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Sample records for preventing kidney stone

  1. Diet for Kidney Stone Prevention

    MedlinePlus

    ... may also help prevent kidney stones, such as citrus drinks. Recommendations based on the specific type of ... do to prevent kidney stones. Some studies suggest citrus drinks like lemonade and orange juice protect against ...

  2. Diet for Kidney Stone Prevention

    MedlinePlus

    ... diet plan should a person follow to prevent future kidney stones? A dietitian can help a person ... Training & Career Development Research at NIDDK Research Resources Technology Advancement & Transfer Meetings & Events Health Information Health Topics ...

  3. 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

  4. 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

  5. Kidney stones.

    PubMed

    Khan, Saeed R; Pearle, Margaret S; Robertson, William G; Gambaro, Giovanni; Canales, Benjamin K; Doizi, Steeve; Traxer, Olivier; Tiselius, Hans-Göran

    2016-01-01

    Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall's plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs. PMID:27188687

  6. Kidney stones

    MedlinePlus Videos and Cool Tools

    ... urine exits the kidney and enters the ureter. As urine can become very concentrated as it passes through the kidneys. When the urine ... chemicals dissolved in the urine can crystallize, forming a kidney stone (renal calculus). Usually the calculus is ...

  7. Kidney stones

    MedlinePlus

    ... kidney or ureter. It uses sound or shock waves to break up stones. Then, the stone fragments ... the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL. Procedures performed by passing a ...

  8. Kidney stones

    MedlinePlus Videos and Cool Tools

    ... cortex to the inner medulla. The renal pelvis is the funnel through which urine exits the kidney ... a kidney stone (renal calculus). Usually the calculus is the size of a small pebble. But ureters ...

  9. Kidney Stones

    MedlinePlus

    ... be signs of kidney stones that need a doctor's help: Extreme pain in your back or side that will not go away Blood in your urine Fever and chills Vomiting Urine that smells bad or looks cloudy A burning feeling when you urinate Your doctor will diagnose a kidney stone with urine, blood, ...

  10. Kidney Stones (For Parents)

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Kidney Stones KidsHealth > For Parents > Kidney Stones Print A ... remove the stones from their urinary tracts. How Kidney Stones Form It's the kidneys' job to remove ...

  11. Kidney stones

    PubMed Central

    2011-01-01

    Introduction The age of peak incidence for stone disease is 20 to 40 years, although stones are seen in all age groups. There is a male to female ratio of 3:2. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions for stone removal in people with asymptomatic kidney stones? What are the effects of interventions for the removal of symptomatic renal stones? What are the effects of interventions to remove symptomatic ureteric stones? What are the effects of interventions for the management of acute renal colic? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antispasmodic drugs, extracorporeal shockwave lithotripsy, intravenous fluids, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, oral fluids, percutaneous nephrolithotomy, and ureteroscopy. PMID:22075544

  12. 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

  13. Kidney Stones in Children

    MedlinePlus

    ... Nephrology American Kidney Fund National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Kidney Stones in Children Page Content On this page: ...

  14. 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

  15. Kidney stones

    MedlinePlus

    ... in adults: comparative effectiveness of preventive medical strategies [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US) 2012 ; Report No.: 12-EHC049-EF. PMID: 22896859 ...

  16. Kidney Stones in Adults

    MedlinePlus

    ... had a kidney stone. 2 2 Scales CD, Smith AC, Hanley JM, Saigal CS. Prevalence of kidney ... table or, less commonly, in a tub of water above the lithotripter. The lithotripter generates shock waves ...

  17. 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

  18. Reconsideration of the 1988 NIH Consensus Statement on Prevention and Treatment of Kidney Stones: Are the Recommendations Out of Date?

    PubMed Central

    Goldfarb, David S

    2002-01-01

    In 1988, a consensus conference was held at the National Institutes of Health to develop guidelines for prevention and treatment of kidney stones. The recommendations regarding the medical evaluation of stone formers and treatment directed at stone prevention are reviewed. The relevance of those 1988 guidelines is evaluated for continued pertinence. Most of the recommendations promulgated in the consensus statement remain useful today. One significant change is the current consensus that dietary calcium restriction is no longer considered appropriate therapy, as there is no evidence that it actually prevents stones and has as a consequence the potential to worsen bone demineralization. PMID:16985656

  19. Kidney Stones in Children

    MedlinePlus

    ... through the child’s body to break the kidney stone into smaller particles to pass more readily through the urinary tract. Children younger than age 12 may receive general anesthesia during the procedure. ...

  20. Diet and Kidney Stones

    MedlinePlus

    ... drink at least three quarts (12 cups) of water a day to help reduce the risk for stone formation. Making these healthy lifestyle changes can also help reduce ... NY Register Now 2016 Orangeburg Kidney Walk Thu, ...

  1. 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.

  2. 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

  3. Kidney stone disease

    PubMed Central

    Coe, Fredric L.; Evan, Andrew; Worcester, Elaine

    2005-01-01

    About 5% of American women and 12% of men will develop a kidney stone at some time in their life, and prevalence has been rising in both sexes. Approximately 80% of stones are composed of calcium oxalate (CaOx) and calcium phosphate (CaP); 10% of struvite (magnesium ammonium phosphate produced during infection with bacteria that possess the enzyme urease), 9% of uric acid (UA); and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stones. Stones ultimately arise because of an unwanted phase change of these substances from liquid to solid state. Here we focus on the mechanisms of pathogenesis involved in CaOx, CaP, UA, and cystine stone formation, including recent developments in our understanding of related changes in human kidney tissue and of underlying genetic causes, in addition to current therapeutics. PMID:16200192

  4. 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 ...

  5. Kidney stones - self-care

    MedlinePlus

    Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care ... You visited your health care provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps ...

  6. Knowledge, attitudes, and practice patterns among healthcare providers in the prevention of recurrent kidney stones in Northern Ontario

    PubMed Central

    Bos, Derek; Abara, Emmanuel; Parmar, Malvinder S.

    2014-01-01

    Introducton: Kidney stone recurrence is common. Preventive measures can lead to improved quality of life and costs savings to the individual and healthcare system. Guidelines to prevent recurrent kidney stones are published by various urological societies. Adherence to guidelines amongst healthcare professionals in general is poor, while adherence to preventive management guidelines regarding stone disease is unknown. To understand this issue, we conducted an online study to assess the knowledge, attitudes, and practice patterns of healthcare practitioners in Northern Ontario. Methods: We used the database of healthcare providers affiliated with the Northern Ontario School of Medicine, in Sudbury (East Campus) and Thunder Bay (West Campus), Ontario. We designed the survey based on current best practice guidelines for the management of recurrent kidney stones. Questions covered 3 domains: knowledge, attitudes, and practice patterns. Demographic data were also collected. The survey was distributed electronically to all participants. Results: A total of 68 healthcare providers completed the survey. Of these, most were primary care physicians (72%). To keep uniformity, we analyzed the data of this homogenous group. A total of 70% of the respondents were aware of the current guidelines; however, only 43% applied their knowledge in clinical practice. Most participants lacked confidence while answering most items in the attitude domain. Conclusions: Most primary care physician respondents were aware of the appropriate preventive measures for recurrent kidney stones; however, they do not appear to apply this knowledge effectively in clinical practice. A low response rate is a limitation of our study. Further studies involving a larger sample size may lead to information sharing and collaborative care among healthcare providers. PMID:25485006

  7. [Kidney stone as a cardiovascular risk marker].

    PubMed

    Ernandez, Thomas; Bonny, Olivier

    2014-09-10

    Most of the time, kidney stones are considered as minor, but painful events. However, several studies have recently shown an association between kidney stone and an increased cardio-vascular risk. We review here these studies and explore the underlying pathophysiological hypotheses. At the end, we propose that lithiasis should be considered as a red flag intervening early during life-time and allowing a check of cardiovascular risk factors and early preventive intervention. Such approach may be successful in reducing the incidence of cardio-vascular events in stone formers. PMID:25322624

  8. [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

  9. Kidney Stones in Children and Teens

    MedlinePlus

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

  10. 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

  11. Kidney stones - what to ask your doctor

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000186.htm Kidney stones - what to ask your doctor To use the ... features on this page, please enable JavaScript. A kidney stone is a solid piece of material that forms ...

  12. 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 ...

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

    PubMed Central

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

    2015-01-01

    Abstract 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

  14. 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

  15. Ultrasonic destruction of kidney stones.

    PubMed

    Brannen, G E; Bush, W H

    1984-02-01

    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. PMID:6730470

  16. 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

  17. 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

  18. [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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. Kidney Stone Risk Following Modern Bariatric Surgery

    PubMed Central

    Gonzalez, Ricardo D.

    2014-01-01

    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

  4. Kidney Stones 2012: Pathogenesis, Diagnosis, and Management

    PubMed Central

    Maalouf, Naim M.; Sinnott, Bridget

    2012-01-01

    Context: The pathogenetic mechanisms of kidney stone formation are complex and involve both metabolic and environmental risk factors. Over the past decade, major advances have been made in the understanding of the pathogenesis, diagnosis, and treatment of kidney stone disease. Evidence Acquisition and Synthesis: Both original and review articles were found via PubMed search reporting on pathophysiology, diagnosis, and management of kidney stones. These resources were integrated with the authors' knowledge of the field. Conclusion: Nephrolithiasis remains a major economic and health burden worldwide. Nephrolithiasis is considered a systemic disorder associated with chronic kidney disease, bone loss and fractures, increased risk of coronary artery disease, hypertension, type 2 diabetes mellitus, and the metabolic syndrome. Further understanding of the pathophysiological link between nephrolithiasis and these systemic disorders is necessary for the development of new therapeutic options. PMID:22466339

  5. Keep Your Kidneys Clear: Kicking Kidney Stones

    MedlinePlus

    ... PDF—450 kb) Hey, Parents: It’s a Noisy Planet Keep Your Kidneys Clear Keep Your Kidneys Clear ... Pike Bethesda, Maryland 20892 Department of Health and Human Services Office of Communications and Public Liaison

  6. 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

  7. 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.

  8. 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 ...

  9. 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.

  10. A Composite Kidney Stone Phantom with Mechanical Properties Controllable Across the Range of Properties of Human Kidney Stones

    PubMed Central

    Simmons, W. N.; Cocks, F. H.; Zhong, P.; Preminger, Glenn

    2013-01-01

    A novel composite kidney stone phantom has been developed. This stone phantom is producible with mechanical properties mimicking the range of tensile fracture strength and acoustic properties of human kidney stones and is an inorganic/organic composite material, as are natural kidney stones. Diametral compression testing was used to measure tensile fracture strength, which determines the acoustic comminution behavior of kidney stones. Ultrasound transmission tests were made to characterize the acoustic properties of these stone phantoms. Both the tensile fracture strength (controllable from 1 to ~ 5 MPa) and acoustic properties (CL = 2700 to 4400m/s and CT = 1600 – 2300 m/s) of these composite phantom stones match those of a wide variety of human kidney stones. These artificial stone phantoms should have wide utility in lithotripsy research. PMID:19878912

  11. 25-Hydroxyvitamin D in the Range of 20 to 100 ng/mL and Incidence of Kidney Stones

    PubMed Central

    Nguyen, Stacie; Baggerly, Leo; French, Christine; Heaney, Robert P.; Gorham, Edward D.

    2014-01-01

    Objectives. Increasing 25-hydroxyvitamin D serum levels can prevent a wide range of diseases. There is a concern about increasing kidney stone risk with vitamin D supplementation. We used GrassrootsHealth data to examine the relationship between vitamin D status and kidney stone incidence. Methods. The study included 2012 participants followed prospectively for a median of 19 months. Thirteen individuals self-reported kidney stones during the study period. Multivariate logistic regression was applied to assess the association between vitamin D status and kidney stones. Results. We found no statistically significant association between serum 25-hydroxyvitamin D and kidney stones (P = .42). Body mass index was significantly associated with kidney stone risk (odds ratio = 3.5; 95% confidence interval = 1.1, 11.3). Conclusions. We concluded that a serum 25-hydroxyvitamin D level of 20 to 100 nanograms per milliliter has no significant association with kidney stone incidence. PMID:24134366

  12. Kidney stones - self-care

    MedlinePlus

    ... cheese, yogurt, oysters, and tofu. Eat lemons or oranges, or drink lemonade. Citrate in these foods prevents ... foods. Eat enough carbohydrates. Eat more lemons and oranges, and drink lemonade because the citrate in these ...

  13. KIDNEY STONES: AN UPDATE ON CURRENT PHARMACOLOGICAL MANAGEMENT AND FUTURE DIRECTIONS

    PubMed Central

    Xu, Hongshi; Zisman, Anna L.; Coe, Fredric L.; Worcester, Elaine M.

    2013-01-01

    Introduction Kidney stones are a common problem worldwide with substantial morbidities and economic costs. Medical therapy reduces stone recurrence significantly. Much progress has been made in the last several decades in improving therapy of stone disease. Areas covered 1) effect of medical expulsive therapy on spontaneous stone passage, 2) pharmacotherapy in the prevention of stone recurrence, 3) future directions in the treatment of kidney stone disease. Expert Opinion fluid intake to promote urine volume of at least 2.5L each day is essential to prevent stone formation. Dietary recommendations should be adjusted based on individual metabolic abnormalities. Properly dosed thiazide treatment is the standard therapy for calcium stone formers with idiopathic hypercalciuria. Potassium alkali therapy is considered for hypocitraturia, but caution should be taken to prevent potential risk of calcium phosphate stone formation. For absorptive hyperoxaluria, low oxalate diet and increased dietary calcium intake are recommended. Pyridoxine has been shown effective in some cases of primary hyperoxaluria type I. Allopurinol is used in calcium oxalate stone formers with hyperuricosuria. Treatment of cystine stones remains challenging. Tiopronin can be used if urinary alkalinization and adequate fluid intake are insufficient. For struvite stones, complete surgical removal coupled with appropriate antibiotic therapy is necessary. PMID:23438422

  14. Medullary Sponge Kidney

    MedlinePlus

    ... UTIs and kidney stones. [ Top ] Medications to Prevent Future Urinary Tract Infections and Kidney Stones Health care ... can recommend medications and dietary changes to prevent future UTIs and kidney stones. [ Top ] Clinical Trials The ...

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Kidney Stones in Several Spinal Abnormalities: A Challenging Treatment.

    PubMed

    Silva, Maximiliano Lopez; Sanguinetti, Horacio; Battiston, Santiago; Alvarez, Patricio; Bernardo, Norberto

    2016-01-01

    Patients with severe skeletal deformities are a challenging group to treat. A female, white, 35-year-old presented with right kidney stones located in renal pelvis, lower calyx, and upper ureter. She was affected by severe spinal deformity with restrictive respiratory obstruction, caused by kyphoscoliosis. Percutaneous nephrolithotomy in supine position was performed, achieving complete removal of kidney stones. The treatment of renal stones in this patient was complex, so special attention to respiratory function was mandatory; this was a challenging but feasible situation. PMID:27579402

  3. Kidney Stones in Several Spinal Abnormalities: A Challenging Treatment

    PubMed Central

    Sanguinetti, Horacio; Battiston, Santiago; Alvarez, Patricio; Bernardo, Norberto

    2016-01-01

    Abstract Patients with severe skeletal deformities are a challenging group to treat. A female, white, 35-year-old presented with right kidney stones located in renal pelvis, lower calyx, and upper ureter. She was affected by severe spinal deformity with restrictive respiratory obstruction, caused by kyphoscoliosis. Percutaneous nephrolithotomy in supine position was performed, achieving complete removal of kidney stones. The treatment of renal stones in this patient was complex, so special attention to respiratory function was mandatory; this was a challenging but feasible situation.

  4. [Horseshoe kidney, stone disease and prostate cancer: a case presentation].

    PubMed

    Hermida Pérez, J A; Bermejo Hernández, A; Hernández Guerra, J S; Sobenes Gutierrez, R J

    2013-01-01

    The horseshoe kidney is the most common congenital renal fusion anomalies. It occurs in 0.25% of the population, or 1 in every 400 people. It is more frequent in males (ratio 2:1). The most observed complication of horseshoe kidney is stone disease, although there may be others such as, abdominal pain, urinary infections, haematuria, hydronephrosis, trauma and tumours (most commonly associated with hypernephroma and Wilms tumour). We describe a case of a male patient with horseshoe kidney, stone disease and adenocarcinoma of the prostate. One carrier of this condition who suffered a transitional cell carcinoma of the prostate was found in a review of the literature. PMID:24315083

  5. An evaluation of Tamm-Horsfall protein glycans in kidney stone formers using novel techniques.

    PubMed

    Argade, Sulabha; Chen, Tony; Shaw, Timothy; Berecz, Zoltan; Shi, William; Choudhury, Biswa; Parsons, C Lowell; Sur, Roger L

    2015-08-01

    Tamm-Horsfall protein (THP) is theorized to play a critical role in preventing kidney stone formation. There is conflicting literature on THP analysis in kidney stone patients; therefore, this study was conducted using sensitive and specific bio-analytical techniques to better understand differences in THP, which play a potential role in nephrolithiasis pathogenesis. THP was isolated from urine samples of 34 male and 19 female kidney stone patients and 30 male and 24 female control subjects using diatomaceous earth. Protein was quantified by Superdex-200 size-exclusion chromatography. Sialic acid was determined by 1,2-diamino-4,5-methylenedioxybenzene high-performance liquid chromatography. Neutral and amino sugars were determined by high pH anion-exchange chromatography (HPAEC) with pulsed amperometric detection. THP N-glycans were derivatized with 2-aminobenzamide (2-AB) and profiled by HPAEC with fluorescence detection. N-glycan structures were confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results indicate that kidney stone patients had 32% lower protein content compared to controls, while sialic acid content was lower by 29 and 24% in male and female kidney stone patients, respectively, compared to controls. The neutral and amino sugars were also lower by 18 and 20% for male and female kidney stone patients, respectively, compared to controls. All results were statistically significant (p<0.001). These results are supported by 2-AB profiling of THP N-glycans and by MALDI-TOF MS of highly sialylated N-glycans in the range of m/z 3000-6000. This study demonstrates quantitative and qualitative differences in THP, which can be crucial contributing factors for nephrolithiasis. PMID:25935139

  6. 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…

  7. 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...

  8. 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.

  9. 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

  10. Diagnosis and initial management of kidney stones.

    PubMed

    Portis, A J; Sundaram, C P

    2001-04-01

    The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected renal colic is one major advance. The superior sensitivity and specificity of helical CT allow urolithiasis to be diagnosed or excluded definitively and expeditiously without the potential harmful effects of contrast media. Initial management is based on three key concepts: (1) the recognition of urgent and emergency requirements for urologic consultation, (2) the provision of effective pain control using a combination of narcotics and nonsteroidal anti-inflammatory drugs in appropriate patients and (3) an understanding of the impact of stone location and size on natural history and definitive urologic management. These concepts are discussed with reference to contemporary literature, with the goal of providing tools that family physicians can use in the emergency department or clinic. PMID:11310648

  11. Online Discussion on #KidneyStones: A Longitudinal Assessment of Activity, Users and Content

    PubMed Central

    Bultitude, Matthew; Fritsche, Hans-Martin; Haferkamp, Axel; Heidenreich, Axel; Miernik, Arkadiusz; Neisius, Andreas; Knoll, Thomas; Thomas, Christian; Tsaur, Igor

    2016-01-01

    Introduction Twitter is a popular microblogging platform for the rapid dissemination of information and reciprocal exchange in the urological field. We aimed to assess the activity, users and content of the online discussion, #KidneyStones, on Twitter. Methods We investigated the Symplur Signals analytics tool for Twitter data distributed via the #KidneyStones hashtag over a one year period. Activity analysis reflected overall activity and tweet enhancements. We assessed users’ geolocations and performed an influencer analysis. Content analysis included the most frequently used words, tweet sentiment and shares for top tweets. Results 3,426 users generated over 10,333 tweets, which were frequently accompanied by links (49%), mentions (30%) and photos (13%). Users came from 106 countries across the globe and were most frequently from North America (63%) and Europe (16%). Individual and organisational healthcare professionals made up 56% of the influencers of the Twitter discussion on #KidneyStones. Besides the words ‘kidney’ (used 4,045 times) and ‘stones’ (3,335), ‘pain’ (1,233), ‘urine’ (1,158), and ‘risk’ (1,023) were the most frequently used words. 56% of tweets had a positive sentiment. The median (range) number of shares was 85 (62–587) for the top 10 links, 45.5 (17–94) for the top 10 photos, and 44 (22–95) for the top 10 retweets. Conclusion The rapidly growing Twitter discussion on #KidneyStones engaged multiple stakeholders in the healthcare sector on a global scale and reached both professionals and laypeople. When used effectively and responsibly, the Twitter platform could improve prevention and medical care of kidney stone patients. PMID:27537406

  12. 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

  13. Prevent Diabetes Problems: Keep Your Kidneys Healthy

    MedlinePlus

    ... Language URL Español Prevent diabetes problems: Keep your kidneys healthy Page Content On this page: What are ... I keep my kidneys healthy? What are my kidneys and what do they do? Your kidneys are ...

  14. Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).

    PubMed

    Turney, Benjamin W; Appleby, Paul N; Reynard, John M; Noble, Jeremy G; Key, Timothy J; Allen, Naomi E

    2014-05-01

    The lifetime prevalence of kidney stones is around 10 % and incidence rates are increasing. Diet may be an important determinant of kidney stone development. Our objective was to investigate the association between diet and kidney stone risk in a population with a wide range of diets. This association was examined among 51,336 participants in the Oxford arm of the European Prospective Investigation into Cancer and Nutrition using data from Hospital Episode Statistics in England and Scottish Morbidity Records. In the cohort, 303 participants attended hospital with a new kidney stone episode. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and their 95 % confidence intervals (95 % CI). Compared to those with high intake of meat (>100 g/day), the HR estimates for moderate meat-eaters (50-99 g/day), low meat-eaters (<50 g/day), fish-eaters and vegetarians were 0.80 (95 % CI 0.57-1.11), 0.52 (95 % CI 0.35-0.8), 0.73 (95 % CI 0.48-1.11) and 0.69 (95 % CI 0.48-0.98), respectively. High intakes of fresh fruit, fibre from wholegrain cereals and magnesium were also associated with a lower risk of kidney stone formation. A high intake of zinc was associated with a higher risk. In conclusion, vegetarians have a lower risk of developing kidney stones compared with those who eat a high meat diet. This information may be important to advise the public about prevention of kidney stone formation. PMID:24752465

  15. 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

  16. 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

  17. Role of nanobacteria in the pathogenesis of kidney stone formation

    PubMed Central

    Hong, Xin; Wang, Xiaofeng; Wang, Tian; Yu, Chengfan; Li, Hui

    2016-01-01

    Objective: This study aimed to investigate the nanobacteria (NB) induced damage to human tubular epithelial HK-2 cells and the potential role of NB in the kidney stone formation. Methods: Serum sample from 15 patients with kidney stone was collected. Four groups were included: control, NB group, nanograde hydroxyapatite (nHAP) and calcium oxalate monohydrate (COM) group. Catalase (CAT), malonaldehyde (MDA) and Na+/K+ ATPase activity was detected in the supernatant at 12 and 24 h. At 12 and 24 h, COM was added. Results: At 12 h and 24 h, the CAT in NB group was significantly higher than in control group and nHAP group (P<0.01). CAT at 24 h was significantly higher than in COM group (P<0.01). At 12 h and 24 h, the MDA in NB group was significantly higher than in control group and nHAP group (P<0.01) and significantly lower than in COM group (P<0.01). At 12 h, the Na+/K+ ATPase activity in NB group and nHAP group was significantly lower than in control group, but dramatically increased as compared to COM group (P<0.01). At 24 h, the Na+/K+ ATPase activity in NB group and nHAP group was significantly lower than in control group (P<0.01). Conclusion: NB may induce lipid peroxidation in HK-2 cells and cause adhesion of HK-2 cells to COM in a time-dependent manner, resulting in damage to HK-2 cells. This injury-causing capability of NB is more potent than nHAP and might be involved in the pathogenesis of kidney stone formation. PMID:27508044

  18. 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

  19. 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

  20. 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

  1. 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.

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

    PubMed

    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. PMID:23429795

  3. 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.

  4. 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.

  5. 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.

  6. 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

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

    PubMed

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

    2015-07-01

    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

  8. Application of spectroscopic techniques for the analysis of kidney stones: a pilot study

    NASA Astrophysics Data System (ADS)

    Shameem, K. M., Muhammed; Chawla, Arun; Bankapur, Aseefhali; Unnikrishnan, V. K.; Santhosh, C.

    2016-03-01

    Identification and characterization of kidney stone remains one of the important analytical tasks in the medical field. Kidney stone is a common health complication throughout the world, which may cause severe pain, obstruction and infection of urinary tract, and can lead to complete renal damage. It commonly occurs in both sexes regardless of age. Kidney stones have different composition, although each stones have a major single characteristic component. A complete understanding of a sample properties and their function can only be feasible by utilizing elemental and molecular information simultaneously. Two laser based analytical techniques; Laser Induced Breakdown spectroscopy (LIBS) and Raman spectroscopy have been used to study different types of kidney stones from different patients. LIBS and Raman spectroscopy are highly complementary spectroscopic techniques, which provide elemental and molecular information of a sample. Q-switched Nd:YAG laser at 355 nm laser having energy 17mJ per pulse at 10 Hz repetition rate was used for getting LIBS spectra. Raman measurements were carried out using a home assembled micro-Raman spectrometer. Using the recorded Raman spectra of kidney stones, we were able to differentiate different kinds of kidney stones. LIBS spectra of the same stones are showing the evidence of C, Ca, H, and O and also suggest the presence of certain pigments.

  9. 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

  10. 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

  11. 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 ...

  12. 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 ...

  13. 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

  14. 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

  15. 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

  16. Non-invasive differentiation of kidney stone types using X-ray dark-field radiography.

    PubMed

    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

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

    PubMed

    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

  18. 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

  19. 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

  20. Detecting Fragmentation of Kidney Stones in Lithotripsy by Means of Shock Wave Scattering

    NASA Astrophysics Data System (ADS)

    Sapozhnikov, Oleg A.; Trusov, Leonid A.; Owen, Neil R.; Bailey, Michael R.; Cleveland, Robin O.

    2006-05-01

    Although extracorporeal shock wave lithotripsy (a procedure of kidney stone comminution using focused shock waves) has been used clinically for many years, a proper monitoring of the stone fragmentation is still undeveloped. A method considered here is based on recording shock wave scattering signals with a focused receiver placed far from the stone, outside the patient body. When a fracture occurs in the stone or the stone becomes smaller, the elastic waves in the stone will propagate differently (e.g. shear waves will not cross a fracture) which, in turn, will change the scattered acoustic wave in the surrounding medium. Theoretical studies of the scattering phenomenon are based on a linear elastic model to predict shock wave scattering by a stone, with and without crack present in it. The elastic waves in the stone and the nearby liquid were modeled using a finite difference time domain approach. The subsequent acoustic propagation of the scattered waves into the far-field was calculated using the Helmholtz-Kirchhoff integral. Experimental studies were conducted using a research electrohydraulic lithotripter that produced the same acoustic output as an unmodified Dornier HM3 clinical lithotripter. Artificial stones, made from Ultracal-30 gypsum and acrylic, were used as targets. The stones had cylindrical shape and were positioned co-axially with the lithotripter axis. The scattered wave was measured by focused broadband PVDF hydrophone. It was shown that the size of the stone noticeably changed the signature of the reflected wave.

  1. Prospective study of beverage use and the risk of kidney stones.

    PubMed

    Curhan, G C; Willett, W C; Rimm, E B; Spiegelman, D; Stampfer, M J

    1996-02-01

    Patients with kidney stones are routinely advised to increase their fluid intake to decrease the risk of stone recurrence. However, there has been no detailed examination to determine whether the effect on recurrence varies by the type of beverage consumed. The authors conducted a prospective study of the relation between the intake of 21 different beverages and the risk of symptomatic kidney stones in a cohort of 45,289 men, 40-75 years of age, who had no history of kidney stones. Beverage use and other dietary information was measured by means of a semiquantitative food frequency questionnaire in 1986. During 6 years of follow-up (242,100 person-years), 753 incident cases of kidney stones were documented. After adjusting simultaneously for age, dietary intake of calcium, animal protein and potassium, thiazide use, geographic region, profession, and total fluid intake, consumption of specific beverages significantly added to the prediction of kidney stone risk (p < 0.001). After mutually adjusting for the intake of other beverages, the risk of stone formation decreased by the following amount for each 240-ml (8-oz) serving consumed daily: caffeinated coffee, 10% (95% confidence interval 4-15%); decaffeinated coffee, 10% (3-16%); tea, 14% (5-22%); beer, 21% (12-30%); and wine, 39% (10-58%). For each 240-ml serving consumed daily, the risk of stone formation increased by 35% (4-75%) for apple juice and 37% (1-85%) for grapefruit juice. The authors conclude that beverage type may have an effect on stone formation that involves more than additional fluid intake alone. PMID:8561157

  2. 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

  3. 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

  4. Giant kidney stone: multi-session percutaneous nephrolithotomy with 12 accesses.

    PubMed

    Erbin, Akif; Yürük, Emrah; Binbay, Murat; Müslümanoğlu, Ahmet Yaser

    2015-09-01

    We report a case of a 37-year-old man with a body mass index of 28 kg/m(2) who presented to our outpatient clinic with intermittent left flank pain. Non-contrast abdominopelvic computed tomography revealed a giant coralliform calculus in the left kidney. This giant kidney stone was successfully treated with 3 sessions of percutaneous nephrolithotomy (PNL) with a total 12 accesses. There was no significant reduction in the split function of the kidney after PNL. PMID:26516601

  5. Cross-sectional study of kidney stones by laser-induced breakdown spectroscopy.

    PubMed

    Singh, V K; Rai, A K; Rai, P K; Jindal, P K

    2009-09-01

    We performed laser-induced breakdown spectroscopy (LIBS) for the in situ quantitative estimation of elemental constituents distributed in different parts of kidney stones obtained directly from patients by surgery. We did this by focusing the laser light directly on the center, shell, and surface of the stones to find the spatial distribution of the elements inside the stone. The elements detected in the stones were calcium, magnesium, manganese, copper, iron, zinc, strontium, sodium, potassium, carbon, hydrogen, nitrogen, oxygen, phosphorus, sulfur, and chlorine (Cl), etc. We optimized the LIBS signals by varying the laser energy from 10 mJ to 40 mJ to obtain the best signal-to-background and signal-to-noise ratios. We estimated the quantities of different elements in the stones by drawing calibration curves, plotting graphs of the analyte signal versus the absolute concentration of the elements in standard samples. The detection limits of the calibration curves were discussed. The concentrations of the different elements were found to be widely different in different stones found in different age groups of patients. It was observed that stones containing higher amounts of copper also possessed higher amounts of zinc. In general, the concentrations of trace elements present in the kidney stones decreased as we moved from center to shell and surface. Our results also revealed that the concentrations of elements present in the stones increased with the age of the patients. The results obtained from the calibration curves were compared with results from inductively coupled plasma mass spectrometry (ICP-MS). We also used the intensity ratios of different elemental lines to find the spatial distribution of different elements inside the kidney stones. PMID:19104906

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

    PubMed Central

    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

    2015-01-01

    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 2weeks 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

  7. Use of Google Insights for Search to track seasonal and geographic kidney stone incidence in the United States

    PubMed Central

    Breyer, Benjamin N.; Sen, Saunak; Aaronson, David S.; Stoller, Marshall L.; Erickson, Bradley A.; Eisenberg, Michael L.

    2011-01-01

    Objective To determine if internet search volume for kidney stones has seasonal and geographic distributions similar to known kidney stone incidence. Materials and Methods Google Insights for Search analyzes a portion of Google web searches from all Google domains to compute how many searches are performed for a given term relative to the total number of searches done over a specific time interval and geographic region. Selected terms related to kidney stones were examined to determine which most closely tracked kidney stone incidence. Google Insights for Search data was correlated with hospital admissions for the emergent treatment of nephrolithiasis found through the Nationwide Inpatient Sample. Ambient temperature in Seattle and New York were compared to search volume for these regions to display qualitative relationships. Results The term “kidney stones” had the highest seasonal correlation of terms examined (r=0.81, p=0.0014). Google Insights for Search output and National Inpatient Sample admissions also correlated when regions were compared (r=.90, p=0.005). Qualitative relationships between ambient temperatures and kidney stone search volume do exist. Conclusion Internet search volume activity for kidney stones correlates with temporal and regional kidney stone insurance claims data. In the future, with improved modeling of search detection algorithms and increased internet usage, search volume has the potential to serve as a surrogate for kidney stone incidence. PMID:21459414

  8. Kidney stones and crushed bones secondary to hyperparathyroidism

    PubMed Central

    Sreejith, G. Nair; Pranab, K. Prabhakaran

    2016-01-01

    Here we report a 65-year-old woman with multiple brown tumors and renal stones secondary to primary hyperparathyroidism. This case highlights the need for early recognition of parathyroid hyperactivity. PMID:26722166

  9. Giant ureteral stone in a patient with a single functioning kidney: a case report.

    PubMed

    Jeong, Y B; Park, J K; Kim, H J; Kim, Y G; Kim, M K

    2011-06-01

    A 43-year-old man presented with long-standing left flank pain. A plain abdominal radiograph and intravenous urography (IVU) revealed a giant ureteral stone measuring 6.2 × 2.2 cm causing ureteral obstruction. A non-enhanced computerized tomography (CT) scan showed a significantly atrophied right kidney and left hydronephroureterosis with a giant stone. A left transperitoneal laparoscopic ureterolithotomy was performed with excellent results. PMID:21612759

  10. [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

  11. 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

  12. A simple method for fabricating artificial kidney stones of different physical properties

    PubMed Central

    Esch, Eric; Simmons, W. Neal; Sankin, Georgy; Cocks, Hadley F.; Preminger, Glenn M.; Zhong, Pei

    2013-01-01

    A simple method for preparing artificial kidney stones with varying physical properties is described. BegoStone was prepared with a powder to water ratio (by weight) ranging from 15:3 to 15:6. The acoustic properties of the phantoms were characterized by using an ultrasound transmission technique, from which the corresponding mechanical properties were calculated based on elastic wave theory. The measured parameters for BegoStone phantoms of different water contents are: longitudinal wave speed (3148 – 4159 m/s), transverse wave speed (1813 – 2319 m/s), density (1563 – 1995 kg/m3), longitudinal acoustic impedance (4.92 – 8.30 Kg/m2*s), transverse acoustic impedance (2.83 – 4.63 Kg/m2*s), Young’s modulus (12.9 – 27.4 GPa), bulk modulus (8.6 – 20.2 GPa), and shear modulus (5.1 – 10.7 GPa), which cover the range of corresponding properties reported in natural kidney stones. In addition, diametral compression tests were carried out to determine tensile failure strength of the stone phantoms. BegoStone phantoms with varying water content at preparation have tensile failure strength from 6.9 – 16.3 MPa when tested dry and 3.2 – 7.1 MPa when tested in water-soaked condition. Overall, it is demonstrated that this new BegoStone preparation method can be used to fabricate artificial stones with physical properties matched with those of natural kidney stones of various chemical compositions. PMID:20652562

  13. A simple method for fabricating artificial kidney stones of different physical properties.

    PubMed

    Esch, Eric; Simmons, Walter Neal; Sankin, Georgy; Cocks, Hadley F; Preminger, Glenn M; Zhong, Pei

    2010-08-01

    A simple method for preparing artificial kidney stones with varying physical properties is described. BegoStone was prepared with a powder-to-water ratio ranging from 15:3 to 15:6. The acoustic properties of the phantoms were characterized using an ultrasound transmission technique, from which the corresponding mechanical properties were calculated based on elastic wave theory. The measured parameters for BegoStone phantoms of different water contents are: longitudinal wave speed (3,148-4,159 m/s), transverse wave speed (1,813-2,319 m/s), density (1,563-1,995 kg/m(3)), longitudinal acoustic impedance (4.92-8.30 kg/m(2) s), transverse acoustic impedance (2.83-4.63 kg/m(2) s), Young's modulus (12.9-27.4 GPa), bulk modulus (8.6-20.2 GPa), and shear modulus (5.1-10.7 GPa), which cover the range of corresponding properties reported in natural kidney stones. In addition, diametral compression tests were carried out to determine tensile failure strength of the stone phantoms. BegoStone phantoms with varying water content at preparation have tensile failure strength from 6.9 to 16.3 MPa when tested dry and 3.2 to 7.1 MPa when tested in water-soaked condition. Overall, it is demonstrated that this new BegoStone preparation method can be used to fabricate artificial stones with physical properties matched with those of natural kidney stones of various chemical compositions. PMID:20652562

  14. [NEW OPTIONS OF ENDOSCOPIC TREATMENT FOR KIDNEY AND URETER STONES IN OBESE PATIENTS].

    PubMed

    Martov, A G; Dutov, S V; Andronov, A S; Kil'chukov, Z I; Tahaev, R A

    2015-01-01

    Effective urolithiasis treatment, especially in overweight patients has a considerable medical and social implication. Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotripsy (PCNL) in prone position of the patient are standard treatment options for kidney and ureter stones. These interventions are not always effective in patients with concomitant obesity and are associated with technical difficulties and an increased risk of complications. The study included 175 patients with obesity. The first group consisted of 96 (54.8%) patients treated with transurethral contact lithotripsy. The 2nd group consisted of 54 (30.9%) patients who underwent PCNL in the supine position. The third group comprised 25 (14.3%) patients with multiple stones of kidney and ureter, who underwent combined transurethral and percutaneous intervention in the supine position. The 1st and 3rd group had a higher prevalence of patients with II degree of obesity, in the 2nd group--with I degree of obesity. The mean duration of surgery in 1st group was 43.4 min, in the 2nd--70.3 min and in the third--84.6 min. Method of kidney drainage depended mainly on the presence, location and size of residual stone fragments. The average duration of the kidney drainage stent in patients of the 1st group was 39 days (ureteral catheter--1.3 days). In all patients of the 2nd and 3rd groups, at the final stage of the operation a nephrostomy tube was placed for an average of 2.7 days. The average postoperative hospital stay was 2.9 days in the 1st group, 4.1 days in the 2nd group and 4.5 days in the third group. In the 1st group, the stone-free status was achieved in 81 (84.4%) patients. Another 10 (10.4%) patients later needed ESWL for the complete disposal of the stones. In the 2nd group, the complete clearance of kidney stones was achieved in 49 (90.7%) patients. Another 3 (5.6%) patients required added ESWL to achieve the stone-free status. In the third group of patients stone free status

  15. 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

  16. 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

  17. 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.

  18. Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature

    PubMed Central

    Ishii, Hiro; Rai, Bhavan; Traxer, Olivier; Kata, Slawomir G.; Somani, Bhaskar K.

    2015-01-01

    Introduction and Objectives: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy. Materials and Methods: We conducted a systematic review of the literature to look at the role of ureteroscopy for stone management in these patients. We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to April 2013 for results of ureteroscopy and stone treatment in HSK patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with HSK. Data were extracted on the outcomes and complications. Results: A total of 3 studies was identified during this period. Forty-one patients with HSK underwent flexible ureteroscopy and stone treatment. The mean age was 42 with a male:female ratio nearly 3:1. The mean stone size was 16 mm (range: 3-35 mm). The mean operating time was 86 min with multiple stones seen in 15 patients. All 41 patients had a ureteral access sheath used and flexible ureteroscopy and holmium laser fragmentation done. Thirty-two (78%) patients were stone-free with a mean hospital stay of 1-day. Minor complications (Clavien I or II) were seen in 13 (32%) of which 6 had stent discomfort, 3 needed intravenous antibiotics for <24 h, 3 had hematuria of which 2 needed blood transfusion and one had pyelonephritis needing re-admission and antibiotics. There were no major complications found in the review. Conclusions: Retrograde stone treatment using ureteroscopy and lasertripsy in HSK patients can be performed with good stone clearance rate, but with a slightly higher complication rate. This procedure should, therefore, be done in high volume stone center with an experienced stone surgeon/team. PMID:26692667

  19. Laparoscopy assisted percutaneous stone surgery can be performed in multiple ways for pelvic ectopic kidneys.

    PubMed

    Soylemez, Haluk; Penbegül, Necmettin; Utangac, Mehmet Mazhar; Dede, Onur; Çakmakçı, Süleyman; Hatipoglu, Namık Kemal

    2016-08-01

    Pelvic kidney stones remain a unique challenge to the endourologists. Treatment options include open surgery, extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy (PNL), retrograde intrarenal surgery, and laparoscopy assisted PNL (LA-PNL). As a minimal invasive option, LA-PNL can decrease the risk for bowel and major vessel injury. Here, we describe our experience using the LA-PNL procedures with different combinations, to treat kidney stones in multiple patients with a pelvic ectopic kidney (PEK). Eight patients, with PEK, kidney stones, and no other treatment choice, but open surgery, were included in the study. Two different laparoscopic techniques such as mesocolon dissection and transmesocolic, and four different percutaneous procedures such as standard-PNL, mini-PNL, micro-PNL, and a PNL through the renal pelvis were used for stone extraction in these patients. The mean age of patients was 25.6 ± 12.9 years and mean stone size was 524.1 ± 430.3 mm(2). Mean operation time was 150.5 ± 40.0 (77-210) min which was composed of retrograde catheterization (14.8 ± 2.9 min), laparoscopic procedure (48.7 ± 20.6 min) and PNL procedure (86.8 ± 31.1 min). Residual stones were seen in two patients (no additional treatment was need), while a 'stone-free' procedure was achieved in six patients (75.0 %). On the post-operative first month visit, a stone was observed on radiological examinations in only one patient (87.5 % stone-free). Mean hospitalization time was 2.8 ± 0.9 days. No perioperative or post-operative complication was observed in all patients. LA-PNL surgery is a safe and effective option for treatment of PEK stones, and has several alternative approaches. PMID:26494553

  20. 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

  1. Pain killers and antibacterial therapy for kidney colic and stones.

    PubMed

    Porena, Massimo; Guiggi, Paolo; Balestra, Antonio; Micheli, Carla

    2004-01-01

    In 85% of patients, renal colic is caused by renal-ureteral stones with extrinsic obstructions such as pelvic, retroperitoneal or intestinal abnormalities, and intrinsic reno-ureteral obstructions, e.g. junction pathologies and malformation, accounting for only 10 and 5%, respectively. The objectives of therapy for renal colic therapy are to eliminate pain, preserve renal function and eliminate the obstruction by the excretory pathway. Many drugs can be used to relieve pain: non-steroid anti-inflammatory agents (NSAIDs), opioid analgesics, antidiuretic hormone (ADH), loco-regional anesthesia and acupuncture. Opiates are the first-choice therapy during pregnancy as no other drug is indicated because of tetragenic potential. Paracetamol (N-acetyl-p-aminophenol) is the only NSAID that is registered for pediatric use because it has none of the adverse side effects that are associated with NSAIDs. Tamsulosin, an alpha-lithic drug, has very recently been included among the drugs that are used for stone expulsion. The rationale underlying its use is that a high concentration of alpha-1D adrenergic receptors has been recently detected in the terminal ureter, especially in the intramural tract. Inhibition of alpha-1D receptor stimulation should relax smooth muscle in the intramural ureteral tract, making stone expulsion easier. PMID:15133331

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Comparison of Tissue Injury from Focused Ultrasonic Propulsion of Kidney Stones Versus Extracorporeal Shock Wave Lithotripsy

    PubMed Central

    Connors, Bret A.; Evan, Andrew P.; Blomgren, Philip M.; Hsi, Ryan S.; Harper, Jonathan D.; Sorensen, Mathew D.; Wang, Yak-Nam; Simon, Julianna C.; Paun, Marla; Starr, Frank; Cunitz, Bryan W.; Bailey, Michael R.; Lingeman, James E.

    2013-01-01

    Purpose Focused ultrasonic propulsion is a new non-invasive technique designed to move kidney stones and stone fragments out of the urinary collecting system. However, the extent of tissue injury associated with this technique is not known. As such, we quantitated the amount of tissue injury produced by focused ultrasonic propulsion under simulated clinical treatment conditions, and under conditions of higher power or continuous duty cycles, and compared those results to SWL injury. Materials and Methods A human calcium oxalate monohydrate stone and/or nickel beads were implanted (with ureteroscopy) into 3 kidneys of live pigs (45–55 kg) and repositioned using focused ultrasonic propulsion. Additional pig kidneys were exposed to SWL level pulse intensities or continuous ultrasound exposure of 10 minutes duration (ultrasound probe either transcutaneous or on the kidney). These kidneys were compared to 6 kidneys treated with an unmodified Dornier HM3 Lithotripter (2400 shocks, 120 SWs/min and 24 kV). Histological analysis was performed to assess the volume of hemorrhagic tissue injury created by each technique (% functional renal volume, FRV). Results SWL produced a lesion of 1.56±0.45% FRV. Ultrasonic propulsion produced no detectable lesion with the simulated clinical treatment. A lesion of 0.46±0.37% FRV or 1.15±0.49% FRV could be produced if excessive treatment parameters were used while the ultrasound probe was placed on the kidney. Conclusions Focused ultrasonic propulsion produced no detectable morphological injury to the renal parenchyma when using clinical treatment parameters and produced injury comparable in size to SWL when using excessive treatment parameters. PMID:23917165

  7. Translocation of mineralo-organic nanoparticles from blood to urine: a new mechanism for the formation of kidney stones?

    PubMed

    Martel, Jan; Wu, Cheng-Yeu; Young, John D

    2016-09-01

    Recent studies indicate that mineralo-organic nanoparticles form in various human body fluids, including blood and urine. These nanoparticles may form within renal tubules and increase in size in supersaturated urine, eventually leading to the formation of kidney stones. Here, we present observations suggesting that mineralo-organic nanoparticles found in blood may induce kidney stone formation via an alternative mechanism in which the particles translocate through endothelial and renal epithelial cells to reach urine. We propose that this alternative mechanism of kidney stone formation and the study of mineralo-organic nanoparticles in general may provide novel strategies for the early detection and treatment of ectopic calcifications and kidney stones. PMID:27498926

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

    PubMed Central

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

    2015-01-01

    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

  9. 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

  10. Effect of pH on the morphology of kidney stones

    NASA Astrophysics Data System (ADS)

    Agarwal, Neelesh; Sova, Stacey; Singh, N. B.; Arnold, Brad; Choa, Fow-Sen; Cullum, Brian; Su, Ching-Hua

    2016-05-01

    The process for the formation of kidney stone is very complex phenomena and has some similarity to the crystal growth from a solution. It is very much dependent on the acidity pH of the fluids. This pH variation affects the content and amount of filtering residue and its morphology. In this study we have performed experiments using carbonate, oxides and urea to simulate and understand the morphologies of the residue filtered and coarsened in different conditions. We observed that different of morphologies of kidney stones can be explained on the basis of acidity and hydration conditions. At lower pH fat prism crystals are observed and as pH increases, long fat needle crystals with large aspect ratio are observed. The coarsening experiments showed further growth of crystals. The remelting experiments showed that during dissolution of kidney stones the joining material breaks first leaving the large faceted crystals undissolved when attempts are made to dissolve into small crystallites. However, the morphology did not change. It was also observed that impurities such as magnesium oxide (MgO) affect the morphology significantly.

  11. Extracorporeal abdominal massage may help prevent recurrent bile duct stones after endoscopic sphincterotomy

    PubMed Central

    Uchida, Naohito; Hamaya, Sae; Tatsuta, Miwa; Nakatsu, Toshiaki

    2016-01-01

    Background and study aims: Endoscopic sphincterotomy (EST) is effective, but recurrent bile duct stones are a common late complication. Because there are still no effective therapies for preventing this complication, some patients have experienced bile duct stone recurrence many times. We describe herein a method of abdominal massage to treat patients with prior cholecystectomy who have experienced recurrence of bile duct stones. PMID:27540575

  12. Serum Estradiol and Testosterone Levels in Kidney Stones Disease with and without Calcium Oxalate Components in Naturally Postmenopausal Women

    PubMed Central

    Ou, Lili; Duan, Xiaolu; Zeng, Guohua

    2013-01-01

    Objective Epidemiological data reveal that the overall risk for kidney stones disease is lower for women compared to age-matched men. However, the beneficial effect for the female sex is lost upon menopause, a time corresponding to the onset of fall in estrogen levels. The aim of this study was to describe the serum estradiol (E2) and testosterone (T) characteristics of naturally postmenopausal women with kidney stones. Methods 113 naturally postmenopausal women with newly diagnosed kidney stones (aged 57.4±4.98 years) and 84 age frequency matched stone-free controls (56.9±4.56 years) were validly recruited in the case-control study. The odds ratios (ORs) for the associations between sex hormones and kidney stones were estimated with logistic regression models, adjusting for demographic data and medical history. Patients were also stratified analyzed according to stone components (calcium oxalate stones [COS]; non-calcium oxalate stones [NCOS]). Results Serum E2 (21.1 vs. 31.1 pg/ml) was significantly lower in kidney stones patients compared to controls. Post-hoc analysis demonstrated that this effect was driven by COS patients (p<0.001). According to tertiles of the E2 levels, a significant higher frequency of COS was seen in the lowest E2 group (p <0.001). Multiple logistic regression analysis identified E2 level as a strong factor that was independently associated with the risk for COS (per 1 SD increase, OR=0.951, 95% confidence interval [CI] = 0.919-0.985; highest: lowest tertile, OR=0.214, 95%CI = 0.069-0.665). However, serum T levels did not significantly differ among the groups. Conclusions Naturally postmenopausal women with higher remaining estradiol levels appear less likely to suffer from kidney calcium oxalate stones. However, no correlation was found between serum T level and kidney stones. These findings support the hypothesis that higher postmenopausal endogenous estrogens may protect against kidney stones with ageing. PMID:24086550

  13. The osteopontin-controlled switching of calcium oxalate monohydrate morphologies in artificial urine provides insights into the formation of papillary kidney stones.

    PubMed

    Langdon, Aaron; Grohe, Bernd

    2016-10-01

    The protein osteopontin (OPN) plays an important role in preventing the formation of calcium oxalate monohydrate (COM) kidney stones. To gain insight into these mechanisms, crystallization was induced by addition of human kidney OPN to artificial urine (ionic strength comparable to urine; without citrate), and the OPN-COM interaction studied using a combination of scanning electron (SEM) and confocal microscopy. By SEM, we found that increasing OPN concentrations formed large monoclinic penetration twins (no protein added) and, at higher concentrations (1-, 2μg/ml OPN), super and hyper twins with crystal habits not found in previous studies. For instance, the hyper twins indicate well-facetted gearwheel-like habits with "teeth" developed in all crystallographic directions. At OPN concentrations ≥2μg/ml, a switching to small dumbbell-shaped COM habits with fine-textured surfaces occurred. Confocal microscopy of these dumbbells indicates protein incorporation in almost the entire crystal structure (in contrast to facetted COM), proposing a threshold concentration of ∼2μg/ml OPN for the facetted to the non-facetted habit transformation. Both the gearwheel-like and the dumbbell-shaped habit are again found side-by-side (presumably triggered by OPN concentration gradients within the sample) in in-vitro formed conglomerates, which resemble cross-sections of papillary kidney stones. The abrupt transformation from facetted to non-facetted habits and the unique compliance of the two in-vitro formed habits with the two main morphologies found in papillary kidney stones propose that OPN is a main effector in direct stone-forming processes. Moreover, stone structures which exhibit these two morphologies side-by-side might serve as a novel indicator for OPN concentrations surrounding those structures. PMID:27362921

  14. Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study

    PubMed Central

    Syahputra, Firtantyo Adi; Birowo, Ponco; Rasyid, Nur; Matondang, Faisal Abdi; Noviandrini, Endrika; Huseini, Maruto Harjanggi

    2016-01-01

    Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL). Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice. Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL).   Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037). Our results revealed that TBL (mL) = -153.379 + 0.229 × stone burden (mm2) + 0.203 x baseline serum hematocrit (%); thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL. PMID:27429745

  15. 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.

  16. Proton magnetic resonance spectroscopy of the kidney in renal stone disease.

    PubMed

    Mairiang, Eimorn; Hanpanich, Petcharakorn; Sriboonlue, Pote

    2002-12-01

    Previous studies of renal stone disease (RSD) in Thailand indicated abnormal urinary aggregator and inhibitor composition among farmers with excessive sweat loss. Our aim was to compare the proton MR spectra obtained from the kidneys of 32 proven cases of RSD (aged 38 to 65 yrs) with nine age-matched normal control subjects. We used the STEAM sequence with TE = 15 ms and TR = 2,000 ms. The spectra at 3.25, 3.6 and 3.9 ppm were analyzed. The results showed a correlation between the three peaks (p < 0.001), however, there was no significant difference between the RSD group and the normal control subjects. We therefore concluded that there was no overloading of these osmolytes among the renal stone patients. PMID:12591573

  17. X-ray diffraction and SEM study of kidney stones in Israel: quantitative analysis, crystallite size determination, and statistical characterization.

    PubMed

    Uvarov, Vladimir; Popov, Inna; Shapur, Nandakishore; Abdin, Tamer; Gofrit, Ofer N; Pode, Dov; Duvdevani, Mordechai

    2011-12-01

    Urinary calculi have been recognized as one of the most painful medical disorders. Tenable knowledge of the phase composition of the stones is very important to elucidate an underlying etiology of the stone disease. We report here the results of quantitative X-ray diffraction phase analysis performed on 278 kidney stones from the 275 patients treated at the Department of Urology of Hadassah Hebrew University Hospital (Jerusalem, Israel). Quantification of biominerals in multicomponent samples was performed using the normalized reference intensity ratio method. According to the observed phase compositions, all the tested stones were classified into five chemical groups: oxalates (43.2%), phosphates (7.7%), urates (10.3%), cystines (2.9%), and stones composed of a mixture of different minerals (35.9%). A detailed analysis of each allocated chemical group is presented along with the crystallite size calculations for all the observed crystalline phases. The obtained results have been compared with the published data originated from different geographical regions. Morphology and spatial distribution of the phases identified in the kidney stones were studied with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). This type of detailed study of phase composition and structural characteristics of the kidney stones was performed in Israel for the first time. PMID:21308400

  18. 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.

  19. 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

  20. Biopsy proven medullary sponge kidney: clinical findings, histopathology, and role of osteogenesis in stone and plaque formation.

    PubMed

    Evan, Andrew P; Worcester, Elaine M; Williams, James C; Sommer, Andre J; Lingeman, James E; Phillips, Carrie L; Coe, Fredric L

    2015-05-01

    Medullary sponge kidney (MSK) is associated with recurrent stone formation, but the clinical phenotype is unclear because patients with other disorders may be incorrectly labeled MSK. We studied 12 patients with histologic findings pathognomonic of MSK. All patients had an endoscopically recognizable pattern of papillary malformation, which may be segmental or diffuse. Affected papillae are enlarged and billowy, due to markedly enlarged inner medullary collecting ducts (IMCD), which contain small, mobile ductal stones. Patients had frequent dilation of Bellini ducts, with occasional mineral plugs. Stones may form over white (Randall's) plaque, but most renal pelvic stones are not attached, and have a similar morphology as ductal stones, which are a mixture of calcium oxalate and apatite. Patients had no abnormalities of urinary acidification or acid excretion; the most frequent metabolic abnormality was idiopathic hypercalciuria. Although both Runx2 and Osterix are expressed in papillae of MSK patients, no mineral deposition was seen at the sites of gene expression, arguing against a role of these genes in this process. Similar studies in idiopathic calcium stone formers showed no expression of these genes at sites of Randall's plaque. The most likely mechanism for stone formation in MSK appears to be crystallization due to urinary stasis in dilated IMCD with subsequent passage of ductal stones into the renal pelvis where they may serve as nuclei for stone formation. PMID:25615853

  1. Kidney Stones

    MedlinePlus

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  2. Proteomic evaluation of biological nanoparticles isolated from human kidney stones and calcified arteries.

    PubMed

    Shiekh, Farooq A; Charlesworth, Jon E; Kim, Sung-Hoon; Hunter, Larry W; Jayachandran, Muthuvel; Miller, Virginia M; Lieske, John C

    2010-10-01

    Calcifying biological nanoparticles (NPs) develop under cell culture conditions from homogenates of diverse tissue samples displaying extraosseous mineralization, including kidney stones and calcified aneurysms. Probes to definitively identify NPs in biological systems are lacking. Therefore, the aim of this study was to begin to establish a proteomic biosignature of NPs in order to facilitate more definitive investigation of their contribution to disease. Biological NPs derived from human kidney stones and calcified aneurysms were completely decalcified by overnight treatment with ethylenediaminetetraacetic acid or brief incubation in HCl, as evidenced by lack of a calcium shell and of Alizarin Red S staining, by transmission electron microscopy and confocal microscopy, respectively. Decalcified NPs contained numerous proteins, including some from bovine serum and others of prokaryotic origin. Most prominent of the latter group was EF-Tu, which appeared to be identical to EF-Tu from Staphylococcus epidermidis. A monoclonal antibody against human EF-Tu recognized a protein in Western blots of total NP lysate, as well as in intact NPs by immunofluorescence and immunogold EM. Approximately 8% of NPs were quantitatively recognized by the antibody using flow cytometry. Therefore, we have defined methods to reproducibly decalcify biological NPs, and identified key components of their proteome. These elements, including EF-Tu, can be used as biomarkers to further define the processes that mediate propagation of biological NPs and their contribution to disease. PMID:20466084

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Hippuric acid in 24 h urine collections as a biomarker of fruits and vegetables intake in kidney stone formers.

    PubMed

    Guerra, Angela; Folesani, Giuseppina; Mena, Pedro; Ticinesi, Andrea; Allegri, Franca; Nouvenne, Antonio; Pinelli, Silvana; Del Rio, Daniele; Borghi, Loris; Meschi, Tiziana

    2014-12-01

    This work aimed to underline the prospects of hippuric acid, a product of the metabolism of polyphenols, as a new biomarker of fruits and vegetables intake associated with lithogenic risk. Biochemical parameters of lithogenic risk and hippuric acid were measured in the 24 h urine collections of a cohort of 696 Italian kidney stone formers divided into two subgroups according to their different dietary habits. The link between lithogenic risk parameters and hippuric acid was assessed and this compound was revealed as a valuable biomarker of fruits and vegetables intake in kidney stone formers. A cut-off value of urinary excretion of hippuric acid, 300 mg/24 h, was set as the threshold of discrimination between low and high intake of fruits and vegetables for these patients. These results highlight the importance of monitoring of the excretion hippuric acid in urine to address proper dietary guidelines for the management of stone former patients. PMID:25198158

  9. 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

  10. 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

  11. Economic impact of urinary stones

    PubMed Central

    Hyams, Elias S.

    2014-01-01

    Kidney stones have been rising in prevalence in the United States and worldwide, and represent a significant cost burden. Cost effectiveness research in this area may enable improvements in treatment efficiency that can benefit patients, providers and the healthcare system. There has been limited research in the cost effectiveness of surgical interventions for stone disease, despite the diverse treatment approaches that are available. Medical expulsive therapy (MET) has been shown to improve rates of stone passage for ureteral stones, and there is evidence that this practice should be liberalized from the standpoint of both clinical and cost effectiveness. While conservative treatment following a primary stone event appears to be cost effective, the economic impact of medical therapy for recurrent stone formers requires clarification despite its clinical efficacy. Future study regarding the cost effectiveness of prevention and interventions for stone disease are likely to improve both the quality and efficiency of care. PMID:26816777

  12. 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

  13. Kidney diseases in children - early diagnosis and prevention.

    PubMed

    Polenakovic, Momir; Gucev, Zoran; Tasic, Velibor

    2016-01-01

    Pediatric kidney diseases were in the focus of the World Kidney Day 2016. Macedonian pediatric nephrologists gave their contribution with public appearance in kindergartens, primary and secondary schools, with interactive lectures and discussion with the youngest about the kidney function, healthy life style and simple measures to prevent kidney and urinary tract diseases. Besides promotive appearance in the media, series of lectures were presented in front of the health professionals. The aim was to attract the attention of the professionals for early diagnosis and prevention of kidney disease. The action starts in utero, followed by early postnatal imaging and assessment, conservative treatment and in selected cases surgical treatment. The emphasis is on the multidisciplinary and comprehensive approach to children and adolescents with kidney diseases. PMID:27442411

  14. 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.

  15. 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.

  16. 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 gravel, ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size ...

  17. 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 ...

  18. 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

  19. 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

  20. 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.

  1. Correction of an enzyme trafficking defect in hereditary kidney stone disease in vitro.

    PubMed Central

    Lumb, Michael J; Birdsey, Graeme M; Danpure, Christopher J

    2003-01-01

    In normal human hepatocytes, the intermediary-metabolic enzyme alanine:glyoxylate aminotransferase (AGT) is located within the peroxisomes. However, in approx. one-third of patients suffering from the hereditary kidney stone disease primary hyperoxaluria type 1, AGT is mistargeted to the mitochondria. AGT mistargeting results from the synergistic interaction between a common P11L (Pro11-->Leu) polymorphism and a disease-specific G170R mutation. The polymorphism generates a functionally weak mitochondrial targeting sequence, the efficiency of which is increased by the mutation. The two substitutions together, but not in isolation, inhibit AGT dimerization, highlighting the different structural requirements of the peroxisomal and mitochondrial protein-import machineries. In the present study, we show that treatments known to increase the stability of proteins non-specifically (i.e. lowering the temperature from 37 to 30 degrees C or by the addition of glycerol) completely normalize the intracellular targeting of mutant AGT expressed in transfected COS cells. On the other hand, treatments known to decrease protein stability (e.g. increasing the temperature from 37 to 42 degrees C) exacerbate the targeting defect. Neither of the treatments affects the relative efficiencies of the peroxisomal and mitochondrial protein-import pathways intrinsically. Results are discussed in the light of the known structural requirements of the two protein trafficking pathways and the formulation of possible treatment strategies for primary hyperoxaluria type 1. PMID:12737622

  2. Diet: from food to stone.

    PubMed

    Friedlander, Justin I; Antonelli, Jodi A; Pearle, Margaret S

    2015-02-01

    Dietary factors have been shown to influence urine composition and modulate the risk of kidney stone disease. With the rising prevalence of stone disease in many industrialized nations, dietary modification as therapy to improve lithogenic risk factors and prevent stone recurrence has gained appeal, as it is both relatively inexpensive and safe. While some dietary measures, such as a high fluid intake, have been shown in long-term randomized clinical trials to have durable effectiveness, other dietary factors have been subjected to only short-term clinical or metabolic studies and their efficacy has been inferred. Herein, we review the current literature regarding the role of diet in stone formation, focusing on both the effect on urinary stone risk factors and the effect on stone recurrence. PMID:24938177

  3. 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

  4. 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.

  5. Unilateral ureteric stone associated with gross hydronephrosis and kidney shrinkage: a cadaveric report

    PubMed Central

    Tay, Ern-Wei; Bay, Boon-Huat

    2014-01-01

    Ureteric stones are a common cause of obstruction of the urinary tract, usually presenting with characteristic signs and symptoms, such as acute ureteric colic and hematuria. Occasionally, stones may present with non-specific symptoms such as low back pain and remain unidentified, leading to stone growth, chronic ureteric obstruction and complications such as hydronephrosis and renal damage. Here, we report a large ureteric stone in a cadaver with complete obstruction at the left ureterovesical junction, resulting in severe dilatation of the left ureter and renal pelvis. PMID:25548725

  6. Urine risk factors in children with calcium kidney stones and their siblings.

    PubMed

    Bergsland, Kristin J; Coe, Fredric L; White, Mark D; Erhard, Michael J; DeFoor, William R; Mahan, John D; Schwaderer, Andrew L; Asplin, John R

    2012-06-01

    Calcium nephrolithiasis in children is increasing in prevalence and tends to be recurrent. Although children have a lower incidence of nephrolithiasis than adults, its etiology in children is less well understood; hence, treatments targeted for adults may not be optimal in children. To better understand metabolic abnormalities in stone-forming children, we compared chemical measurements and the crystallization properties of 24-h urine collections from 129 stone formers matched to 105 non-stone-forming siblings and 183 normal, healthy children with no family history of stones, all aged 6 to 17 years. The principal risk factor for calcium stone formation was hypercalciuria. Stone formers have strikingly higher calcium excretion along with high supersaturation for calcium oxalate and calcium phosphate, and a reduced distance between the upper limit of metastability and supersaturation for calcium phosphate, indicating increased risk of calcium phosphate crystallization. Other differences in urine chemistry that exist between adult stone formers and normal individuals such as hyperoxaluria, hypocitraturia, abnormal urine pH, and low urine volume were not found in these children. Hence, hypercalciuria and a reduction in the gap between calcium phosphate upper limit of metastability and supersaturation are crucial determinants of stone risk. This highlights the importance of managing hypercalciuria in children with calcium stones. PMID:22358148

  7. Urine risk factors in children with calcium kidney stones and their siblings

    PubMed Central

    Bergsland, Kristin J.; Coe, Fredric L.; White, Mark D.; Erhard, Michael J.; DeFoor, William R.; Mahan, John D.; Schwaderer, Andrew L.; Asplin, John R.

    2012-01-01

    Calcium nephrolithiasis in children is increasing in prevalence and tends to be recurrent. Although children have a lower incidence of nephrolithiasis than adults, its etiology in children is less well understood; hence treatments targeted for adults may not be optimal in children. To better understand metabolic abnormalities in stone forming children, we compared chemical measurements and the crystallization properties of 24-hour urine collections from 129 stone formers matched to 105 non-stone forming siblings and 183 normal, healthy children with no family history of stones; all aged 6 to 17 years. The principal risk factor for calcium stone formation was hypercalciuria. Stone formers have strikingly higher calcium excretion along with high supersaturation for calcium oxalate and calcium phosphate, and a reduced distance between the upper limit of metastability and supersaturation for calcium phosphate, indicating increased risk of calcium phosphate crystallization. Other differences in urine chemistry that exist between adult stone formers and normal individuals such as hyperoxaluria, hypocitraturia, abnormal urine pH and low urine volume were not found in these children. Hence, hypercalciuria and a reduction in the gap between calcium phosphate upper limit of metastability and supersaturation are crucial determinants of stone risk. This highlights the importance of managing hypercalciuria in children with calcium stones. PMID:22358148

  8. 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

  9. 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

  10. Approaches to Dropout Prevention: The Philosopher's Stone Revisited.

    ERIC Educational Resources Information Center

    McCaul, Edward

    1989-01-01

    Summarizes the major issues and perspectives related to dropout prevention. Reviews general strategies and school-based efforts, with emphasis on community involvement and the teacher-student relationship. Discusses related social and cultural issues, and examines the alternative school approach. Contains 23 references. (SV)

  11. [Diet therapy and life guidance to prevent calcium stones].

    PubMed

    Moriyama, Manabu T

    2011-10-01

    Urolithiasis patients have a low continuation rate with regard to visiting the hospital and undergoing periodic check-ups following therapy. The increased Westernization of diets has played a major role in its onset, and it is believed to be a lifestyle disease. Therefore, the prevention of relapse is difficult without improving the patients' lifestyle and eating habits, and it has been defined as a disease with an extremely high relapse rate. On the other hand, it is believed that the opportunity for periodic visits to the hospital and check-ups can be assured by continuously performing careful dietary interventions appropriate for each patient and by educating patients about the disease, thereby contributing to the prevention of relapses of urolithiasis. PMID:21960239

  12. Activity, energy intake, obesity, and the risk of incident kidney stones in postmenopausal women: a report from the Women's Health Initiative.

    PubMed

    Sorensen, Mathew D; Chi, Thomas; Shara, Nawar M; Wang, Hong; Hsi, Ryan S; Orchard, Tonya; Kahn, Arnold J; Jackson, Rebecca D; Miller, Joe; Reiner, Alex P; Stoller, Marshall L

    2014-02-01

    Obesity is a strong risk factor for nephrolithiasis, but the role of physical activity and caloric intake remains poorly understood. We evaluated this relationship in 84,225 women with no history of stones as part of the Women's Health Initiative Observational Study, a longitudinal, prospective cohort of postmenopausal women enrolled from 1993 to 1998 with 8 years' median follow-up. The independent association of physical activity (metabolic equivalents [METs]/wk), calibrated dietary energy intake, and body mass index (BMI) with incident kidney stone development was evaluated after adjustment for nephrolithiasis risk factors. Activity intensity was evaluated in stratified analyses. Compared with the risk in inactive women, the risk of incident stones decreased by 16% in women with the lowest physical activity level (adjusted hazard ratio [aHR], 0.84; 95% confidence interval [95% CI], 0.74 to 0.97). As activity increased, the risk of incident stones continued to decline until plateauing at a decrease of approximately 31% for activity levels ≥10 METs/wk (aHR, 0.69; 95% CI, 0.60 to 0.79). Intensity of activity was not associated with stone formation. As dietary energy intake increased, the risk of incident stones increased by up to 42% (aHR, 1.42; 95% CI, 1.02 to 1.98). However, intake <1800 kcal/d did not protect against stone formation. Higher BMI category was associated with increased risk of incident stones. In summary, physical activity may reduce the risk of incident kidney stones in postmenopausal women independent of caloric intake and BMI, primarily because of the amount of activity rather than exercise intensity. Higher caloric intake further increases the risk of incident stones. PMID:24335976

  13. Geoenvironmental factors related to high incidence of human urinary calculi (kidney stones) in Central Highlands of Sri Lanka.

    PubMed

    Abeywickarama, Buddhika; Ralapanawa, Udaya; Chandrajith, Rohana

    2016-10-01

    An area with extremely high incidence of urinary calculi was investigated in the view of identifying the relationship between the disease prevalence and the drinking water geochemistry. The prevalence of the kidney stone disease in the selected Padiyapelella-Hanguranketa area in Central Highlands of Sri Lanka is significantly higher compared with neighboring regions. Drinking water samples were collected from water sources that used by clinically identified kidney stone patients and healthy people. A total of 83 samples were collected and analyzed for major anions and cations. The anions in the area varied in the order HCO3 (-) > Cl(-) > SO4 (2-) > NO3 (-) and cations varied in the order Ca(2+) > Mg(2+) > Na(+) > K(+) > Fe(2+). The dissolved silica that occurs as silicic acid (H4SiO4) in natural waters varied from 8.8 to 84 mg/L in prevalence samples, while it was between 9.7 and 65 mg/L for samples from non-prevalence locations. Hydrogeochemical data obtained from the two groups were compared using the Wilcoxon rank-sum test. It showed that pH, total hardness, Na(+), Ca(2+) and Fe(2+) had significant difference (p < 0.005) between water sources used by patients and non-patients. Elemental ratio plots, Gibbs' plot and factor analysis indicated that the chemical composition of water sources in this area is strongly influenced by rock-water interactions, particularly the weathering of carbonate and silicate minerals. This study reveals a kind of association between stone formation and drinking water geochemistry as evident by the high hardness/calcium contents in spring water used by patients. PMID:26620679

  14. Effects of hydrochlorothiazide on kidney stone therapy with extracorporeal shock wave lithotripsy

    PubMed Central

    Tehranchi, Ali; Rezaei, Yousef; Mohammadi-Fallah, Mohammadreza; Mokhtari, Mohammadreza; Alizadeh, Mansour; Abedi, Farzad; Khalilzadeh, Masoud; Tehranchi, Parisa

    2014-01-01

    Objective: The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi (diameter ≤2 cm) were enrolled from February 2010 to September 2010. ESWL protocol was performed by 2,500 shocks per session. The patients were randomized into two groups: (1) 26 patients who were given 25 mg hydrochlorothiazide twice daily; and (2) 26 patients who received placebo. The stone-free rate was defined as residual calculus size ≤4 mm in controlled ultrasound on 2nd week, 1 month and 3 months after ESWL. Results: 19 (78%) of the first group and 9 (42.9%) of the second group were stone-free after one session of ESWL (P = 0.02). 88% of the group 1 and 47.8% of the group 2 were stone-free on 1 month after ESWL (P = 0.003); however, this effect of hydrochlorothiazide was not related to the patients' body mass index, age and gender. The accessory treatment procedures were applied in 24% of the group 1 compared with 19% of the group 2 during 3 months (P = 0.68). All patients in both groups were stone-free on 3 months following lithotripsy. Conclusions: Hydrochlorothiazide did not impact on the stone-free rate and using accessory procedure within 3 months; however, it decreased duration of stone-free status and number of ESWL sessions. PMID:25125892

  15. Recurrent urethral hairball and stone in a hypospadiac: management and prevention.

    PubMed

    Singh, I; Hemal, A K

    2001-08-01

    A 32-year-old perineal hypospadiac man presented with recurrent urethral hair growth, stone, and stricture with a history of multiple urethroplasties. He was treated by urethrolithotomy, internal urethrotomy, laser epilation of the hair-bearing urethral graft, closure of the fistula, and chemical depilation of the neourethral hair. A dilute solution of thioglycolate was prophylactically instilled into the neourethra at intervals of 3 months to ensure complete tricholysis and to prevent recurrent hair growth in the future. PMID:11552792

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

    PubMed

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    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

  17. 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

  18. The evolving epidemiology of stone disease.

    PubMed

    Roudakova, Ksenia; Monga, Manoj

    2014-01-01

    The epidemiology of kidney stones is evolving - not only is the prevalence increasing, but also the gender gap has narrowed. What drives these changes? Diet, obesity or environmental factors? This article will review the possible explanations for a shift in the epidemiology, with the hope of gaining a better understanding of the extent to which modifiable risk factors play a role on stone formation and what measures may be undertaken for disease prevention in view of these changing trends. PMID:24497682

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

    PubMed

    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

  20. 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

  1. 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

  2. Herbal preparations affect the kinetic factors of calcium oxalate crystallization in synthetic urine: implications for kidney stone therapy.

    PubMed

    Rodgers, Allen L; Webber, Dawn; Ramsout, Ronica; Gohel, Mayur Danny I

    2014-06-01

    Herbal remedies are increasingly being considered as suitable long-term treatments for renal dysfunction. The objective of the present study was to investigate the effect of some herbal extracts, all previously identified in published studies as influencing kidney stone formation, on the crystallization characteristics of calcium oxalate (CaOx) in synthetic urine (SU). Five herbal extracts were selected for the study: Folium pyrrosiae, Desmodium styracifolium, Phyllanthus niruri, Orthosiphon stamineus and Cystone(®). Concentrated stock solutions of each herbal extract were prepared and were tested at their recommended dosages in in vitro crystallization studies in SU. CaOx crystallization experiments were performed in which the metastable limit (MSL), average particle size, and nucleation and growth rates were determined. The CaOx MSL of SU was unaltered by the five herbal extracts. Three of the herbs (Desmodium styracifolium, Orthosiphon stamineus and Cystone(®)) significantly reduced the average particle size of precipitated crystals relative to undosed SU. All of the extracts increased the rate of nucleation and decreased the rate of growth significantly in SU. Cystone(®) showed the greatest effect on the measured risk factors. It is concluded that all of the herbs have the potential to serve as inhibitors of calcium oxalate stone formation and warrant investigation in clinical trials. PMID:24648109

  3. Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones.

    PubMed

    Massey, L K; Roman-Smith, H; Sutton, R A

    1993-08-01

    Dietary restriction of oxalate intake has been used as therapy to reduce the risk of recurrence of calcium oxalate kidney stones. Although urinary oxalate is derived predominantly from endogenous synthesis, it may also be affected by dietary intake of oxalate and calcium. The risk of increasing urinary oxalate excretion by excessive consumption of dietary oxalate is greatest in individuals with a high rate of oxalate absorption, both with and without overt intestinal disease. Although oxalate-rich foods enhanced excretion of urinary oxalate in normal volunteers, the increase was not proportional to the oxalate content of the food. Only eight foods--spinach, rhubarb, beets, nuts, chocolate, tea, wheat bran, and strawberries--caused a significant increase in urinary oxalate excretion. Restriction of dietary calcium enhances oxalate absorption and excretion, whereas an increase in calcium intake may reduce urinary oxalate excretion by binding more oxalate in the gut. This review of the literature indicates that initial dietary therapy for stone-forming individuals can be limited to the restriction of foods definitely shown to increase urinary oxalate. The effects of oxalate-restricted diets on urinary oxalate should be evaluated by means of laboratory analyses of urine composition. Subsequent long-term therapy can be recommended if beneficial results are obtained from oxalate restriction at an appropriate calcium intake. PMID:8335871

  4. Citrate occurs widely in healthy and pathological apatitic biomineral: mineralized articular cartilage, and intimal atherosclerotic plaque and apatitic kidney stones.

    PubMed

    Reid, David G; Duer, Melinda J; Jackson, Graham E; Murray, Rachel C; Rodgers, Allen L; Shanahan, Catherine M

    2013-09-01

    There is continuing debate about whether abundant citrate plays an active role in biomineralization of bone. Using solid state NMR dipolar dephasing, we examined another normally mineralized hard tissue, mineralized articular cartilage, as well as biocalcifications arising in pathological conditions, mineralized intimal atherosclerotic vascular plaque, and apatitic uroliths (urinary stones). Residual nondephasing ¹³C NMR signal at 76 ppm in the spectra of mineralized cartilage and vascular plaque indicates that a quaternary carbon atom resonates at this frequency, consistent with the presence of citrate. The presence, and as yet unproven possible mechanistic involvement, of citrate in tissue mineralization extends the compositional, structural, biogenetic, and cytological similarities between these tissues and bone itself. Out of 10 apatitic kidney stones, five contained NMR-detectable citrate. Finding citrate in a high proportion of uroliths may be significant in view of the use of citrate in urolithiasis therapy and prophylaxis. Citrate may be essential for normal biomineralization (e.g., of cartilage), play a modulatory role in vascular calcification which could be a target for therapeutic intervention, and drive the formation of apatitic rather than other calcific uroliths, including more therapeutically intractable forms of calcium phosphate. PMID:23780351

  5. 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

  6. 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.

  7. The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease?

    PubMed

    Kok, Dirk Jan

    2016-02-01

    Whether prevention of Urolithiasis is worthwhile is the outcome of the balance between efficacy of prevention and costs and efforts related of respectively prevention and treatment of a new stone. Well controlled trials demonstrate that effective prevention of new stone formation is possible using medical treatment and lifestyle interventions. In long-term general practice the results obtained with preventive interventions is disappointing. Low and diminishing long-term compliance to the intervention is a major cause for this. Both the long-term aspect and the natural resistance to lifestyle changes contribute to this low compliance. From an analysis of the existing data on trials of preventive interventions and from experiences obtained in other patient groups where lifestyle changes are applied I will make the case that self-empowerment of the patient using m-health lifestyle coaching (a smart phone application) can considerably enhance the level of prevention that is obtained in general practice. In conclusion, I will describe what features will improve usage and efficacy of such an app. PMID:26667826

  8. Continuous-wave and quasi-continuous wave thulium-doped all-fiber laser: implementation on kidney stone fragmentations.

    PubMed

    Pal, Debasis; Ghosh, Aditi; Sen, Ranjan; Pal, Atasi

    2016-08-10

    A continuous-wave (CW) as well as quasi-continuous wave (QCW) thulium-doped all-fiber laser at 1.94 μm has been designed for targeting applications in urology. The thulium-doped active fiber with an octagonal-shaped inner cladding is pumped at 793 nm to achieve stable CW laser power of 10 W with 32% lasing efficiency (against launched pump power). The linear variation of laser power with pump offers a scope of further power scaling. A QCW operation with variation of duty cycle from 0.5% to 90%, repetition rate from 0.1 Hz to 1 kHz, and pulse width from 40 μs to 2 s has been presented. Laser power of 9.5 W in CW mode of operation and average power of 5.2 W with energy range of 10.4-104 mJ in QCW mode of operation has been employed to fragment calcium oxalate monohydrate kidney stones (size of 1.5-4 cm) having different colors and composition. Dependence of ablation threshold, ablation rate, and average fragmented particle size on the average power and energy has been studied. One minute of laser exposure results in fragmentation of a stone surface with ablation rate of 8  mg/min having minimum particle size of 6.54 μm with an average size of 20-100 μm ensuring the natural removal of fragmented parts through the urethra. PMID:27534454

  9. 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.

  10. Prediction and Prevention of Acute Kidney Injury after Cardiac Surgery

    PubMed Central

    Shin, Su Rin; Kim, Won Ho; Kim, Dong Joon; Shin, Il-Woo; Sohn, Ju-Tae

    2016-01-01

    The incidence of acute kidney injury after cardiac surgery (CS-AKI) ranges from 33% to 94% and is associated with a high incidence of morbidity and mortality. The etiology is suggested to be multifactorial and related to almost all aspects of perioperative management. Numerous studies have reported the risk factors and risk scores and novel biomarkers of AKI have been investigated to facilitate the subclinical diagnosis of AKI. Based on the known independent risk factors, many preventive interventions to reduce the risk of CS-AKI have been tested. However, any single preventive intervention did not show a definite and persistent benefit to reduce the incidence of CS-AKI. Goal-directed therapy has been considered to be a preventive strategy with a substantial level of efficacy. Many pharmacologic agents were tested for any benefit to treat or prevent CS-AKI but the results were conflicting and evidences are still lacking. The present review will summarize the current updated evidences about the risk factors and preventive strategies for CS-AKI. PMID:27419130

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

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

    SciTech Connect

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

    2015-10-28

    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.

  18. 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. PMID:27087711

  19. 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

  20. 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

  1. 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.

  2. Extraintestinal Complications: Kidney Disorders

    MedlinePlus

    ... Extraintestinal Complications: Kidney Disorders Go Back Extraintestinal Complications: Kidney Disorders Email Print + Share The kidneys filter the ... but some less serious ones occur more frequently. Kidney stones These are probably the most commonly encountered ...

  3. 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.

  4. [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

  5. Hydronephrosis of one kidney

    MedlinePlus

    ... Acute hydronephrosis; Urinary obstruction; Unilateral hydronephrosis; Nephrolithiasis - hydronephrosis; Kidney stone - hydronephrosis; Renal calculi - hydronephrosis; Ureteral calculi - hydronephrosis; ...

  6. 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

  7. 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

  8. 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

  9. Kidney Stones in Adults

    MedlinePlus

    ... Griffin Rodgers, Director of the NIDDK Clinical Trials Current research studies and how you can volunteer Community Outreach and Health Fairs Science-based information and tips for planning an outreach effort or community event For Health Care Professionals Patient and provider resources ...

  10. Kidney stones - lithotripsy - discharge

    MedlinePlus

    Extracorporeal shock wave lithotripsy - discharge; Shock wave lithotripsy - discharge; Laser lithotripsy - discharge; Percutaneous lithotripsy - discharge; Endoscopic lithotripsy - discharge; ESWL - discharge

  11. Kidney (Renal) Failure

    MedlinePlus

    ... renal function using ureteral stenting, nephrostomy, surgery or dialysis. What is kidney (renal) failure? How is kidney ... as a urinary stent or kidney stone removal. Dialysis , including hemodialysis and peritoneal dialysis: These procedures remove ...

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. American Kidney Fund

    MedlinePlus

    ... ago. Kidney Disease About your kidneys About your kidneys Your kidneys are vital organs that remove waste ... long as possible. Kidney-friendly diet for CKD Kidney-friendly diet You may be able to prevent ...

  17. 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

  18. Predicting and preventing readmissions in kidney transplant recipients.

    PubMed

    Covert, Kelly L; Fleming, James N; Staino, Carmelina; Casale, Jillian P; Boyle, Kimberly M; Pilch, Nicole A; Meadows, Holly B; Mardis, Caitlin R; McGillicuddy, John W; Nadig, Satish; Bratton, Charles F; Chavin, Kenneth D; Baliga, Prabhakar K; Taber, David J

    2016-07-01

    A lack of research exploring post-transplant process optimization to reduce readmissions and increasing readmission rates at our center from 2009 to 2013 led to this study, aimed at assessing the effect of patient and process factors on 30-d readmission rates after kidney transplantation. This was a retrospective case-control study in adult kidney transplant recipients. Univariate and multivariate analyses were utilized to assess patient and process determinants of 30-d readmissions. 384 patients were included; 30-d readmissions were significantly associated with graft loss and death (p = 0.001). Diabetes (p = 0.049), pharmacist identification of poor understanding or adherence, and prolonged time on hemodialysis prior to transplant were associated with an increased risk of 30-d readmissions. After controlling for risk factors, readmission rates were only independently predicted by pharmacist identification of patient lack of understanding or adherence regarding post-transplant medications and dialysis exposure for more than three yr (OR 2.3, 95% CI 1.10-4.71, p = 0.026 and OR 2.1, 95% CI 1.22, 3.70, respectively), both of which were significantly modified by history of diabetes. Thirty-d readmissions are attributable to both patient and process-level factors. These data suggest that a lack of post-transplant medication knowledge in high-risk patients drives early hospital readmission. PMID:27101090

  19. AT1 receptor antagonism before ischemia prevents the transition of acute kidney injury to chronic kidney disease.

    PubMed

    Rodríguez-Romo, Roxana; Benítez, Kenia; Barrera-Chimal, Jonatan; Pérez-Villalva, Rosalba; Gómez, Arturo; Aguilar-León, Diana; Rangel-Santiago, Jesús F; Huerta, Sara; Gamba, Gerardo; Uribe, Norma; Bobadilla, Norma A

    2016-02-01

    Despite clinical recovery of patients from an episode of acute kidney injury (AKI), progression to chronic kidney disease (CKD) is possible on long-term follow-up. However, mechanisms of this are poorly understood. Here, we determine whether activation of angiotensin-II type 1 receptors during AKI triggers maladaptive mechanisms that lead to CKD. Nine months after AKI, male Wistar rats develop CKD characterized by renal dysfunction, proteinuria, renal hypertrophy, glomerulosclerosis, tubular atrophy, and tubulointerstitial fibrosis. Renal injury was associated with increased oxidative stress, inflammation, α-smooth muscle actin expression, and activation of transforming growth factor β; the latter mainly found in epithelial cells. Although administration of losartan prior to the initial ischemic insult did not prevent or reduce AKI severity, it effectively prevented eventual CKD. Three days after AKI, renal dysfunction, tubular structural injury, and elevation of urinary biomarkers were present. While the losartan group had similar early renal injury, renal perfusion was completely restored as early as day 3 postischemia. Further, there was increased vascular endothelial growth factor expression and an early activation of hypoxia-inducible factor 1 α, a transcription factor that regulates expression of many genes that help reduce renal injury. Thus, AT1 receptor antagonism prior to ischemia prevented AKI to CKD transition by improving early renal blood flow recovery, lesser inflammation, and increased hypoxia-inducible factor 1 α activity. PMID:26509589

  20. 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.

  1. Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments.

    PubMed

    Skolarikos, Andreas; Papatsoris, Athanasios G

    2009-10-01

    Residual stone fragments can occur in up to 8% of patients who are treated with percutaneous nephrolithotomy (PCNL). When left untreated, approximately half of these patients will experience a stone-related event, for which more than half will need a secondary surgical intervention. Predictors of adverse events are a residual fragment larger than 2 mm that is located in the pelvis or ureter. Preventive measures for the creation of residual fragments include a carefully selected access giving exposure to the bulk of the stone, the creation of multiple tracts, the use of single pulse pneumatic lithotripsy, the prevention of stone migration with ureteral balloons or stone cones, and careful flushing of the stones from the collecting system. Plain radiography of the kidneys, ureters, and bladder, linear tomography, and ultrasonography have all been used to judge the result of PCNL and to detect the presence of residual fragments. Thin-slice, unenhanced helical CT, however, is more sensitive and should be performed at 1 month after surgery. While medical therapy and shockwave lithotripsy possess a minor role, second-look flexible nephroscopy and/or flexible ureterorenoscopy seem to be the treatments of choice for residual stone fragments after PCNL. PMID:19747041

  2. 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.

  3. Preventing kidney injury in children with neurogenic bladder dysfunction.

    PubMed

    Larijani, Faezeh Javadi; Moghtaderi, Mastaneh; Hajizadeh, Nilofar; Assadi, Farahnak

    2013-12-01

    The most common cause of neurogenic bladder dysfunction (NBD) in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD), which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newborn infant includes a renal and bladder ultrasound, measurement of urine residual, determination of serum creatinine level, and urodynamics study. Voiding cystogram is indicated when either hydronephrosis or DSD is present. The main goal of treatment is prevention of urinary tract deterioration and achievement of continuance at an appropriate age. Clean intermittent catheterization (CIC) in combination with anticholinergic (oxybutynin) and antibiotics are instituted in those with high filling and voiding pressures, DSD and/or high grade reflux immediately after the myelomeningocele is repaired. Botulium toxin-A injection into detrusor is a safe alternative in patients with insufficient response or significant side effects to anticholinergic (oral or intravesical instillation) therapy. Surgery is an effective alternative in patients with persistent detrusor hyperactivity and/or dyssynergic detrusor sphincter despites of the CIC and maximum dosage of anticholinergic therapy. Children with NBD require care from a multidisciplinary team approach consisting of pediatricians, neurosurgeon, urologist, nephrologists, orthopedic surgeon, and other allied medical specialists. PMID:24498490

  4. 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.

  5. Superoxide dismutase derivative prevents oxidative damage in liver and kidney of rats induced by exhausting exercise.

    PubMed

    Radák, Z; Asano, K; Inoue, M; Kizaki, T; Oh-Ishi, S; Suzuki, K; Taniguchi, N; Ohno, H

    1996-01-01

    To prevent oxidative tissue damage induced by strenuous exercise in the liver and kidney superoxide dismutase derivative (SM-SOD), which circulated bound to albumin with a half-life of 6 h, was injected intraperitoneally into rats. Exhausting treadmill running caused a significant increase in the activities of xanthine oxidase (XO), and glutathione peroxidase (GPX) in addition to concentrations of thiobarbituric acid-reactive substances (TBARS) in hepatic tissue immediately after running. There was a definite increase in the immunoreactive content of mitochondrial superoxide dismutase (Mn-SOD) 1 day after the running. Meanwhile, the TBARS concentration in the kidney was markedly elevated 3 days after running. The activities of GPX, and catalase in the kidney increased significantly immediately and on days 1 and 3 following the test. The immunoreactive content of Mn-SOD also increased 1 day after running. The exercise induced no significant changes in immunoreactive Cu, Zn-SOD content in either tissue. The administration of SM-SOD provided effective protection against lipid peroxidation, and significantly attenuated the alterations in XO and all the anti-oxidant enzymes, measured. In summary, the present data would suggest that exhausting exercise may induce XO-derived oxidative damage in the liver, while the increase in lipid peroxidation in the kidney might be the result of washout-dependent accumulation of peroxidised metabolites. We found that the administration of SM-SOD provided excellent protection against exercise-induced oxidative stress in both liver and kidney. PMID:8820884

  6. 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

  7. Challenging Case: Stones.

    PubMed

    Soloway, Mark S; Ziemba, Justin B; Matlaga, Brian R; Monga, Manoj

    2016-10-01

    A 40-year-old woman presents to the emergency department after a motor vehicle accident, and a CT scan revealed no injuries but incidentally notes three non-obstructing stones in the left kidney of 3, 4, and 5 mm in size. She is completely asymptomatic and has no history of urolithiasis. PMID:27566646

  8. [Prevention of Chronic Kidney Disease and strategies to counteract chronic diseases in Italy].

    PubMed

    Mastrilli, Valeria; D'Elia, Roberto; Galeone, Daniela

    2016-01-01

    The Prevention of Chronic Kidney Disease (CKD) is placed in the more general context of prevention of major chronic Non Communicable Diseases (NCDs): cardiovascular diseases, diabetes, chronic lung diseases and tumors that are the main problem for public health worldwide. Any health policy strategy aimed to the prevention of NCDs has to provide knowledge of health and socioeconomic status of the population, to reduce the level of exposure to risk factors and to adapt health services to the request for assistance. To this purpose, population monitoring systems have been implemented in the last years. The NCDs share some risk factors that are related, in large part, to unhealthy individual behaviours: smoking, alcohol abuse, unhealthy diet and physical inactivity. NCDs prevention has to be understood as the set of all actions, sanitary and not, aiming to prevent or delay the onset of diseases or their complications. Preventive measures should, therefore, involve not only the health sector but also all the actors that can help to prevent that disease. As for the Prevention of CKD, the Ministry of Health has established a working table, which handled the Drafting of the "Position paper for the CKD", approved in the State-Regions Conference on august 8th 2014. The document draws a national strategy to combat this disease through primary prevention, early diagnosis and the establishment of diagnostic - therapeutic pathways (DTP). PMID:27545630

  9. 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

  10. Novel Plasminogen Activator Inhibitor-1 Inhibitors Prevent Diabetic Kidney Injury in a Mouse Model

    PubMed Central

    Park, Jong Hee; Lee, Jung Hwa; Lee, Hi Bahl; Miyata, Toshio; Ha, Hunjoo

    2016-01-01

    Diabetic nephropathy is the leading cause of end-stage renal disease worldwide, but no effective therapeutic strategy is available. Because plasminogen activator inhibitor-1 (PAI-1) is increasingly recognized as a key factor in extracellular matrix (ECM) accumulation in diabetic nephropathy, this study examined the renoprotective effects of TM5275 and TM5441, two novel orally active PAI-1 inhibitors that do not trigger bleeding episodes, in streptozotocin (STZ)-induced diabetic mice. TM5275 (50 mg/kg) and TM5441 (10 mg/kg) were administered orally for 16 weeks to STZ-induced diabetic and age-matched control mice. Relative to the control mice, the diabetic mice showed significantly increased (p < 0.05) plasma glucose and creatinine levels, urinary albumin excretion, kidney-to-bodyweight ratios, glomerular volume, and fractional mesangial area. Markers of fibrosis and inflammation along with PAI-1 were also upregulated in the kidney of diabetic mice, and treatment with TM5275 and TM5441 effectively inhibited albuminuria, mesangial expansion, ECM accumulation, and macrophage infiltration in diabetic kidneys. Furthermore, in mouse proximal tubular epithelial (mProx24) cells, both TM5275 and TM5441 effectively inhibited PAI-1-induced mRNA expression of fibrosis and inflammation markers and also reversed PAI-1-induced inhibition of plasmin activity, which confirmed the efficacy of the TM compounds as PAI-1 inhibitors. These data suggest that TM compounds could be used to prevent diabetic kidney injury. PMID:27258009

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

    PubMed

    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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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....

  17. 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....

  18. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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....

  19. 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....

  20. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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....

  1. The future of stone research: rummagings in the attic, Randall's plaque, nanobacteria, and lessons from phylogeny.

    PubMed

    Ryall, Rosemary Lyons

    2008-05-01

    The prevention or cure of stone disease will be achieved only by identifying biochemical, physiological and molecular mechanisms operating before the formation of a calculus. Yet, the gradual increase in the total number of papers devoted to the study of kidney stones that has occurred since the beginning of the 21st century can be attributed almost entirely to papers concerned with the investigation of factors associated with urolithiasis after stones have already formed. The need to prevent stones by discovering how the human body routinely stops their formation in those of us who do not suffer from them is therefore as exigent as ever and a new approach to investigating the causes of stones is urgently needed. In this paper, I develop the view that stone research will best progress by examining and understanding how healthy plants and animals control the formation of biominerals. In addition to structures like bones, teeth, shells and spines, many organisms spanning the entire phylogenetic tree form intra- and extracellular granules which are use as storage depots for calcium and other important ions, which they can reclaim to maintain homeostasis or to satisfy specific needs during periods of high demand, such as shell formation, moulting or skeletal development. These electron-dense granules, which also bear an uncanny resemblance to calcified nanobacteria, are remarkably similar in general structure, size and composition to particles observed in healthy human kidneys and in Randall's plaque. Therefore, it is likely that the granules in human kidneys fulfil analogous functions to those in other organisms-particularly in calcium homeostasis. Their study in a large range of creatures has already provided a deep well of information about their structure, movement, composition, macromolecular content, synthesis and resorption, from which we can draw to quench our thirst for knowledge of basic mechanisms and events involved in the formation of human kidney stones

  2. 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 ...

  3. The kidney in space.

    PubMed

    Liakopoulos, Vassilios; Leivaditis, Konstantinos; Eleftheriadis, Theodoros; Dombros, Nicholas

    2012-12-01

    Renal adaptation in space has been studied during various space missions since the early 70s. Technical and financial disadvantages of performing experiments under real microgravity conditions have warranted the conductance of relative studies under simulated weightlessness on earth. Arriving in microgravity leads to a redistribution of body fluids to the upper part of the body and an exaggerated extravasation very early in-flight. Plasma volume as well as skin evaporation and oral hydration are reduced, while total body water seems to remain stable. Urinary sodium is diminished and a substantial amount of sodium is retained outside the intravascular space. Glomerular filtration rate shows a transient mild increase. Urinary albumin excretion is reduced although initial studies had demonstrated the opposite. Examination of renal histopathology after exposure to simulated microgravity in rats revealed glomerular atrophy, interstitial edema, and degeneration of renal tubular cells. Acute urinary retention which has been reported during spaceflights can lead to certain medical complications that could compromise an entire mission. Kidney stone formation is another important potential hazard for any manned spaceflight. Increased kidney stone formation in space is attributed to several factors including reduced fluid intake, hypercalciuria, and the presence of nanobacteria. Nutritional and pharmacological interventions are currently recommended as preventive measures against renal stone formation in space travelers. PMID:23001611

  4. 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

  5. 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

  6. 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

  7. Kidney transplant

    MedlinePlus

    ... infections 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 that suppress their immune ...

  8. 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

  9. [Infection-induced urinary stones].

    PubMed

    Bichler, K-H; Eipper, E; Naber, K

    2003-01-01

    Infection stones make up approximately 15% of urinary stone diseases and are thus an important group. These stones are composed of struvite and/or carbonate apatite. The basic precondition for the formation of infection stones is a urease-positive urinary tract infection. Urease is necessary to split urea into ammonia and CO(2). As a result, ammonia ions can form and at the same time alkaline urine develops, both being preconditions for the formation of struvite and carbonate apatite crystals. When these crystals are deposited infection stones form. Pathogenetically, various risk factors play a role: urinary obstruction, neurogenic bladder, dRTA, and MSK. If these infections are not treated and the stones are not removed, the kidney will be damaged. Modern methods are available for stone removal, e.g., ESWL and/or instrumental urinary stone removal. Here, especially less invasive methods are preferable. Any treatment must be adjusted to the patient individually. Patients should be examined frequently for recurrent urinary tract infections and stone recurrences, and new infections must be resolutely treated. Good therapy and prophylaxis are possible with present-day treatment modalities. PMID:12574884

  10. 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