibroblast progenitors; however, the role of these effectors during fibrogenesis is poorly understood. Here, we demonstrated that GLI2, but not GLI1, drives myofibroblast cell-cycle progression in cultured mesenchymal stem cell-like progenitors. In animals exposed to unilateral ureteral obstruction, Hh pathway suppression by expression of the GLI3 repressor in GLI1+ myofibroblast progenitors limited kidney fibrosis. Myofibroblast-specific deletion of Gli2, but not Gli1, also limited kidney fibrosis, and induction of myofibroblast-specific cell-cycle arrest mediated this inhibition. Pharmacologic targeting of this pathway with darinaparsin, an arsenical in clinical trials, reduced fibrosis through reduction of GLI2 protein levels and subsequent cell-cycle arrest in myofibroblasts. GLI2 overexpression rescued the cell-cycle effect of darinaparsin in vitro. While darinaparsin ameliorated fibrosis in WT and Gli1-KO mice, it was not effective in conditional Gli2-KO mice, supporting GLI2 as a direct darinaparsin target. The GLI inhibitor GANT61 also reduced fibrosis in mice. Finally, GLI1 and GLI2 were upregulated in the kidneys of patients with high-grade fibrosis. Together, these data indicate that GLI inhibition has potential as a therapeutic strategy to limit myofibroblast proliferation in kidney fibrosis. PMID:26193634

  8. Pharmacological GLI2 inhibition prevents myofibroblast cell-cycle progression and reduces kidney fibrosis

    PubMed Central

    Kramann, Rafael; Fleig, Susanne V.; Schneider, Rebekka K.; Fabian, Steven L.; DiRocco, Derek P.; Maarouf, Omar; Wongboonsin, Janewit; Ikeda, Yoichiro; Heckl, Dirk; Chang, Steven L.; Rennke, Helmut G.; Waikar, Sushrut S.; Humphreys, Benjamin D.

    2015-01-01

    Chronic kidney disease is characterized by interstitial fibrosis and proliferation of scar-secreting myofibroblasts, ultimately leading to end-stage renal disease. The hedgehog (Hh) pathway transcriptional effectors GLI1 and GLI2 are expressed in myofibroblast progenitors; however, the role of these effectors during fibrogenesis is poorly understood. Here, we demonstrated that GLI2, but not GLI1, drives myofibroblast cell-cycle progression in cultured mesenchymal stem cell–like progenitors. In animals exposed to unilateral ureteral obstruction, Hh pathway suppression by expression of the GLI3 repressor in GLI1+ myofibroblast progenitors limited kidney fibrosis. Myofibroblast-specific deletion of Gli2, but not Gli1, also limited kidney fibrosis, and induction of myofibroblast-specific cell-cycle arrest mediated this inhibition. Pharmacologic targeting of this pathway with darinaparsin, an arsenical in clinical trials, reduced fibrosis through reduction of GLI2 protein levels and subsequent cell-cycle arrest in myofibroblasts. GLI2 overexpression rescued the cell-cycle effect of darinaparsin in vitro. While darinaparsin ameliorated fibrosis in WT and Gli1-KO mice, it was not effective in conditional Gli2-KO mice, supporting GLI2 as a direct darinaparsin target. The GLI inhibitor GANT61 also reduced fibrosis in mice. Finally, GLI1 and GLI2 were upregulated in the kidneys of patients with high-grade fibrosis. Together, these data indicate that GLI inhibition has potential as a therapeutic strategy to limit myofibroblast proliferation in kidney fibrosis. PMID:26193634

  9. Nitro-Arachidonic Acid Prevents Angiotensin II-Induced Mitochondrial Dysfunction in a Cell Line of Kidney Proximal Tubular Cells

    PubMed Central

    Sánchez-Calvo, Beatriz; Cassina, Adriana; Rios, Natalia; Boggia, José; Radi, Rafael; Rubbo, Homero; Trostchansky, Andres

    2016-01-01

    Nitro-arachidonic acid (NO2-AA) is a cell signaling nitroalkene that exerts anti-inflammatory activities during macrophage activation. While angiotensin II (ANG II) produces an increase in reactive oxygen species (ROS) production and mitochondrial dysfunction in renal tubular cells, little is known regarding the potential protective effects of NO2-AA in ANG II-mediated kidney injury. As such, this study examines the impact of NO2-AA on ANG II-induced mitochondrial dysfunction in an immortalized renal proximal tubule cell line (HK-2 cells). Treatment of HK-2 cells with ANG II increases the production of superoxide (O2●-), nitric oxide (●NO), inducible nitric oxide synthase (NOS2) expression, peroxynitrite (ONOO-) and mitochondrial dysfunction. Using high-resolution respirometry, it was observed that the presence of NO2-AA prevented ANG II-mediated mitochondrial dysfunction. Attempting to address mechanism, we treated isolated rat kidney mitochondria with ONOO-, a key mediator of ANG II-induced mitochondrial damage, in the presence or absence of NO2-AA. Whereas the activity of succinate dehydrogenase (SDH) and ATP synthase (ATPase) were diminished upon exposure to ONOO-, they were restored by pre-incubating the mitochondria with NO2-AA. Moreover, NO2-AA prevents oxidation and nitration of mitochondrial proteins. Combined, these data demonstrate that ANG II-mediated oxidative damage and mitochondrial dysfunction is abrogated by NO2-AA, identifying this compound as a promising pharmacological tool to prevent ANG II–induced renal disease. PMID:26943326

  10. Vitamin D and Calcium Supplementation to Prevent Fractures

    MedlinePlus

    ... older women and may increase the risk of kidney stones. This fact sheet explains the recommendation and what ... small, but may include an increased risk of kidney stones. February 2013 Task Force FINAL Recommendation | 1 Vitamin ...

  11. The Stone Center: A Visitor's Perspective.

    ERIC Educational Resources Information Center

    Liddle, Shirley M.

    1991-01-01

    Author describes her perspective on the Stone Center for Developmental Services and Studies, integral part of Wellesley College established in 1981 and dedicated to prevention of emotional problems, primarily among women. Describes Education, Research, and Counseling divisions of the Stone Center and the basic tenets that drive the center's…

  12. Epidemiologic Insights into Stone Disease as a Systemic Disorder

    NASA Astrophysics Data System (ADS)

    Curhan, Gary C.

    2007-04-01

    Examining the epidemiology of stone disease can provide insight into etiology. There is a growing body of evidence that stone disease is not simply a disorder of the kidney. In fact, nephrolithiasis is clearly a systemic disorder. Conditions associated with stone disease include the classic ones such as inflammatory bowel disease and primary hyperparathyroidism. More recent studies have demonstrated strong associations with obesity, gout, diabetes and hypertension. Future studies will help uncover the underlying common pathophysiologic abnormalities.

  13. Does increased water intake prevent disease progression in autosomal dominant polycystic kidney disease?

    PubMed Central

    Higashihara, Eiji; Nutahara, Kikuo; Tanbo, Mitsuhiro; Hara, Hidehiko; Miyazaki, Isao; Kobayashi, Kuninori; Nitatori, Toshiaki

    2014-01-01

    Background The clinical effects of increased water intake on autosomal dominant polycystic kidney disease (ADPKD) progression are unknown. Methods ADPKD patients with creatinine clearance ≧50 mL/min/1.73 m2 were divided into high (H-, n = 18) and free (F-, n = 16) water-intake groups, mainly according to their preference. Prior to the study, 30 patients underwent annual evaluation of total kidney volume (TKV) and 24-h urine for an average of 33 months. During the 1-year study period, TKV and 24-h urine were analyzed at the beginning and end of the study and every 4 months, respectively. Results During the pre-study period, urine volume (UV) in the H-group was higher (P = 0.034), but TKV and kidney function and their slopes were not significantly different between the two groups. After the study commenced, UV further increased (P < 0.001) in the H-group but not in the F-group. During the study period, TKV and kidney function slopes were not significantly different between the two groups (primary endpoint). Plasma copeptin was lower (P = 0.024) in the H-group than in the F-group. TKV and kidney function slopes became worse (P = 0.047 and 0.011, respectively) after high water intake (H-group) but not in the F-group. High UV was associated with increased urine sodium, and urine sodium positively correlated with the % TKV slope (P = 0.014). Conclusions Although the main endpoint was not significant, high water intake enhanced disease progression in the H-group when compared with the pre-study period. These findings necessitate a long-term randomized study before drawing a final conclusion. PMID:24739484

  14. Aggregation of Calcium Phosphate and Oxalate Phases in the Formation of Renal Stones

    PubMed Central

    2015-01-01

    The majority of human kidney stones are comprised of multiple calcium oxalate monohydrate (COM) crystals encasing a calcium phosphate nucleus. The physiochemical mechanism of nephrolithiasis has not been well determined on the molecular level; this is crucial to the control and prevention of renal stone formation. This work investigates the role of phosphate ions on the formation of calcium oxalate stones; recent work has identified amorphous calcium phosphate (ACP) as a rapidly forming initial precursor to the formation of calcium phosphate minerals in vivo. The effect of phosphate on the nucleation of COM has been investigated using the constant composition (CC) method in combination with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Our findings indicate COM nucleation is strongly promoted by the presence of phosphate; this occurs at relatively low phosphate concentrations, undersaturated with respect to brushite (dicalcium phosphate dehydrate, DCPD) formation. The results show that ACP plays a crucial role in the nucleation of calcium oxalate stones by promoting the aggregation of amorphous calcium oxalate (ACO) precursors at early induction times. The coaggregations of ACP and ACO precursors induce the multiple-point nucleation of COM. These novel findings expand our knowledge of urinary stone development, providing potential targets for treating the condition at the molecular level. PMID:25598742

  15. The preventive effect of N-butanol fraction of Nigella sativa on ethylene glycol-induced kidney calculi in rats

    PubMed Central

    Hadjzadeh, Mousa-Al-Reza; Rad, Abolfazl Khajavi; Rajaei, Ziba; Tehranipour, Maryam; Monavar, Nahid

    2011-01-01

    Background: The current study was carried out to determine whether the aqueous-ethanolic extract or the butanolic fraction of Nigella sativa (NS) seeds could prevent or reduce calculi aggregation in experimental calcium oxalate nephrolithiasis in Wistar rats. Materials and Methods: Male Wistar rats were randomly divided into 5 groups: group A received tap drinking water for 28 days. Groups B, C, D and E received 1% ethylene glycol for induction of calcium oxalate (CaOx) calculus formation for 28 days. Rats in groups C, D and E also received aqueous-ethanolic extract of NS, N-butanol fraction and N-butanol phase remnant of NS, respectively, in drinking water at a dose of 250 mg/kg for 28 days. Urine concentration of oxalate, citrate, and calcium on days 0, 14, and 28, and also serum concentration of magnesium and calcium on days 0 and 28, were measured. On day 29, kidneys were removed for histopathologic study and examined for counting the calcium oxalate deposits in 10 microscopic fields. Result: Treatment of rats with N-butanol fraction and N-butanol phase remnant of NS significantly reduced the number and size of kidney calcium oxalate deposits compared with ethylene glycol group. Urinary concentration of oxalate in all experimental groups increased compared with control group on days 14 and 28, whereas the urine citrate concentration was lower in all experimental groups compared with control group on days 14 and 28. Conclusion: N-butanol fraction and N-butanol phase remnant of NS showed a beneficial effect on calcium oxalate deposition in the rat kidney. Therefore, the butanolic fraction of NS may be suggested for prevention of calcium oxalate calculi in humans. PMID:22262938

  16. Preventive Role of Endothelin Antagonist on Kidney Ischemia: Reperfusion Injury in Male and Female Rats

    PubMed Central

    Afyouni, Nazgol Esmalian; Halili, Hanieh; Moslemi, Fatemeh; Nematbakhsh, Mehdi; Talebi, Ardeshir; Shirdavani, Soheila; Maleki, Maryam

    2015-01-01

    Background: Renal ischemia/reperfusion injury (RIRI) is the most common cause of acute kidney injury. We tested the protective role of endothelin-1 receptor blocker; bosentan (BOS) in animal model of RIRI in two different genders. Methods: Male and female Wistar rats were assigned as sham operated (sham), control group (ischemia), and case group (ischemia + BOS) treated with BOS (50 mg/kg) 2 h before bilateral kidney ischemia induced by clamping renal vessels for 45 min followed by 24 h of renal reperfusion. Results: The RIRI significantly increased the serum levels of blood urea nitrogen and creatinine in both genders (P < 0.05). These values were significantly decreased by BOS in both genders. In male rats, the serum levels of malondialdehyde in the ischemia + BOS group were decreased significantly when compared with ischemia group (P < 0.05). Conclusions: BOS can be used in both genders to attenuate kidney ischemia injury possibly due to its effect in the renal vascular system. PMID:26900442

  17. Type 2 diabetes mellitus and renal stones

    PubMed Central

    Nerli, Rajendra; Jali, Mallikarjuna; Guntaka, Ajay Kumar; Patne, Pravin; Patil, Shivagouda; Hiremath, Murigendra Basayya

    2015-01-01

    Background: The incidence of urinary stone disease has shown a steep rise in recent decades along with marked modifications in dietary habits and life- style. There has been an increased prevalence of urinary stone disease in patients with diabetes. We took up this study to determine the association of diabetes mellitus with kidney stones in patients undergoing surgical treatment. Materials and Methods: Patients presenting with renal stones for surgical management formed the study group. Body mass index (BMI) was calculated by noting the weight and height of the patient. The extracted stone/stone fragments were analyzed to determine the chemical composition. Urinary pH was similarly noted in all. Results: The mean BMI among the diabetics was 26.35 ± 5.20 (range 17.75-35.60), whereas the mean BMI among the non-diabetics was 23.41 ± 2.85 (range 17.71-31.62) (P < 0.0004). The incidence of uric acid calculi in the diabetics was significantly high (P < 0.03). The mean urinary pH among the diabetics was 5.61 ± 0.36 and among the non-diabetics was 6.87 ± 0.32, which was significantly lower (P < 0.000044). Conclusions: There is a strong association between type 2 diabetes and uric acid stone formation. There is also a strong association between diabetes mellitus, BMI, and also with lower urinary pH. PMID:26605219

  18. Should chloride-rich crystalloids remain the mainstay of fluid resuscitation to prevent pre-renal' acute kidney injury?: con

    PubMed Central

    Lobo, Dileep N; Awad, Sherif

    2014-01-01

    The high chloride content of 0.9% saline leads to adverse pathophysiological effects in both animals and healthy human volunteers, changes not seen after balanced crystalloids. Small randomized trials confirm that the hyperchloremic acidosis induced by saline also occurs in patients, but no clinical outcome benefit was demonstrable when compared with balanced crystalloids, perhaps due to a type II error. A strong signal is emerging from recent large propensity-matched and cohort studies for the adverse effects that 0.9% saline has on the clinical outcome in surgical and critically ill patients when compared with balanced crystalloids. Major complications are the increased incidence of acute kidney injury and the need for renal replacement therapy, and that pathological hyperchloremia may increase postoperative mortality. However, there are no large-scale randomized trials comparing 0.9% saline with balanced crystalloids. Some balanced crystalloids are hypo-osmolar and may not be suitable for neurosurgical patients because of their propensity to cause brain edema. Saline may be the solution of choice used for the resuscitation of patients with alkalosis and hypochloremia. Nevertheless, there is evidence to suggest that balanced crystalloids cause less detriment to renal function than 0.9% saline, with perhaps better clinical outcome. Hence, we argue that chloride-rich crystalloids such as 0.9% saline should be replaced with balanced crystalloids as the mainstay of fluid resuscitation to prevent pre-renal' acute kidney injury. PMID:24717302

  19. Acute arterial occlusion - kidney

    MedlinePlus

    ... quickly or it is affecting the only working kidney. Treatment to open the artery may include: Clot-dissolving medicines (thrombolytics) Medicines that prevent the blood from ... kidney failure. Medicines to lower cholesterol may be needed ...

  20. Kidney transplant - series (image)

    MedlinePlus

    ... functions that both kidneys perform in healthy people. Kidney transplant recipients are required to take immunosuppressive medications for the rest of the lives, to prevent immune rejection of the transplanted organ.

  1. Acute kidney failure

    MedlinePlus

    ... days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your ... your kidneys work again and prevent fluid and waste from building up in your body while they ...

  2. Prevention of infection in patients with chronic kidney disease part III: surveillance and auditing in a renal care environment.

    PubMed

    Donlon, Sheila; Redmond, Avril; McCann, Margaret; Einarsdottir, Hildur

    2011-09-01

    This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance programme requires: commitment from senior management and the multidisciplinary team, prompt feedback of the data to clinical managers resulting in action been taken if necessary, to address specific areas of concern. While many renal units have access to infection prevention and control expertise to assist in the development of such a programme, units without such expertise should also have a surveillance programme in place. PMID:21810199

  3. Primary prevention implantable cardioverter defibrillators in end-stage kidney disease patients on dialysis: a matched cohort study

    PubMed Central

    Pun, Patrick H.; Hellkamp, Anne S.; Sanders, Gillian D.; Middleton, John P.; Hammill, Stephen C.; Al-Khalidi, Hussein R.; Curtis, Lesley H.; Fonarow, Gregg C.; Al-Khatib, Sana M.

    2015-01-01

    Background Sudden cardiac death is the leading cause of death among end-stage kidney disease patients (ESKD) on dialysis, but the benefit of primary prevention implantable cardioverter defibrillators (ICDs) in this population is uncertain. We conducted this investigation to compare the mortality of dialysis patients receiving a primary prevention ICD with matched controls. Methods We used data from the National Cardiovascular Data Registry's ICD Registry to select dialysis patients who received a primary prevention ICD, and the Get with the Guidelines-Heart Failure Registry to select a comparator cohort. We matched ICD recipients and no-ICD patients using propensity score techniques to reduce confounding, and overall survival was compared between groups. Results We identified 108 dialysis patients receiving primary prevention ICDs and 195 comparable dialysis patients without ICDs. One year (3-year) mortality was 42.2% (68.8%) in the ICD registry cohort compared with 38.1% (75.7%) in the control cohort. There was no significant survival advantage associated with ICD [hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.66–1.13, log-rank P = 0.29]. After propensity matching, our analysis included 86 ICD patients and 86 matched controls. Comparing the propensity-matched cohorts, 1 year (3 years) mortality was 43.4% (74.0%) in the ICD cohort and 39.7% (76.6%) in the control cohort; there was no significant difference in mortality outcome between groups (HR = 0.94, 95% CI: 0.67–1.31, log-rank P = 0.71). Conclusions We did not observe a significant association between primary prevention ICDs and reduced mortality among ESKD patients receiving dialysis. Consideration of the potential risks and benefits of ICD implantation in these patients should be undertaken while awaiting the results of definitive clinical trials. PMID:25404241

  4. Frequent office visits of patients with chronic kidney disease: Is a prelude to prevention of dialysis

    PubMed Central

    Mandal, Anil K

    2014-01-01

    This study is an excerpt of broad-based office practice which is designed to treat patients with diabetes and hypertension, the two most common causes of chronic kidney disease (CKD), as well as CKD of unknown etiology. This model of office practice is dedicated to evaluating patients with CKD for their complete well-being; blood pressure control, fluid control and maintenance of acid-base status and hemoglobin. Frequent office visits, every four to six weeks, confer a healthy life style year after year associated with a feeling of good well-being and a positive outlook. Having gained that, such patients remain compliant to their medication and diet, and scheduled laboratory and office visits which are determinant of a dialysis-free life. PMID:24527401

  5. Aqueous Extract of Phyllanthus niruri Leaves Displays In Vitro Antioxidant Activity and Prevents the Elevation of Oxidative Stress in the Kidney of Streptozotocin-Induced Diabetic Male Rats

    PubMed Central

    Giribabu, Nelli; Rao, Pasupuleti Visweswara; Kumar, Korla Praveen; Muniandy, Sekaran; Swapna Rekha, Somesula; Salleh, Naguib

    2014-01-01

    P. niruri has been reported to possess antidiabetic and kidney protective effects. In the present study, the phytochemical constituents and in vitro antioxidant activity of P. niruri leaf aqueous extract were investigated together with its effect on oxidative stress and antioxidant enzymes levels in diabetic rat kidney. Results. Treatment of diabetic male rats with P. niruri leaf aqueous extract (200 and 400 mg/kg) for 28 consecutive days prevents the increase in the amount of lipid peroxidation (LPO) product, malondialdehyde (MDA), and the diminution of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activity levels in the kidney of diabetic rats. The amount of LPO showed strong negative correlation with SOD, CAT, and GPx activity levels. P. niruri leaf aqueous extract exhibits in vitro antioxidant activity with IC50 slightly lower than ascorbic acid. Phytochemical screening of plant extract indicates the presence of polyphenols. Conclusion. P. niruri leaf extract protects the kidney from oxidative stress induced by diabetes. PMID:24991228

  6. Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?

    PubMed Central

    Özgör, Faruk; Küçüktopcu, Onur; Şimşek, Abdulmuttalip; Sarılar, Ömer; Binbay, Murat; Gürbüz, Gökhan

    2015-01-01

    Objective To evaluate the effect of percutaneous access site on the success and complication rates of isolated calyceal stones. Material and methods We retrospectively evaluated 2700 patients who underwent percutaneous nephrolithotomy (PNL) in our clinic between October 2002 and August 2014. We selected only the patients with isolated lower, middle or upper calyceal stones and we grouped the patients according to the location of their stones. Successful operation was defined as complete stone clearence or retention of stone fragments smaller than 4 mm which do not lead to infection, obstruction or pain requiring treatment. Intraoperative and postoperative complications were also recorded. Results Totally 360 patients underwent PNL for their isolated upper, middle and lower calyceal stones. Access sites for those patients were selected based on stone location. The stones were localized in the lower (n=304), middle (n=14), and upper (n=42) calices. There was no statistically significant difference between the groups with respect to operation and scopy times. Hemoglobin drop was seen more frequently in the upper calyceal access group, without any significant intergroup difference. Thoracic complications including hemothorax, pneumothorax and pleural effusion were more common in the upper calyceal access group (11.9%; p<0.001). Complete stone clerance was accomplished in 81.9%, 92.9% and 78.6% of the patients with lower, middle and upper calyceal stones respectively without any significant intergroup difference (p=0.537). Conclusion PNL is an effective and safe treatment modality for isolated calyceal kidney stones and upper calyceal access causes thoracic complications more than other access sites. PMID:26623144

  7. Managing acute and chronic renal stone disease.

    PubMed

    Moran, Conor P; Courtney, Aisling E

    2016-02-01

    Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones. CT KUB should be the primary mode of imaging for all patients with colic unless contraindicated. In such instances, or if a CT KUB is not available, an ultrasound KUB is an alternative. This has advantages in terms of radiation exposure and cost, but is limited in sensitivity, particularly for ureteric stones. Once diagnosed, a plain film KUB can be used for follow-up of radiopaque stones. For most patients diclofenac is a reasonable first choice of analgesia, e.g. 50-100 mg rectally, or 75 mg IM. Opioid medication can worsen nausea and be less effective, but should be used if there is a contraindication to NSAIDs. A combination of diclofenac, paracetamol, and/or codeine regularly can provide adequate pain control in many cases. Failure of this analgesic combination should prompt consideration of secondary care support. If a ureteric stone < 5 mm in diameter is identified, the expectation is that this will pass without intervention. Initially medical management is still useful for stones between 5 and 10mm in diameter, but urology input is more likely to be necessary as up to 50% of these may require intervention. Stones that are >10 mm in diameter should be discussed with the urology service as they are unlikely to pass spontaneously. PMID:27032222

  8. Prevention of Chronic Kidney Disease and Subsequent Effect on Mortality: A Systematic Review and Meta-Analysis

    PubMed Central

    Khan, Usman A.; Garg, Amit X.; Parikh, Chirag R.; Coca, Steven G.

    2013-01-01

    Objectives To perform a systematic review of randomized controlled trials to determine whether prevention or slowing of progression of chronic kidney disease would translate into improved mortality, and if so, the attributable risk due to CKD itself on mortality. Background CKD is associated with increased mortality. This association is largely based on evidence from the observational studies and evidence from randomized controlled trials is lacking. Methods We searched Ovid, Medline and Embase for RCTs in which an intervention was given to prevent or slow the progression of CKD and mortality was reported as primary, secondary or adverse outcomes were eligible and selected. For the first phase, pooled relative risks for renal endpoints were assessed. For the second phase, we assessed the effect on mortality in trials of interventions that definitively reduced CKD endpoints. Results Among 52 studies selected in first phase, only renin-angiotensin-aldosterone-system blockade vs. placebo (n = 18 trials, 32,557 participants) met the efficacy criteria for further analysis in the second phase by reducing renal endpoints 15 to 27% compared to placebo. There was no difference in all-cause mortality (RR 0.99, 95% CI 0.92 to 1.08) or CV death (RR 0.97, 95% CI 0.78 to 1.21) between the treatment and control groups in these trials. There was sufficient statistical power to detect a 9% relative risk reduction in all-cause mortality and a 14% relative risk reduction in cardiovascular mortality. Conclusions Firm evidence is lacking that prevention of CKD translates into reductions in mortality. Larger trials with longer follow-up time are needed to determine the benefit of CKD prevention on survival. PMID:24009665

  9. Prevention of sudden cardiac death in patients with chronic kidney disease.

    PubMed

    Franczyk-Skóra, Beata; Gluba, Anna; Banach, Maciej; Kozłowski, Dariusz; Małyszko, Jolanta; Rysz, Jacek

    2012-01-01

    Cardiovascular deaths account for about 40% of all deaths of patients with chronic kidney disease (CKD), particularly those on dialysis, while sudden cardiac death (SCD) might be responsible for as many as 60% of SCD in patients undergoing dialysis. Studies have demonstrated a number of factors occurring in hemodialysis (HD) that could lead to cardiac arrhythmias. Patients with CKD undergoing HD are at high risk of ventricular arrhythmia and SCD since changes associated with renal failure and hemodialysis-related disorders overlap. Antiarrhythmic therapy is much more difficult in patients with CKD, but the general principles are similar to those in patients with normal renal function - at first, the cause of arrhythmias should be found and eliminated. Also the choice of therapy is narrowed due to the altered pharmacokinetics of many drugs resulting from renal failure, neurotoxicity of certain drugs and their complex interactions. Cardiac pacing in elderly patients is a common method of treatment. Assessment of patients' prognosis is important when deciding whether to implant complex devices. There are reports concerning greater risk of surgical complications, which depends also on the extent of the surgical site. The decision concerning implantation of a pacing system in patients with CKD should be made on the basis of individual assessment of the patient. PMID:23206758

  10. Swimming Exercise Prevents Fibrogenesis in Chronic Kidney Disease by Inhibiting the Myofibroblast Transdifferentiation

    PubMed Central

    Peng, Chiung-Chi; Chen, Kuan-Chou; Hsieh, Chiu-Lan; Peng, Robert Y.

    2012-01-01

    Background The renal function of chronic kidney disease (CKD) patients may be improved by a number of rehabilitative mechanisms. Swimming exercise training was supposed to be beneficial to its recovery. Methodology/Principal Findings Doxorubicin-induced CKD (DRCKD) rat model was performed. Swimming training was programmed three days per week, 30 or 60 min per day for a total period of 11 weeks. Serum biochemical and pathological parameters were examined. In DRCKD, hyperlipidemia was observed. Active mesangial cell activation was evidenced by overexpression of PDGFR, P-PDGFR, MMP-2, MMP-9, α-SMA, and CD34 with a huge amount collagen deposition. Apparent myofibroblast transdifferentiation implicating fibrogenesis in the glomerular mesangium, glomerulonephritis and glomeruloscelorosis was observed with highly elevated proteinuria and urinary BUN excretion. The 60-min swimming exercise but not the 30 min equivalent rescued most of the symptoms. To quantify the effectiveness of exercise training, a physical parameter, i.e. “the strenuosity coefficient” or “the myokine releasing coefficient”, was estimated to be 7.154×10−3 pg/mL-J. Conclusions The 60-min swimming exercise may ameliorate DRCKD by inhibiting the transdifferentiation of myofibroblasts in the glomerular mesangium. Moreover, rehabilitative exercise training to rescue CKD is a personalized remedy. Benefits depend on the duration and strength of exercise, and more importantly, on the individual physiological condition. PMID:22761655

  11. Nutrition and renal stone disease in space

    NASA Technical Reports Server (NTRS)

    Zerwekh, Joseph E.

    2002-01-01

    There is a growing body of evidence from the National Aeronautics and Space Administration and the Russian space program showing that humans exposed to the microgravity environment of space have a greater risk for developing renal stones. Increased bone resorption and the attendant hypercalciuria and hyperphosphaturia contribute significantly to raising the urinary state of saturation with respect to the calcium salts, namely calcium oxalate and calcium phosphate. In addition, other environmental and dietary factors may adversely affect urine composition and increase stone formation risk during space flight. For example, reductions in urinary volume, pH, and citrate contribute to raising stone formation risk. In addition to raising the risk for calcium stone formation, this metabolic profile is conducive to the formation of uric acid stones. Although observations to date have suggested that there may actually be a reduced food intake during the early phase of flight, crew members on longer-duration flights may increase food intake and be at increased risk for stone formation. Taken together, these findings support the use of nutritional recommendations for crew members that would serve to reduce the stone-forming propensity of the urinary environment. Pharmacologic intervention should be directed at raising urinary volumes, diminishing bone losses, and preventing reductions in urinary pH and citrate. Success in reducing the risk for stone formation in astronauts would also be of potential major benefit to the estimated 20 million Americans with nephrolithiasis.

  12. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease

    PubMed Central

    Wasser, Walter G.; Gil, Amnon; Skorecki, Karl L.

    2015-01-01

    During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework. PMID:26241225

  13. Bile duct stone formation around a Prolene suture after cholangioenterostomy

    PubMed Central

    Li, Qiang; Tao, Liang; Wu, Xingyu; Mou, Lingjun; Sun, Xitai; Zhou, Jianxin

    2016-01-01

    The iatrogenic cause of bile duct stone formation is mainly due to suture materials, especially silk sutures. In recent years, Prolene and Vicryl sutures have been widely used in biliary surgery, and bile duct stone formation related to sutures are seemingly becoming rare, as there has only been one report of bile duct stone formation caused by Prolene sutures in the literature. In the last few years we have had two cases of Prolene suture-related bile duct stone formation within our unit. We therefore suggest that Vicryl sutures should be used as the first choice in biliary surgery, in order to prevent the formation of iatrogenic bile duct stones. PMID:27022388

  14. Bile duct stone formation around a Prolene suture after cholangioenterostomy.

    PubMed

    Li, Qiang; Tao, Liang; Wu, Xingyu; Mou, Lingjun; Sun, Xitai; Zhou, Jianxin

    2016-01-01

    The iatrogenic cause of bile duct stone formation is mainly due to suture materials, especially silk sutures. In recent years, Prolene and Vicryl sutures have been widely used in biliary surgery, and bile duct stone formation related to sutures are seemingly becoming rare, as there has only been one report of bile duct stone formation caused by Prolene sutures in the literature. In the last few years we have had two cases of Prolene suture-related bile duct stone formation within our unit. We therefore suggest that Vicryl sutures should be used as the first choice in biliary surgery, in order to prevent the formation of iatrogenic bile duct stones. PMID:27022388

  15. Bisphosphonates for prevention of osteopenia in kidney-transplant recipients: a systematic review of randomized controlled trials.

    PubMed

    Wang, J; Yao, M; Xu, J-H; Shu, B; Wang, Y-J; Cui, X-J

    2016-05-01

    We conducted a systematic review of randomized controlled trials (RCTs) of bisphosphonates for the prevention of osteopenia in kidney-transplant recipients. Bisphosphonates improved bone mineral density at the lumbar spine and femoral neck after 12 months. However, additional well-designed RCTs are required to determine the optimal treatment strategy. Osteopenic-osteoporotic syndrome is a bone complication of renal transplantation. Bisphosphonates, calcitonin, and vitamin D analogs may be used to prevent or treat osteoporosis or bone loss after renal transplantation. However, there is currently no widely recognized strategy for the prevention of corticosteroid-induced osteoporosis. This study aims to assess the available evidence to guide the targeted use of bisphosphonates for reducing osteoporosis and bone loss in renal-transplant recipients. We searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE for randomized controlled trials of bisphosphonates for osteoporosis or bone loss after renal transplantation. A total of 352 abstracts were identified, of which 55 were considered for evaluation and 9 were included in the final analysis. The primary outcome measure was change in the bone mineral density (BMD) of the lumbar spine and femoral neck after 12 months. Data extraction was performed independently by two investigators. BMD at the lumbar spine was improved after treatment with bisphosphonates [9 trials; 418 patients; weighted mean difference (WMD), 0.61; 95 % confidence interval (CI), 0.16-1.06]. Eight trials (406 patients) that reported changes in BMD at the femoral neck also showed improved outcomes after treatment with bisphosphonates (WMD, 0.06; 95 % CI, 0.03-0.09). Bisphosphonates improve BMD at the lumbar spine and femoral neck after 12 months in renal-transplant recipients. PMID:26733377

  16. Starting a joint venture kidney stone center.

    PubMed

    Russel, K; McFarlin, C

    1989-12-01

    When considering a joint venture, hospitals should evaluate the risks and benefits associated with cooperating with a major competitor. Factors to be analyzed during the decision-making process include: goals, medical staff involvement, corporate strategies, financial considerations, volume considerations, market share, environmental influences and level of competition. Hospitals can join forces to extend their medical services into new areas. PMID:10304100

  17. Kidney Stones in Children (Beyond the Basics)

    MedlinePlus

    ... large amounts of oxalate, including beet and turnip greens, rhubarb, strawberries, star fruit, sweet potatoes, wheat bran, ... cooked [113 g]) 60 to 80 Dark, leafy green vegetables (1/2 cup cooked [113 g]) 50 ...

  18. Does Safe Dosing of Iodinated Contrast Prevent Contrast-Induced Acute Kidney Injury?

    PubMed Central

    Brown, Jeremiah R.; Robb, John F.; Block, Clay A.; Schoolwerth, Anton C.; Kaplan, Aaron V.; O’Connor, Gerald T.; Solomon, Richard J.; Malenka, David J.

    2016-01-01

    Background Previous work on contrast-induced acute kidney injury (CI-AKI) has identified contrast volume as a risk factor and suggested there is a maximum allowable contrast dose (MACD) above which the risk of CI-AKI is markedly increased. We hypothesized there is a relationship between contrast volume and CI-AKI and there might be reason to track incremental contrast volumes above and below the MACD limit. Methods and Results Consecutive patients undergoing percutaneous coronary intervention (PCI) were prospectively enrolled from 2000 – 2008 (N=10,065). Patients on dialysis prior to PCI were excluded (N=155). MACD was defined as (5 mL×body weight (kg))/baseline serum creatinine (mg/dL)) and divided into categories where 1.0 reflects the MACD limit: ≤MACD ratios (< 0.5, 0.5-0.75, 0.75-1.0) and exceeding MACD (1.0-1.5, 1.5-2.0, and > 2.0). CI-AKI was defined as a ≥0.3 (mg/dL) or ≥50% increase in serum creatinine from baseline or new dialysis. Multivariable regression was conducted to evaluate the effect of exceeding the MACD on CI-AKI. 20% of patients exceeded the MACD. Risk-adjusted CI-AKI increased by an average of 45% for each category exceeding the MACD (OR: 1.45; 95%CI: 1.29-1.62) Adjusted odds ratios (OR) for each category exceeding the MACD were 1.60 (95%CI: 1.29-1.97), 2.02 (95%CI: 1.45-2.81), and 2.94 (95%CI: 1.93-4.48). CI-AKI for contrast dose

  19. Greco-Roman Stone Disease

    NASA Astrophysics Data System (ADS)

    Moran, Michael E.; Ruzhansky, Katherine

    2008-09-01

    Greek and Roman thought had a profound influence upon Western medical practice. From the fall of the Greek civilization to the fall of the Roman, remarkable progress of our understanding of human anatomy and physiology occurred. Here we review the attempts of Greek and Roman thinkers to develop the first understanding of the pathophysiology of urolithiasis, its epidemiology, differential diagnosis of renal versus bladder stones, medications for both colic and prevention, the role of familial syndromes, and dietary management.

  20. Efficacy of Extended Valganciclovir Prophylaxis in Preventing Cytomegalovirus Infection in Pediatric Kidney Transplantation

    PubMed Central

    Hashim, Faris; Gregg, Jon A.; Dharnidharka, Vikas R.

    2014-01-01

    Cytomegalovirus (CMV) is one of the most frequent opportunistic infection in renal transplant (RTx) recipients. Valganciclovir (VGC) has been showed to be safe and highly effective in prophylaxis of CMV infection in RTx recipients. Recently, an increase in delayed onset CMV disease has been noted with some arguing that longer prophylaxis may decrease the late-onset disease. We retrospectively tested the hypothesis that extended term prophylaxis (ETP) of VGC for 12 months is more effective than short term prophylaxis (STP) of 6 months in preventing CMV infection and disease in pediatric RTx performed at the University of Florida from July 2003 to December 2010. In this period, all recipients underwent prospective CMV PCR (Polymerase Chain Reaction) monitoring and were maintained on similar immunosuppression. Eighty six patients received RTx during that period. All eligible subjects had to have at least 12 months of graft survival and 18 months of follow up, leaving 73 eligible subjects in final study group. CMV infection or disease occurred in 6/29 (20%) in the STP group vs 6/44 (14%) in the ETP group with no statistical significant difference (P= 0.42). Donor positive/recipients negative CMV serology status (D+/R-) were associated with a higher risk of CMV infection in both univariate and multivariate analysis (P=0.01). Anemia and Leucopenia directly associated with VGC were similar in both groups (P=0.58 and P=0.2 respectively). Biopsy-proven acute rejection was also non-significant in both groups (P=0.39). Although ETP for CMV from 6 months to 12 months is safe and has minimal adverse effect, it did not reduce CMV infection or disease. Further controlled studies in pediatrics age group are considered to compare longer versus shorter periods of prophylaxis and their impact on prevention of CMV infection, resistance, cost, and toxicity. PMID:25821528

  1. Genistein prevents myocardial hypertrophy in 2-kidney 1-clip renal hypertensive rats by restoring eNOS pathway.

    PubMed

    Li, Jie; Xie, Zhi-Zhong; Tang, Yong-Bo

    2010-01-01

    Genistein has been shown to increase nitric oxide (NO) production derived from endothelial nitric oxide synthase (eNOS). This study was to investigate whether genistein could prevent myocardial hypertrophy in the 2-kidney 1-clip (2K1C) renohypertensive rat through the NO pathway and to clarify the underlying mechanisms. After the 2K1C operation, plasma angiotensin II increased, and the rats developed significant left ventricular hypertrophy (LVH) and increased collagen I expression. Phosphorylated eNOS, NOS activity, NO production and cGMP contents were markedly decreased in ventricular tissues of 2K1C rats. Chronic administration of genistein to 2K1C rats restored NO, NOS activity, phosphorylated eNOS expression, cGMP in ventricular tissues, and the restoration was parallel with the improvement of LVH and attenuated the excessive ventricular collagen I expression. Genistein also elevated angiotensin II type 2 receptor (AT2) expression, and the effects of genistein on LVH could be completely abolished by an AT2 antagonist, PD123319. The antagonist also reversed the increase in eNOS activity, NO and cGMP restored by genistein in hypertensive rats. We further explored the mechanisms by which genistein restored NO in hypertension and found that genistein significantly enhanced phosphorylated eNOS but left relatively unchanged total eNOS and the eNOS dimer/monomer ratio. In addition, genistein decreased the binding of eNOS with caveolin 3 and simultaneously promoted its binding with calmodulin and heat shock protein 90. We conclude that the preventive effects of genistein on cardiac remodeling induced by 2K1C hypertension are mediated by AT2-dependent NO production. PMID:20938214

  2. Epoetin beta pegol prevents endothelial dysfunction as evaluated by flow-mediated dilation in chronic kidney disease rats.

    PubMed

    Serizawa, Kenichi; Yogo, Kenji; Tashiro, Yoshihito; Aizawa, Ken; Kawasaki, Ryohei; Hirata, Michinori; Endo, Koichi

    2015-11-15

    Chronic kidney disease (CKD) patients have a poor prognosis due to cardiovascular disease. Anemia and endothelial dysfunction are important risk factors for cardiovascular events in CKD patients, and treatment with erythropoiesis-stimulating agent (ESA) has been reported to improve the quality of life in CKD patients. In this study, we evaluated the effect of anemia correcting dose of epoetin beta pegol (continuous erythropoietin receptor activator; C.E.R.A.) on endothelial function in 5/6 nephrectomized rats (Nx rats). C.E.R.A. was subcutaneously administered once a fortnight, 5 times in total, from 1 week after nephrectomy. Twenty-four hours after last administration, endothelial function was evaluated by measuring flow-mediated dilation (FMD) in the femoral arteries of anesthetized Nx rats by ultrasound system. Femoral arteries were harvested for western blot analysis. C.E.R.A. significantly increased FMD of Nx rats. Endothelium-independent vasodilation induced by nitroglycerin injection was not influenced by C.E.R.A treatment. Nox4 expression and nitrotyrosine accumulation were significantly decreased, and phosphorylation of eNOS was significantly enhanced in the femoral arteries of C.E.R.A.-treated rats. C.E.R.A. normalized hemoglobin levels but did not affect body weight, systolic blood pressure, heart rate, urinary protein excretion and plasma creatinine. These results indicate that C.E.R.A. prevented endothelial dysfunction in Nx rats, possibly through reduction of local oxidative stress and enhancement of eNOS phosphorylation in the arteries. This study provides the first evidence that C.E.R.A. prevented endothelial dysfunction in CKD model rats under conditions of amelioration of anemia. PMID:26432688

  3. Belatacept for prevention of acute rejection in adult patients who have had a kidney transplant: an update

    PubMed Central

    Wojciechowski, David; Vincenti, Flavio

    2012-01-01

    In June 2011, the US Food and Drug Administration approved belatacept for the prophylaxis of organ rejection in adult kidney transplant recipients. This review discusses the use of belatacept for the prevention of acute rejection as part of a maintenance immunosuppression regimen. Belatacept is a selective costimulation blocker designed to provide effective immunosuppression while avoiding the toxicities associated with calcineurin inhibitors. Phase III trial data have demonstrated that belatacept is noninferior to cyclosporine in 1-year patient and allograft survival. Three-year data demonstrate an ongoing improvement in mean measured glomerular filtration rate in belatacept-treated versus cyclosporine-treated patients. However, the rate of acute rejection was higher in belatacept-treated patients compared with cyclosporine. Specifically, there was a higher incidence of Banff type II rejections in patients treated with belatacept. Despite the higher Banff grade, rejections on belatacept were not associated with other factors associated with poor outcomes, such as the development of donor-specific antibodies or reduced estimated glomerular filtration rate. One safety issue that must be considered when using belatacept is the potential for increased risk of post-transplant lymphoproliferative disease. There were more cases of post-transplant lymphoproliferative disease in belatacept-treated patients, especially in recipients seronegative for Epstein–Barr virus or patients treated with lymphocyte-depleting agents. Therefore, belatacept can be recommended for use in Epstein–Barr virus antibody-positive recipients. PMID:23152668

  4. A Prototype Ultrasound Instrument To Size Stone Fragments During Ureteroscopy

    NASA Astrophysics Data System (ADS)

    Sorensen, Mathew D.; Teichman, Joel M. H.; Bailey, Michael R.

    2008-09-01

    An intraoperative tool to measure the size of kidney stones or stone fragments during ureteroscopy would help urologists assess if a fragment is small enough to be removed through the ureter or ureteral access sheath. The goal of this study was to determine the accuracy and precision of a prototype ultrasound device used to measure in vitro stone fragments compared to caliper measurements. A 10-MHz, 10-french ultrasound transducer probe was used to send an ultrasound pulse and receive ultrasound reflections from the stone using two methods. In Method 1 the instrument was aligned over the stone and the ultrasound pulse traveled through the stone. The time between reflections from the proximal and the distal surface of the stone were used along with the sound speed to calculate the stone size. Although the sound speed varied between stones, it was unlikely to be known during surgery and thus was estimated at 3000 m/s for calculations. In Method 2 the instrument was aligned partially over the stone and the ultrasound pulse traveled through water with a sound speed of 1481 m/s. Time was determined between the reflection from the proximal stone surface and the reflection from the tissue phantom on which the stone rested. Methods 1 and 2 were compared by linear regression to caliper measurements of the size of 19 human stones of 3 different stone types. Accuracy was measured by the difference of the mean ultrasound and mean caliper measurement and precision was measured as the standard deviation in the ultrasound measurements. For Method 1, the correlation between caliper-determined stone size and ultrasound-determined stone size was r2 = 0.71 (p<0.0001). In all but two stones accuracy and precision were less than 1 mm. For Method 2, the correlation was r2 = 0.99 (p<0.0001) and measurements were accurate and precise to within 0.25 mm. We conclude that the prototype device and either method measure stone size with good accuracy.

  5. The mechanisms of stone disintegration by shock waves.

    PubMed

    Sass, W; Bräunlich, M; Dreyer, H P; Matura, E; Folberth, W; Preismeyer, H G; Seifert, J

    1991-01-01

    Through interpretation of high-speed films at 10,000 frames per second of shock wave action on kidney stones and gallstones, the mechanism of stone destruction was analyzed in detail. This shows that the interaction of the shock wave with the targets firstly produces fissures in the stone material. Liquid then enters these small cracks. The actual disintegration is caused later by the enormous violence of imploding cavitation bubbles within these small split lines. That cavitation acts inside the stone and causes fragmentation even within the human gallbladder could furthermore be demonstrated by using scanning electron microscopy. These results should lead to a different process in gallstone lithotripsy leaving intervals between the shock wave treatments. This will allow the viscous bile fluids to occupy the fissures of the stones more completely and, therefore, should increase the cavitational activity on the subsequent treatment with shock pulses. PMID:1887509

  6. Managing caliceal stones

    PubMed Central

    Gross, Andreas J.; Knipper, Sophie; Netsch, Christopher

    2014-01-01

    The natural course of untreated asymptomatic caliceal calculi has not been clearly defined, especially in terms of disease progression, and the indications for and outcomes of surgical intervention are not precise. Caliceal stones may remain asymptomatic but, in case of migration, ureteral calculi can cause acute ureteric colic with severe complications. The decision for an active treatment of caliceal calculi is based on stone composition, stone size and symptoms. Extracorporal shock-wave lithotripsy (ESWL) has a low complication rate and is recommended by the current guidelines of the European Association of Urology as a first-line therapy for the treatment of caliceal stones <2 cm in diameter. However, immediate stone removal is not achieved with ESWL. The primary stone-free rates (SFR) after ESWL depend on stone site and composition and, especially for lower pole calculi, the SFR differ widely from other caliceal stones. Minimally-invasive procedures including percutaneous nephrolithotomy and ureteroscopy are alternatives for the treatment of caliceal stones, associated with low morbidity and high primary SFR when performed in centers of excellence. PMID:24497690

  7. Prevention and treatment of nephrolithiasis: a review on the role of spa therapy.

    PubMed

    Mennuni, G; Serio, A; Fontana, M; Nocchi, S; Costantino, C; Tanzi, G; Stornelli, G; Fraioli, A

    2015-01-01

    The prevalence and incidence of nephrolithiasis is reported to be increasing across the world. It is a disease of increased urinary concentration of stone-forming salts. The physicochemical mechanism of stone formation includes precipitation, homogenous/heterogeneous nucleation, growth, aggregation and concretion of various modulators in urine. Necessary condition to develop stones is urinary supersaturation, due to reduced urinary volume or to an excesses solutes. Fluid intake is the main determinant of urine volume. Urine dilution can significantly decrease both the crystallization rate of the urinary salts and the aggregation of the crystals. A correct fluid intake can act on different effects: urinary tract washing, urinary volume increasing and dilution of solutes. In addition mineral waters have other particular features: greater diuretic effect, more important urinary dilution with solutes and microbial concentration reduction, urinary pH changes, superior washout effect due to mechanical effects and ureteral contractions. Adequate water intake is the most important conservative strategy in urolithiasis prevention; particularly hydropinotherapy with oligomineral water should be considered as an important instrument to prevent stones in subjects predisposed to the disease (family members of people suffering from kidney stones), to reduce relapses, and can help to eliminate residual fragments also after extracorporeal shock wave lithotripsy. It is recommended a management with increased mineral water intake to promote urine volume of at least 2.5L each day to prevent stone formation. Obviously water intake shall be varied in relation to the presence of contraindications or any diseases. PMID:26550821

  8. Changes in Renal Function and Blood Pressure in Patients with Stone Disease

    NASA Astrophysics Data System (ADS)

    Worcester, Elaine M.

    2007-04-01

    Stone disease is a rare cause of renal failure, but a history of kidney stones is associated with an increased risk for chronic kidney disease, particularly in overweight patients. Loss of renal function seems especially notable for patients with stones associated with cystinuria, hyperoxaluria, and renal tubular acidosis, in whom the renal pathology shows deposits of mineral obstructing inner medullary collecting ducts, often diffusely. However, even idiopathic calcium oxalate stone formers have a mild but significant decrease in renal function, compared to age, sex and weight-matched normals, and appear to lose renal function with age at a slightly faster rate than non-stone formers. There is also an increased incidence of hypertension among stone formers, although women are more likely to be affected than men.

  9. Blockade of T-Lymphocyte KCa3.1 and Kv1.3 Channels as Novel Immunosuppressive Strategy for Preventing Kidney Allograft Rejection

    PubMed Central

    Grgic, Ivica; Wulff, Heike; Eichler, Ines; Flothmann, Christoph; Köhler, Ralf; Hoyer, Joachim

    2012-01-01

    There currently is an unmet clinical need for novel immunosuppressants for the long-term prevention of kidney transplant rejection as alternatives to the nephrotoxic calcineurin inhibitor cyclosporine A (CsA). Recent studies show that K+-channels play a crucial role in T-lymphocyte activities. In the present study we investigated whether combined blockade of the T-cell K+-channels KCa3.1 and Kv1.3, both of which regulate calcium signaling during lymphocyte activation, is effective in preventing rejection of kidney allografts from Fisher to Lewis rats. All recipients were treated for an initial period of 7 days with CsA (5mg/kg/d). In rats with intact allograft function, treatment was continued for another 10 days either with CsA (5mg/kg/d), or a combination of TRAM-34 (KCa3.1 inhibitor; 120mg/kg/d) plus ShK (Kv1.3 inhibitor; 80μg/kg thrice daily), or vehicle alone. Kidney sections were stained with PAS/H&E as well as immunohistochemically for markers of macrophages (CD68), T-lymphocytes (CD43) or cytotoxic T-cells (CD8) and evaluated by standard scoring. Our results show that combined TRAM-34/ShK-treatment effectively reduced total interstitial mononuclear cell infiltration (−42%) as well as infiltration of CD43+ T-cells (−32%), cytotoxic CD8+ T-cells (−32%) and CD68+ macrophages (−26%) as compared to allografts from vehicle-treated controls. Notably, the efficacy of TRAM-34/ShK-treatment here was comparable to that of CsA. Besides, no visible organ damage or other discernible adverse effects were observed with this treatment. Thus, selective blockade of T-lymphocyte KCa3.1 and Kv1.3 channels may represent a novel alternative therapeutic approach for preventing kidney allograft rejection. PMID:19715983

  10. SOURCE ASSESSMENT: CRUSHED STONE

    EPA Science Inventory

    This report describes a study of air emissions from crushed stone production. The potential environmental effect of the source is evaluated. Crushed stone production in 1972 was 1.07 x 10 to the 8th power metric tons (1.18 x 10 to the 8th power tons), 68% of which was traprock. C...

  11. Chimpanzee accumulative stone throwing.

    PubMed

    Kühl, Hjalmar S; Kalan, Ammie K; Arandjelovic, Mimi; Aubert, Floris; D'Auvergne, Lucy; Goedmakers, Annemarie; Jones, Sorrel; Kehoe, Laura; Regnaut, Sebastien; Tickle, Alexander; Ton, Els; van Schijndel, Joost; Abwe, Ekwoge E; Angedakin, Samuel; Agbor, Anthony; Ayimisin, Emmanuel Ayuk; Bailey, Emma; Bessone, Mattia; Bonnet, Matthieu; Brazolla, Gregory; Buh, Valentine Ebua; Chancellor, Rebecca; Cipoletta, Chloe; Cohen, Heather; Corogenes, Katherine; Coupland, Charlotte; Curran, Bryan; Deschner, Tobias; Dierks, Karsten; Dieguez, Paula; Dilambaka, Emmanuel; Diotoh, Orume; Dowd, Dervla; Dunn, Andrew; Eshuis, Henk; Fernandez, Rumen; Ginath, Yisa; Hart, John; Hedwig, Daniela; Ter Heegde, Martijn; Hicks, Thurston Cleveland; Imong, Inaoyom; Jeffery, Kathryn J; Junker, Jessica; Kadam, Parag; Kambi, Mohamed; Kienast, Ivonne; Kujirakwinja, Deo; Langergraber, Kevin; Lapeyre, Vincent; Lapuente, Juan; Lee, Kevin; Leinert, Vera; Meier, Amelia; Maretti, Giovanna; Marrocoli, Sergio; Mbi, Tanyi Julius; Mihindou, Vianet; Moebius, Yasmin; Morgan, David; Morgan, Bethan; Mulindahabi, Felix; Murai, Mizuki; Niyigabae, Protais; Normand, Emma; Ntare, Nicolas; Ormsby, Lucy Jayne; Piel, Alex; Pruetz, Jill; Rundus, Aaron; Sanz, Crickette; Sommer, Volker; Stewart, Fiona; Tagg, Nikki; Vanleeuwe, Hilde; Vergnes, Virginie; Willie, Jacob; Wittig, Roman M; Zuberbuehler, Klaus; Boesch, Christophe

    2016-01-01

    The study of the archaeological remains of fossil hominins must rely on reconstructions to elucidate the behaviour that may have resulted in particular stone tools and their accumulation. Comparatively, stone tool use among living primates has illuminated behaviours that are also amenable to archaeological examination, permitting direct observations of the behaviour leading to artefacts and their assemblages to be incorporated. Here, we describe newly discovered stone tool-use behaviour and stone accumulation sites in wild chimpanzees reminiscent of human cairns. In addition to data from 17 mid- to long-term chimpanzee research sites, we sampled a further 34 Pan troglodytes communities. We found four populations in West Africa where chimpanzees habitually bang and throw rocks against trees, or toss them into tree cavities, resulting in conspicuous stone accumulations at these sites. This represents the first record of repeated observations of individual chimpanzees exhibiting stone tool use for a purpose other than extractive foraging at what appear to be targeted trees. The ritualized behavioural display and collection of artefacts at particular locations observed in chimpanzee accumulative stone throwing may have implications for the inferences that can be drawn from archaeological stone assemblages and the origins of ritual sites. PMID:26923684

  12. Chimpanzee accumulative stone throwing

    PubMed Central

    Kühl, Hjalmar S.; Kalan, Ammie K.; Arandjelovic, Mimi; Aubert, Floris; D’Auvergne, Lucy; Goedmakers, Annemarie; Jones, Sorrel; Kehoe, Laura; Regnaut, Sebastien; Tickle, Alexander; Ton, Els; van Schijndel, Joost; Abwe, Ekwoge E.; Angedakin, Samuel; Agbor, Anthony; Ayimisin, Emmanuel Ayuk; Bailey, Emma; Bessone, Mattia; Bonnet, Matthieu; Brazolla, Gregory; Buh, Valentine Ebua; Chancellor, Rebecca; Cipoletta, Chloe; Cohen, Heather; Corogenes, Katherine; Coupland, Charlotte; Curran, Bryan; Deschner, Tobias; Dierks, Karsten; Dieguez, Paula; Dilambaka, Emmanuel; Diotoh, Orume; Dowd, Dervla; Dunn, Andrew; Eshuis, Henk; Fernandez, Rumen; Ginath, Yisa; Hart, John; Hedwig, Daniela; Ter Heegde, Martijn; Hicks, Thurston Cleveland; Imong, Inaoyom; Jeffery, Kathryn J.; Junker, Jessica; Kadam, Parag; Kambi, Mohamed; Kienast, Ivonne; Kujirakwinja, Deo; Langergraber, Kevin; Lapeyre, Vincent; Lapuente, Juan; Lee, Kevin; Leinert, Vera; Meier, Amelia; Maretti, Giovanna; Marrocoli, Sergio; Mbi, Tanyi Julius; Mihindou, Vianet; Moebius, Yasmin; Morgan, David; Morgan, Bethan; Mulindahabi, Felix; Murai, Mizuki; Niyigabae, Protais; Normand, Emma; Ntare, Nicolas; Ormsby, Lucy Jayne; Piel, Alex; Pruetz, Jill; Rundus, Aaron; Sanz, Crickette; Sommer, Volker; Stewart, Fiona; Tagg, Nikki; Vanleeuwe, Hilde; Vergnes, Virginie; Willie, Jacob; Wittig, Roman M.; Zuberbuehler, Klaus; Boesch, Christophe

    2016-01-01

    The study of the archaeological remains of fossil hominins must rely on reconstructions to elucidate the behaviour that may have resulted in particular stone tools and their accumulation. Comparatively, stone tool use among living primates has illuminated behaviours that are also amenable to archaeological examination, permitting direct observations of the behaviour leading to artefacts and their assemblages to be incorporated. Here, we describe newly discovered stone tool-use behaviour and stone accumulation sites in wild chimpanzees reminiscent of human cairns. In addition to data from 17 mid- to long-term chimpanzee research sites, we sampled a further 34 Pan troglodytes communities. We found four populations in West Africa where chimpanzees habitually bang and throw rocks against trees, or toss them into tree cavities, resulting in conspicuous stone accumulations at these sites. This represents the first record of repeated observations of individual chimpanzees exhibiting stone tool use for a purpose other than extractive foraging at what appear to be targeted trees. The ritualized behavioural display and collection of artefacts at particular locations observed in chimpanzee accumulative stone throwing may have implications for the inferences that can be drawn from archaeological stone assemblages and the origins of ritual sites. PMID:26923684

  13. Old Stone Field Marker

    This is a stone field marker that marked boundaries for land ownership. In the early days of Land Office Recordings, this is one type of monument used. Trees, Posts, Iron Pipes and as shown stones were used to mark off land during the Land Rush days. Later, when mapping was being done, Brass Caps wi...

  14. Visceral obesity: A new risk factor for stone disease

    PubMed Central

    Akarken, Ilker; Tarhan, Hüseyin; Ekin, Rahmi Gökhan; Çakmak, Özgür; Koç, Gökan; İlbey, Yusuf Özlem; Zorlu, Ferruh

    2015-01-01

    Introduction: We examined the relationship between stone disease and the amount of visceral adipose tissue measured with unenhanced computed tomography (CT). Methods: We included 149 patients with complaints of flank pain and kidney stones detected by CT, from August 2012 to April 2013. In addition, as the control group we included 139 healthy individuals, with flank pain within the same time period, with no previous history of urological disease and no current kidney stones identified by CT. Patients were analyzed for age, gender, body mass index, amount of visceral and subcutaneous adipose tissue, and serum level of low-density lipoprotein and triglyceride. Results: There were no differences between groups in terms of gender and age (p = 0.27 and 0.06, respectively). Respective measurements for the stone and control groups for body mass index were 29.1 and 27.6 kg/m2; for visceral fat measurement 186.0 and 120.2 cm2; and for subcutaneous fat measurements 275.9 and 261.9 cm2 (p = 0.01; 0.01 and 0.36, respectively). Using multivariate analysis, the following factors were identified as increasing the risk of kidney stone formation: hyperlipidemia (p = 0.003), hypertension (p = 0.001), and ratio of visceral fat tissue to subcutaneous fat tissue (p = 0.01). Our study has its limitations, including its retrospective nature, its small sample size, possible selection bias, and missing data. The lack of stone composition data is another major limitation of our study. Conclusion: The ratio of visceral to subcutaneous adipose tissue, in addition to obesity, hyperlipidemia, and hypertension, was identified as an emerging factor in the formation of kidney stones. PMID:26600887

  15. Stone formation and calcification by nanobacteria in the human body

    NASA Astrophysics Data System (ADS)

    Ciftcioglu, Neva; Bjorklund, Michael; Kajander, E. Olavi

    1998-07-01

    The formation of discrete and organized inorganic crystalline structures within macromolecular extracellular matrices is a widespread biological phenomenon generally referred to as biomineralization. Recently, bacteria have been implicated as factors in biogeochemical cycles for formation of many minerals in aqueous sediments. We have found nanobacterial culture systems that allow for reproducible production of apatite calcification in vitro. Depending on the culture conditions, tiny nanocolloid-sized particles covered with apatite, forming various size of aggregates and stones were observed. In this study, we detected the presence of nanobacteria in demineralized trilobit fossil, geode, apatite, and calcite stones by immunofluorescence staining. Amethyst and other quartz stones, and chalk gave negative results. Microorganisms are capable of depositing apatite outside the thermodynamic equilibrium in sea water. We bring now evidence that this occurs in the human body as well. Previously, only struvite kidney stones composed of magnesium ammonium phosphate and small amounts of apatite have been regarded as bacteria related. 90 percent of demineralized human kidney stones now screened, contained nanobacteria. At least three different distribution patterns of nanobacteria were conditions, and human kidney stones that are formed from small apatite units. Prerequisites for the formation of kidney stones are the supersaturation of urine and presence of nidi for crystallization. Nanobacteria are important nidi and their presence might be of special interest in space flights where supersaturation of urine is present due to the loss of bone. Furthermore, we bring evidence that nanobacteria may act as crystallization nidi for the formation of biogenic apatite structures in tissue calcification found in e.g., atherosclerotic plaques, extensive metastatic and tumoral calcification, acute periarthritis, malacoplakia, and malignant diseases. In nanaobacteria-infected fibroblasts, electron microscopy revealed intra- and extra-cellular needle-like crystal deposits, which were stainable with von Kossa stain and resemble calcospherules found in pathological calcification. Thus bacteria-mediated apatite formation takes place in aqueous environments, in humans and in geological sediments.

  16. Risk Factors for Chronic Kidney Disease

    MedlinePlus

    ... Renal. Home » Kidney Info » 1 in 9 Adults Risk Factors for CKD x What are you doing to ... to prevent or delay kidney failure. Kidney Disease Risk Factors You Can Change Diabetes Type 2 diabetes is ...

  17. Stone formation and management after bariatric surgery.

    PubMed

    Tarplin, Sarah; Ganesan, Vishnu; Monga, Manoj

    2015-05-01

    Obesity is a significant health concern and is associated with an increased risk of nephrolithiasis, particularly in women. The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are common in these patients. Use of surgical procedures for obesity (bariatric surgery) has risen over the past two decades. Although such procedures effectively manage obesity-dependent comorbidities, several large, controlled studies have revealed that modern bariatric surgeries increase the risk of nephrolithiasis by approximately twofold. In patients who have undergone bariatric surgery, fat malabsorption leads to hyperabsorption of oxalate, which is exacerbated by an increased permeability of the gut to oxalate. Patients who have undergone bariatric surgery show characteristic 24 h urine parameters including low urine volume, low urinary pH, hypocitraturia, hyperoxaluria and hyperuricosuria. Prevention of stones with dietary limitation of oxalate and sodium and a high intake of fluids is critical, and calcium supplementation with calcium citrate is typically required. Potassium citrate is valuable for treating the common metabolic derangements as it raises urinary pH, enhances the activity of stone inhibitors, reduces the supersaturation of calcium oxalate, and corrects hypokalaemia. Both pyridoxine and probiotics have been shown in small studies to reduce hyperoxaluria, but further study is necessary to clarify their effects on stone morbidity in the bariatric surgery population. PMID:25850790

  18. 12. FLOOR 2; STONE CRANE IN PLACE FOR ROCK STONES; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. FLOOR 2; STONE CRANE IN PLACE FOR ROCK STONES; STONE CRANE HAS OAK SPAR, JIB AND BRACE, METAL SCREW, IRON YOKE AND DOGS; IRON PINS FIT THROUGH HOLES IN DOGS INTO HOLES DRILLED IN RUNNER STONE - Hook Windmill, North Main Street at Pantigo Road, East Hampton, Suffolk County, NY

  19. Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone

    PubMed Central

    Shahandeh, Zahra; Shafi, Hamid; Sadighian, Farahnaz

    2015-01-01

    Background: Stphylococcus cohnii is an organism of coagulase negative species which is considered as normal flora. However, it has been isolated from urinary tract infections and surgical prostheses but its relation with staghorn stones has not been reported, yet. Case Presentation: A 50-years-old woman presented with left renal staghorn stone in June 2014. She had bilateral staghorn stones 7 years ago. Staphylococcus cohnii subspecies urealyticum were detected from a removed stone. After 7 years, recurrence staghorn stone in her left kidney was diagnosed and patient underwent another surgery. The patient had several attacks of cystitis during these 7 years. The results of stone and urine cultures revealed staphylococcus cohnii subspecies urealyticum. Conclusion: This case report emphasizes a possible association between staphylococcus cohnii subspecies urealyticum infection and recurrence renal staghhorn stone. PMID:26221496

  20. Biologically active extracts with kidney affections applications

    NASA Astrophysics Data System (ADS)

    Pascu (Neagu), Mihaela; Pascu, Daniela-Elena; Cozea, Andreea; Bunaciu, Andrei A.; Miron, Alexandra Raluca; Nechifor, Cristina Aurelia

    2015-12-01

    This paper is aimed to select plant materials rich in bioflavonoid compounds, made from herbs known for their application performances in the prevention and therapy of renal diseases, namely kidney stones and urinary infections (renal lithiasis, nephritis, urethritis, cystitis, etc.). This paper presents a comparative study of the medicinal plant extracts composition belonging to Ericaceae-Cranberry (fruit and leaves) - Vaccinium vitis-idaea L. and Bilberry (fruit) - Vaccinium myrtillus L. Concentrated extracts obtained from medicinal plants used in this work were analyzed from structural, morphological and compositional points of view using different techniques: chromatographic methods (HPLC), scanning electronic microscopy, infrared, and UV spectrophotometry, also by using kinetic model. Liquid chromatography was able to identify the specific compounds of the Ericaceae family, present in all three extracts, arbutosid, as well as specific components of each species, mostly from the class of polyphenols. The identification and quantitative determination of the active ingredients from these extracts can give information related to their therapeutic effects.

  1. Sedimentary rocks in our mouth: dental pulp stones made by nanobacteria

    NASA Astrophysics Data System (ADS)

    Ciftcioglu, Neva; Ciftcioglu, Vefa; Vali, Hojatollah; Turcott, Eduardo; Kajander, E. Olavi

    1998-07-01

    The mechanisms of dental pulp stone formation are still largely unknown. Pulp stones are mainly composed of carbonate apatite. Only few experimental reports have elucidated the potential of some selected bacteria to produce apatite under in vitro conditions using special calcification media. The tested stone forming bacteria were, in fact, often better known for their cariogenic potential. Our preliminary work with 18 dental pulp stones from Turkey, selected only by severity of the stone formation, indicated the presence of nanobacterial antigens in the demineralized stones. Furthermore, high incidence of kidney stones and gall stones in the patient group and in their parents was found. This raises the implication that nanobacteria may enter the body also via oral route, in addition to the parenteral and transplacental routes. The role of nanobacteria in dental pulp stone formation was further studied by following nanobacterial colonization and mineral formation on human tooth in vitro. Two molar teeth, one having pulp stone and one without, were vertically cut into two pieces, sterilized by autoclaving and incubated with or without nanobacteria in DMEM. Electron microscopic observations indicate that nanobacteria can cause apatite stone formation on tooth surface. The sever from of dental pulp stone formation might be associated with nanobacteria. This form of dental disease results in loss of teeth due to osteolytic processes. This addresses the necessity for a study on unconventional mineral-forming bacteria as a cause for human diseases.

  2. Kidney Cysts

    MedlinePlus

    ... fluid-filled sac. There are two types of kidney cysts. Polycystic kidney disease (PKD) runs in families. In PKD, the ... place of the normal tissue. They enlarge the kidneys and make them work poorly, leading to kidney ...

  3. Kidney Transplant

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  4. Kidney Biopsy

    MedlinePlus

    ... More Information American Kidney Fund National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Kidney Biopsy Page Content On this page: What is ...

  5. Kidney Failure

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  6. Monitoring for Renal Stone Recurrence in Astronauts With History of Stone

    NASA Technical Reports Server (NTRS)

    Reyes, David P.; Sargsyan, Ashot; Locke, James; Davis, Jeffrey

    2014-01-01

    After an initial stone episode persons are at increased risk for future stone formation. A systematic approach is required to monitor the efficacy of treatment and preventive measures, and to assess the risk of developing new stones. This is important for persons working in critical jobs or austere environments, such as astronauts. A literature review of the current standards of care for renal stone monitoring and imaging was done. Military and civil aviation standards were also reviewed, as well as the medical precedents from the space program. Additionally, a new, more effective, renal stone ultrasound protocol has been developed. Using this work, a monitoring algorithm was proposed that takes into consideration the unique mission and operational environment of spaceflight. The approach to imaging persons with history of renal stones varies widely in the literature. Imaging is often done yearly or biannually, which may be too long for mission critical personnel. In the proposed algorithm astronauts with a history of renal stone, who may be under consideration for assignment, are imaged by a detailed, physiciandriven, ultrasound protocol. Unassigned personnel are monitored by yearly ultrasound and urine studies. Any positive ultrasound study is then followed by low-dose renal computed tomography scan. Other criteria are also established. The proposed algorithm provides a balanced approach between efficacy and reduced radiation exposure for the monitoring of astronauts with a renal stone history. This may eventually allow a transition from a risk-averse, to a risk-modifying approach that can enable continued service of individuals with history of renal stone that have adequately controlled risk factors.

  7. Skimming and Skipping Stones

    ERIC Educational Resources Information Center

    Humble, Steve

    2007-01-01

    This article presents an example of skimming and skipping stone motion in mathematical terms available to students studying A-level mathematics. The theory developed in the article postulates a possible mathematical model that is verified by experimental results.

  8. Diet and renal stone formation.

    PubMed

    Trinchieri, A

    2013-02-01

    The relationship between diet and the formation of renal stones is demonstrated, but restrictive diets do not take into account the complexity of metabolism and the complex mechanisms that regulate the saturation and crystallization processes in the urine. The restriction of dietary calcium can reduce the urinary excretion of calcium but severe dietary restriction of calcium causes hyperoxaluria and a progressive loss of bone mineral component. Furthermore urinary calcium excretion is influenced by other nutrients than calcium as sodium, potassium, protein and refined carbohydrates. Up to 40% of the daily excretion of oxalate in the urine is from dietary source, but oxalate absorption in the intestine depends linearly on the concomitant dietary intake of calcium and is influenced by the bacterial degradation by several bacterial species of intestinal flora. A more rational approach should be based on the cumulative effects of foods and different dietary patterns on urinary saturation rather than on the effect of single nutrients. A diet based on a adequate intake of calcium (1000-1200 mg per day) and containment of animal protein and salt can decrease significantly urinary supersaturation for calcium oxalate and reduce the relative risk of stone recurrence in hypercalciuric renal stone formers. The DASH-style diet that is high in fruits and vegetables, moderate in low-fat dairy products and low in animal proteins and salt is associated with a lower relative supersaturation for calcium oxalate and a marked decrease in risk of incident stone formation. All the diets above mentioned have as a common characteristic the reduction of the potential acid load of the diet that can be correlated with a higher risk of recurrent nephrolithiasis, because the acid load of diet is inversely related to urinary citrate excretion. The restriction of protein and salt with an adequate calcium intake seem to be advisable but should be implemented with the advice to increase the intake of vegetables that can carry a plentiful supply of alkali that counteract the acid load coming from animal protein. New prospective studies to evaluate the effectiveness of the diet for the prevention of renal stones should be oriented to simple dietary advices that should be focused on a few specific goals easily controlled by means of self-evaluation tools, such as the LAKE food screener. PMID:23392537

  9. Long-Term Therapeutic Plasma Exchange to Prevent End-Stage Kidney Disease in Adult Severe Resistant Henoch-Schonlein Purpura Nephritis

    PubMed Central

    Hamilton, Patrick; Ogundare, Olumide; Raza, Ammar; Ponnusamy, Arvind; Gorton, Julie; Alachkar, Hana; Choudhury, Jamil; Barratt, Jonathan; Kalra, Philip A.

    2015-01-01

    A 27-year-old man presented with a palpable purpuric skin rash and joint and abdominal pain in April 2010. He had acute kidney injury and his creatinine quickly deteriorated to 687 μmol/L, with associated nephrotic range proteinuria. Kidney biopsy showed crescentic Henoch-Schonlein nephritis. He was treated with intravenous cyclophosphamide and prednisolone despite which his renal function deteriorated; he required haemodialysis for a short duration and seven sessions of therapeutic plasma exchange (TPE). Renal function improved, but after discharge from hospital he suffered 2 further relapses, each with AKI, in 4 months. Cyclophosphamide was not effective and therefore Rituximab was introduced. He initially had a partial response but his renal function deteriorated despite continued therapy. TPE was the only treatment that prevented rapid renal functional deterioration. A novel long-term treatment strategy involving regular TPE every one to two weeks was initiated. This helped to slow his progression to end-stage kidney disease over a 3-year period and to prolong the need for renal replacement therapy over this time. PMID:26613053

  10. Long-Term Therapeutic Plasma Exchange to Prevent End-Stage Kidney Disease in Adult Severe Resistant Henoch-Schonlein Purpura Nephritis.

    PubMed

    Hamilton, Patrick; Ogundare, Olumide; Raza, Ammar; Ponnusamy, Arvind; Gorton, Julie; Alachkar, Hana; Choudhury, Jamil; Barratt, Jonathan; Kalra, Philip A

    2015-01-01

    A 27-year-old man presented with a palpable purpuric skin rash and joint and abdominal pain in April 2010. He had acute kidney injury and his creatinine quickly deteriorated to 687??mol/L, with associated nephrotic range proteinuria. Kidney biopsy showed crescentic Henoch-Schonlein nephritis. He was treated with intravenous cyclophosphamide and prednisolone despite which his renal function deteriorated; he required haemodialysis for a short duration and seven sessions of therapeutic plasma exchange (TPE). Renal function improved, but after discharge from hospital he suffered 2 further relapses, each with AKI, in 4 months. Cyclophosphamide was not effective and therefore Rituximab was introduced. He initially had a partial response but his renal function deteriorated despite continued therapy. TPE was the only treatment that prevented rapid renal functional deterioration. A novel long-term treatment strategy involving regular TPE every one to two weeks was initiated. This helped to slow his progression to end-stage kidney disease over a 3-year period and to prolong the need for renal replacement therapy over this time. PMID:26613053

  11. Percutaneous nephrolithotomy in solitary kidneys: experience with 412 cases from Southern Iran.

    PubMed

    Hosseini, Mohammad Mehdi; Yousefi, Alireza; Hassanpour, Abbas; Jahanbini, Shahrokh; Zaki-Abbasi, Mohammad

    2015-06-01

    Some patients with nephrolithiasis who become candidates for percutaneous nephrolithotomy (PCNL) have a single kidney. This poses a challenge for the physician regarding the safety and efficacy of this procedure for these patients. This study has aimed to evaluate the safety and efficacy of PCNL in these patients. Between 2002 and 2014, out of 10,800 cases who underwent PCNL in our centres, 412 had a single kidney. We recorded the results and complications in these patients. Out of 412 patients, 279 were men and 133 women. Their mean age was 46.4 years (range 19-71) and mean stone size was 26.5 mm (range 21-55); 161 of them had a functional single kidney, 36 were congenital, and the remaining 215 had undergone contralateral nephrectomy because of stones, trauma, infection or tumour. Comorbidities included 104 hypertensive, 66 diabetic, 65 morbidly obese, 56 uremic and 47 ischemic heart disease cases. The stone-free rate was 91.3% (376/412) on postoperative X-ray/sonography. However, 42 patients required ancillary measures. Complications include fever (T > 38.3 °C) in 34 cases (8.2%), bleeding requiring transfusion 19 cases (4.6%), UTI nine cases (2%), sepsis one case (0.2%), perinephric collection three cases (0.7%), hydro/pneumothorax two cases (0.4%), access failure in five morbidly obese cases (1.2%), pyonephrosis two cases (0.4%), myocardial infarction four cases (1%), transient increasing of blood urea nitrogen (BUN) and serum creatinine (Scr.) in four normal functioning kidney (1%) and eight uremic cases (1.9%), and two cases resulted in death (0.4%). PCNL seems a safe and effective option in cases of a single kidney, but it needs more attention in order to prevent even minor complications that can result in an anephric state. PMID:25430791

  12. Assessing applicants to the NASA flight program for their renal stone-forming potential

    NASA Technical Reports Server (NTRS)

    Pak, Charles Y. C.; Hill, Kathy; Cintron, Nitza M.; Huntoon, Carolyn

    1989-01-01

    Because spaceflight can provoke the formation of kidney stones, 24-hour urine samples for 104 male applicants were analyzed for stone-forming risk factors prior to their selection into the NASA astronaut-mission specialist corps. A high level of supersaturation (with either calcium oxalate, brushite, or monosodium urate) was noted in these applicants which predisposes them to the crystallization of stone-forming calcium salts. It is suggested that most of the abnormal stone risk factors found were environmental, rather than metabolic, in origin.

  13. Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones

    PubMed Central

    Knoll, Thomas; Buchholz, Noor; Wendt-Nordahl, Gunnar

    2012-01-01

    Objectives To review previous reports and discuss current trends in extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS). ESWL was recommended as the first-line treatment for small and intermediate-sized stones in the lower pole, while it is the standard treatment for large stones. However, the stone clearance rate after ESWL seems to be lower than that of stones in other locations. This seems to result from a lower rate of fragment passage, due to anatomical factors. Methods Reports on urinary stone disease were reviewed, assessing only publications in peer-reviewed, Medline-listed journals in the English language (publication years 1990–2011). Results Recent experience with flexible URS (fURS) for intrarenal stones showed that excellent stone-free rates can be achieved. With increasing experience and technically improved equipment, fURS has become an alternative to ESWL for small and intermediate-sized renal stones. Furthermore, several authors reported successful retrograde treatment for large renal stones, proposing fURS as an alternative to PCNL. However, the major drawbacks are long operating times and commonly, staged procedures, which is why PCNL remains the method of choice for such stones. Conclusions Considering the currents trends and evidence, the 2012 update of the European Association of Urology Guidelines on Urolithiasis has upgraded the endourological treatment of kidney stones. Individual factors such as body habitus, renal anatomy, costs and patient preference must be considered. PMID:26558046

  14. The Role of Eugenol in the Prevention of Acute Pancreatitis-Induced Acute Kidney Injury: Experimental Study.

    PubMed

    Markakis, Charalampos; Tsaroucha, Alexandra; Papalois, Apostolos E; Lambropoulou, Maria; Spartalis, Eleftherios; Tsigalou, Christina; Romanidis, Konstantinos; Simopoulos, Constantinos

    2016-01-01

    Aim. Acute pancreatitis is an inflammatory intra-abdominal disease, which takes a severe form in 15-20% of patients and can result in high mortality especially when complicated by acute renal failure. The aim of this study is to assess the possible reduction in the extent of acute kidney injury after administration of eugenol in an experimental model of acute pancreatitis. Materials and Methods. 106 male Wistar rats weighing 220-350 g were divided into 3 groups: (1) Sham, with sham surgery; (2) Control, with induction of acute pancreatitis, through ligation of the biliopancreatic duct; and (3) Eugenol, with induction of acute pancreatitis and eugenol administration at a dose of 15 mg/kg. Serum urea and creatinine, histopathological changes, TNF-α, IL-6, and MPO activity in the kidneys were evaluated at predetermined time intervals. Results. The group that was administered eugenol showed milder histopathological changes than the Control group, TNF-α activity was milder in the Eugenol group, and there was no difference in activity for MPO and IL-6. Serum urea and creatinine levels were lower in the Eugenol group than in the Control group. Conclusions. Eugenol administration was protective for the kidneys in an experimental model of acute pancreatitis in rats. PMID:26884642

  15. The Role of Eugenol in the Prevention of Acute Pancreatitis-Induced Acute Kidney Injury: Experimental Study

    PubMed Central

    Markakis, Charalampos; Tsaroucha, Alexandra; Papalois, Apostolos E.; Lambropoulou, Maria; Spartalis, Eleftherios; Tsigalou, Christina; Romanidis, Konstantinos; Simopoulos, Constantinos

    2016-01-01

    Aim. Acute pancreatitis is an inflammatory intra-abdominal disease, which takes a severe form in 15–20% of patients and can result in high mortality especially when complicated by acute renal failure. The aim of this study is to assess the possible reduction in the extent of acute kidney injury after administration of eugenol in an experimental model of acute pancreatitis. Materials and Methods. 106 male Wistar rats weighing 220–350 g were divided into 3 groups: (1) Sham, with sham surgery; (2) Control, with induction of acute pancreatitis, through ligation of the biliopancreatic duct; and (3) Eugenol, with induction of acute pancreatitis and eugenol administration at a dose of 15 mg/kg. Serum urea and creatinine, histopathological changes, TNF-α, IL-6, and MPO activity in the kidneys were evaluated at predetermined time intervals. Results. The group that was administered eugenol showed milder histopathological changes than the Control group, TNF-α activity was milder in the Eugenol group, and there was no difference in activity for MPO and IL-6. Serum urea and creatinine levels were lower in the Eugenol group than in the Control group. Conclusions. Eugenol administration was protective for the kidneys in an experimental model of acute pancreatitis in rats. PMID:26884642

  16. Renal Stone Risk During Space Flight

    NASA Technical Reports Server (NTRS)

    Whitson, Peggy A.; Pietrzyk, Robert A.; Sams, Clarence F.; Pak, Charles Y. C.; Jones, Jeffrey A.

    1999-01-01

    Space flight produces a number of metabolic and physiological changes in the crewmembers exposed to microgravity. Following launch, body fluid volumes, electrolyte levels, and bone and muscle undergo changes as the human body adapts to the weightless environment. Changes in the urinary chemical composition may lead to the potentially serious consequences of renal stone formation. Previous data collected immediately after space flight indicate changes in the urine chemistry favoring an increased risk of calcium oxalate and uric acid stone formation (n = 323). During short term Shuttle space flights, the changes observed include increased urinary calcium and decreased urine volume, pH and citrate resulting in a greater risk for calcium oxalate and brushite stone formation (n = 6). Results from long duration Shuttle/Mir missions (n = 9) followed a similar trend and demonstrated decreased fluid intake and urine volume and increased urinary calcium resulting in a urinary environment saturated with the calcium stone-forming salts. The increased risk occurs rapidly upon exposure to microgravity, continues throughout the space flight and following landing. Dietary factors, especially fluid intake, or pharmacologic intervention can significantly influence the urinary chemical composition. Increasing fluid intake to produce a daily urine output of 2 liters/day may allow the excess salts in the urine to remain in solution, crystals formation will not occur and a renal stone will not develop. Results from long duration crewmembers (n = 2) who had urine volumes greater than 2.5 L/day minimized their risk of renal stone formation. Also, comparisons of stone-forming risk in short duration crewmembers clearly identified greater risk in those who produced less than 2 liters of urine/day. However, hydration and increased urine output does not correct the underlying calcium excretion due to bone loss and only treats the symptoms and not the cause of the increased urinary salts. Dietary modification and promising pharmacologic treatments may also be used to reduce the potential risk for renal stone formation. Potassium citrate is being used clinically to increase the urinary inhibitor levels to minimize the development of crystals and the growth of renal stones. Bisphosphonates are a class of drugs recently shown to help in patients with osteoporosis by inhibiting the loss of bones in elderly patients. This drug could potentially prevent the bone loss observed in astronauts and thereby minimize the increase in urinary calcium and reduce the risk for renal stone development. Results of NASA's renal stone risk assessment program clearly indicate that exposure to microgravity changes the urinary chemical environment such that there is an increased risk for supersaturation of stone-forming salts, including calcium oxalaie and brushite. These studies have indicated specific avenues for development of countermeasures for the increased renal stone risk observed during and following space flight. Increased hydration and implementation of pharmacologic countermeasures should largely mitigate the in-flight risk of renal stones.

  17. Melatonin prevents kidney injury in a high salt diet-induced hypertension model by decreasing oxidative stress.

    PubMed

    Leibowitz, Avshalom; Volkov, Alexander; Voloshin, Konstantin; Shemesh, Chen; Barshack, Iris; Grossman, Ehud

    2016-01-01

    Melatonin, a potent antioxidant molecule, plays a role in blood pressure regulation. We hypothesized that melatonin may generate a protective effect in a high salt diet (HSD) rodent model mediated by decreasing renal oxidative stress. Dahl salt-sensitive rats were divided into three groups according to diet: normal chow (control); HSD; HSD with melatonin [30/mg/kg/day]) placed in their water (HSD + Mel) over an 8-wk period. Blood pressure was measured by the tail cuff method. Kidney injury was evaluated by 24 H urine protein excretion. Glomerular injury index (GII) (fibrotic glomeruli/100 glomeruli) was evaluated from a Masson's trichrome-stained section. Kidney oxidative stress was determined by superoxide production via dihydroethidium staining. Expression of oxidative stress-related genes was measured by reverse transcriptase-qPCR. Melatonin had no effect on blood pressure increase induced by HSD and attenuated proteinuria induced by HSD (HSD - 50.7 ± 12, HSD + Mel - 22.3 ± 4.3, controls - 6.5 ± 1.0 gram protein/gram creatinine, P < 0.001). HSD-induced glomerular damage was significantly diminished by melatonin (GII in HSD - 24 ± 6, HSD + Mel - 3.6 ± 0.8, controls - 0.8 ± 0.5, P < 0.05). Superoxide production was significantly higher in kidneys of HSD fed rats than the controls (99 ± 9 versus 60 ± 7 relative fluorescent units (RFU)/μm(2) , respectively, P < 0.05). Melatonin also decreased superoxide production (74 ± 5 RFU/μm(2) , P < 0.05). The expression of kidney inducible nitric oxide synthase and p67(phox) mRNA was significantly higher in HSD than in the controls and HSD + Mel rats. Treatment with melatonin eliminated the deleterious effect of HSD in the kidneys of Dahl salt-sensitive rats. The beneficial effect of melatonin is not mediated by lowering blood pressure but by a direct antioxidative effect. PMID:26465239

  18. Functional aspects of silent ureteral stones investigated with MAG-3 renal scintigraphy

    PubMed Central

    2014-01-01

    Background To investigate functional aspects of silent ureteral stones with special focus on obstruction and its relationship to renal anatomy. The present study is the first investigation of renal excretory function in patients with silent ureteral stones. Methods Patients with primarily asymptomatic ureteral stones underwent a mercapto-acetyltriglycine (MAG-3) renal scintigraphy prior to treatment, in addition to anatomic evaluation of renal units and serum creatinine levels. The primary outcome measure was the presence or absence of obstruction. Secondary outcome measures were kidney anatomy, grade of hydronephrosis, location of stones, stone size, and serum creatinine levels. Results During a ten-year period, 14 patients (median age 52.6 years; range 37.3 to 80.7 years) were included in the study. The relative frequency of primarily asymptomatic ureteral stones among all patients treated for ureteral stones in the study period was 0.7%. Eleven renal units showed some degree of hydronephrosis while 3 kidneys were not dilated. On the MAG-3 scan, 7 patients had an obstruction of the ureter, 5 had no obstruction, and 2 had dysfunction of the kidney. A statistically significant correlation was established between the grade of obstruction and stone size (p = 0.02). Conclusions At the time of presentation, only 64.3% of the patients revealed an obstruction in the stone-bearing renal unit. The degree of hydronephrosis and renal function were very diverse in this subgroup of patients with ureteral stones. The onset of ureterolithiasis and the chronological sequence of obstruction remain unclear in patients who have never experienced symptoms due to their stones. PMID:24397735

  19. Nephrolithiasis: Molecular Mechanism of Renal Stone Formation and the Critical Role Played by Modulators

    PubMed Central

    Aggarwal, Kanu Priya; Narula, Shifa; Kakkar, Monica

    2013-01-01

    Urinary stone disease is an ailment that has afflicted human kind for many centuries. Nephrolithiasis is a significant clinical problem in everyday practice with a subsequent burden for the health system. Nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis of stones as well as their prevention and cure still remains rudimentary. Regardless of the fact that supersaturation of stone-forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation. The pathogenesis of calcium oxalate stone formation is a multistep process and essentially includes nucleation, crystal growth, crystal aggregation, and crystal retention. Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person's ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it. Besides low urine volume and low urine pH, high calcium, sodium, oxalate and urate are also known to promote calcium oxalate stone formation. Many inorganic (citrate, magnesium) and organic substances (nephrocalcin, urinary prothrombin fragment-1, osteopontin) are known to inhibit stone formation. This review presents a comprehensive account of the mechanism of renal stone formation and the role of inhibitors/promoters in calcium oxalate crystallisation. PMID:24151593

  20. Kidney Disease

    MedlinePlus

    ... version of this page please turn Javascript on. Kidney Disease What is Kidney Disease? What the Kidneys Do Click for more information You have two ... damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced ...

  1. FXR activation prevents the development of vascular calcification in ApoE?/? mice with chronic kidney disease

    PubMed Central

    Miyazaki-Anzai, Shinobu; Levi, Moshe; Kratzer, Adelheid; Ting, Tabitha C.; Lewis, Linda B.; Miyazaki, Makoto

    2010-01-01

    Rationale Vascular calcification is highly associated with cardiovascular morbidity and mortality, especially in patients with chronic kidney disease. The nuclear receptor farnesoid X receptor (FXR) has been implicated in the control of lipid, carbohydrate and bile acid metabolism in several cell types. Although recent studies have shown that FXR is also expressed in vascular smooth muscle cells, its physiological role in vasculature tissue remains obscure. Objective Here, we have examined the role of FXR in vascular calcification. Methods and Results The FXR gene, a bile acid nuclear receptor, was highly induced during osteogenic differentiation of bovine calcifying vascular cells (CVC) and in the aorta of apolipoprotein E (ApoE)?/? mice with chronic kidney disease which are common tissue culture and mouse model, respectively, for aortic calcification. FXR activation by a synthetic FXR agonist, 6?-ethyl chenodeoxycholic acid (INT-747) inhibited phosphate induced-mineralization and triglyceride accumulation in CVC. FXR dominant negative expression augmented mineralization of CVC and blocked the anti-calcific effect of INT-747 whereas VP16FXR that is a constitutively active form reduced mineralization of CVC. INT-747 treatment also increased phosphorylated c-Jun N-terminal kinase (JNK). SP600125 (specific JNK inhibitor) significantly induced mineralization of CVC and ALP expression, suggesting that the anti-calcific effect of INT-747 is due to JNK activation. We also found that INT-747 ameliorates chronic kidney disease (CKD) induced-vascular calcification in 5/6 nephrectomized ApoE?/? mice without affecting the development of atherosclerosis. Conclusions These observations provide direct evidence for that FXR is a key signaling component in regulation of vascular osteogenic differentiation and, thus representing a promising target for the treatment of vascular calcification. PMID:20431060

  2. Sinomenine activation of Nrf2 signaling prevents hyperactive inflammation and kidney injury in a mouse model of obstructive nephropathy.

    PubMed

    Qin, Tian; Du, Ronghui; Huang, Fengjie; Yin, Shasha; Yang, Jun; Qin, Siyuan; Cao, Wangsen

    2016-03-01

    Sinomenine is originally derived from medicinal herb and used preferentially in treatment of rheumatoid diseases in Far East regions. SIN has strong anti-inflammatory and immune-regulatory properties, acting mainly through inhibiting NF-kB signaling. Although the upstream target through which SIN affects NF-kB activity is unknown, evidence suggests that SIN might regulate inflammation through Nrf2 signaling. In this study we explored the role of Nrf2 in mediating SIN's anti-inflammation and kidney protection in a mouse model of obstructive nephropathy. We found that SIN is an activator of Nrf2 signaling. It markedly increased Nrf2 protein level, Nrf2 nuclear translocation, Nef2 transcription capacity, and the downstream protein expression. We further demonstrated that SIN activation of Nrf2 is likely due to its repression of the Nrf2 inhibitor Keap1 since it drastically reduced Keap1 protein through the PKC-sensitive ubiquitination-proteasomal degradation. SIN treatment of nephropathy mice effectively reduced the kidney damage and inflammatory responses, balanced renal oxidative stress, and improved the pathological protein expression in an Nrf2 dependent manner. In addition, SIN also Nrf2-dependently modulated macrophage M1/M2 polarization and inhibited the IkBα phosphorylation and NF-kB nuclear translocation, hence revealing an important upstream event that contributed to its anti-inflammation and tissue protection. Taken together our study has identified a novel pathway through which SIN exerts its anti-inflammation and renal protective functions, and provided a molecular basis for SIN potential applications in the treatment of kidney and other inflammatory disorders. PMID:26795599

  3. Meckel's stone ileus.

    PubMed

    Rudge, F W

    1992-02-01

    Meckel's diverticulum is the most common congenital abnormality of the small bowel; it occurs in approximately 2% of the population. Complications of Meckel's diverticulum include hemorrhage, usually associated with heterotopic tissue within the diverticulum, intussusception, development of benign or malignant neoplasms, and inflammation. Formation of one or more enteroliths within a diverticulum is rare. An extremely rare complication is mechanical small bowel obstruction secondary to extrusion of an enterolith from a Meckel's diverticulum (Meckel's stone ileus). A case of Meckel's stone ileus is described herein, with a review of the literature of this extremely rare complication. PMID:1603394

  4. AB094. Upper urinary stone management in China

    PubMed Central

    Wang, Shaogang; Liu, Jihong; Ye, Zhangqun

    2015-01-01

    Objective To give an overview of the contemporary management for upper urinary stones in China. Methods Contemporary treatment methods, especially novel or developing modality with Chinese characteristics, for upper urinary stones in China has been reviewed and introduced. Results Urolithiasis is one of the most prevalent diseases in the urologic clinic and usually affects people aged 20 to 60 years. In recent years, the overall morbidity of urolithiasis in Chinese population has increased with a significant reduction of lower urinary stone and an increase of upper urinary stone. Upper urinary stone may induce more severe complications and have been considered to be the main cause of nephrectomy besides urinary tumor. The management of upper urinary stone can be challenging somehow. Extracorporeal shock wave lithotripsy (ESWL) is usually the first choice for patients with simple upper urinary stone sized 2 cm or less. Recent years, according to the mechanism of lithecbole by vibration and body position, some Chinese urologists have developed a novel machine, external physical vibration lithecbole (EPVL), which can facilitate removal of urinary stone after ESWL or endoscopic lithotripsy. The combination of EPVL therapy with ESWL or endoscopic lithotripsy significantly improves the stone-free rate. Percutaneous nephrolithotomy (PCNL) is increasingly employed as a major modality for patients with large and complex upper urinary stone. The minimally invasive PCNL (mPCNL), which was performed with a miniature endoscope by way of a small size tract (12-20 F), could decrease morbidity, especially uncontrolled hemorrhage. However, its efficiency of removing stone fragments is lower. The Chinese urologists have modified PCNL technique by using an 8/9.8 F rigid ureteroscope through the 14-18 F percutaneous tract under the guidance of ultrasound or X-ray. The results from a series of studies demonstrate that Chinese mPCNL is a safe, feasible and efficient method for treating upper urinary stone with a low complication rate. With the development of technology, flexible ureteroscopy has become one of the main actors in clinical practice over the past several years. Flexible ureteroscopy can reach most parts of the kidney so that all stones can be removed or vaporised provided they are of an appropriate size and accessible. Moreover, flexible ureteroscopy is well tolerated and effective which allows us to obtain a high success rate, low morbidity, and a brief hospital stay. It could be the best option in managing the special patients with multiple intrarenal stones, stone-bearing caliceal diverticula, anticoagulated history, obesity, anomalous kidneys and pregnancy, which are not applicable for ESWL or PCNL. However, the flexible ureteroscopy is much more difficult to handle than the rigid ureteroscope. In addition, the flexible ureteroscope is expensive and easy to be damaged or broken, the treatment cost usually higher than ordinary treatment. In the past decades, some Chinese urologists and engineers have put in a great effort to design novel types of flexible ureteroscope which is cheaper and easier to operate. The integrated flexible and rigid ureteroscope is one of the new designed instruments of which the body is an ordinary rigid ureteroscope but have a flexible end. This novel device could be operated as easy as rigid ureteroscope and the end of ureteroscope could move flexiblely after its entry of the renal pelvis. Several different types of the Chinese flexible ureteroscope have completed the clinical trials and are going to be commercially available. Conclusions Generally, upper urinary stone is one of the most common diseases in urologic department in China and some novel treatment methods with Chinese characteristics has been developed. Each treatment method has advantages and disadvantages. The urologists’ choice of the treatment strategy should be made individually according to the properties of stone and the patient’s body condition.

  5. Diagnosis and management of bile stone disease and its complications.

    PubMed

    Cremer, Anneline; Arvanitakis, Marianna

    2016-03-01

    Bile stone disease is one of the most prevalent gastroenterological diseases with a considerable geographical and ethnic variation. Bile stones can be classified according their origin, their localization and their biochemical structure. Development and clinical expression depend on a complex interaction between congenital and acquired risk factors. Indeed, bile stones can be either asymptomatic, or cause biliary colic or complications such as acute cholecystitis, jaundice, cholangitis and acute pancreatitis. Diagnosis is based on a combination of clinical features, laboratory findings and imaging techniques and correct identification of symptomatic gallstone patients is essential before cholecystectomy. Transabdominal ultrasonography is the gold standard for the diagnosis of gallstones. However, endoscopic ultrasonography, magnetic resonance cholangiopancreatography and intraoperative cholangiography may also play a role in the diagnosis of bile stones. Management includes prevention measures against modifiable risk factors. Biliary colic and acute cholecystitis are common indications of laparoscopic cholecystectomy, while endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy and stone extraction is the gold standard for the treatment of common bile duct (CBD) stones. Timing of ERCP and cholecystectomy are of critical importance in the management. Lithotripsy modalities are generally reserved for patients with technically difficult CBD stone removal. Percutaneous access combined with lithotripsy may be helpful for complicated intrahepatic stones. PMID:26771377

  6. Kidney School

    MedlinePlus

    ... copies? Read our licensing agreement Living Successfully with Kidney Disease People with kidney disease can live long ... Listen Printing multiple copies? Read our licensing agreement Kidneys: How They Work, How They Fail, What You ...

  7. Kidney Problems

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & Information The kidneys are two ... the production of red blood cells. What are Kidney Diseases? For about one-third of older people, ...

  8. Kidney biopsy

    MedlinePlus

    ... through the kidney Connective tissue diseases such as systemic lupus erythematosus Other diseases that may be affecting the kidney, such as diabetes Kidney transplant rejection , if you had a transplant

  9. 6-Gingerol-Rich Fraction from Zingiber officinale Prevents Hematotoxicity and Oxidative Damage in Kidney and Liver of Rats Exposed to Carbendazim.

    PubMed

    Salihu, Mariama; Ajayi, Babajide O; Adedara, Isaac A; Farombi, Ebenezer O

    2016-07-01

    Ginger (Zingiber officinale) is a globally marketed flavoring agent and cooking spice with a long history of human health benefits. The fungicide carbendazim (CBZ) is often detected in fruits and vegetables for human nutrition and has been reported to elicit toxic effects in different experimental animal models. The present study investigated the protective effects of 6-Gingerol-rich fraction (6-GRF) from ginger on hematotoxicity and hepatorenal damage in rats exposed to CBZ. CBZ was administered at a dose of 50 mg/kg alone or simultaneously administered with 6-GRF at 50, 100, and 200 mg/kg, whereas control rats received corn oil alone at 2 mL/kg for 14 days. Hematological examination showed that CBZ-mediated toxicity to the total white blood cell (WBC), neutrophils, lymphocytes, and platelets counts were normalized to the control values in rats cotreated with 6-GRF. Moreover, administration of CBZ significantly decreased the activities of superoxide dismutase, catalase, glutathione peroxidase, and glutathione S-transferase as well as glutathione level in the livers and kidneys of rats compared with control. However, the levels of hydrogen peroxide (H2O2) and malondialdehyde were markedly elevated in kidneys and livers of CBZ-treated rats compared with control. The significant elevation in the plasma indices of renal and hepatic dysfunction in CBZ-treated rats was confirmed by light microscopy. Coadministration of 6-GRF exhibited chemoprotection against CBZ-mediated hematotoxicity, augmented antioxidant status, and prevented oxidative damage in the kidney and liver of rats. PMID:26673969

  10. Effect of Twice-Yearly Denosumab on Prevention of Bone Mineral Density Loss in De Novo Kidney Transplant Recipients: A Randomized Controlled Trial.

    PubMed

    Bonani, M; Frey, D; Brockmann, J; Fehr, T; Mueller, T F; Saleh, L; von Eckardstein, A; Graf, N; Wüthrich, R P

    2016-06-01

    We conducted an open-label, prospective, randomized trial to assess the efficacy and safety of RANKL inhibition with denosumab to prevent the loss of bone mineral density (BMD) in the first year after kidney transplantation. Ninety kidney transplant recipients were randomized 1:1 2 weeks after surgery to receive denosumab (60 mg at baseline and 6 months) or no treatment. After 12 months, total lumbar spine areal BMD (aBMD) increased by 4.6% (95% confidence interval [CI] 3.3-5.9%) in 46 patients in the denosumab group and decreased by -0.5% (95% CI -1.8% to 0.9%) in 44 patients in the control group (between-group difference 5.1% [95% CI 3.1-7.0%], p < 0.0001). Denosumab also increased aBMD at the total hip by 1.9% (95% CI, 0.1-3.7%; p = 0.035) over that in the control group at 12 months. High-resolution peripheral quantitative computed tomography in a subgroup of 24 patients showed that denosumab increased volumetric BMD at the distal tibia and radius (all p < 0.05). Biomarkers of bone turnover (C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide) markedly decreased with denosumab (all p < 0.0001). Episodes of cystitis and asymptomatic hypocalcemia occurred more often with denosumab, whereas graft function, rate of rejections, and incidence of opportunistic infections were similar. In conclusion, denosumab increased BMD in the first year after kidney transplantation but was associated with more frequent episodes of urinary tract infection. PMID:26713403

  11. Glycyrrhizic acid pretreatment prevents sepsis-induced acute kidney injury via suppressing inflammation, apoptosis and oxidative stress.

    PubMed

    Zhao, Hongyu; Liu, Zhenning; Shen, Haitao; Jin, Shuai; Zhang, Shun

    2016-06-15

    Glycyrrhizic acid (GA), an active ingredient in licorice, has multiple pharmacological activities. The aim of our study was to investigate the molecular mechanism involved in the protective effects of GA in lipopolysaccharide (LPS) stimulated rat mesangial cells (HBZY-1) and septic rats. Sepsis model was established by injection of 5mg/kg LPS in rats or incubation with 1μg/ml LPS for 24h in HBZY-1 cells. A variety of molecular biological experiments were carried out to assess the effects of GA on inflammation, apoptosis, and oxidative stress. First we found that GA alleviated sepsis-induced kidney injury in vivo. Furthermore, GA suppressed inflammatory response in vivo and in vitro. Additionally, GA inhibited cell apoptosis and the changes in expressions of apoptosis related proteins induced by LPS. Moreover, GA markedly inhibited oxidative stress induced by LPS via activation of ERK signaling pathway. Finally GA could inhibit the activation of NF-κ B induced by LPS. Our present study indicates that GA has a protective effect against sepsis-induced inflammatory response, apoptosis, and oxidative stress damage, which provides a molecular basis for a new medical treatment of septic acute kidney injury. PMID:27063444

  12. Impact of Stone Removal on Renal Function: A Review

    PubMed Central

    Wood, Kyle; Keys, Tristan; Mufarrij, Patrick; Assimos, Dean G

    2011-01-01

    Stone removal can improve renal function by eradicating obstruction and, in certain cases, an underlying infection. Stone-removing procedures, however, may negatively impact functional integrity. Many things may impact the latter, including the procedures used, the methods of assessing function, the time when these assessments are made, the occurrence of complications, the baseline condition of the kidney, and patient-related factors. In the majority of cases, little significant functional impairment occurs. However, there are gaps in our knowledge of this subject, including the cumulative effects of multiple procedures violating the renal parenchyma and long-term functional outcomes. PMID:21935339

  13. Biomimetic Randall's plaque as an in vitro model system for studying the role of acidic biopolymers in idiopathic stone formation.

    PubMed

    Chidambaram, Archana; Rodriguez, Douglas; Khan, Saeed; Gower, Laurie

    2015-01-01

    Randall's plaque (RP) deposits seem to be consistent among the most common type of kidney stone formers, idiopathic calcium oxalate stone formers. This group forms calcium oxalate renal stones without any systemic symptoms, which contributes to the difficulty of understanding and treating this painful and recurring disease. Thus, the development of an in vitro model system to study idiopathic nephrolithiasis, beginning with RP pathogenesis, can help in identifying how plaques and subsequently stones form. One main theory of RP formation is that calcium phosphate deposits initially form in the basement membrane of the thin loops of Henle, which then fuse and spread into the interstitial tissue, and ultimately make their way across the urothelium, where upon exposure to the urine, the mineralized tissue serves as a nidus for overgrowth with calcium oxalate into a stone. Our group has found that many of the unusual morphologies found in RP and stones, such as concentrically laminated spherulites and mineralized collagenous tissue, can be reproduced in vitro using a polymer-induced liquid precursor (PILP) process, in which acidic polypeptides induce a liquid phase amorphous precursor to the mineral, yielding non-equilibrium crystal morphologies. Given that there are many acidic proteins and polysaccharides present in the renal tissue and urine, we have put forth the hypothesis that the PILP system may be involved in urolithiasis. Therefore, our goal is to develop an in vitro model system of these two stages of composite stone formation to study the role that various acidic macromolecules may play. In our initial experiments presented here, the development of "biomimetic" RP was investigated, which will then serve as a nidus for calcium oxalate overgrowth studies. To mimic the tissue environment, MatriStem(®) (ACell, Inc.), a decellularized porcine urinary bladder matrix was used, because it has both an intact epithelial basement membrane surface and a tunica propria layer, thus providing the two types of matrix constituents found associated with mineral in the early stages of RP formation. We found that when using the PILP process to mineralize this tissue matrix, the two sides led to dramatically different mineral textures, and they bore a striking resemblance to native RP, which was not seen in the tissue mineralized via the classical crystal nucleation and growth process. The interstitium side predominantly consisted of collagen-associated mineral, while the luminal side had much less mineral, which appeared to be tiny spherules embedded within the basement membrane. Although these studies are only preliminary, they support our hypothesis that kidney stones may involve non-classical crystallization pathways induced by the large variety of macromolecular species in the urinary environment. We believe that mineralization of native tissue scaffolds is useful for developing a model system of stone formation, with the ultimate goal of developing strategies to avoid RP and its detrimental consequences in stone formation, or developing therapeutic treatments to prevent or cure the disease. Supported by NIDDK grant RO1DK092311. PMID:25119505

  14. Long-term effects of insulin therapy, islet transplantation, and pancreas transplantation in the prevention of glomerular changes in kidneys of alloxan-induced diabetic rats.

    PubMed

    Spadella, C T; Lerco, M M; Machado, J L M; Macedo, C S

    2005-10-01

    Groups of inbred alloxan-induced diabetic rats were treated with insulin (I), islets (IT), or pancreas transplantation (PT). Nondiabetic (N) and untreated diabetic (D) control groups were concurrently included. Each group was divided into five subgroups of 10 rats and killed after follow-up of 1, 3, 6, 9, and 12 months. Clinical and laboratory parameters were recorded, and kidney ultrastructural and morphometric analyses performed in each 12-month subgroup, namely glomerular basement membrane (GM) thickening, podocyte number, and number/extension of slit diaphragms (S). Rats from the I group showed poor metabolic control of diabetes compared with N group control rats. However, successfully transplanted rats (IT and PT) had complete restoration to normal levels for all metabolic parameters. GM thickening was significantly higher in diabetic compared with control rats. In contrast, the numbers of podocytes and slits as well as slit extensions were significantly decreased. Insulin therapy did not prevent any alterations upon comparison of diabetic vs control rats. Despite good metabolic control in IT rats, the degree of kidney lesion control never compared with that achieved in PT rats. In this group all glomerular changes were similar to the age-dependent lesions observed in control rats. We conclude that either IT or PT may be a good option for diabetes treatment, although pancreas transplantation seems to be the most effective treatment to control chronic complications. PMID:16298631

  15. When Stones Teach.

    ERIC Educational Resources Information Center

    Lucier, Todd

    2001-01-01

    Creating towers of balanced stones is a versatile outdoor learning activity that can be experienced in the classroom, school yard, forest, or parking lot. Students discover hidden talents, learn to work and communicate clearly with others, and reconnect with the natural world. Several variations on the exercise are given, along with principles of…

  16. Effects of cranberry extract on prevention of urinary tract infection in dogs and on adhesion of Escherichia coli to Madin-Darby canine kidney cells.

    PubMed

    Chou, Hsin-I; Chen, Kuan-Sheng; Wang, Hsien-Chi; Lee, Wei-Ming

    2016-04-01

    OBJECTIVE To determine effects of cranberry extract on development of urinary tract infection (UTI) in dogs and on adherence of Escherichia coli to Madin-Darby canine kidney (MDCK) cells. ANIMALS 12 client-owned dogs (in vivo experiment) and 6 client-owned dogs (in vitro experiment). PROCEDURES 12 dogs with a history of recurrent UTI received an antimicrobial (n = 6) or cranberry extract (6) orally for 6 months. Dogs were monitored for a UTI. For the in vitro experiment, cranberry extract was orally administered to 6 dogs for 60 days. Voided urine samples were collected from each dog before and 30 and 60 days after onset of extract administration. Urine was evaluated by use of a bacteriostasis assay. An antiadhesion assay and microscopic examination were used to determine inhibition of bacterial adherence to MDCK cells. RESULTS None of the 12 dogs developed a UTI. The bacteriostasis assay revealed no zone of inhibition for any urine samples. Bacterial adhesion was significantly reduced after culture with urine samples obtained at 30 and 60 days, compared with results for urine samples obtained before extract administration. Microscopic examination revealed that bacterial adherence to MDCK cells was significantly reduced after culture with urine samples obtained at 30 and 60 days, compared with results after culture with urine samples obtained before extract administration. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of cranberry extract prevented development of a UTI and prevented E coli adherence to MDCK cells, which may indicate it has benefit for preventing UTIs in dogs. PMID:27027843

  17. The kidney tight junction (Review)

    PubMed Central

    HOU, JIANGHUI

    2014-01-01

    The tight junction is an important subcellular organelle which plays a vital role in epithelial barrier function. Claudin, as the integral membrane component of tight junctions, creates a paracellular transport pathway for various ions to be reabsorbed by the kidneys. This review summarizes advances in claudin structure, function and pathophysiology in kidney diseases. Different claudin species confer selective paracellular permeability to each of three major renal tubular segments: the proximal tubule, the thick ascending limb of Henle’s loop and the distal nephron. Defects in claudin function can cause a wide spectrum of kidney diseases, such as hypomagnesemia, hypercalciuria, kidney stones and hypertension. Studies using transgenic mouse models with claudin mutations have recapitulated several of these renal disease phenotypes and have elucidated the underlying biological mechanisms. Modern recording approaches based upon scanning ion conductance microscopy may resolve the biophysical nature of claudin transport function and provide novel insight into tight junction architecture. PMID:25319473

  18. Renal Stone Risk during Spaceflight: Assessment and Countermeasure Validation

    NASA Technical Reports Server (NTRS)

    Whitson, Peggy A.; Pietrzyk, Robert A.; Jones, Jeffery A.; Sams, Clarence F.; Hudson, Ed K.; Nelman-Gonzalez, Mayra

    2009-01-01

    NASA's Vision for Space Exploration centers on exploration class missions including the goals of returning to the moon and landing on Mars. One of NASA's objectives is to focus research on astronaut health and the development of countermeasures that will protect crewmembers during long duration voyages. Exposure to microgravity affects human physiology and results in changes in the urinary chemical composition favoring urinary supersaturation and an increased risk of stone formation. Nephrolithiasis is a multifactorial disease and development of a renal stone is significantly influenced by both dietary and environmental factors. Previous results from long duration Mir and short duration Shuttle missions have shown decreased urine volume, pH, and citrate levels and increased calcium. Citrate, an important inhibitor of calcium-containing stones, binds with urinary calcium reducing the amount of calcium available to form stones. Citrate inhibits renal stone recurrence by preventing crystal growth, aggregation, and nucleation and is one of the most common therapeutic agents used to prevent stone formation. Methods: Thirty long duration crewmembers (29 male, 1 female) participated in this study. 24-hour urines were collected and dietary monitoring was performed pre-, in-, and postflight. Crewmembers in the treatment group received two potassium citrate (KCIT) pills, 10 mEq/pill, ingested daily beginning 3 days before launch, all in-flight days and through 14 days postflight. Urinary biochemical and dietary analyses were completed. Results: KCIT treated subjects exhibited decreased urinary calcium excretion and maintained the levels of calcium oxalate supersaturation risk at their preflight levels. The increased urinary pH levels in these subjects reduced the risk of uric acid stones. Discussion: The current study investigated the use of potassium citrate as a countermeasure to minimize the risk of stone formation during ISS missions. Results suggest that supplementation with potassium citrate decreases the risk of stone formation during and immediately after spaceflight.

  19. Methanolic Extract of Curcuma caesia Roxb. Prevents the Toxicity Caused by Cyclophosphamide to Bone Marrow Cells, Liver and Kidney of Mice

    PubMed Central

    Devi, Heisanam Pushparani; Mazumder, Pranab Behari

    2016-01-01

    Introduction: With an ever increasing cause of cancer, it has been recommended to treat with conventional drugs, however because of the side effects caused by the conventional drugs, the research on medicinal plants has been intensified due to their less adverse and toxic effects. Objectives: The primary objective of the present study was to evaluate the protective effect of the medicinal plant Curcuma caesia Roxb. against free radicals ABTS+ and O2-. Also it was aimed to evaluate the protective effect of C.caesia Roxb. against the chemotherapeutic drug Cyclophosphamide and its side effects in liver and kidney. Methods: The rhizomes of the plant was extracted with methanol through soxhlet and its antioxidant activity was tested against ABTS+ and O2-. For antigenotoxic studies, animals were divided into eight groups and micronucleus assay was employed and for biochemical analysis serum sample was collected from the blood and SGOT, SGPT analysis was performed. Also the biochemical analysis was performed from both the liver and kidney. Results: The methanolic extract of Curcuma caesia Roxb. was found to scavenge the free radicals ABTS+ and O2-. the micronuclei formation was found to be increased in the positive control group as compared to the negative control group significantly (P<0.002) however increase in the number of micronuclei was found to be decrease with the pretreatment of the extract at different concentrations significantly as compared to the negative control groups (P<0.01, P<0.005, P<0.001). The increased level of serum SGPT and SGOT as well as peroxidation level in both liver and kidney due to treatment of cyclophosphamide was also found to be decreased with the pretreatment of the extract significantly as compared to the positive control groups. There was decreased in the level of endogenous antioxidant such as GSH and GR in the positive control group however decreased level of GSH and GR was found to be increased with the pretreatment of the methanolic extract of C. caesia Roxb. Conclusion: The present study suggested that the methanolic extract of C. caesia Roxb has not shown any genotoxicity and reduces the genotoxicity caused by cyclophosphamide. It was also to have the protective effects against the liver and kidney. So it could be provided as one of the herbal supplementation in chemoprevention of CP to ameliorate the side effects of it. SUMMARY Cancer is characterized by uncontrolled growth of cells and much research has been done for the past several years from various disciplines for the treatment of cancer but till now no therapy has been discovered. Treatment of cancer with chemotherapeutic drugs has been suggested to prevent cancer cells however they are often limited with their toxicity to normal cells. Therefore it has been suggested that the supplementation of medicinal plants which are rich source of antioxidants can decrease the toxic effect caused by chemotherapeutic drugs. Curcuma caesia Roxb is a medicinal plant which has high antioxidant activity, as per present study, methanolic extract of Curcuma caesia Roxb prevents the toxicity caused by cyclophosphosphamide (chemotherapeutic drug) in bone marrow cells by reducing the micronuclei formation; it also prevents the hepatotoxicity and nephrotoxicity caused by cyclophosphamide, so it can be used as a supplement in cancer treatment with cyclophosphamide. PMID:26941535

  20. Solitary Kidney

    MedlinePlus

    ... Institute, Inc., Kidney School National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Solitary Kidney Page Content On this page: What is a ...

  1. Efficacy of Preventive Interventions for Iodinated Contrast-Induced Acute Kidney Injury Evaluated by Intrarenal Oxygenation as an Early Marker

    PubMed Central

    Li, Lu-Ping; Thacker, Jon; Lu, Jing; Franklin, Tammy; Zhou, Ying; Papadopoulou, Maria V.; Solomon, Richard; Prasad, Pottumarthi V.

    2015-01-01

    Objective The objective of this study was to evaluate the effects of potential renoprotective interventions such as the administration of N-acetylcysteine (NAC; antioxidant) and furosemide (diuretic) on intrarenal oxygenation as evaluated by blood oxygen level–dependent (BOLD) magnetic resonance imaging (MRI) in combination with urinary neutrophil gelatinase–associated lipocalin (NGAL) measurements. Materials and Methods Rats received nitric oxide synthase inhibitor L-NAME (10 mg/kg) and cyclooxygenase inhibitor indomethacin (10 mg/kg) to induce the risk for developing iodinated contrast-induced acute kidney injury before receiving one of the interventions: NAC, furosemide, or placebo. One of the 3 iodinated contrast agents (iohexol, ioxaglate, or iodixanol) was then administered (1600-mg organic iodine per kilogram body weight). Fifty-four Sprague-Dawley rats were allocated in a random order into 9 groups on the basis of the intervention and the contrast agent received. Blood-oxygen-level–dependent MRI–weighted images were acquired on a Siemens 3.0-T scanner using a multiple gradient recalled echo sequence at baseline, after L-NAME, indomethacin, interventions or placebo, and iodinated contrast agents. Data acquisition and analysis were performed in a blind fashion. R2* (=1/T2*) maps were generated inline on the scanner. A mixed-effects growth curve model with first-order autoregressive variance-covariance was used to analyze the temporal data. Urinary NGAL, a marker of acute kidney injury, was measured at baseline, 2 and 4 hours after the contrast injection. Results Compared with the placebo-treated rats, those treated with furosemide showed a significantly lower rate of increase in R2* (P < 0.05) in the renal inner stripe of the outer medulla. The rats treated with NAC showed a lower rate of increase in R2* compared with the controls, but the difference did not reach statistical significance. Urinary NGAL showed little to no increase in R2* after administration of iodixanol in the rats pretreated with furosemide but demonstrated significant increase in the rats pretreated with NAC or placebo (P < 0.05). Conclusions This is the first study to evaluate the effects of interventions to mitigate the deleterious effects of contrast media using BOLD MRI. The rate of increase in R2* after administration of iodinated contrast is associated with acute renal injury as evaluated by NGAL. Further studies are warranted to determine the optimum dose of furosemide and NAC for mitigating the ill effects of contrast media. Because NGAL has been shown to be useful in humans to document iodinated contrast-induced acute kidney injury, the method presented in this study using BOLD MRI and NGAL measurements can be translated to humans. PMID:24872003

  2. Diagnosis of rare inherited glyoxalate metabolic disorders through in-situ analysis of renal stones

    NASA Astrophysics Data System (ADS)

    Jacob, D. E.; Grohe, B.; Hoppe, B.; Beck, B. B.; Tessadri, R.

    2012-04-01

    The primary hyperoxalurias type I - III constitute rare autosomal-recessive inherited disorders of the human glyoxylate metabolism. By mechanisms that are ill understood progressive nephrocalcinosis and recurrent urolithiasis (kidney stone formation) often starting in early childhood, along with their secondary complications results in loss of nephron mass which progresses to end-stage renal failure over time. In the most frequent form, end-stage renal failure (ESRF) is the rule and combined liver/kidney transplantation respectively pre-emptive liver transplantation are the only causative treatment today. Hence, this contributes significantly to healthcare costs and early diagnosis is extremely important for a positive outcome for the patient. We are developing a stone-based diagnostic method by in-detail multi-methods investigation of the crystalline moiety in concert with urine and stone proteomics. Stone analysis will allow faster analysis at low-impact for the patients in the early stages of the disease. First results from combined spectroscopic (Raman, FTIR)and geochemical micro-analyses (Electron Microprobe and Laser Ablation ICP-MS) are presented here that show significant differences between stones from hyperoxaluria patients and those formed by patients without this disorder (idiopathic stones). Major differences exist in chemistry as well as in morphology and phase composition of the stones. Ca/P ratios and Mg contents differentiate between oxalate-stones from hyperoxaluria patients and idiopathic stones. Results show that also within the different subtypes of primary hyperoxaluria significant differences can be found in stone composition. These imply differences in stone formation which could be exploited for new therapeutic pathways. Furthermore, the results provide important feedback for suspected but yet unconfirmed cases of primary hyperoxaluria when used in concert with the genetic methods routinely applied.

  3. AB109. Upper urinary stone management in China

    PubMed Central

    Wang, Shaogang; Liu, Jihong; Ye, Zhangqun

    2015-01-01

    Objective Urolithiasis is one of the most prevalent diseases in the urologic clinic and usually affects people aged 20 to 60 years. In recent years, the overall morbidity of urolithiasis in Chinese population has increased with significant reduction in patients with lower urinary stone and an increase in patients with upper urinary stone. Upper urinary stone may induce more severe complications and have been considered to be the main cause of nephrectomy besides urinary tumor. Methods The management of upper urinary stone may still challenging somehow. Extracorporeal shock wave lithotripsy (ESWL) usually is the first choice for the patients with simple upper urinary stone of 2 cm and down. Recent years, according to the mechanism of lithecbole by vibration and body position, some Chinese urologists have developed a novel machine, external physical vibration lithecbole (EPVL), which can facilitate removal of urinary stone after ESWL or endoscopic lithotripsy. The combination of EPVL therapy with ESWL or endoscopic lithotripsy significantly increases the stone-free rate. Percutaneous nephrostolithotomy (PCNL) is increasingly employed as a major modality for patients with large and complex upper urinary stone. The minimally invasive PCNL (mPCNL), which was performed with a miniature endoscope by way of a small size tract (12-20 F), could decrease morbidity, especially uncontrolled hemorrhage but have the disadvantages of low efficiency to remove stone fragment. The Chinese urologists have modified PCNL technique by using an 8/9.8 F rigid ureteroscope through the 14-18 F percutaneous tract under ultrasound or X-ray guidance. The results from a series of studies demonstrate that Chinese mPCNL is safe, feasible and efficient for treating upper urinary stone with a low complicate rate. Results With the development of techology, the flexible ureteroscope have become the main actors in clinical practice over the past several years. Flexible ureteroscopy allows entry into all parts of the kidney so that all stones can be removed or vaporised provided they are of an appropriate size and accessible. Moreover, flexible ureteroscopy is well tolerated and effective which allowed us to obtain a high success rate, low morbidity, and a brief hospital stay. It could be the best option in managing the special patients with multiple intrarenal stones, stone-bearing caliceal diverticula、anticoagulated history, obesity, anomalous kidneys and pregnancy, which are not applicable for ESWL or PCN. However, the flexible ureteroscope is much more difficult to handle than the rigid ureteroscope. In addition, the flexible ureteroscope is expensive and easy to damage or break, the treatment cost usually higher than ordinary treatment. In past decades, some Chinese urologists and engineers have put in a great effort to design novel types of flexible ureteroscope which more cheap and easy to operate. The integrated flexible and rigid uroteroscope is the one of the new designed instruments of which the body is the ordinary rigid ureteroscope but have a flexible end. This novel device could be operated as easy as rigid ureterosope and the end of uroteroscope could move flexible after it entry the renal pelvis. Several different types of the Chinese flexible uroteroscope have completed the clinical trials and are going to be commercially available. Conclusions Generally, Upper urinary stone is one of the most common diseases in urologic department in China. Each treatment has advantages and disadvantages. The urologist’s choice of the treatment strategy should be made individually according to the properties of stone and the patient’s body condition.

  4. Wanted: suitable replacement stones for the Lede stone (Belgium)

    NASA Astrophysics Data System (ADS)

    De Kock, T.; Dewanckele, J.; Boone, M. A.; De Boever, W.; De Schutter, G.; Jacobs, P.; Cnudde, V.

    2012-04-01

    The Lede stone is an arenaceous limestone with a Lutetian age, occurring as discrete (most of the times three) stone banks in the marine sandy sediments of the Lede Formation (Belgium). It has a quartz content of approximate 40%. This increases abrasion strength and together with the cementation results in an average compressive strength of about 80-85 MPa. The cement is a microsparitic calcite cement. Other carbonate particles are both microfossils (mainly foraminifers) and macrofossils (bivalves, serpulids, echinoderms, …). This great diversity gives the stone a heterogeneous, animated appearance. The intra- and interparticle porosity is in total 5-10 % in average and the apparent density is 2400-2550 kg/m3. Another important constituent is glauconite, present in a few percent. In fresh state, the stone has a greenish-grey colour, but when it is exposed to atmospheric conditions for a couple of years, the stone acquires a yellowish to rust-coloured patina due to the weathering of glauconite. Sulphatation causes severe damage to the stone, and black gypsum crusts are common in urban environments on stones protected from runoff. This stone was excavated in both open air and underground quarries in the areas of Brussels and Ghent. The proximity of main rivers such as the Scheldt and Zenne provided transport routes for export towards the north (e.g. Antwerp and The Netherlands). Its first known use dates back to Roman times but the stone flourished in Gothic architecture due to its easy workability and its 'divine' light coloured patina. This results nowadays in a dominant occurrence in the cultural heritage of northwestern Belgium and the south of The Netherlands. Socio-economical reasons caused several declines and revivals of Lede stone in use. In the beginning of the 20th century, only a few excavation sites remained, with as main quarry the one located at Bambrugge (Belgium). By the end of the first half of the 20th century, however, no quarry sites remained. In the sixties, a sand quarry located in Balegem (Belgium) started with the extraction of Lede stone combined with its other activities. Until now, only this site supplies blocks of fresh Lede stones and it doesn't seem there will rise an opportunity of a new site in the near future. Therefore, during the huge amount of renovation works in the past century, the Lede stone was often replaced by imported (mostly French) limestones such as Massangis stone, Savonnières stone and Euville stone. The commercial value seems to have had a large impact and too little attention was paid on the optical appearance, ageing and technical compatibility of the stones. The use of especially Massangis stone was taken for granted. In the 21st century, there is a growing awareness of the impact of such consequent replacement for the historical value of our cultural heritage and several alternative stones are suggested and even used. These include stones from France, Spain and Portugal, but also from other regions in Belgium. For the moment, there is no consensus on the most appropriate replacement stone and further research should be done in order to evaluate compatibility of the different stone types with Lede stone. In this context, it is also very important to actively search for better alternatives, which resemble the Lede stone in both a mechanical and aesthetical point of view. Therefore, this abstract is an open question to its readers. Any commercial natural stone suggestions with affiliation to the aforementioned properties are welcome by e-mailing the corresponding author.

  5. First-in-Human Study of the Safety and Efficacy of TOL101 Induction to Prevent Kidney Transplant Rejection

    PubMed Central

    Flechner, S. M.; Mulgoankar, S.; Melton, L. B.; Waid, T. H.; Agarwal, A.; Miller, S. D.; Fokta, F.; Getts, M. T.; Frederick, T. J.; Herrman, J. J.; Puisis, J. P.; O’Toole, L.; Sung, R.; Shihab, F.; Wiseman, A. C.; Getts, D. R.

    2015-01-01

    TOL101 is a murine IgM mAb targeting the αβ TCR. Unlike other T cell targets, the αβ TCR has no known intracellular signaling domains and may provide a nonmitogenic target for T cell inactivation. We report the 6-month Phase 2 trial data testing TOL101 in kidney transplantation. The study was designed to identify a dose that resulted in significant CD3 T cell modulation (<25 T cell/mm3), to examine the safety and tolerability of TOL101 and to obtain preliminary efficacy information. Thirty-six patients were enrolled and given 5–10 daily doses of TOL101; 33 patients completed dosing, while three discontinued after two doses due to a self-limiting urticarial rash. Infusion adjustments, antihistamines, steroids and dose escalation of TOL101 reduced the incidence of the rash. Doses of TOL101 above 28mg resulted in prolonged CD3 modulation, with rapid recovery observed 7 days after therapy cessation. There were no cases of patient or graft loss. Few significant adverse events were reported, with one nosocomial pneumonia. There were five biopsy-confirmed acute cellular rejections (13.9%); however, no donor-specific antibodies were detected. Overall TOL101 was well-tolerated, supporting continued clinical development using the dose escalating 21– 28–42–42–42mg regimen. PMID:24751150

  6. Complicated bile duct stones

    PubMed Central

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  7. Complicated bile duct stones.

    PubMed

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  8. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature

    PubMed Central

    Agrawal, Santosh; Chipde, Saurabh Sudhir; Kalathia, Jaisukh; Agrawal, Rajeev

    2016-01-01

    Management of renal stone in crossed fused renal ectopia (CFRE) is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly. PMID:27141201

  9. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature.

    PubMed

    Agrawal, Santosh; Chipde, Saurabh Sudhir; Kalathia, Jaisukh; Agrawal, Rajeev

    2016-01-01

    Management of renal stone in crossed fused renal ectopia (CFRE) is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly. PMID:27141201

  10. Effect of vegetarianism on development of gall stones in women.

    PubMed Central

    Pixley, F; Wilson, D; McPherson, K; Mann, J

    1985-01-01

    Real time ultrasonography was used to compare the prevalence of gall stones in two groups of women aged 40-69: 632 women recruited from general practice registers and 130 vegetarians. One hundred and fifty-six (25%) of the 632 women who ate meat and 15 (12%) of the 130 vegetarian women either had gall stones visible on ultrasonography or had previously undergone cholecystectomy (p less than 0.01). The prevalence of gall stones was found to increase with age and body mass index. The 2.5 fold increase in risk of developing gall stones in non-vegetarians compared with vegetarians was reduced to 1.9 when controlling for these two potentially confounding factors, but remained significant. A family history of gall stones was reported more often by women with gall stones, but no association was found with parity or use of exogenous oestrogens. Thus the importance of age and obesity to determine the prevalence of gall stone was confirmed, and a dietary factor associated with vegetarianism may prevent this common condition. PMID:3926039

  11. Effect of vegetarianism on development of gall stones in women.

    PubMed

    Pixley, F; Wilson, D; McPherson, K; Mann, J

    1985-07-01

    Real time ultrasonography was used to compare the prevalence of gall stones in two groups of women aged 40-69: 632 women recruited from general practice registers and 130 vegetarians. One hundred and fifty-six (25%) of the 632 women who ate meat and 15 (12%) of the 130 vegetarian women either had gall stones visible on ultrasonography or had previously undergone cholecystectomy (p less than 0.01). The prevalence of gall stones was found to increase with age and body mass index. The 2.5 fold increase in risk of developing gall stones in non-vegetarians compared with vegetarians was reduced to 1.9 when controlling for these two potentially confounding factors, but remained significant. A family history of gall stones was reported more often by women with gall stones, but no association was found with parity or use of exogenous oestrogens. Thus the importance of age and obesity to determine the prevalence of gall stone was confirmed, and a dietary factor associated with vegetarianism may prevent this common condition. PMID:3926039

  12. Renovascular acute renal failure precipitated by extracorporeal shock wave lithotripsy for pancreatic stones.

    PubMed

    Cecere, Nicolas; Goffette, Pierre; Deprez, Pierre; Jadoul, Michel; Morelle, Johann

    2015-08-01

    Extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones is considered a safe and efficient method to facilitate fragmentation and stone removal. We describe the case of a 73-year-old woman with a solitary functioning kidney who presented an acute-onset anuria and renovascular renal failure the day after ESWL. We speculate that vascular calcifications in the area targeted by shock waves played a critical role in renal artery obstruction in the present case. PMID:26251710

  13. Urinary retention and acute kidney injury in a tetraplegic patient using condom catheter after partying: a preventable complication

    PubMed Central

    Vaidyanathan, Subramanian; Selmi, Fahed; Hughes, Peter L; Singh, Gurpreet; Soni, Bakul M

    2015-01-01

    Background Spinal cord injury patients, who manage their bladder using a condom catheter, are at risk of developing urine retention when they consume large volumes of alcoholic drinks within a short period of time. Case presentation A male tetraplegic patient had been managing satisfactorily penile sheath drainage for 8 years. He went out socializing during which he consumed large volumes of alcohol but did not take any recreational drugs. The following morning, he noticed distension of the lower abdomen and passed urine in dribbles. He then developed a temperature and became unwell. He was seen by district nurses and a doctor, who prescribed antibiotics. He continued to feel unwell. After 8 days, he referred himself to a spinal unit at Regional Spinal Injuries Centre, Southport. The blood test results showed the following: blood urea: 19.8 mmol/L; creatinine: 172 μmol/L; and C-reactive protein: 336.4 mg/L. Urethral catheterization led to immediate drainage of 1,400 mL of urine. A computed tomography scan revealed an enlarged, swollen left kidney, indicating acute bacterial nephritis. He was prescribed intravenous fluids and Meropenem. Creatinine decreased to 46 μmol/L. Conclusion Spinal cord injury patients using condom catheters should be made aware of the risk of urine retention when they consume large amounts of alcoholic drinks in a short period of time. Patients and caregivers should be informed to consider intermittent catheterizations for 24–48 hours or insert indwelling urethral catheter when planning for an evening out. PMID:26508892

  14. [Advance in detection methods of microbes on historic stones--a review].

    PubMed

    Yu, Miao; Zhu, Xudong; Pan, Jiao

    2011-11-01

    We reviewed the methods for identification of microorganisms on the surface of historic stones, including nucleic acid analysis, cell membrane analysis, secondary metabolites analysis and the traditional culture analysis. After comprehensive comparison of the advantages and disadvantages of each method, we addressed the biological protection of stone artifacts. The establishment of rapid detection of microorganisms on the historic stones is important to prevent corrosion caused by microorganisms and to protect our valuable cultural heritage. PMID:22260041

  15. 77 FR 7167 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... Kidney Diseases Special Emphasis Panel Multi-Center Study of Tamsulosin for Ureteral Stones in the... of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel, Collaborative...

  16. Stone Morphology: Implication for Pathogenesis

    NASA Astrophysics Data System (ADS)

    Daudon, Michel; Jungers, Paul; Bazin, Dominique

    2008-09-01

    Urinary stones of similar crystalline composition as identified by X-ray diffraction or Fourier transform infrared spectroscopy (FT-IR) may exhibit distinct structures, which are reflected in distinctive stone morphology. Among factors involved in stone morphology—some reflecting lithogenic activity, others depending on the crystal shape, or on the propensity of crystalline phases to form large aggregates, finally the environment where the stone is growing—all of these factors influence the inner structure of the stone and its superficial characteristics. We present here examples of the clinical interest of refined morphologic examination of stones, in addition to X-ray diffraction or FT-IR identification of its components. Such combination of methods allows the identification of specific etiologies among calcium oxalate stones, especially a morphological type pathognomonic of primary hyperoxaluria and other types related to distinct conditions of stone formation. Among phosphatic stones—in addition to stone composition, which must be considered not only on the basis of the main component, but also taking into account the minor crystalline phases, which often are clinically relevant—morphological types also contribute to diagnosis of the underlying etiology, especially for stones related to distal tubular acidosis. Finally, common purine stones also exhibit different morphologies related to stone composition and etiology: two main structures for uric acid and two for ammonium urate help to distinguish risk factors and lithogenic conditions involved in the formation of these calculi. Morphologic examination is a simple, rapid and cheap method that points to specific diseases or lithogenic factors. Better awareness of its clinical relevance should lead to wider utilization.

  17. Mitigation of Liquefaction in Sandy Soils Using Stone Columns

    NASA Astrophysics Data System (ADS)

    Selcuk, Levent; Kayabalı, Kamil

    2010-05-01

    Soil liquefaction is one of the leading causes of earthquake-induced damage to structures. Soil improvement methods provide effective solutions to reduce the risk of soil liquefaction. Thus, soil ground treatments are applied using various techniques. However, except for a few ground treatment methods, they generally require a high cost and a lot of time. Especially in order to prevent the risk of soil liquefaction, stone columns conctructed by vibro-systems (vibro-compaction, vibro-replacement) are one of the traditional geotechnical methods. The construction of stone columns not only enhances the ability of clean sand to drain excess pore water during an earthquake, but also increases the relative density of the soil. Thus, this application prevents the development of the excess pore water pressure in sand during earthquakes and keeps the pore pressure ratio below a certain value. This paper presents the stone column methods used against soil liquefaction in detail. At this stage, (a) the performances of the stone columns were investigated in different spacing and diameters of columns during past earthquakes, (b) recent studies about design and field applications of stone columns were presented, and (c) a new design method considering the relative density of soil and the capacity of drenage of columns were explained in sandy soil. Furthermore, with this new method, earthquake performances of the stone columns constructed at different areas were investigated before the 1989 Loma Prieta and the 1994 Northbridge earthquakes, as case histories of field applications, and design charts were compiled for suitable spacing and diameters of stone columns with consideration to the different sandy soil parameters and earhquake conditions. Key Words: Soil improvement, stone column, excess pore water pressure

  18. Villamayor stone (Golden Stone) as a Global Heritage Stone Resource from Salamanca (NW of Spain)

    NASA Astrophysics Data System (ADS)

    Garcia-Talegon, Jacinta; Iñigo, Adolfo; Vicente-Tavera, Santiago

    2013-04-01

    Villamayor stone is an arkosic stone of Middle Eocene age and belongs to the Cabrerizos Sandstone Formation that comprising braided fluvial systems and paleosoils at the top of each stratigraphic sequence. The sandstone is known by several names: i) the Villamayor Stone because the quarries are located in Villamayor de Armuña village that are situated at 7 km to the North from Salamanca city; ii) the Golden Stone due to its patina that produced a ochreous/golden color on the façades of monuments of Salamanca (World Heritage City,1988) built in this Natural stone (one of the silicated rocks utilised). We present in this work, the Villamayor Stone to be candidate as Global Heritage Stone Resource. The Villamayor Stone were quarrying for the construction and ornamentation of Romanesque religious monuments as the Old Cathedral and San Julian church; Gothic (Spanish plateresc style) as the New Cathedral, San Esteban church and the sculpted façade of the Salamanca University, one of the oldest University in Europe (it had established in 1250); and this stone was one of the type of one of the most sumptuous Baroque monuments is the Main Square of the its galleries and arcades (1729). Also, this stone was used in building palaces, walls and reconstruction of Roman bridge. Currently, Villamayor Stone is being quarried by small and family companies, without a modernized processing, for cladding of the façades of the new buildings until that the construction sector was burst (in 2008 the international economic crisis). However, Villamayor Stone is the main stone material used in the city of Salamanca for the restoration of monuments and, even in small quantities when compared with just before the economic crisis, it would be of great importance for future generations protect their quarries and the craft of masonry. Villamayor Stone has several varieties from channels facies to floodplains facies, in this work the selected varieties are: i) the fine-grained stone, microporous, is partially cemented by dolomite, 27% (bulk porosity), ii) the ochre and fine-grained stone, microporous, with smectite, 30% (bulk porosity), iii) the medium-grained stone, 38% (bulk porosity). Main components for all three varieties: Quartz (up to 60%), feldspars, 2:1 layered silicates (smectites), palygorskite-type fibrous silicates, and small amounts of micaceous minerals (illite/mica).

  19. Kidney Diseases

    MedlinePlus

    Your kidneys are two bean-shaped organs, each about the size of your fists. They are located near the ... back, just below the rib cage. Inside each kidney about a million tiny structures called nephrons filter ...

  20. Kidney Failure

    MedlinePlus

    Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your ... strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful ...

  1. Ectopic Kidney

    MedlinePlus

    ... kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to ... until being released through urination. The kidneys remove wastes and extra water from the blood to form ...

  2. Kidney Biopsy

    MedlinePlus

    ... right diagnosis. [ Top ] What should a person do days before a kidney biopsy? Days before the procedure, ... Top ] What can a person expect on the day of the kidney biopsy? A person should arrive ...

  3. [Investigation of typical melamine urinary stones using infrared spectra].

    PubMed

    Si, Min-Zhen; Li, Qing-Yun; Liu, Ren-Ming; Kang, Yi-Pu; Wang, Kun-Hua; Zhang, Zhi-Guo

    2010-02-01

    A typical melamine kidney stone confirmed by some medicine expert was collected from the first people's hospital of Yunnan. The kidney stone was adequately determined by PE corporation spectra 100(with resolution of 1 cm(-1)). The stone samples for FTIR analysis were prepared using the KBr pellet technique, where 2 mg of the pretreated stone powder was mixed with 200 mg of analytical grade KBr using an agate pestle and mortar. The digital spectrum was then scanned in the mid-infrared region from 4 000 to 400 cm(-1) at room temperature. The appearing bands between 4 000 and 2 000 cm(-1) were 3 487, 3 325, 3 162 and 2 788 cm(-1), those between 1 700 and 1 000 cm(-1) were 1 694, 1 555, 1 383, 1 340, 1 189 and 1 122 cm(-1), and those between 1 000 and 400 cm(-1) were 993, 782, 748, 709, 624, 585, 565 and 476 cm(-1). It was found that the main constituent of calculi showed few comparability with cat kidney stone, which was from cats that died after consuming the contaminated food, and confirmed that these deposits were primarily composed of melamine and cyanuric acid compared to the IR spectra of calculi in literature. It was also found that the main constituent of calculi showed few comparability with popular kidney stone by comparison with the IR spectra of calculi in literature. The spectrum of calculi was 50% respectively similar with melamine and uric acid as compared with the IR spectrum. It was found that the main constituent of calculi was melamine itself and uric acid as compared with the IR spectra of calculi and melamine: (1 : 1), because the spectrum of calculi was 83. 3% similar to melamine and uric acid (1 : 1). The appearing bands of melamine and uric acid (1 : 1) between 4 000 and 2 000 cm(-1) were 3 469, 3 419, 3 333, 3 132, 3 026, 2 827 cm(-1), those between 1 700 and 1 000 cm(-1) were 1 696, 1 656, 1 555, 1 489, 1 439, 1 350, 1 311, 1 198, 1 124 and 1 028 cm(-1), and those between 1 000 and 400 cm(-1) were 993, 878, 814, 784, 745, 708, 619, 577 and 475 cm(-1). PMID:20384125

  4. Our Modern Stone Age

    NASA Astrophysics Data System (ADS)

    Lowry, W. D.

    Unlike most books dealing with industrial minerals and rocks, Our Modern Stone Age is a pleasure to read. Within a matter of several hours, one can get an excellent introduction to nonmetallic mineral resources and industries exclusive o f the mineral fuels. The book is very well written and well illustrated with photographs and drawings; although pitched for the intelligent layman, it is in no way dull reading for even a well-versed economic geologist. Nearly every geologist, mining engineer, mineral economist, planner, and politician will find points of interest in this book.

  5. Kidney Dysplasia

    MedlinePlus

    ... Dimes National Kidney Foundation Urology Care Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Kidney Dysplasia Page Content On this page: What is ...

  6. Renal Stone Risk During Space Flight: Assessment and Countermeasure Validation

    NASA Technical Reports Server (NTRS)

    Whitson, P. A.; Sams, C. F.; Jones, J. A.; Pietrzke, R. A.; Nelman-Gonzalez, M. A.; Hudson, E. K.

    2007-01-01

    NASA has focused its future on exploration class missions including the goal of returning to the moon and landing on Mars. With these objectives, humans will experience an extended exposure to the harsh environment of microgravity and the associated negative effects on all the physiological systems of the body. Exposure to microgravity affects human physiology and results in changes to the urinary chemical composition during and after space flight. These changes are associated with an increased risk of renal stone formation. The development of a renal stone would have health consequences for the crewmember and negatively impact the success of the mission. As of January 2007, 15 known symptomatic medical events consistent with urinary calculi have been experienced by 13 U.S. astronauts and Russian cosmonauts. Previous results from both MIR and Shuttle missions have demonstrated an increased risk for renal stone formation. These data have shown decreased urine volume, urinary pH and citrate levels and increased urinary calcium. Citrate, an important urinary inhibitor of calcium-containing renal stones binds with calcium in the urine, thereby reducing the amount of calcium available to form calcium oxalate stones. Urinary citrate also prevents calcium oxalate crystals from aggregating into larger crystals and into renal stones. In addition, citrate makes the urine less acidic which inhibits the development of uric acid stones. Potassium citrate supplementation has been successfully used to treat patients who have formed renal stones. The evaluation of potassium citrate as a countermeasure has been performed during the ISS Expeditions 3-6, 8, 11-13 and is currently in progress during the ISS Expedition 14 mission. Together with the assessment of stone risk and the evaluation of a countermeasure, this investigation provides an educational opportunity to all crewmembers. Individual urinary biochemical profiles are generated and the risk of stone formation is estimated. Increasing fluid intake is recommended to all crewmembers. These results can be used to lower the risk for stone formation through lifestyle, diet changes or therapeutic administration to minimize the risk for stone development. With human presence in microgravity a continuing presence and exploration class missions being planned, maintaining the health and welfare of all crewmembers is critical to the exploration of space.

  7. Scottish Short Stone Rows

    NASA Astrophysics Data System (ADS)

    Ruggles, Clive L. N.

    Short stone rows received a good deal of attention during the 1980s and 1990s, at a time when archaeoastronomy in prehistoric Britain and Ireland was moving beyond reassessments of Alexander Thom's "megalithic observatories" by identifying coherent groups of similar monuments with clear orientation trends. Many such rows are found in western Scotland, with the main concentration in Argyll and the island of Mull. Systematic analyses of their orientations produced credible evidence of an awareness of the 18.6-year lunar node cycle, within a "primary-secondary" pattern whereby isolated rows were oriented close to moonrise or moonset at the southern major standstill limit, while others oriented in this way were accompanied by a second row oriented in a declination range that could be interpreted either as lunar or solar. A detailed investigation of the landscape situation of the sites in northern Mull, accompanied by excavations at two of the sites, suggested that they were deliberately placed in locations where critical moonsets would be seen against prominent distant landscape features, but where the distant horizon in most or all other directions was hidden from view. A lack of independent archaeological evidence may help to explain why archaeoastronomical investigations at short stone rows have never progressed beyond "data-driven" studies of orientations and landscape situation. Nonetheless, the work that was done at these sites raised important general methodological issues, and pioneered techniques, that remain relevant across archaeoastronomy today.

  8. Recumbent Stone Circles

    NASA Astrophysics Data System (ADS)

    Ruggles, Clive L. N.

    During the 1970s and early 1980s, British archaeoastronomers were striving to bridge the interpretative gulf between the "megalithic observatories" of Alexander Thom and an archaeological mainstream that, generally speaking, was hostile to any mention of astronomy in relation to the megalithic monuments of Neolithic and Early Bronze Age Britain. The Scottish recumbent stone circles (RSCs) came to represent an example where sounder methodology could overcome many of the data selection issues that had beset earlier studies and, with due restraint, produce credible interpretations. Systematic studies of their orientations consistently concluded that the RSCs had a strong lunar connection, and it was widely envisaged that they were the setting for ceremonies associated with the appearance of the moon over the recumbent stone. Other evidence such as the presence of white quartz and the spatial distribution of cupmarks appeared to back up this conclusion. New archaeological investigations since 1999 have challenged and modified these conclusions, confirming in particular that the circles were built to enclose cairns rather than to demarcate open spaces. Yet the restricted pattern of orientations of these structures could only have been achieved by reference to the basic diurnal motions of the skies, and orientation in relation to simple observations of the midsummer moon remains the most likely reading of the alignment evidence taken as a whole. On the other hand, a consideration of the broader context, which includes the nearby Clava cairns, highlights instead the symbolic importance of the sun.

  9. Activin receptor IIA ligand trap in chronic kidney disease: 1 drug to prevent 2 complications-or even more?

    PubMed

    Massy, Ziad A; Drueke, Tilman B

    2016-06-01

    Vascular calcification and kidney fibrosis are 2 important features of chronic kidney disease. Bone morphogenetic proteins/growth differentiation factors and their receptors are implicated in the pathogenesis of both processes. Modulation of the bone morphogenetic protein/growth differentiation factor pathways by a soluble chimeric protein that contains the activin receptor IIA (ActRIIA) domain and acts as an ActRIIA ligand trap for activin and other ligands could become a new therapeutic strategy for vascular calcification and kidney fibrosis in chronic kidney disease. PMID:27181771

  10. Claudins and the Kidney

    PubMed Central

    2015-01-01

    Claudins are tight-junction membrane proteins that function as both pores and barriers in the paracellular pathway in epithelial cells. In the kidney, claudins determine the permeability and selectivity of different nephron segments along the renal tubule. In the proximal tubule, claudins have a role in the bulk reabsorption of salt and water. In the thick ascending limb, claudins are important for the reabsorption of calcium and magnesium and are tightly regulated by the calcium-sensing receptor. In the distal nephron, claudins need to form cation barriers and chloride pores to facilitate electrogenic sodium reabsorption and potassium and acid secretion. Aldosterone and the with-no-lysine (WNK) proteins likely regulate claudins to fine-tune distal nephron salt transport. Genetic mutations in claudin-16 and -19 cause familial hypomagnesemic hypercalciuria with nephrocalcinosis, whereas polymorphisms in claudin-14 are associated with kidney stone risk. It is likely that additional roles for claudins in the pathogenesis of other types of kidney diseases have yet to be uncovered. PMID:24948743

  11. Radionuclide renal function study in various surgical treatments of upper urinary stones.

    PubMed

    Chen, K K; Chen, M T; Yeh, S H; Chang, L S

    1992-05-01

    We conducted a radionuclide renal function study using 131I-hippuran in 188 patients with upper urinary stones before and every 3 months to the maximum of 12 months after various surgical treatments. Of 28 patients with renal staghorn stone, 24 underwent anatrophic nephrolithotomy and 4 percutaneous nephrolithotomy (PCNL). Of 36 patients with renal pelvic stone, 15 received open pyelolithotomy, 16 received PCNL and 5 received extracorporeal shock wave lithotripsy (ESWL). Of 71 patients with renal calyceal stone, 48 underwent PCNL and 23 ESWL. Of 53 patients with ureteral stone, 41 received ureterolithotomy, 8 PCNL and 4 ureteroscopic extraction. The renal function study determined individual and total renal function in terms of effective renal plasma flow (ERPF) at unilateral and bilateral kidneys. The mean total ERPF decreased 3-6 months after anatrophic nephrolithotomy (377.4 +/- 121.8 vs. 308.8 +/- 105.4 ml/min) or PCNL (447.4 +/- 152.3 vs. 386.8 +/- 140.8 ml/min) for staghorn stone. The mean ERPF of the kidney on the operative side decreased significantly to an extent of 29.4% up to 6 months after anatrophic nephrolithotomy. The mean ERPF on operative side increased significantly to an extent of 18.3% up to 6 months after ureterolithotomy. In conclusion, among the upper urinary stones, the unilateral (operative side) and total bilateral renal function decreased 1, 3, and 6 months, respectively, after anatrophic nephrolithotomy. On the contrary, the renal function increased significantly on the operative side up to 6 months after open ureterolithotomy. There was no significant change of mean ERPF at the kidney on operative or non-operative side in other kinds of upper urinary stones and surgical treatment. PMID:1320991

  12. Determination of the chemical composition of human renal stones with MDCT: influence of the surrounding media

    NASA Astrophysics Data System (ADS)

    Grosjean, Romain; Sauer, Benoît; Guerra, Rui; Kermarrec, Isabelle; Ponvianne, Yannick; Winninger, Daniel; Daudon, Michel; Blum, Alain; Felblinger, Jacques; Hubert, Jacques

    2007-03-01

    The selection of the optimal treatment method for urinary stones diseases depends on the chemical composition of the stone and its corresponding fragility. MDCT has become the most used modality to determine rapidly and accurately the presence of stones when evaluating urinary lithiasis treatment. That is why several studies have tempted to determine the chemical composition of the stones based on the stone X-ray attenuation in-vitro and invivo. However, in-vitro studies did not reproduce the normal abdominal wall and fat, making uncertain the standardization of the obtained values. The aim of this study is to obtain X-ray attenuation values (in Hounsfield Units) of the six more frequent types of human renal stones (n=217) and to analyze the influence of the surrounding media on these values. The stones were first placed in a jelly, which X-ray attenuation is similar to that of the human kidney (30 HU at 120 kV). They were then stuck on a grid, scanned in a water tank and finally scanned in the air. Significant differences in CT-attenuation values were obtained with the three different surrounding media (jelly, water, air). Furthermore there was an influence of the surrounding media and consequently discrepancies in determination of the chemical composition of the renal stones. Consequently, CT-attenuation values found in in-vitro studies cannot really be considered as a reference for the determination of the chemical composition except if the used phantom is an anthropomorphic one.

  13. A double-blind, randomized, controlled trial on N-acetylcysteine for the prevention of acute kidney injury in patients undergoing allogeneic hematopoietic stem cell transplantation.

    PubMed

    Ataei, Sara; Hadjibabaie, Molouk; Moslehi, Amirhossein; Taghizadeh-Ghehi, Maryam; Ashouri, Asieh; Amini, Elham; Gholami, Kheirollah; Hayatshahi, Alireza; Vaezi, Mohammad; Ghavamzadeh, Ardeshir

    2015-06-01

    Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-End-stage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9 and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan-Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analysed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients. PMID:24711000

  14. Do Intravenous N-Acetylcysteine and Sodium Bicarbonate Prevent High Osmolal Contrast-Induced Acute Kidney Injury? A Randomized Controlled Trial

    PubMed Central

    Inda-Filho, Antonio Jose; Caixeta, Adriano; Manggini, Marcia; Schor, Nestor

    2014-01-01

    Background N-acetylcysteine (NAC) or sodium bicarbonate (NaHCO3), singly or combined, inconsistently prevent patients exposed to radiographic contrast media from developing contrast-induced acute kidney injury (CI-AKI). Objective We asked whether intravenous isotonic saline and either NaHCO3 in 5% dextrose or else a high dose of NAC in 5% dextrose prevent CI-AKI in outpatients exposed to high-osmolal iodinated contrast medium more than does saline alone. Methods This completed prospective, parallel, superiority, open-label, controlled, computer-randomized, single-center, Brazilian trial (NCT01612013) hydrated 500 adult outpatients (214 at high risk of developing CI-AKI) exposed to ioxitalamate during elective coronary angiography and ventriculography. From 1 hour before through 6 hours after exposure, 126 patients (group 1) received a high dose of NAC and saline, 125 (group 2) received NaHCO3 and saline, 124 (group 3) received both treatments, and 125 (group 4) received only saline. Results Groups were similar with respect to age, gender, weight, pre-existing renal dysfunction, hypertension, medication, and baseline serum creatinine and serum cystatin C, but diabetes mellitus was significantly less prevalent in group 1. CI-AKI incidence 72 hours after exposure to contrast medium was 51.4% (257/500), measured as serum creatinine > (baseline+0.3 mg/dL) and/or serum cystatin C > (1.1· baseline), and 7.6% (38/500), measured as both serum creatinine and serum cystatin C > (baseline+0.3 mg/dL) or > (1.25 · baseline). CI-AKI incidence measured less sensitively was similar among groups. Measured more sensitively, incidence in group 1 was significantly (p<0.05) lower than in groups 2 and 3 but not group 4; adjustment for confounding by infused volume equalized incidence in groups 1 and 3. Conclusion: We found no evidence that intravenous isotonic saline and either NaHCO3 or else a high dose of NAC prevent CI-AKI in outpatients exposed to high osmolal iodinated contrast medium more than does saline alone. Trial Registration ClinicalTrials.gov NCT01612013. PMID:25254489

  15. Natural Abundance 43Ca NMR as a Tool for Exploring Calcium Biomineralization: Renal Stone Formation and Growth

    SciTech Connect

    Bowers, Geoffrey M.; Kirkpatrick, Robert J.

    2011-12-07

    Renal stone diseases are a global health issue with little effective therapeutic recourse aside from surgery and shock-wave lithotripsy, primarily because the fundamental chemical mechanisms behind calcium biomineralization are poorly understood. In this work, we show that natural abundance 43Ca NMR at 21.1 T is an effective means to probe the molecular-level Ca2+ structure in oxalate-based kidney stones. We find that the 43Ca NMR resonance of an authentic oxalate-based kidney stone cannot be explained by a single pure phase of any common Ca2+-bearing stone mineral. Combined with XRD results, our findings suggest an altered calcium oxalate monohydrate-like Ca2+ coordination environment for some fraction of Ca2+ in our sample. The evidence is consistent with existing literature hypothesizing that nonoxalate organic material interacts directly with Ca2+ at stone surfaces and is the primary driver of renal stone aggregation and growth. Our findings show that 43Ca NMR spectroscopy may provide unique and crucial insight into the fundamental chemistry of kidney stone formation, growth, and the role organic molecules play in these processes.

  16. Bath Stone - a Possible Global Heritage Stone from England

    NASA Astrophysics Data System (ADS)

    Marker, Brian

    2014-05-01

    The Middle Jurassic strata of England have several horizons of oolitic and bioclastic limestones that provide high quality dimension stone. One of the most important is found in and near the City of Bath. The Great Oolite Group (Upper Bathonian) contains the Combe Down and Bath Oolites, consisting of current bedded oolites and shelly oolites, that have been used extensively as freestones for construction nearby, for prestigious buildings through much of southern England and more widely. The stone has been used to some extent since Roman times when the city, then known as Aquae Sulis, was an important hot spa. The stone was used to a limited extent through medieval times but from the early 18th century onwards was exploited on a large scale through surface quarrying and underground mining. The City was extensively redeveloped in the 18th to early 19th century, mostly using Bath Stone, when the spas made it a fashionable resort. Buildings from that period include architectural "gems" such as the Royal Crescent and Pulteney Bridge, as well as the renovated Roman Baths. Many buildings were designed by some of the foremost British architects of the time. The consistent use of this stone gives the City an architectural integrity throughout. These features led to the designation of the City as a World Heritage Site. It is a requirement in current City planning policy documents that Bath Stone should be used for new building to preserve the appearance of the City. More widely the stone was used in major houses (e.g. Buckingham Palace and Apsley House in London; King's Pavilion in Brighton); civic buildings (e.g. Bristol Guildhall; Dartmouth Naval College in Devon); churches and cathedrals (e.g. Truro Cathedral in Cornwall); and engineered structures (e.g. the large Dundas Aqueduct on the Kennet and Avon Canal). More widely, Bath Stone has been used in Union Station in Washington DC; Toronto Bible College and the Town Hall at Cape Town, South Africa. Extraction declined in the late 20th century but several quarries and underground mines remain operational providing stone for the local market, repair and maintenance of historic buildings and for special international projects. Reserves permitted for extraction are substantial and resources are fairly extensive so the stone will be accessible in the long term. Taking such points into account, it is suggested that Bath Stone should be recognised as a Global Heritage Stone Resource.

  17. [Successful familial kidney transplant in an infant weighing less than 10 kg: case report and review of the literature].

    PubMed

    Mourani, Chebi; Azar, Hiba; Moukarzel, Maroun; Gerbaka, Bernard; Kallas Chemaly, Anthony; Nehme Chelala, Dania

    2015-01-01

    We report the case of a Lebanese infant born by normal delivery at 40 weeks of gestation. Weight and height at birth were 3200 grams and 49 cm respectively. Serum creatinine in the first week of life was 323 mmol/l (normal value for age is less than 20 mmol/l). Kidney ultrasound confirmed diagnosis of hypoplastic small kidneys. Conservative treatment of renal failure was initiated from the first days of life. Conservative management of renal failure included careful attention to fluid balance, maintenance of adequate nutrition and correction of hyperkalemia, acidosis, hyperphosphatemia and prevention of renal osteodystrophy by the use of dietary phosphate binders and vitamin D analogs. After a slight decrease of serum creatinine in the first three months of life, creatininemia increased progressively despite conservative treatment associated to hyperkalemia and severe pruritis due to hyperphosphatemia. Faced with the progression of renal failure, we decided to start automated peritoneal dialysis at seven months of life. Weight and height were respectively 6200 g and 63 cm. Serum creatinine was 432 mmol/L. Pruritis improved after starting peritoneal dialysis as well as appetite. At 20 months of life and a weight of 9.7 kg, a familial kidney transplant was performed. Immunosuppressive treatment included SimulectO, on day 1 and day 4, associated to mycophenolate mofetil, tacrolymus and prednisolone. The immediate post-transplant period was complicated by urinay tract infection due to BSLE E. coli. After four episodes of urinary tract infection due to resistant E coli associated to a non obstructive stone of 15 mm in the allograft kidney, we performed two sessions of lithotripsy and placed a double J stent. Biochemical urinary analysis did not reveal any causes for lithiasis. Stone disappeared as well as infection after lithotripsy. Renal function is normal for age one year after the kidney transplant. To our knowledge, this is the first reported case of a successful kidney transplant in a Lebanese infant with kidney failure since birth with kidney transplant performed at less than 10 kg of weight on the transplant day. Peritoneal dialysis is the treatment of choice for infants with chronic kidney failure. Familial or cadaveric kidney transplant should be encouraged and performed even in infants weighing less than 10 kg allowing them to have normal growth as well as social and school integration. PMID:26591190

  18. The bioreceptivity of building stone

    NASA Astrophysics Data System (ADS)

    Mauko Pranjić, Alenka; Mulec, Janez; Muck, Tadeja; Hladnik, Aleš; Mladenovič, Ana

    2015-04-01

    Bioreceptivity is an intrinsic property of stone, and is defined as the ability of a material to be colonized by living organisms. The fouling and staining of building stone material due to the activity of microorganisms presents a serious problem in modern as well as historical buildings, not only due to the aesthetic impact but also due to the deterioration of the material. Biological colonisation on stone materials is influenced by a number of factors, e.g. the intrinsic properties of the stone (porosity, roughness, permeability, mineral composition), environmental parameters (e.g. solar radiation, temperature, water regime, climate, etc.), and specific microclimatic parameters (e.g. orientation, exposure to shadow, permanent capillary humidity, etc.). In order to assess the bioreceptivity of building stones, use is often made of artificial colonisation experiments compromising the inoculation of stones with a single species or a few isolated strains under laboratory conditions. In the present work the authors present the development of a method for the determination of bioreceptivity, as well as a study of the bioreceptivity of selected natural stone versus the latter's intrinsic properties. Field examples of biodeterioration are also presented. The study was supported by the Slovenian Research Agency (L1-5453).

  19. Pathophysiology of the Hypercalciuria in the Genetic Hypercalciuric Stone-Forming Rats

    NASA Astrophysics Data System (ADS)

    Bushinsky, David A.

    2007-04-01

    Given evidence for a genetic cause of hypercalciuria, we screened adult male and female Sprague-Dawley (SD) rats for hypercalciuria and used those with the highest urinary calcium excretion to breed the next generation, followed by subsequent selection and inbreeding of their most hypercalciuric progeny. By the 30th generation, and continuing to the present, the GHS rats (for Genetic Hypercalciuric Stone-forming rats) excrete 8-10 times as much calcium as simultaneously studied control rats The GHS rats were found to have defects in calcium transport in the intestine, kidneys and bone, similar to abnormalities found in many patients with idiopathic hypercalciuria. The GHS rats also form kidney stones. By the conclusion of an 18 wk study, all of the GHS rats formed stones, while there was no stone formation in similarly treated SD controls. The GHS rats, when fed a standard 1.2% calcium diet, form only poorly crystalline apatite stones. However, when 5% hydroxyproline is added to the diet of the GHS rats, they form only calcium oxalate stones.

  20. Gout

    MedlinePlus

    ... tophi. You have kidney disease or uric acid kidney stones . Diet and lifestyle changes may help prevent gouty ... Complications may include: Chronic gouty arthritis Kidney stones Deposits in the kidneys, leading to chronic kidney failure

  1. Liver Resection for Intrahepatic Stones

    PubMed Central

    Tranberg, Karl-Göran; Beng-Mark, Stig

    1990-01-01

    Intrahepatic stones are difficult to manage, especially when they are associated with bile duct stricture, cholangitis and destruction of liver parenchyma. Suggested modes of treatment include surgical bile duct exploration, endoscopic procedures, transhepatic cholangiolithotomy and liver resection. This paper reports 2 patients in whom liver resection was performed because of intrahepatic ductal stones, bile duct strictures and repeated episodes of cholangitis. Liver resection was uncomplicated and long-term results were satisfactory. Our results support the view that liver resection is indicated in rare instances of intrahepatic bile duct stones associated with bile duct strictures. PMID:2278909

  2. Nephroliths and ureteroliths: a new stone age.

    PubMed

    Adams, L G

    2013-07-01

    Nephroliths may obstruct the renal pelvis or ureter, predispose to pyelonephritis, or result in compressive injury of the renal parenchyma leading to progressive chronic kidney disease. Indications for removal of nephroliths in dogs include obstruction, recurrent infection, progressive nephrolith enlargement, presence of clinical signs (renal pain), and patients with nephroliths in a solitary functional kidney. The most common indication for removal of upper tract uroliths in cats is ureteral obstruction caused by ureteroliths. Nonobstructive nephroliths in cats are not usually treated unless they move into the ureter resulting in ureteral obstruction. The treatment approach to nephroliths and ureteroliths is different for dogs versus cats. Surgical removal of nephroliths or ureteroliths by nephrotomy and ureterotomy respectively is associated with potential for complications in more than 30% of cats treated by ureterotomy; therefore, minimally invasive options should also be considered. Extracorporeal shock wave lithotripsy (ESWL) treatment of nephroliths results in small "passable" stone fragments in most dogs, whereas ESWL does not work effectively in cats. Ureteral stents are effective for relief of ureteral obstruction by ureteroliths in both dogs and cats. Ureteral stents may be left in place long-term to relieve ureteral obstruction by ureteroliths. Post-operative morbidity and mortality are substantially lower for ureteral stent placement compared to open surgical ureterotomy in cats. PMID:23484823

  3. Androgens Involvement in the Pathogenesis of Renal Stones Formation

    PubMed Central

    Naghii, Mohammad Reza; Babaei, Mnasour; Hedayati, Mehdi

    2014-01-01

    Objective The potential role for the gonadal steroids in the pathogenesis of urolithiasis, higher mean of plasma oxalate concentration and kidney calcium oxalate deposition influenced by androgens in men has been proposed. In this study, the serum levels of steroid hormones as a pathogenesis of this condition in male patients with active renal stone disease compared with controls was investigated. Methods Forty patients diagnosed with renal stones and hospitalized for further clinical treatments or referred to our office after ultrasonographic evaluations participated in the study. Forty six healthy subjects served as controls. Steroid sex hormones in the plasma samples including testosterone, free testosterone, dihydrotestosterone, estradiol, and sex hormone binding globulin were analyzed. Results A significant difference was observed between patients and the control subjects regarding serum testosterone, free testosterone, dihydrotestosterone, estradiol, and sex hormone binding globulin. Conclusions Based on the results, a higher androgens level was diagnosed in renal stone patients, indicating a possibility of a substantial pathogenic role of testosterone, free testosterone, and dihydrotestosterone involvement in the pathogenesis of renal stones formation. Therefore, data presentation and further investigation on the relation between male steroids and urolithiasis is of importance and should be considered in evaluation of the etiology of the disease. PMID:24695421

  4. Adhesion of calcium oxalate crystals to Madin-Darby canine kidney cells and some effects of glycosaminoglycans or cell injuries.

    PubMed

    Ebisuno, S; Kohjimoto, Y; Tamura, M; Ohkawa, T

    1995-01-01

    The present investigation studied the quantitative adhesion of calcium oxalate monohydrate (COM) crystals to the surface of Madin-Darby canine kidney cells, which exhibit many characteristics of renal cortical collecting tubule cells. COM crystals adhered to the cell surface, and the attachment showed a time and concentration dependency with plateau. The results suggested that the attachment of microcrystals to the cortical tubular cell might be one of the earliest processes in the formation of kidney stones. Pretreatment with glycosaminoglycans significantly reduced the adherent crystals. Injuries to the Madin-Darby cells induced by 0.1 M HCl and gentamicin resulted in significant decreases of COM crystal adhesion to the cell surface. It was suggested that urinary glycosaminoglycans might play some critical role in preventing crystal adhesion to these cellular membranes and that cell injuries might not be essential for the attachment of microcrystals to the tubular cells. PMID:8521899

  5. Kidney biomimicry--a rediscovered scientific field that could provide hope to patients with kidney disease.

    PubMed

    Stenvinkel, Peter; Johnson, Richard J

    2013-11-01

    Most studies on kidney disease have relied on classic experimental studies in mice and rats or clinical studies in humans. From such studies much understanding of the physiology and pathophysiology of kidney disease has been obtained. However, breakthroughs in the prevention and treatment of kidney diseases have been relatively few, and new approaches to fight kidney disease are needed. Here we discuss kidney biomimicry as a new approach to understand kidney disease. Examples are given of how various animals have developed ways to prevent or respond to kidney failure, how to protect themselves from hypoxia or oxidative stress and from the scourge of hyperglycemia. We suggest that investigation of evolutionary biology and comparative physiology might provide new insights for the prevention and treatment of kidney disease. PMID:24220764

  6. Stone weathering in Southeast England

    NASA Astrophysics Data System (ADS)

    Jaynes, Suzanne M.; Cooke, R. U.

    A 2-year exposure programme of Portland stone and Monk's Park stone at 25 sites in SE England revealed significant differences in weight losses, changes in surface roughness and chemistry at each location that can be attributed to the activity of air pollutants and salts. In particular it was shown that weight loss of exposed samples can be attributed to both solution and sulphation (the latter probably contributing an average of at least 39% for Portland stone, 44% of Monk's Park stone); that salt attack of sheltered samples is evident at Bletchley (brickmaking) and coastal locations; and surface roughness changes, measured by Ra values on a Surfcom plotter, appear to be particularly sensitive to processes of surface disruption, such as salt weathering. Analysis of SO 2 data at the sites showed significantly higher concentrations at London sites. The corresponding gradient in weight loss was gentler, probably as the result of the influence of other atmospheric variables.

  7. Treatment of renal uric acid stone by extracorporeal shock wave lithotripsy combined with sodium bicarbonate: 2 case reports.

    PubMed

    Li, Hao-Yong; Lian, Pei-Yu; Zhou, Zhi-Yan; Song, Peng; Yan, Yi; Liu, Ji-Hong

    2015-01-01

    Uric acid stone is the most comment radiolucent renal stone with high recurrence rate, which would further cause acute upper urinary tract obstruction and kidney failure. Here we report two cases of renal uric acid stone from December 2012 to April 2013. One 43-year-old male patient suffered from chronic uric acid nephrolithiasis caused by the long-term indwelling of bilateral double-J stent. Another 69-year-old patient was also diagnosed with uric acid nephrolithiasis at the right kidney. Both patients were first treated with extracorporeal shock wave lithotripsy (ESWL), followed by 1.5% sodium bicarbonate dissolution therapy. After a week of the treatment, the uric acid stones in both patients were completely dissolved without retrograde infection. In summary, the use of ESWL and sodium bicarbonate dissolution therapy as a combined modality is a safe, effective, inexpensive treatment for uric acid nephrolithiasis. PMID:26550383

  8. Treatment of renal uric acid stone by extracorporeal shock wave lithotripsy combined with sodium bicarbonate: 2 case reports

    PubMed Central

    Li, Hao-Yong; Lian, Pei-Yu; Zhou, Zhi-Yan; Song, Peng; Yan, Yi; Liu, Ji-Hong

    2015-01-01

    Uric acid stone is the most comment radiolucent renal stone with high recurrence rate, which would further cause acute upper urinary tract obstruction and kidney failure. Here we report two cases of renal uric acid stone from December 2012 to April 2013. One 43-year-old male patient suffered from chronic uric acid nephrolithiasis caused by the long-term indwelling of bilateral double-J stent. Another 69-year-old patient was also diagnosed with uric acid nephrolithiasis at the right kidney. Both patients were first treated with extracorporeal shock wave lithotripsy (ESWL), followed by 1.5% sodium bicarbonate dissolution therapy. After a week of the treatment, the uric acid stones in both patients were completely dissolved without retrograde infection. In summary, the use of ESWL and sodium bicarbonate dissolution therapy as a combined modality is a safe, effective, inexpensive treatment for uric acid nephrolithiasis. PMID:26550383

  9. Optimal Management of Lower Polar Calyceal Stone 15 to 20 mm

    PubMed Central

    Haroon, Naveed; Nazim, Syed M

    2013-01-01

    Purpose To compare the stone clearance rate, efficiency quotient (EQ), and early complications of shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) for solitary lower-pole renal stones measuring 15 to 20 mm. Materials and Methods This was a retrospective matched-pair analysis of 142 patients (78 in the SWL and 64 in the PCNL group). Preoperative imaging was done by use of noncontrast computed tomography (CT kidney, ureter, and bladder [KUB]), intravenous urogram, or plain X-ray and ultrasound KUB to assess the largest dimension of the stones. Only patients with radiopaque stones were included. The stone-free rates were assessed with plain X-ray and ultrasound at 4 weeks. Data were analyzed by use of SPSS ver. 19. Results The patients' demographic profiles (age, body mass index) and the stone sizes were comparable in the two groups. The mean stone size was 17.4±2.12 in the PCNL group compared with 17.67±2.04 in the SWL group (p=0.45). At 4 weeks, 83% of patients undergoing PCNL were stone-free compared with 51% in the SWL group (p<0.001). The EQ for the PCNL group was 76% compared with 44% for the SWL group (p<0.001). Ancillary procedures were required by 9% of patients in the PCNL group compared with 15% in the SWL group. The complication rate was 19% in both groups. The SWL complications were minor. Conclusions Stone clearance from the lower pole of solitary stones sized 15 to 20 mm at the greatest diameter following SWL is poorer. These calculi can be better managed with percutaneous surgery owing to its higher efficacy and acceptably low morbidity. PMID:23614064

  10. Anuria in a 9-Month-Old Infant Resulting from Ureteral Cystine Stones

    PubMed Central

    2011-01-01

    Pediatric urolithiasis and calcular anuria in early infancy are rare. Cystine stones may develop in utero or during early infancy. We report the case of a female 9-month-old infant with obstructive anuria resulting from cystine stones in a single functioning unit. She presented to the emergency department owing to the absence of micturition for 3 days. Radiological investigations revealed four left ureteral stones and an atrophic right kidney resulting from a calcular obstruction. Her laboratory values were as follows: serum creatinine 6.7 mg/dl, Na 132 mEq/l, K 6 mg/dl, and hematocrit 32%. An urgent percutaneous nephrostomy tube was inserted into the left side for urinary drainage, and her serum levels of creatinine and K returned to normal within 3 days. A left ureterolithotomy was the final management. Stone analysis revealed pure cystine crystals. PMID:22025963

  11. Anuria in a 9-month-old infant resulting from ureteral cystine stones.

    PubMed

    Aboutaleb, Hamdy

    2011-09-01

    Pediatric urolithiasis and calcular anuria in early infancy are rare. Cystine stones may develop in utero or during early infancy. We report the case of a female 9-month-old infant with obstructive anuria resulting from cystine stones in a single functioning unit. She presented to the emergency department owing to the absence of micturition for 3 days. Radiological investigations revealed four left ureteral stones and an atrophic right kidney resulting from a calcular obstruction. Her laboratory values were as follows: serum creatinine 6.7 mg/dl, Na 132 mEq/l, K 6 mg/dl, and hematocrit 32%. An urgent percutaneous nephrostomy tube was inserted into the left side for urinary drainage, and her serum levels of creatinine and K returned to normal within 3 days. A left ureterolithotomy was the final management. Stone analysis revealed pure cystine crystals. PMID:22025963

  12. Kidney Cancer

    MedlinePlus

    You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and ... blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes ...

  13. Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure.

    PubMed

    Shafi, Hamid; Shahandeh, Zahra; Heidari, Behzad; Sedigiani, Farahnaz; Ramaji, Arsalan Ali; Pasha, Yousef Reza Yousefnia; Kassaeian, Ali Akbar; Pasha, Abazar Akbarzadeh; Mir, Mir Muhammad Reza Aghajani

    2013-03-01

    This study was conducted to determine the composition of staghorn stones and to assess the proportion of infected stones as well as the correlation between infection in the stones and bacteria grown in urine. Samples of 45 consecutive stones removed through anatrophic nephrolithotomic procedures were taken from the operation site and samples of urine were obtained by simultaneous bladder catheterization. The frequency of infection in the stones and correlation between infection of stone and urine samples were determined with respect to the composition of the stones. Twenty-two males and 23 females, with respective mean ages of 48.3 ± 15.6 years and 51 ± 7.4 years, were studied. The stone and urine cultures yielded positive results in ten and 16 patients, respectively, of a total of 45 patients (22.2% and 35.5%, respectively). Calcium oxalate was the main constituent of staghorn stones, seen in 31 patients (68.8%), uric acid in 12 patients (26.6%) and struvite and/or calcium phosphate in 11 patients (24.4%). In seven of ten stones with bacterial growth, bacteria were isolated from urine cultures as well, which accounted for a concordance rate of 70%. The bacteria grown in the stone were the cause of urinary tract infection (UTI) in 43.5% of the cases. Stone infection was significantly associated with UTI (OR = 6.47; 95% CI 1.43-31.7, P = 0.021) and presence of phosphate in the stones (OR = 18, 95% CI 3.28-99.6, P = 0.0006). E. coli was the most common bacteria grown from the stones, and was isolated in 50% of the cases; Ureaplasma urealyticum was the most common organism causing UTI, grown in 62.5% of the urine samples. There was a high concordance rate between bacteria in the stones and urine. These findings indicate that the urine culture can provide information for selection of an appropriate anti-microbial agent for stone sterilization. In addition, preventing re-growth or recurrence of stones and treatment of post-surgical infections would be facilitated based on the results of the urine culture. PMID:23538378

  14. The Stepping Stone Approach

    NASA Astrophysics Data System (ADS)

    Brumfitt, A.

    Education is a profession in its own right. It has its own parameters, passions and language. Having the responsibility both of educare and educere, education has a focus of delivering specific factual knowledge whilst drawing out the creative mind. Space Science is a special vehicle having the properties of both educare and educere. It has a magic and wonder that touches the very essence of an individual and his place in time and space; it offers the "wow" factor that all teachers strive for. Space Science is the wrapping paper for other elements in the curriculum, e.g. cross-curricula and skill-based activities, such as language development, creativity, etc. as well as the pure sciences which comprise of engineering, physics and other natural sciences from astronomy to chemistry to biology. Each of these spheres of influence are relevant from kindergarten to undergraduate studies and complement, and in addition support informal education in museums, science centers and the world of e-learning. ESA Science Education has devised the "Stepping Stone Approach" to maximize the greatest outreach to all education stakeholders in Europe. In this paper we illustrate how to best reach these target groups with very specific activities to trigger and sustain enthusiasm whilst supporting the pedagogical, subject content and skill-based needs of a prescribed curriculum.

  15. Lunar stone saw

    NASA Technical Reports Server (NTRS)

    Clark, Tom; Croker, Todd; Hines, Ken; Knight, Mike; Walton, Todd

    1988-01-01

    This project addresses the problem of cutting lunar stones into blocks to be used to construct shelters to protect personnel and equipment from harmful solar radiation. This plant will manufacture 6 in x 1 ft x 2 ft blocks and will be located near the south pole to allow it to be in the shade at all times. This design uses a computer controlled robot, a boulder handler that uses hydraulics for movement, a computer system that used 3-D vision to determine the size of boulders, a polycrystalline diamond tipped saw blade that utilizes radiation for cooling, and a solar tower to collect solar energy. Only two electric motors are used in this plant because of the heavy weight of electric motors and the problem of cooling them. These two motors will be cooled by thermoelectric cooling. All other motors and actuators are to be hydraulic. The architectural design for the building as well as the conceptual design of the machines for cutting the blocks are described.

  16. Silodosin vs tamsulosin in the management of distal ureteric stones: A prospective randomised study

    PubMed Central

    Elgalaly, Hazem; Sakr, Ahmed; Fawzi, Amr; Salem, Emad A.; Desoky, Esam; Shahin, Ashraf; Kamel, Mostafa

    2015-01-01

    Objectives To compare the efficacy of silodosin (8 mg) vs tamsulosin (0.4 mg), as a medical expulsive therapy, in the management of distal ureteric stones (DUS) in terms of stone clearance rate and stone expulsion time. Patients and methods A prospective randomised study was conducted on 115 patients, aged 21–55 years, who had unilateral DUS of ⩽10 mm. Patients were divided into two groups. Group 1 received silodosin (8 mg) and Group 2 received tamsulosin (0.4 mg) daily for 1 month. The patients were followed-up by ultrasonography, plain abdominal radiograph of the kidneys, ureters and bladder, and computed tomography (in some cases). Results There was a significantly higher stone clearance rate of 83% in Group 1 vs 57% in Group 2 (P = 0.007). Group 1 also showed a significant advantage for stone expulsion time and analgesic use. Four patients, two in each group, discontinued the treatment in first few days due to side-effects (orthostatic hypotension). No severe complications were recorded during the treatment period. Retrograde ejaculation was recorded in nine and three patients in Groups 1 and 2, respectively. Conclusion Our data show that silodosin is more effective than tamsulosin in the management of DUS for stone clearance rates and stone expulsion times. A multicentre study on larger scale is needed to confirm the efficacy and safety of silodosin. PMID:26966587

  17. Laparoscopic-assisted mini percutaneous nephrolithotomy in the ectopic pelvic kidney: Outcomes with the laser dusting technique

    PubMed Central

    D’souza, Nischith; Verma, Ashish; Rai, Avinash

    2016-01-01

    Introduction: The treatment of renal lithiasis has undergone a sea change with the advent of extracorporeal shock wave lithotripsy (ESWL) and endourological procedures such as percutaneous nephrolithotomy (PCNL), ureterorenoscopy and retrograde intrarenal surgery (RIRS). The presence of anatomical anomalies, such as ectopic pelvic kidney, imposes limitations to such therapeutic procedures. This study is aimed to find a simple and effective way to treat the stones in ectopic kidney. Materials and Methods: From 2010 to 2014, nine patients underwent laparoscopic-assisted mini PCNL with Laser dusting for calculi in ectopic pelvic kidneys at our hospital. Retrograde pyelography was done to locate the kidney. Laparoscopy was performed and after mobilizing the bowel and peritoneum, the puncture was made in the kidney and using rigid mini nephroscope, and stones were dusted with Laser. Results: The median interquartile range (IQR) stone size was 18 (6.5) mm. Median (IQR) duration of the procedure was 90 (40) min. The median (IQR) duration of postoperative hospital stay was 4 (2) days. The stone clearance in our series was 88.9%, with only one patient having a residual stone. No intra- or post-operative complications were encountered. Conclusion: Laparoscopy-assisted mini PCNL with Laser dusting offers advantages in ectopic pelvic kidneys in achieving good stone clearance, especially in patients with a large stone burden or failed ESWL or RIRS. PMID:26834410

  18. Purbeck Stone - A possible Global Heritage Stone from England

    NASA Astrophysics Data System (ADS)

    Marker, Brian

    2014-05-01

    By definition, a Global Heritage Stone Resource (GHSR) should have international significance. The Purbeck Group of uppermost Jurassic to lowermost Cretaceous age (Tithonian- Berriasian) outcrops mainly in the Purbeck area of Dorset, England. It was deposited in shallow freshwater to brackish lagoons with occasional marine incursions. Limestones, mainly biosparites, occur at 6 main levels. Differences in bed thickness, jointing and hardness make it suitable for a variety of purposes including dimension stone, monumental and ornamental stone, roofing tiles, paving, flooring and rockery stone. Near the top of the sequence is a dark gastropod biosparite, traditionally called Purbeck Marble, easily carved, which has been extensively used for decorative interior work in churches and cathedrals particularly for fonts, tombs, flooring and facings on columns for example in the medieval cathedrals of Salisbury, Exeter, Durham, York and Wells and Worcester and Westminster Abbey. The stone was extracted at least from Roman times (1st century AD) through the medieval period. Quarrying expanded from about 1700 reaching a peak in the late 18th and 19th centuries. Stone was transported first by sea but later by rail for wider use. Used in many local buildings, it gives an important element of local character. Many of the villages are designated conservation areas with a requirement for repair, maintenance and new building using local stone. Initially the stone was taken from quarries but was later mined. The number of operating companies declined from 15 to 5 over the past 40 years, with 10 active small quarries. Outputs are from few hundred tonnes to a few thousand tonnes per annum or about 9 to 12 years of permitted reserves but the Planning Authority intends to make sufficient provision for production at recent levels for their development plan period. The extraction sites are in an Area of Outstanding Natural Beauty and close to Jurassic Coast World Heritage Site. This might be a test case for considering whether a stone with this history is significant enough to be designated as a GHSR or is, rather, of national significance.

  19. Urinary stones in Eastern Saudi Arabia

    PubMed Central

    Alkhunaizi, Ahmed Mansour

    2016-01-01

    Introduction: Nephrolithiasis is a common problem worldwide especially in areas of the hot climate like Saudi Arabia. The aim of this analysis was to study the characteristics of urinary stones in Eastern Saudi Arabia and to report the following: Composition of urinary stones, age and gender distribution, seasonal variation of stone development, comorbid conditions associated with stone development and the incidence of urinary stones. Methods: All urinary stones that were submitted to the Johns Hopkins Aramco Healthcare, previously Saudi Aramco Medical Services Organization for analysis from January 2011 through January 2013 were analyzed. Results: A total of 384 urinary stones were collected and submitted for analysis from 347 patients. There was a male predominance with a male: female ratio of 3.9:1. The average age was 48.5 ± 12.8 years. Weight abnormality was predominant in both genders, and especially females. Calcium-based stones constituted the great majority (84.6%) followed by uric acid stones (12.8%). The other forms of stones were rare. More stones were recovered during the hot season, May to September. The calculated annual incidence of urolithiasis was 111/100,000 individuals. Conclusion: Calcium based stones are the most common urinary stones observed in Eastern Saudi Arabia. There is a clear association between the diagnosis of urinary stones and the hot season PMID:26834393

  20. Chronic Kidney Diseases

    MedlinePlus

    ... Skiing, Snowboarding, Skating Crushes What's a Booger? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  1. Kidney (Renal) Failure

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, ... evaluated? How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain ...

  2. Kidney disease - resources

    MedlinePlus

    Resources - kidney disease ... The following organizations are good resources for information on kidney disease: National Kidney Disease Education Program -- www.nkdep.nih.gov National Kidney Foundation -- www.kidney.org National ...

  3. Chronic Kidney Disease (CKD)

    MedlinePlus

    ... kidneys Your kidneys are vital organs that remove waste and extra fluid from your blood. Chronic kidney ... kidneys Your kidneys are vital organs that remove waste and extra fluid from your blood. Tests for ...

  4. Tests for Kidney Health

    MedlinePlus

    ... kidneys Your kidneys are vital organs that remove waste and extra fluid from your blood. Chronic kidney ... kidneys Your kidneys are vital organs that remove waste and extra fluid from your blood. Tests for ...

  5. Fluid dynamic modelling of renal pelvic pressure during endoscopic stone removal

    NASA Astrophysics Data System (ADS)

    Oratis, Alexandros; Subasic, John; Bird, James; Eisner, Brian

    2015-11-01

    Endoscopic kidney stone removal procedures are known to increase internal pressure in the renal pelvis, the kidney's urinary collecting system. High renal pelvic pressure incites systemic absorption of irrigation fluid, which can increase the risk of postoperative fever and sepsis or the unwanted absorption of electrolytes. Urologists choose the appropriate surgical procedure based on patient history and kidney stone size. However, no study has been conducted to compare the pressure profiles of each procedure, nor is there a precise sense of how the renal pelvic pressure scales with various operational parameters. Here we develop physical models for the flow rates and renal pelvic pressure for various procedures. We show that the results of our models are consistent with existing urological data on each procedure and that the models can predict pressure profiles where data is unavailable.

  6. Renal cell carcinoma in a natural remaining kidney after two kidney transplantations. Case report.

    PubMed

    Jekunen, A; Maiche, A; Rissanen, P; Virkkunen, P

    1994-06-01

    A 57-year-old woman with nephropathy following a streptococcal infection had received a kidney transplant in 1980 and 1986 and immunosuppressive treatment since 1980. Renal cell carcinoma was found in the right native kidney in 1991, with skeletal metastases. Nephrectomy was performed and radiotherapy given. Removal of non-functioning kidneys would prevent development of such cancer. PMID:7939471

  7. Kidney Failure

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. October 2, 2013 Contact Us Health Information Center Phone: 1-800-860- ...

  8. Keeping kidneys.

    PubMed

    2012-10-01

    Most countries struggle to meet the demand for transplant kidneys, but a few are reaping the benefits of systems dedicated to increasing the number of organ donations after death. Ben Jones and Mireia Bes report. PMID:23109738

  9. Kidney removal

    MedlinePlus

    ... removed (simple nephrectomy) Removal of one entire kidney, surrounding fat, and the adrenal gland (radical nephrectomy). In ... removed. Your surgeon will also take out the surrounding fat, and sometimes the adrenal gland and some ...

  10. Usefulness of hounsfield unit and density in the assessment and treatment of urinary stones

    PubMed Central

    Gücük, Adnan; Üyetürk, Uğur

    2014-01-01

    Computed tomography (CT) is widely used to examine stones in the urinary system. In addition to the size and location of the stone and the overall health of the kidney, CT can also assess the density of the stone in Hounsfield units (HU). The HU, or Hounsfield density, measured by CT, is related to the density of the tissue or stone. A number of studies have assessed the use of HU in urology. HUs have been used to predict the type and opacity of stones during diagnosis, and the efficacy has been assessed using methods including extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopic ureterolithotripsy (URSL), and medical expulsive treatment (MET). Previous studies have focused on the success rate of HU for predicting the type of stone and of ESWL treatment. Understanding the composition of the stone plays a key role in determining the most appropriate treatment modality. The most recent reports have suggested that the HU value and its variants facilitate prediction of stone composition. However, the inclusion of data regarding urine, such as pH and presence of crystals, increases the predictive accuracy. HUs, which now form part of the clinical guidelines, allow us to predict the success of ESWL; therefore, they should be taken into account when ESWL is considered as a treatment option. However, there are currently insufficient data available regarding the value of HU for assessing the efficacy of PCNL, URSL, and MET. Studies performed to date suggest that these values would make a significant contribution to the diagnosis and treatment of urinary system stones. However, more data are required to assess this further. PMID:25374823

  11. The elementome of calcium-based urinary stones and its role in urolithiasis.

    PubMed

    Ramaswamy, Krishna; Killilea, David W; Kapahi, Pankaj; Kahn, Arnold J; Chi, Thomas; Stoller, Marshall L

    2015-10-01

    Urolithiasis affects around 10% of the US population with an increasing rate of prevalence, recurrence and penetrance. The causes for the formation of most urinary calculi remain poorly understood, but obtaining the chemical composition of these stones might help identify key aspects of this process and new targets for treatment. The majority of urinary stones are composed of calcium that is complexed in a crystalline matrix with organic and inorganic components. Surprisingly, mitigation of urolithiasis risk by altering calcium homeostasis has not been very effective. Thus, studies to identify other therapeutic stone-specific targets, using proteomics, metabolomics and microscopy techniques, have been conducted, revealing a high level of complexity. The data suggest that numerous metals other than calcium and many nonmetals are present within calculi at measurable levels and several have distinct distribution patterns. Manipulation of the levels of some of these elemental components of calcium-based stones has resulted in clinically beneficial changes in stone chemistry and rate of stone formation. The elementome--the full spectrum of elemental content--of calcium-based urinary calculi is emerging as a new concept in stone research that continues to provide important insights for improved understanding and prevention of urinary stone disease. PMID:26334088

  12. The elementome of calcium-based urinary stones and its role in urolithiasis

    PubMed Central

    Ramaswamy, Krishna; Killilea, David W.; Kapahi, Pankaj; Kahn, Arnold J.; Chi, Thomas; Stoller, Marshall L.

    2016-01-01

    Urolithiasis affects around 10% of the US population with an increasing rate of prevalence, recurrence and penetrance. The causes for the formation of most urinary calculi remain poorly understood, but obtaining the chemical composition of these stones might help identify key aspects of this process and new targets for treatment. The majority of urinary stones are composed of calcium that is complexed in a crystalline matrix with organic and inorganic components. Surprisingly, mitigation of urolithiasis risk by altering calcium homeostasis has not been very effective. Thus, studies to identify other therapeutic stone-specific targets, using proteomics, metabolomics and microscopy techniques, have been conducted, revealing a high level of complexity. The data suggest that numerous metals other than calcium and many nonmetals are present within calculi at measurable levels and several have distinct distribution patterns. Manipulation of the levels of some of these elemental components of calcium-based stones has resulted in clinically beneficial changes in stone chemistry and rate of stone formation. The elementome—the full spectrum of elemental content—of calcium-based urinary calculi is emerging as a new concept in stone research that continues to provide important insights for improved understanding and prevention of urinary stone disease. PMID:26334088

  13. Bioreceptivity of building stones: a review.

    PubMed

    Miller, A Z; Sanmartín, P; Pereira-Pardo, L; Dionísio, A; Saiz-Jimenez, C; Macedo, M F; Prieto, B

    2012-06-01

    In 1995, Guillitte defined bioreceptivity, a new term in ecology, as the ability of a material to be colonized by living organisms. Information about the bioreceptivity of stone is of great importance since it will help us to understand the material properties which influence the development of biological colonization in the built environment, and will also provide useful information as regards selecting stones for the conservation of heritage monuments and construction of new buildings. Studies of the bioreceptivity of stone materials are reviewed here with the aim of providing a clear set of conclusions on the topic. Definitions of bioreceptivity are given, stone bioreceptivity experiments are described, and finally the stone properties related to bioreceptivity are discussed. We suggest that a standardized laboratory protocol for evaluating stone bioreceptivity and definition of a stone bioreceptivity index are required to enable creation of a database on the primary bioreceptivity of stone materials. PMID:22534363

  14. Gender Distribution of Pediatric Stone Formers

    NASA Astrophysics Data System (ADS)

    Novak, Thomas E.; Trock, Bruce J.; Lakshmanan, Yegappan; Gearhart, John P.; Matlaga, Brian R.

    2008-09-01

    Recent epidemiologic evidence suggests that the gender prevalence among adult stone-formers is changing, with an increasing incidence of stone disease among women. No similar data have ever been reported for the pediatric stone-forming population. We performed a study to define the gender distribution among pediatric stone-formers using a large-scale national pediatric database. Our findings suggest that gender distribution among stone formers varies by age with male predominance in the first decade of life shifting to female predominance in the second decade. In contrast to adults, females in the pediatric population are more commonly affected by stones than are males. The incidence of pediatric stone disease appears to be increasing at a great rate in both sexes. Further studies should build on this hypothesis-generating work and define the effects of metabolic and environmental risk factors that may influence stone risk in the pediatric patient population

  15. "Stone Age" Fun: Releasing the Animal Within.

    ERIC Educational Resources Information Center

    Geist, Janet Marie

    2000-01-01

    Discusses a fifth-grade sculpture project that uses a subtractive, rather than additive, technique. Students carve an animal sculpture from a block of simulated stone compound. Explains the process and how to make the simulated stone compound. (CMK)

  16. Baicalein, a Bioflavonoid, Prevents Cisplatin-Induced Acute Kidney Injury by Up-Regulating Antioxidant Defenses and Down-Regulating the MAPKs and NF-κB Pathways

    PubMed Central

    Sahu, Bidya Dhar; Kumar, Jerald Mahesh; Sistla, Ramakrishna

    2015-01-01

    Acute renal failure is a serious complication of the anticancer drug cisplatin. The potential role of baicalein, a naturally occurring bioflavonoid on cisplatin-induced renal injury is unknown. Here, we assessed the effect of baicalein against a murine model of cisplatin-induced acute renal failure and investigated the underlying possible mechanisms. Renal function, kidney histology, inflammation, oxidative stress, renal mitochondrial function, proteins involved in apoptosis, nuclear translocation of Nrf2 and effects on intracellular signaling pathways such as MAPKs, and NF-κB were assessed. Pretreatment with baicalein ameliorated the cisplatin-induced renal oxidative stress, apoptosis and inflammation and improved kidney injury and function. Baicalein inhibited the cisplatin-induced expression of iNOS, TNF-α, IL-6 and mononuclear cell infiltration and concealed redox-sensitive transcription factor NF-κB activation via reduced DNA-binding activity, IκBα phosphorylation and p65 nuclear translocation in kidneys. Further studies demonstrated baicalein markedly attenuated cisplatin-induced p38 MAPK, ERK1/2 and JNK phosphorylation in kidneys. Baicalein also restored the renal antioxidants and increased the amount of total and nuclear accumulation of Nrf2 and downstream target protein, HO-1 in kidneys. Moreover, baicalein preserved mitochondrial respiratory enzyme activities and inhibited cisplatin-induced apoptosis by suppressing p53 expression, Bax/Bcl-2 imbalance, cytochrome c release and activation of caspase-9, caspase-3 and PARP. Our findings suggest that baicalein ameliorates cisplatin-induced renal damage through up-regulation of antioxidant defense mechanisms and down regulation of the MAPKs and NF-κB signaling pathways. PMID:26222683

  17. Luserna Stone: A nomination for "Global Heritage Stone Resource"

    NASA Astrophysics Data System (ADS)

    Primavori, Piero

    2015-04-01

    Luserna Stone (Pietra di Luserna) is the commercial name of a grey-greenish leucogranitic orthogneiss, probably from the Lower Permian Age, that outcrops in the Luserna-Infernotto basin (Cottian Alps, Piedmont, NW Italy) on the border between the Turin and Cuneo provinces. Geologically speaking, it pertains to the Dora-Maira Massif that represents a part of the ancient European margin annexed to the Cottian Alps during the Alpine orogenesis; from a petrographic point of view, it is the metamorphic result of a late-Ercinian leucogranitic rock transformation. Lithological features and building applications allow the recognition of two main varieties: 1) a micro-augen gneiss with very regular schistosity planes with centimetric spacing and easy split workability, known as Splittable facies; 2) a micro-Augen gneiss characterized by lower schistosity and poor split, suitable for blocks cutting machines (diamond wires, gang-saws, traditional saws), known as Massive facies. A third, rare, white variety also exists, called "Bianchetta". Luserna stone extends over an area of approximately 50 km2, where more than fifty quarries are in operation, together with a relevant number of processing plants and artisanal laboratories. The stone is quarried and processed since almost the Middle Age, and currently represents one of the three most important siliceous production cluster in Italy (together with the Ossola and Sardegna Island granites). Some characteristics of this stone - such as the relevant physical-mechanical properties, an intrinsic versatility and its peculiar splittability - have made it one of the most widely used stone materials in Italy and in the countries surrounding the North Western border of Italy. Apart from its intrinsic geological, petrographic, commercial and technical properties, several issues related to the Luserna Stone are considered to be of relevant importance for its designation as a Global Heritage Stone Resource, such as the distinctive mark on the architecture and urban landscape of many areas in NW Italy, some quite peculiar applications (for ex.: the "so-called "loze" or "lose", for the traditional roofing in alpine buildings) and the related constructive culture, the presence of an Eco-Museum, the occurrence of a local Fair (Pietra & Meccanizzazione), and many other important aspects.

  18. 77 FR 27245 - Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ... Fish and Wildlife Service Big Stone National Wildlife Refuge, Big Stone and Lac Qui Parle Counties, MN... comprehensive conservation plan (CCP) and environmental assessment (EA) for Big Stone National Wildlife Refuge...: r3planning@fws.gov . Include ``Big Stone Draft CCP/ EA'' in the subject line of the message. Fax:...

  19. Metabolic Syndrome after Kidney Transplantation - Are You at Risk?

    MedlinePlus

    ... Sign up for our FREE magazine, Kidney Living Organ Donation & Transplantation Be an Organ Donor Living Donation Donor ... Giving Primary menu Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate Search Search Header ...

  20. Extracorporeal stone disintegration using chemical explosive pellets as an energy source of underwater shock waves.

    PubMed

    Kuwahara, M; Kambe, K; Kurosu, S; Orikasa, S; Takayama, K

    1986-04-01

    Extracorporeal renal stone disintegration using a chemical explosive pellet (lead azide 10 mg.) as an energy source of underwater shock waves has been successfully performed in animals. The shock wave was observed by holographic interferometry. Shock wave generation was performed by a reflector whose configuration was part of a pseudoellipsoid. The explosions were conducted 10 to 100 times for each animal and the stone (extracted human renal calculus or model calculus of activated alumina) placed in the renal pelvis was disintegrated satisfactorily. Negative findings in explorative laparotomy and histological examination, except for minor bleeding in several tubular lumina of the kidney, indicated that the method was clinically applicable. PMID:3959213

  1. Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases

    PubMed Central

    2014-01-01

    Background In most hospitals, several options for the management of renal stones are available: shockwave lithotripsy, endourologic treatment, or surgery. Choice of treatment is based on the anatomic characteristics of the patient, and the location and size of the stones. In this study we assessed a retroperitoneal laparoscopic technique for treatment of complex renal stones. Methods Seventy-five patients, including 53 men and 22 women with a mean age of 47.8 years (range 18–74 y), underwent retroperitoneal laparoscopy for the treatment of complex renal stones between July 2006 and November 2012 in our hospital. Results The retroperitoneal laparoscopic procedures for treatment of complex renal stones were completely successful in 73 cases, while 2 cases converted to open surgery. The operative time was 85–190 min with a mean of 96 min. The estimated blood lost was 20–400 mL with a mean of 80 mL. After the operation 7 patients experienced urinary leakage. Ultrasonography, x-ray of the kidney, ureter and bladder, and intravenous urography were reviewed at post-procedural follow-up at 6–82 months. No hydronephrosis aggravation was found, and there was no calculus recurrence. Conclusion The merits of retroperitoneal laparoscopy for the treatment of complex renal stones include sparing the nephron, less bleeding, short hospitalization, quick postoperative recovery, and controllable procedure after training Success depends on the experience of surgeons and judicious selection of cases. PMID:24491207

  2. Retrograde Intrarenal Surgery in Patients Who Previously Underwent Open Renal Stone Surgery

    PubMed Central

    Alkan, Erdal; Saribacak, Ali; Ozkanli, Ahmet Oguz; Başar, Mehmet Murad; Acar, Oguz; Balbay, Mevlana Derya

    2015-01-01

    Purpose. To ascertain whether retrograde intrarenal surgery (RIRS) is as effective in patients treated previously with open renal stone surgery (ORSS) on the same kidney as in patients with no previous ORSS. Methods. There were 32 patients with renal stones who had previous ORSS and were treated with RIRS in the study group (Group 1). A total of 38 patients with renal stones who had no previous ORSS and were treated with RIRS were selected as the control group (Group 2). Recorded data regarding preoperative characteristics of the patients, stone properties, surgical parameters, outcomes, SFRs (no fragments or small fragments <4 mm), and complications between groups were compared. Results. Mean age, mean BMI, mean hospital stay, and mean operative time were not statistically different between groups. Mean stone size (10.1 ± 5.6 versus 10.3 ± 4.2; p = 0.551) and mean stone burden (25.4 ± 14.7 versus 23.5 ± 9.9; p = 0.504) were also similar between groups. After the second procedures, SFRs were 100% and 95% in groups 1 and 2, respectively (p = 0.496). No major perioperative complications were seen. Conclusion. RIRS can be safely and effectively performed with acceptable complication rates in patients treated previously with ORSS as in patients with no previous ORSS. PMID:26357570

  3. Urolithiasis in Tunisian children: a study of 120 cases based on stone composition.

    PubMed

    Kamoun, A; Daudon, M; Abdelmoula, J; Hamzaoui, M; Chaouachi, B; Houissa, T; Zghal, A; Ben Ammar, S; Belkahia, C; Lakhoua, R

    1999-11-01

    The composition of urinary stones in children depends on socioeconomic conditions and hygiene, geographical area, and dietary habits. We analyzed urinary stones from 120 consecutive Tunisian children (81 males, 39 females) aged 5 months to 15 years. The stone was located in the upper urinary tract in 91 cases (76%). Stone analysis included both a morphological examination and an infrared analysis of the nucleus and the inner and peripheral layers. The main components of bladder calculi were whewellite (69%) and struvite (22%), whereas the main component of upper urinary tract calculi was whewellite (67%). The nucleus of bladder stones was composed of ammonium urate (45%), struvite (28%), cystine (10%), and carbapatite (7%). The nucleus of kidney and ureteral calculi was mainly composed of ammonium urate (38%), whewellite (24%), carbapatite (13%), or struvite (11%). Based on stone composition, urinary tract infection was involved in the nucleation or growth of a third of calculi. Endemic urolithiasis involving simultaneous nutritional, metabolic, and infectious factors, and defined by its nucleus composed of ammonium urate without struvite, represented 40% of cases. Exclusive metabolic factors - including genetic diseases such as primary hyperoxaluria, cystinuria, and hypercalciuria - were responsible for less than 25% of cases. PMID:10603149

  4. Spironolactone to prevent cardiovascular events in early-stage chronic kidney disease (STOP-CKD): study protocol for a randomized controlled pilot trial

    PubMed Central

    2014-01-01

    Background Chronic kidney disease is associated with increased arterial stiffness even in the early stages and this is thought to be a key mediator in the pathophysiology of the increased cardiovascular risk associated with this condition. The use of low-dose spironolactone has previously been shown to improve arterial stiffness and reduce left ventricular mass safely in early-stage chronic kidney disease in the context of careful monitoring at a university hospital. However, the majority of patients with chronic kidney disease are managed by their general practitioners in the community. It is not known whether similar beneficial effects can be achieved safely using spironolactone in the primary care setting. The aim of this study is to determine whether low-dose spironolactone can safely lower arterial stiffness in patients with stage 3 chronic kidney disease in the primary care setting. Methods/design STOP-CKD is a multicentre, prospective, randomized, double-blind, placebo-controlled pilot trial of 240 adult patients with stage 3 chronic kidney disease recruited from up to 20 general practices in South Birmingham, England. Participants will be randomly allocated using a secured web-based computer randomization system to receive either spironolactone 25 mg once daily or a matching inactive placebo for 40 weeks, followed by a wash-out period of 6 weeks. Investigators, outcome assessors, data analysts and participants will all be blinded to the treatment allocation. The primary endpoint is improved arterial stiffness, as measured by carotid-femoral pulse wave velocity between baseline and 40 weeks. The secondary endpoints are incidence of hyperkalaemia, change in estimated glomerular filtration rate, change in urine albumin:creatinine ratio, change in brachial blood pressure, change in pulse waveform characteristics and overall tolerability of spironolactone. An additional quality control study, aiming to compare the laboratory serum potassium results of samples processed via two methods (utilizing routine transport or centrifugation on site before rapid transport to the laboratory) for 100 participants and a qualitative research study exploring patients’ and general practitioners’ attitudes to research and the use of spironolactone in chronic kidney disease in the community setting will be embedded in this pilot study. Trial registration Current Controlled Trials ISRCTN80658312. PMID:24886272

  5. Developing disease resistant stone fruits

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Stone fruit (Prunus spp.) (peach, nectarine, plum, apricot, cherry) and almonds are susceptible to a number of pathogens. These pathogens can cause extensive losses in the field, during transport and storage, and in the market. Breeding for disease resistance requires an extensive knowledge of the...

  6. Probabilistic Modeling of the Renal Stone Formation Module

    NASA Technical Reports Server (NTRS)

    Best, Lauren M.; Myers, Jerry G.; Goodenow, Debra A.; McRae, Michael P.; Jackson, Travis C.

    2013-01-01

    The Integrated Medical Model (IMM) is a probabilistic tool, used in mission planning decision making and medical systems risk assessments. The IMM project maintains a database of over 80 medical conditions that could occur during a spaceflight, documenting an incidence rate and end case scenarios for each. In some cases, where observational data are insufficient to adequately define the inflight medical risk, the IMM utilizes external probabilistic modules to model and estimate the event likelihoods. One such medical event of interest is an unpassed renal stone. Due to a high salt diet and high concentrations of calcium in the blood (due to bone depletion caused by unloading in the microgravity environment) astronauts are at a considerable elevated risk for developing renal calculi (nephrolithiasis) while in space. Lack of observed incidences of nephrolithiasis has led HRP to initiate the development of the Renal Stone Formation Module (RSFM) to create a probabilistic simulator capable of estimating the likelihood of symptomatic renal stone presentation in astronauts on exploration missions. The model consists of two major parts. The first is the probabilistic component, which utilizes probability distributions to assess the range of urine electrolyte parameters and a multivariate regression to transform estimated crystal density and size distributions to the likelihood of the presentation of nephrolithiasis symptoms. The second is a deterministic physical and chemical model of renal stone growth in the kidney developed by Kassemi et al. The probabilistic component of the renal stone model couples the input probability distributions describing the urine chemistry, astronaut physiology, and system parameters with the physical and chemical outputs and inputs to the deterministic stone growth model. These two parts of the model are necessary to capture the uncertainty in the likelihood estimate. The model will be driven by Monte Carlo simulations, continuously randomly sampling the probability distributions of the electrolyte concentrations and system parameters that are inputs into the deterministic model. The total urine chemistry concentrations are used to determine the urine chemistry activity using the Joint Expert Speciation System (JESS), a biochemistry model. Information used from JESS is then fed into the deterministic growth model. Outputs from JESS and the deterministic model are passed back to the probabilistic model where a multivariate regression is used to assess the likelihood of a stone forming and the likelihood of a stone requiring clinical intervention. The parameters used to determine to quantify these risks include: relative supersaturation (RS) of calcium oxalate, citrate/calcium ratio, crystal number density, total urine volume, pH, magnesium excretion, maximum stone width, and ureteral location. Methods and Validation: The RSFM is designed to perform a Monte Carlo simulation to generate probability distributions of clinically significant renal stones, as well as provide an associated uncertainty in the estimate. Initially, early versions will be used to test integration of the components and assess component validation and verification (V&V), with later versions used to address questions regarding design reference mission scenarios. Once integrated with the deterministic component, the credibility assessment of the integrated model will follow NASA STD 7009 requirements.

  7. Prevention of cardiac dysfunction, kidney fibrosis and lipid metabolic alterations in l-NAME hypertensive rats by sinapic acid-Role of HMG-CoA reductase.

    PubMed

    Silambarasan, Thangarasu; Manivannan, Jeganathan; Raja, Boobalan; Chatterjee, Suvro

    2016-04-15

    The present study was designed to evaluate the effect of sinapic acid, a bioactive phenolic acid on high blood pressure associated cardiac dysfunction, kidney fibrosis and lipid alterations in N(ω)-nitro-l-arginine methyl ester hydrochloride (l-NAME) induced hypertensive rats. Sinapic acid was administered to rats orally at a dosage of 40mg/kg everyday for a period of 4 weeks. Sinapic acid treatment significantly decreased mean arterial pressure, left ventricular end diastolic pressure, organ weights (liver and kidney), lipid peroxidation products in tissues (liver and kidney), activities of hepatic marker enzymes and the levels of renal function markers in serum of l-NAME rats. Sinapic acid treatment also significantly increased the level of plasma nitric oxide metabolites, and enzymatic and non-enzymatic antioxidants in tissues of l-NAME rats. Tissue damage was assessed by histopathological examination. Alterations in plasma angiotensin-converting enzyme activity, level of plasma lipoproteins and tissue lipids were corrected by sinapic acid treatment in l-NAME rats. Sinapic acid treatment significantly decreased the activity of 3-hydroxy-3-methylglutaryl-Coenzyme A (HMG-CoA) reductase in plasma and liver, whereas the activity of lecithin cholesterol acyl transferase was significantly increased in the plasma of hypertensive rats. Docking result showed the interaction between sinapic acid and HMG-CoA reductase. Sinapic acid has shown best ligand binding energy of -5.5kcal/M. Moreover, in chick embryo model, sinapic acid improved vessel density on chorioallantoic membrane. These results of the present study concludes that sinapic acid acts as a protective agent against hypertension associated cardiac dysfunction, kidney fibrosis and lipid alterations. PMID:26945821

  8. Prevention of kidney ischemia/reperfusion-induced functional injury, MAPK and MAPK kinase activation, and inflammation by remote transient ureteral obstruction.

    PubMed

    Park, Kwon Moo; Kramers, Cornelis; Vayssier-Taussat, Muriel; Chen, Ang; Bonventre, Joseph V

    2002-01-18

    Protection against ischemic kidney injury is afforded by 24 h of ureteral obstruction (UO) applied 6 or 8 days prior to the ischemia. Uremia or humoral factors are not responsible for the protection, since unilateral UO confers protection on that kidney but not the contralateral kidney. Prior UO results in reduced postischemic outer medullary congestion and leukocyte infiltration. Prior UO results in reduced postischemic phosphorylation of c-Jun N-terminal stress-activated protein kinase 1/2 (JNK1/2), p38, mitogen-activated protein kinase (MAPK) kinase 4 (MKK4), and MKK3/6. Very few cells stain positively for proliferating cell nuclear antigen after obstruction, indicating that subsequent protection against ischemia is not related to proliferation with increased numbers of newly formed daughter cells more resistant to injury. UO increases the expression of heat shock protein (HSP)-25 and HSP-72. The increased HSP-25 expression persists for 6 or 8 days, whereas HSP-72 does not. HSP-25 expression is increased in the proximal tubule cells in the outer stripe of the outer medulla postobstruction, prior to, and 24 h after ischemia. In LLC-PK(1) renal epithelial cells, adenovirus-expressed human HSP-27 confers resistance to chemical anoxia and oxidative stress. Increased HSP-27 expression in LLC-PK(1) cells results in reduced H(2)O(2)-induced phosphorylation of JNK1/2 and p38. In conclusion, prior transient UO renders the kidney resistant to ischemia. This resistance to functional consequences of ischemia is associated with reduced postischemic activation of JNK, p38 MAP kinases, and their upstream MAPK kinases. The persistent increase in HSP-25 that occurs as a result of UO may contribute to the reduction in phosphorylation of MAPKs that have been implicated in adhesion molecule up-regulation and cell death. PMID:11696540

  9. Antagonism of scavenger receptor CD36 by 5A peptide prevents chronic kidney disease progression in mice independent of blood pressure regulation.

    PubMed

    Souza, Ana Carolina P; Bocharov, Alexander V; Baranova, Irina N; Vishnyakova, Tatyana G; Huang, Yuning G; Wilkins, Kenneth J; Hu, Xuzhen; Street, Jonathan M; Alvarez-Prats, Alejandro; Mullick, Adam E; Patterson, Amy P; Remaley, Alan T; Eggerman, Thomas L; Yuen, Peter S T; Star, Robert A

    2016-04-01

    Scavenger receptor CD36 participates in lipid metabolism and inflammatory pathways important for cardiovascular disease and chronic kidney disease (CKD). Few pharmacological agents are available to slow the progression of CKD. However, apolipoprotein A-I-mimetic peptide 5A antagonizes CD36 in vitro. To test the efficacy of 5A, and to test the role of CD36 during CKD, we compared wild-type to CD36 knockout mice and wild-type mice treated with 5A, in a progressive CKD model that resembles human disease. Knockout and 5A-treated wild-type mice were protected from CKD progression without changes in blood pressure and had reductions in cardiovascular risk surrogate markers that are associated with CKD. Treatment with 5A did not further protect CD36 knockout mice from CKD progression, implicating CD36 as its main site of action. In a separate model of kidney fibrosis, 5A-treated wild-type mice had less macrophage infiltration and interstitial fibrosis. Peptide 5A exerted anti-inflammatory effects in the kidney and decreased renal expression of inflammasome genes. Thus, CD36 is a new therapeutic target for CKD and its associated cardiovascular risk factors. Peptide 5A may be a promising new agent to slow CKD progression. PMID:26994575

  10. Treatment Outcomes of Retrograde Intrarenal Surgery for Renal Stones and Predictive Factors of Stone-Free

    PubMed Central

    Lim, Soo Hyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo

    2010-01-01

    Purpose The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free. Materials and Methods We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated. Results Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9±392.5 mm2. The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%. Conclusions RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones. PMID:21165199

  11. Pregnancy and Kidney Disease

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  12. Polycystic kidney disease

    MedlinePlus

    Cysts - kidneys; Kidney - polycystic; Autosomal dominant polycystic kidney disease; ADPKD ... Polycystic kidney disease (PKD) is passed down through families (inherited). The 2 inherited forms of PKD are autosomal dominant ...

  13. Kidney-Pancreas Transplant

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  14. About Chronic Kidney Disease

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  15. Chronic Kidney Disease (CKD)

    MedlinePlus

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  16. National Kidney Foundation

    MedlinePlus

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... checks Your Kidneys and You Meetings Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  17. American Kidney Fund

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  18. Silicosis among Stone- Cutter Workers: A Cross-Sectional Study

    PubMed Central

    Naserbakht, Ali; Naserbakht, Morteza; Attari, Ghavamedin

    2012-01-01

    Background Production process of most factory-made products is harmful to our health and environment. Silica is the most important stone used in stone cutting factories. Numerous researches have reported respiratory diseases due to the inhalation of these particles in various occupations. Silicosis is a disease with typical radiographic pattern caused as the result of inhalation of silica particles. According to the intensity of exposures and onset of initiation of clinical symptoms silicosis is classified into three groups of acute, chronic and accelerated forms. The present study evaluated silicosis among stone cutter workers. Materials and Methods This cross sectional study was performed on stone cutter workers in Malayer city (Azandarian) between 2008 and 2009. Respiratory data of our study participants were collected with a respiratory questionnaire and performing spirometry tests and chest radiography. Results Among our participants, 16 silicosis cases were diagnosed by radiographic changes. Among them, 10 workers had exposure for more than three years and 6 workers were smokers. Eleven workers had an abnormal radiographic pattern on their chest x-rays. Seven workers had obstructive and 4 workers had restrictive spirometric patterns. Conclusion Prevalence of silicosis was high among our understudy workers and preventive strategies are required to control it. PMID:25191413

  19. Impact of Residual Fragments following Endourological Treatments in Renal Stones

    PubMed Central

    Acar, Cenk; Cal, Cag

    2012-01-01

    Today, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs) after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs <4 mm after SWL and <2 mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs. PMID:22829812

  20. Use of Potassium Citrate to Reduce the Risk of Renal Stone Formation During Spaceflight

    NASA Technical Reports Server (NTRS)

    Whitson, P. A.; Pietrzyk, R. A.; Sams, C. F.; Jones, J. A.; Nelman-Gonzalez, M.; Hudson, E. K.

    2008-01-01

    Introduction: NASA s Vision for Space Exploration centers on exploration class missions including the goals of returning to the moon and landing on Mars. One of NASA s objectives is to focus research on astronaut health and the development of countermeasures that will protect crewmembers during long duration voyages. Exposure to microgravity affects human physiology and results in changes in the urinary chemical composition favoring urinary supersaturation and an increased risk of stone formation. Nephrolithiasis is a multifactorial disease and development of a renal stone is significantly influenced by both dietary and environmental factors. Previous results from long duration Mir and short duration Shuttle missions have shown decreased urine volume, pH, and citrate levels and increased calcium. Citrate, an important inhibitor of calcium-containing stones, binds with urinary calcium reducing the amount of calcium available to form stones. Citrate inhibits renal stone recurrence by preventing crystal growth, aggregation, and nucleation and is one of the most common therapeutic agents used to prevent stone formation. Methods: Thirty long duration crewmembers (29 male, 1 female) participated in this study. 24-hour urines were collected and dietary monitoring was performed pre, in, and postflight. Crewmembers in the treatment group received two potassium citrate (KCIT) pills, 10 mEq/pill, ingested daily beginning 3 days before launch, all inflight days and through 14 days postflight. Urinary biochemical and dietary analyses were completed. Results: KCIT treated subjects exhibited decreased urinary calcium excretion and maintained the levels of calcium oxalate supersaturation risk at their preflight levels. The increased urinary pH levels in these subjects reduced the risk of uric acid stones. Discussion: The current study investigated the use of potassium citrate as a countermeasure to minimize the risk of stone formation during ISS missions. Results suggest that supplementation with potassium citrate decreases the risk of stone formation during and immediately after spaceflight.

  1. Your Kidneys

    MedlinePlus

    ... jobs of the kidneys is to filter the waste out of the blood . How does the waste get in your blood? Well, your blood delivers ... to break down the nutrients. Some of the waste is the result of these chemical reactions. Some ...

  2. Chronic kidney disease (CKD) in disadvantaged populations.

    PubMed

    Garcia-Garcia, Guillermo; Jha, Vivekanand; Tao Li, Philip Kam; Garcia-Garcia, Guillermo; Couser, William G; Erk, Timur; Zakharova, Elena; Segantini, Luca; Shay, Paul; Riella, Miguel C; Osafo, Charlotte; Dupuis, Sophie; Kernahan, Charles

    2015-02-01

    Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

  3. Chronic kidney disease (CKD) in disadvantaged populations

    PubMed Central

    Garcia-Garcia, Guillermo; Jha, Vivekanand

    2015-01-01

    Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

  4. Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

    PubMed Central

    Li, Jing; Li, Yi; Xu, Biao; Jia, Guoliang; Guo, Tao; Wang, Dongmei; Xu, Kai; Deng, Jie

    2016-01-01

    Background Female patients are at higher risk of contrast-induced acute kidney injury (CIAKI) compared to males. In the multicenter, prospective, TRACK-D study, short-term rosuvastatin has proven effectively reduce CIAKI in patients with type 2 diabetes mellitus and stage 2-3 chronic kidney disease (CKD). This study aimed to explore the efficacy of rosuvastatin in the female TRACK-D population. Methods This study was a gender-based analysis of 2,998 patients (1,044 females) enrolled in the TRACK-D study and were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard of care. The primary outcome was the incidence of CIAKI and the secondary outcome was a composite of death, dialysis/hemofiltration or worsening heart failure at 30 days. Results CIAKI incidence was comparable between male and female patients in the overall study population (2.5% vs. 3.4%, P=0.165) and in the rosuvastatin group (2.4% vs. 2.1%, P=0.72), while it was higher in females than in males in the control group (3.1% vs. 5.3%, P=0.04). Female gender was an independent risk factor of CIAKI [odds ratio (OR) =1.65; 95% confidence interval (CI), 1.03–2.63; P=0.036]. Rosuvastatin treatment vs. control lowered CIAKI rate in females [2.1% vs. 5.3%; relative risk (RR) =0.39; 95% CI, 0.19–0.77; number needed to treat (NNT) =31], particularly among those with CKD stage 2 (1.2% vs. 4.1%, P=0.011). Secondary outcome incidence was similar for females in the rosuvastatin and control groups (3.7% vs. 4.9%, P=0.37). Conclusions Compared to males, untreated females with diabetes mellitus and CKD had a higher risk of CIAKI, which can be reduced by short-term rosuvastatin treatment. PMID:27162677

  5. Cystine Growth Inhibition Through Molecular Mimicry: a New Paradigm for the Prevention of Crystal Diseases

    PubMed Central

    Lee, Michael H.; Sahota, Amrik; Ward, Michael D.

    2015-01-01

    Cystinuria is a genetic disease marked by recurrent kidney stone formation, usually at a young age. It frequently leads to chronic kidney disease. Treatment options for cystinuria have been limited despite comprehensive understanding of its genetic pathophysiology. Currently available therapies suffer from either poor clinical adherence to the regimen or potentially serious adverse effects. Recently, we employed atomic force miscopy (AFM) to identify l-cystine dimethylester (CDME) as an effective molecular imposter of l-cystine, capable of inhibiting crystal growth in vitro. More recently, we demonstrated CDME’s efficacy in inhibiting l-cystine crystal growth in vivo utilizing a murine model of cystinuria. The application of AFM to discover inhibitors of crystal growth through structural mimicry suggests a novel approach to preventing and treating crystal diseases. PMID:25874348

  6. The Matariki Stone of Rapanui

    NASA Astrophysics Data System (ADS)

    Hockey, T. A.

    2005-12-01

    Anthropological studies of Rapanui (Easter Island) are valuable insofar as the island's remoteness allowed its culture to develop independently until western contact. Of special importance to cultural astronomers is the indigenous inhabitants' expressed interest in the sky, through lore, monumental architecture, and rock art. 1 The Matariki Stone is a unique basaltic boulder found on Rapanui; my analysis of it is the result of in situ investigation (2000). The boulder is 1 m x 1.5 m x 2 m in approximate size and weighs in excess of 10,000 kg. According to local informants, at least six cupules, averaging 6 cm in diameter and 5 cm in depth, were placed in it prior to western contact with the island and prior to transport to the boulder's present location. Information about the Matariki Stone's original setting, orientation, and context is lost. "Matariki" means "Pleiades" (or, more generally, a group of stars). However, the pattern of the Matariki Stone cupules strongly resembles another familiar asterism of third-magnitude stars. 2 These zodiac stars were placed significantly in the Rapanui sky of 1500 CE. Yet no local ethnographic evidence mentions these stars, nor is association with these stars and other regional cultures (e. g., Australian aboriginal and Mayan) compelling. 3 Moreover, there is no Polynesian tradition of constellation depiction in rock art at all, whereas the Pleiades figure prominently in that culture's oral tradition. 4 Thus, the Matariki Stone remains a conundrum. 1 Liller, William. The Ancient Solar Observatories of Rapanui: The Archaeoastronomy of Easter Island. (1993) 2 Hockey, Thomas and Hoffman, Alice. "An Archaeoastronomical Investigation: Does A Constellation Pattern Appear in Rapanui Rock Art?" Rapa Nui Journal. 14, no. 3. (2000) 3 For example, Kelly, David H. and Milone, Eugene F. Exploring Ancient Skies: An Encyclopedic Survey of Archaeoastronomy. (2005) 4 For example, Makemson, Maude. The Morning Star Rises. (1941)

  7. Reappraisal of endoscopic papillary balloon dilation for the management of common bile duct stones

    PubMed Central

    Lai, Kwok-Hung; Chan, Hoi-Hung; Tsai, Tzung-Jiun; Cheng, Jin-Shiung; Hsu, Ping-I

    2015-01-01

    Although endoscopic sphincterotomy (EST) is still considered as a gold standard treatment for common bile duct (CBD) stones in western guideline, endoscopic papillary balloon dilation (EPBD) is commonly used by the endoscopists in Asia as the first-line treatment for CBD stones. Besides the advantages of a technical easy procedure, endoscopic papillary large balloon dilation (EPLBD) can facilitate the removal of large CBD stones. The indication of EPBD is now extended from removal of the small stones by using traditional balloon, to removal of large stones and avoidance of lithotripsy by using large balloon alone or after EST. According to the reports of antegrade papillary balloon dilatation, balloon dilation itself is not the cause of pancreatitis. On the contrary, adequate dilation of papillary orifice can reduce the trauma to the papilla and pancreas by the basket or lithotripter during the procedure of stone extraction. EPLBD alone is as effective as EPLBD with limited EST. Longer ballooning time may be beneficial in EPLBD alone to achieve adequate loosening of papillary orifice. The longer ballooning time does not increase the risk of pancreatitis but may reduce the bleeding episodes in patients with coagulopathy. Slowly inflation of the balloon, but not exceed the diameter of bile duct and tolerance of the patients are important to prevent the complication of perforation. EPBLD alone or with EST are not the sphincter preserved procedures, regular follow up is necessary for early detection and management of CBD stones recurrence. PMID:25685263

  8. Reappraisal of endoscopic papillary balloon dilation for the management of common bile duct stones.

    PubMed

    Lai, Kwok-Hung; Chan, Hoi-Hung; Tsai, Tzung-Jiun; Cheng, Jin-Shiung; Hsu, Ping-I

    2015-02-16

    Although endoscopic sphincterotomy (EST) is still considered as a gold standard treatment for common bile duct (CBD) stones in western guideline, endoscopic papillary balloon dilation (EPBD) is commonly used by the endoscopists in Asia as the first-line treatment for CBD stones. Besides the advantages of a technical easy procedure, endoscopic papillary large balloon dilation (EPLBD) can facilitate the removal of large CBD stones. The indication of EPBD is now extended from removal of the small stones by using traditional balloon, to removal of large stones and avoidance of lithotripsy by using large balloon alone or after EST. According to the reports of antegrade papillary balloon dilatation, balloon dilation itself is not the cause of pancreatitis. On the contrary, adequate dilation of papillary orifice can reduce the trauma to the papilla and pancreas by the basket or lithotripter during the procedure of stone extraction. EPLBD alone is as effective as EPLBD with limited EST. Longer ballooning time may be beneficial in EPLBD alone to achieve adequate loosening of papillary orifice. The longer ballooning time does not increase the risk of pancreatitis but may reduce the bleeding episodes in patients with coagulopathy. Slowly inflation of the balloon, but not exceed the diameter of bile duct and tolerance of the patients are important to prevent the complication of perforation. EPBLD alone or with EST are not the sphincter preserved procedures, regular follow up is necessary for early detection and management of CBD stones recurrence. PMID:25685263

  9. Removal of Residual Cavitation Nuclei to Enhance Histotripsy Erosion of Model Urinary Stones

    PubMed Central

    Duryea, Alexander P.; Roberts, William W.; Cain, Charles A.; Hall, Timothy L.

    2015-01-01

    Histotripsy has been shown to be an effective treatment for model kidney stones, eroding their surface to tiny particulate debris via a cavitational bubble cloud. However, similar to shock wave lithotripsy, histotripsy stone treatments display a rate-dependent efficacy with pulses applied at low rate generating more efficient stone erosion in comparison to those applied at high rate. This is hypothesized to be the result of residual cavitation bubble nuclei generated by bubble cloud collapse. While the histotripsy bubble cloud only lasts on the order of 100 µs, these microscopic remnant bubbles can persist on the order of 1 second—inducing direct attenuation of subsequent histotripsy pulses and influencing bubble cloud dynamics. In an effort to mitigate these effects, we have developed a novel strategy to actively remove residual cavitation nuclei from the field using low-amplitude ultrasound pulses. Previous work has demonstrated that with selection of the appropriate acoustic parameters these bubble removal pulses can stimulate the aggregation and subsequent coalescence of microscopic bubble nuclei—effectively deleting them from the target volume. Here, we incorporate bubble removal pulses in histotripsy treatment of model kidney stones. It was found that when histotripsy is applied at low rate (1 Hz), bubble removal does not produce a statistically significant change in erosion. At higher pulse rates of 10, 100, and 500 Hz, incorporating bubble removal results in 3.7-, 7.5-, and 2.7-fold increases in stone erosion, respectively. High speed imaging indicates that the introduction of bubble removal pulses allows bubble cloud dynamics resulting from high pulse rates to more closely approximate those generated at the low rate of 1 Hz. These results corroborate previous work in the field of shock wave lithotripsy regarding the ill-effects of residual bubble nuclei, and suggest that high treatment efficiency can be recovered at high pulse rates through appropriate manipulation of the cavitation environment surrounding the stone. PMID:25965682

  10. Management of stone disease in infants.

    PubMed

    Azili, Mujdem Nur; Ozturk, Fatma; Inozu, Mihriban; Çayci, Fatma Şemsa; Acar, Banu; Ozmert, Sengul; Tiryaki, Tugrul

    2015-11-01

    Evaluating and treating renal stone disease in infants are technically challenging. In this study, we evaluated the surgical treatment of renal stones in children under 1 year of age. We retrospectively reviewed the records of patients under 1 year old who were treated with ESWL, endourological or open surgical procedures for renal stone disease between January, 2009 and December, 2012. The patients' age, gender, stone size, stone location and number, complications, stone-free status, and postoperative complications were recorded. 19 of 121 infants with a mean age of 10.2 ± 3.07 months were treated with surgical procedures. Six (75%) of eight cystinuria patients required a surgical intervention. Retrograde endoscopic management was performed in thirteen patients (63.4%) as an initial surgical approach. There were three major (15.7%) complications. The rate of open surgical procedures was 31.6% (6 of 19 infants). The cutoff value of stone size for open surgery was 10 mm. There was a significant relationship between the conversion to open procedures and stone size, stone location, and symptom presentation especially the presence of obstruction (p < 0.05). After repeated treatments, the stone clearance rate of RIRS reached 84.6%. Retrograde intrarenal surgery is an effective and safe treatment method for renal stones in infants and can be used as a first-line therapy in most patients under 1 year old. This is especially important if an associated ureteral stone or lower pole stone that requires treatment is present and for patients with cystinuria, which does not respond favorably to ESWL. PMID:26036325

  11. Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi

    PubMed Central

    Ding, Jie; Huang, Yunteng; Gu, Siping; Chen, Yifan; Peng, Jie; Bai, Qiang; Ye, Min; Qi, Jun

    2015-01-01

    ABSTRACT Purpose: To evaluate the clinical efficacy of flexible ureteroscope (F-URS) combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney. Materials and Methods: From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9±11.6 years, range 26-66 years), including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29±8 mm (range 17-42 mm2). Mean stone digitized surface area (DSA) was 321±94 mm2 (range 180-538 mm2). Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed. Results: The average operative time was 92±16 minutes (range 74-127 min.). No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole. Conclusions: F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm) in HSKs with high clearance rates and low complication rates. PMID:26401860

  12. Dysplastic kidneys.

    PubMed

    Winyard, Paul; Chitty, Lyn S

    2008-06-01

    Dysplastic kidneys are common malformations affecting up to 1 in 1000 of the general population. They are part of the spectrum of Congenital Abnormalities of the Kidney and Urinary Tract (CAKUT) and an increasing number of children are being diagnosed on antenatal ultrasound. In the past, these patients may not have been detected until adulthood following investigation for other illness, or even as incidental findings at post mortem, unless there was severe bilateral dysplasia leading to Potter's sequence or renal failure in childhood. Excluding syndromic cases with defects in other organ systems, features linked to worse prognosis at presentation are: (1) bilateral disease; (2) decreased functional renal mass (which encompasses not just small kidneys but also large ones where cysts replace normal architecture); (3) lower urinary tract obstruction; and (4) anhydramnios or severe oligohydramnios. Dysplasia and renal function are dynamic and can evolve during pregnancy, so repeated assessment is necessary when pathology is expected. Worsening dimensions or decreasing amniotic fluid levels imply poorer prognosis, but there are no proven therapies during pregnancy, though vesicoamniotic shunting may be indicated with obstruction. Postnatal investigations aim to define the anatomy, which helps to estimate risks of infection and kidney function. Management might then involve observation, prophylactic antibiotics, surgery and/or renal support. Risks of renal malignancy and hypertension are low during childhood, but longer-term follow-up is needed, particularly to determine blood pressure and renal function in adulthood and pregnancy. Around 10% of cases have a family history of significant renal/urinary tract malformation. Monogenic causes include mutations in individual genes, such as TCF2/hepatocyte nuclear factor 1ss (HNF1beta), PAX2 and uroplakins, but there are also recent reports of children with compound heterozygote mutations in several renal/urinary tract developmental genes. Effective genetic screening in future may require gene chip or other techniques to assess multiple genes concurrently, but this should not replace a multidisciplinary approach to these often difficult cases. PMID:18065301

  13. Complications of extracorporeal shock wave lithotripsy for urinary stones: to know and to manage them-a review.

    PubMed

    D'Addessi, Alessandro; Vittori, Matteo; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, PierFrancesco

    2012-01-01

    To identify the possible complications after extracorporeal shock wave lithotripsy (SWL) and to suggest how to manage them, the significant literature concerning SWL treatment and complications was analyzed and reviewed. Complications after SWL are mainly connected to the formation and passage of fragments, infections, the effects on renal and nonrenal tissues, and the effects on kidney function. Each of these complications can be prevented adopting appropriate measures, such as the respect of the contraindications and the recognition and the correction of concomitant diseases or infection, and using the SWL in the most efficient and safe way, tailoring the treatment to the single case. In conclusion, SWL is an efficient and relatively noninvasive treatment for urinary stones. However, as with any other type of therapy, some contraindications and potential complications do exist. The strictness in following the first could really limit the onset and danger of the appearance of others, which however must be fully known so that every possible preventive measure be implemented. PMID:22489195

  14. Complications of Extracorporeal Shock Wave Lithotripsy for Urinary Stones: To Know and to Manage Them—A Review

    PubMed Central

    D'Addessi, Alessandro; Vittori, Matteo; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, PierFrancesco

    2012-01-01

    To identify the possible complications after extracorporeal shock wave lithotripsy (SWL) and to suggest how to manage them, the significant literature concerning SWL treatment and complications was analyzed and reviewed. Complications after SWL are mainly connected to the formation and passage of fragments, infections, the effects on renal and nonrenal tissues, and the effects on kidney function. Each of these complications can be prevented adopting appropriate measures, such as the respect of the contraindications and the recognition and the correction of concomitant diseases or infection, and using the SWL in the most efficient and safe way, tailoring the treatment to the single case. In conclusion, SWL is an efficient and relatively noninvasive treatment for urinary stones. However, as with any other type of therapy, some contraindications and potential complications do exist. The strictness in following the first could really limit the onset and danger of the appearance of others, which however must be fully known so that every possible preventive measure be implemented. PMID:22489195

  15. Investigations of stone consolidants by neutron imaging

    NASA Astrophysics Data System (ADS)

    Hameed, F.; Schillinger, B.; Rohatsch, A.; Zawisky, M.; Rauch, H.

    2009-06-01

    The chemical preservation and structural reintegration of natural stones applied in historical buildings is carried out by the use of different stone strengtheners. As these agents contain hydrogen, they offer good properties for neutron imaging. The main interest in the restoration process is the development of a suitable stone consolidant. In cooperation with the St. Stephans Cathedral and the geologists at Vienna University of Technology, we are investigating the penetration depth and distribution of different stone consolidants. These studies are being carried out with different stone samples, mostly porous natural building stones, limestones and sandstones. The two strengtheners used in this study are ethyl silicate ester (Wacker OH100) and dissolved polymethylmetacrylate (PMMA, Paraloid B72). Neutron radiography and neutron tomography can be used successfully to visualize the distribution of consolidants both in two and three dimensions.

  16. Bioremediation of weathered-building stone surfaces.

    PubMed

    Webster, Alison; May, Eric

    2006-06-01

    Atmospheric pollution and weathering of stone surfaces in urban historic buildings frequently results in disfigurement or damage by salt crust formation (often gypsum), presenting opportunities for bioremediation using microorganisms. Conventional techniques for the removal of these salt crusts from stone have several disadvantages: they can cause colour changes; adversely affect the movement of salts within the stone structure; or remove excessive amounts of the original surface. Although microorganisms are commonly associated with detrimental effects to the integrity of stone structures, there is growing evidence that they can be used to treat this type of stone deterioration in objects of historical and cultural significance. In particular, the ability and potential of different microorganisms to either remove sulfate crusts or form sacrificial layers of calcite that consolidate mineral surfaces have been demonstrated. Current research suggests that bioremediation has the potential to offer an additional technology to conservators working to restore stone surfaces in heritage buildings. PMID:16647149

  17. Efficacy and Safety of Erythropoietin to Prevent Acute Kidney Injury in Patients With Critical Illness or Perioperative Care: A Systematic Review and Meta-analysis of Randomized Controlled Trials

    PubMed Central

    Zhao, Chen; Lin, Zhenchuan; Luo, Qimei; Xia, Xi; Yu, Xueqing

    2015-01-01

    Objective: The aim was to investigate the efficacy and safety of erythropoietin (EPO) to prevent acute kidney injury (AKI) in patients with critical illness or perioperative care. Methods: Randomized controlled trials comparing EPO with placebo for AKI prevention in adult patients with critical illness or perioperative care were searched in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, and Clinical Trials.gov until October 2014. The outcomes of interest included the incidence of AKI, dialysis requirement, mortality, and adverse event. Fixed effect model was used to calculate the pooled risk ratio (RR) and 95% confidence interval (CI) for eligible studies. Results: Ten randomized controlled trials involving 2759 participants were identified and included in the analysis. Compared with placebo, EPO administration did not reduce the incidence of AKI (RR, 0.97; 95% CI, 0.79–1.19; P = 0.782), dialysis requirement (RR, 0.72; 95% CI, 0.31–1.70; P = 0.457), or mortality (RR, 0.96; 95% CI, 0.78–1.18; P = 0.705). Moreover, EPO had no effect on the risk of adverse events, but estimations of RR were difficult due to their relatively infrequent occurrence. Conclusions: This meta-analysis suggests that prophylactic administration of EPO in patients with critical illness or perioperative care does not prevent AKI, dialysis requirement, or mortality. PMID:26065644

  18. The cell cycle and acute kidney injury

    PubMed Central

    Price, Peter M.; Safirstein, Robert L.; Megyesi, Judit

    2009-01-01

    Acute kidney injury (AKI) activates pathways of cell death and cell proliferation. Although seemingly discrete and unrelated mechanisms, these pathways can now be shown to be connected and even to be controlled by similar pathways. The dependence of the severity of renal-cell injury on cell cycle pathways can be used to control and perhaps to prevent acute kidney injury. This review is written to address the correlation between cellular life and death in kidney tubules, especially in acute kidney injury. PMID:19536080

  19. Vascular Calcification and Stone Disease: A New Look towards the Mechanism

    PubMed Central

    Yiu, Allen J.; Callaghan, Daniel; Sultana, Razia; Bandyopadhyay, Bidhan C.

    2015-01-01

    Calcium phosphate (CaP) crystals are formed in pathological calcification as well as during stone formation. Although there are several theories as to how these crystals can develop through the combined interactions of biochemical and biophysical factors, the exact mechanism of such mineralization is largely unknown. Based on the published scientific literature, we found that common factors can link the initial stages of stone formation and calcification in anatomically distal tissues and organs. For example, changes to the spatiotemporal conditions of the fluid flow in tubular structures may provide initial condition(s) for CaP crystal generation needed for stone formation. Additionally, recent evidence has provided a meaningful association between the active participation of proteins and transcription factors found in the bone forming (ossification) mechanism that are also involved in the early stages of kidney stone formation and arterial calcification. Our review will focus on three topics of discussion (physiological influences—calcium and phosphate concentration—and similarities to ossification, or bone formation) that may elucidate some commonality in the mechanisms of stone formation and calcification, and pave the way towards opening new avenues for further research. PMID:26185749

  20. Assessing applicants to the NASA flight program for their renal stone-forming potential.

    PubMed

    Pak, C Y; Hill, K; Cintron, N M; Huntoon, C

    1989-02-01

    Spaceflight could provoke formation of kidney stones, in part by causing hypercalciuria and hyperphosphaturia. Applicants for spaceflight who have metabolic or environmental derangements to begin with might be particularly susceptible to stone formation in space. We, therefore, analyzed 24-h urine samples for stone-forming risk factors in 104 male applicants before their selection into the astronaut-mission specialist corps. The urinary environment was abnormally supersaturated with calcium oxalate in 25.0% of applicants, brushite in 36.5%, and monosodium urate in 66.3%, predisposing these applicants to crystallization of stone-forming calcium salts. This high level of supersaturation was caused by both "metabolic" and environmental disturbances. Thus, hypercalciuria was found in 11.5% of applicants, hyperoxaluria in 2.9%, hyperuricosuria in 18.3% and hypocitraturia in 5.8%. Environmental derangements were generally more prominent, as indicated by low urine volume of less than 2 L.d-1 in 84.6%, high urinary phosphate in 24.4%, and high urinary sodium in 10.6% of applicants. The results suggest that most of the abnormal stone risk factors disclosed among applicants for spaceflight programs were environmental in origin. PMID:2930428

  1. Results and lessons from the Spironolactone To Prevent Cardiovascular Events in Early Stage Chronic Kidney Disease (STOP-CKD) randomised controlled trial

    PubMed Central

    Ng, Khai P; Jain, Poorva; Gill, Paramjit S; Heer, Gurdip; Townend, Jonathan N; Freemantle, Nick; Greenfield, Sheila; Ferro, Charles J

    2016-01-01

    Objectives To determine whether low-dose spironolactone can safely lower arterial stiffness in patients with chronic kidney disease stage 3 in the primary care setting. Design A multicentre, prospective, randomised, placebo-controlled, double-blinded study. Setting 11 primary care centres in South Birmingham, England. Participants Adult patients with stage 3 chronic kidney disease. Main exclusion criteria were diagnosis of diabetes mellitus, chronic heart failure, atrial fibrillation, severe hypertension, systolic blood pressure <120 mm Hg or baseline serum potassium ≥5 mmol/L. Intervention Eligible participants were randomised to receive either spironolactone 25 mg once daily, or matching placebo for an intended period of 40 weeks. Outcome measures The primary end point was the change in arterial stiffness as measured by pulse wave velocity. Secondary outcome measures included the rate of hyperkalaemia, deterioration of renal function, barriers to participation and expected recruitment rates to a potential future hard end point study. Results From the 11 practices serving a population of 112 462, there were 1598 (1.4%) patients identified as being eligible and were invited to participate. Of these, 134 (8.4%) attended the screening visit of which only 16 (1.0%) were eligible for randomisation. The main reasons for exclusion were low systolic blood pressure (<120 mm Hg: 40 patients) and high estimated glomerular filtration rate (≥60 mL/min/1.73 m2: 38 patients). The trial was considered unfeasible and was terminated early. Conclusions We highlight some of the challenges in undertaking research in primary care including patient participation in trials. This study not only challenged our preconceptions, but also provided important learning for future research in this large and important group of patients. Trial registration number ISRCTN80658312. PMID:26916697

  2. High-speed photography during laser-based gall bladder stone lithotripsy

    NASA Astrophysics Data System (ADS)

    Kokaj, Jahja O.

    2001-04-01

    Shadowgraphy of gall bladder stone, which is held by a basket and immersed in a civete is performed. The exposure time is determined by the time of a N-Dye laser pulse used as a lightening source for photography. The shadowgram is projected in the objective of a camera which is connected to a microscope. The light coming from the laser, illuminates the civete collecting optical information of the stone and physical phenomena appearing above the stone. On top of the stone a tip of optical fiber is fixed, which is used for transmitting Ho:Yag laser power to the stone. Using a computer and time delay the laser pulses used for destruction and illumination are synchronized. Since the N-Dye laser pulse is pico-second range and the Ho:Yag laser pulse is in the range of micro-second, many image frames are obtained within the time of one pulse applied during the destruction. It is known that in the process of stone destruction several phenomena like plume, plasma, shock wave and bubble formation take place. However, the physical mechanism of the stone destruction is not yet completely understood. From the obtained results the above phenomena are studied which gives new information and clue for understanding some of the mentioned phenomena. The laser power which is guided by an optical fiber into the gall bladder or kidney of the human body can damage the living tissue and cause some serious health problems. For this reason the fiber needs to be oriented properly during the action of the laser power.

  3. Nephrocalcinosis is a risk factor for kidney failure in primary hyperoxaluria

    PubMed Central

    Tang, Xiaojing; Bergstralh, Eric J.; Mehta, Ramila A.; Vrtiska, Terri J.; Milliner, Dawn S.; Lieske, John C.

    2014-01-01

    Stone formation and nephrocalcinosis are both very common features of primary hyperoxaluria, yet the extent of each disease varies markedly between patients. Here we studied whether kidney damage from nephrocalcinosis and/or stone related events contributed to end stage kidney disease (ESKD). Clinical information was analyzed from 348 patients enrolled in the Rare Kidney Stone Consortium Primary Hyperoxaluria registry and included demographic, laboratory and imaging features. Among all patients there were 277 with type 1, 37 with type 2, and 34 with type 3 primary hyperoxaluria. Overall, 58% passed a stone (mean 0.3/year) and one or more urologic procedures were required by 70% of patients (mean 0.15/year). Nephrocalcinosis was found in 34% of patients, including 41% with type 1 primary hyperoxaluria. High urine oxalate was associated with increased risk for both nephrocalcinosis and stone number, while low urine citrate was a risk factor for stone events and stone number. After adjustment for the type of primary hyperoxaluria, diagnosis by family screening and age at first image, the overall adjusted hazard ratio for ESKD among those with a history of nephrocalcinosis was 1.7 [95% CI 1.0–3.0], while the risk was 4.0 [1.9–8.5] for new onset nephrocalcinosis during follow-up. In contrast, the number of stones and stone events were not significantly associated with ESKD risk. Thus, nephrolithiasis and nephrocalcinosis appear to be pathophysiologically distinct entities. The presence of nephrocalcinosis implies increased risk for ESKD. PMID:25229337

  4. Modern management of common bile duct stones.

    PubMed

    Buxbaum, James

    2013-04-01

    It is imperative for gastroenterologists to understand the different formations of bile duct stones and the various medical treatments available. To minimize the complications of endoscopic retrograde cholangiopancreatography (ERCP), it is critical to appropriately assess the risk of bile duct stones before intervention. Biliary endoscopists should be comfortable with the basic techniques of stone removal, including sphincterotomy, mechanical lithotripsy, and stent placement. It is important to be aware of advanced options, including laser and electrohydraulic stone fragmentation, and papillary dilatation for problematic cases. The timing and need for ERCP in those who require a cholecystectomy is also a consideration. PMID:23540960

  5. Computational stoning method for surface defect detection

    NASA Astrophysics Data System (ADS)

    Ma, Ninshu; Zhu, Xinhai

    2013-12-01

    Surface defects on outer panels of automotive bodies must be controlled in order to improve the surface quality. The detection and quantitative evaluation of surface defects are quite difficult because the deflection of surface defects is very small. One of detecting methods for surface defects used in factories is a stoning method in which a stone block is moved on the surface of a stamped panel. The computational stoning method was developed to detect surface low defect by authors based on a geometry contact algorithm between a stone block and a stamped panel. If the surface is convex, the stone block always contacts with the convex surface of a stamped panel and the contact gap between them is zero. If there is a surface low, the stone block does not contact to the surface and the contact gap can be computed based on contact algorithm. The convex surface defect can also be detected by applying computational stoning method to the back surface of a stamped panel. By performing two way stoning computations from both the normal surface and the back surface, not only the depth of surface low defect but also the height of convex surface defect can be detected. The surface low defect and convex surface defect can also be detected through multi-directions. Surface defects on the handle emboss of outer panels were accurately detected using the computational stoning method and compared with the real shape. A very good accuracy was obtained.

  6. Determination of Chemical Compositions on Adult Kidney Stones—A Spectroscopic Study

    NASA Astrophysics Data System (ADS)

    Raju, K.; Rakkappan, C.

    2008-11-01

    The chemical compositions of the kidney stones of both the sexes of patients, aged from 40 to 70, living in and around Chidambaram town are determined by using FT-IR and X-RD technique. The kidney stone samples used in the present study were procured from the Rajah Muthiah Medical College and Hospital, Annamalai University. The FT-IR spectra of different kidney stone samples were recorded in the range of 4000-400 cm-1. By identifying the characteristic frequency, the chemical compositions of the samples are determined. The results analyzed by FTIR technique were confirmed by X-RD method, in which the recorded X-ray diffractogram are compared with JCPDS files using search match method. Further analysis of XRD pattern also reveals the same.

  7. Acute kidney injury

    PubMed Central

    Müller, Gerhard Anton

    2015-01-01

    Abstract: Acute kidney injury is a frequent and serious complication in hospitalized patients. Mortality rates have not substantially been decreased during the last 20 years. In most patients AKI results from transient renal hypoperfusion or ischemia. The consequences include tubular cell dysfunction/damage, inflammation of the organ, and post-ischemic microvasculopathy. The two latter events perpetuate kidney damage in AKI. Clinical manifestations result from diminished excretion of water, electrolytes, and endogenous / exogenous waste products. Patients are endangered by cardiovascular complications such as hypertension, heart failure, and arrhythmia. In addition, the whole organism may be affected by systemic toxification (uremia). The diagnostic approach in AKI involves several steps with renal biopsy inevitable in some patients. The current therapy focuses on preventing further kidney damage and on treatment of complications. Different pharmacological strategies have failed to significantly improve prognosis in AKI. If dialysis treatment becomes mandatory, intermittent and continuous renal replacement therapies are equally effective. Thus, new therapies are urgently needed in order to reduce short- and long-term outcome in AKI. In this respect, stem cell-based regimens may offer promising perspectives. PMID:25618438

  8. Accidental and iatrogenic causes of acute kidney injury

    PubMed Central

    Twombley, Katherine; Baum, Michel; Gattineni, Jyothsna

    2014-01-01

    Purpose of review Ingestions and iatrogenic administration of drugs are all too common causes of acute kidney injury. This review will discuss these preventable causes of acute kidney injury. Recent findings Recent studies have examined the pathophysiology of acute kidney injury by several commonly used drugs. These studies have shown that drugs and toxins can cause acute kidney injury by altering renal hemodynamics, direct tubular injury or causing renal tubular obstruction. Summary Knowledge of the drugs that cause acute kidney injury and how this injury is manifested can lead to improved diagnosis and treatment with the ultimate goal of prevention. PMID:21293274

  9. [How to prevent protein-energy wasting in patients with chronic kidney disease--position statement of the Croatian Society of Nephrology, Dialysis and Transplantation].

    PubMed

    Bašić-Jukić, Nikolina; Rački, Sanjin; Kes, Petar; Ljutić, Dragan; Vujičić, Bozidar; Lovčić, Vesna; Orlić, Lidija; Prkačin, Ingrid; Radić, Josipa; Jakić, Marko; Klarić, Dragan; Gulin, Marijana

    2014-04-01

    Protein-energy wasting (PEW) is a frequent problem in patients with end-stage renal disease, which is associated with adverse outcome. Risk factors for development of PEW in dialysis patients include anorexia, limitations in food intake due to problems with mineral metabolism (hyperphosphatemia, hyperkalemia). Prevention of PEW in dialysis population demands different therapeutic measures to correct abnormalities and to prevent loss of energy and proteins. Therapeutic approach should be individualized based on the specific problems of each patient in order to correct metabolic problems and to optimize food intake. In patients with inability to maintain nutritional status with standard oral feeding, other measures which include oral nutrition supplements and intradialytic parenteral feeding should be applied. Anabolic steroids, growth hormone and adequate oral nutritional supplements, together with physical activity may prevent further catabolism and correct abnormalities. Appetite stimulators, antiinflammatory interventions and anabolic drugs seem promising; however, their efficacy should be investigated in future clinical trials. PMID:26012159

  10. Acute kidney injury: an increasing global concern.

    PubMed

    Lameire, Norbert H; Bagga, Arvind; Cruz, Dinna; De Maeseneer, Jan; Endre, Zoltan; Kellum, John A; Liu, Kathleen D; Mehta, Ravindra L; Pannu, Neesh; Van Biesen, Wim; Vanholder, Raymond

    2013-07-13

    Despite an increasing incidence of acute kidney injury in both high-income and low-income countries and growing insight into the causes and mechanisms of disease, few preventive and therapeutic options exist. Even small acute changes in kidney function can result in short-term and long-term complications, including chronic