Renal Stone Formation Research Articles

Influence of BMI on the Recurrence Rate of Nephrolithiasis in the Adult Population of Saudi Arabia: A Retrospective Study.

Objectives Nephrolithiasis is a common disease, and Saudi Arabia is among the countries with the highest prevalence of nephrolithiasis. Obesity is one of the risk factors associated with the increased formation of renal calculi. We aimed to assess whether obesity also increases the recurrence rate of nephrolithiasis. Methods We retrospectively identified and collected data of 283 adult patients with renal stones who were managed at our hospital from November 2018 to November 2021. The demographic information, comorbidities, stone burden, and treatment methods related to them were identified, collected, and analyzed. Moreover, we performed the chi-squared test (χ2) and multivariate logistic regression analysis in order to assess the risk factors (i.e., independent predictors) of recurrence among the studied patients. Additionally, the odds ratio (OR) was calculated at a confidence interval (CI) of 95%. A p-value of less than 0.05 was considered statistically significant. Results Of the 283 adult patients we analyzed, 35 did not meet the criteria of our study and, consequently, were excluded. Therefore, we ended up with 248 patients, of whom 179 (68.1%) were males, 131 (52.8%) had a previous history of renal stones, and 90 (36.3%) had chronic illnesses. Moreover, the mean age of the studied patients was 48.91 ± 14.51 years, and the mean BMI was 29.44 ± 6.1 kg/m2. It was found that most of the patients (35.5%) had only one stone, while 23.4% of them had more than 5 stones. Furthermore, the majority of the stones (35.9%) were medium size (with a stone diameter of 10-19 mm [1-1.9 cm]). We did not find a relationship between obesity and the recurrence rate of renal stones. However, there was a significant association (p < 0.05) between the recurrence rate and Saudi nationality, chronic diseases (more specifically, HTN), unilateral stones, and a stone diameter of 10-19 mm (1-1.9 cm). Additionally, we identified diabetes and the kidney as stone location factors that are associated with less recurrence. Conclusion Although obesity was reported to increase the risk of renal stone formation, we did not find it to be associated with an increased recurrent rate of the disease in the Saudi Arabian population, which is inconsistent with other studies conducted in this area in other countries. Therefore, larger studies are needed to prove this finding.

Perception and awareness towards urolithiasis among the public at Bisha city; a cross-sectional study

Objective: This study aimed to estimate the level of awareness about urolithiasis among the Bisha population. Methods: This cross-sectional study was conducted through an online questionnaire between June 2023 and July 2023 in Bisha, Saudi Arabia. The electronic questionnaire consisted of 28 questions and was distributed via multiple social media platforms. Results: A total of 1,002 participants were included with a mean age of 26.1 ± 13.9 years old. About 55% were males and 927 (92.5%) were Saudi nationals. Regarding awareness, 405 (40.4%) were in the low awareness level, 575 (57.4%) were in the medium level, and only 22 (2.2%) participants were in the high level of awareness. Also, 83 (8.3%) were hypertensive, 75 (7.5%) had hyperparathyroidism, and 69 (6.9%) were diabetic, while 634 (63.3%) had no chronic health problems. A participant with a history of renal stones was associated with a low level of awareness, and there was a negative association between age and awareness level. Moreover, most participants were aware that there was a relationship between dietary habits and renal stone formation. Conclusion: The study shows a low to medium level of awareness among study participants, especially among urolithiasis patients. In terms of risk factors, there is a low level of awareness about the family history, weight gain, and hot climate. Finally, we recommend adequate public education about urolithiasis and its risk factors.

Spectrum of Bacterial Pathogens from Urinary Infections Associated with Struvite and Metabolic Stones

The purposes of this multi-center study were to evaluate the rate of infection stones and to evaluate the urine cultures of patients with infection stones. Charts of adulpatients with urinary stones were reviewed and data on stone analyses and urine cultures were collected. In total, 1204 renal stone formers (RSFs) from 10 countries were included (776 males, 428 females). Fifty-six patients (4.6%) had struvite stones. The highest frequency of struvite stones was observed in India (23%) and Pakistan (18%). Lower rates were reported in Canada (2%), China (3%), Argentina (3%), Iraq (3%), Italy (3.5%) and Poland (3%), and intermediate rates in Egypt (5.5%) and Bulgaria (5.4%). Urine cultures were retrieved from 508 patients. Patients with struvite stones had a positive culture in 64.3% of the samples and patients with other stones, in 26.7%. In struvite stones, the most common isolates were Escherichia coli (27.7%) and Proteus spp. (27.7%), followed by Klebsiella spp. (16.7%); in other types of stone, it was Escherichia coli (47.6%), followed by Gram-positive bacteria (14.0%) Conclusions: The struvite stone composition was associated with a urinary infection, although an infection was not demonstrable with a conventional midstream urine culture in about 30%.

Metabolic evaluation of first-time uncomplicated renal stone formers: A prospective study.

Nephrolithiasis is a global health problem. The recurrence rate after the first stone clearance is approximately 50% at 5 years. Metabolic abnormalities are an important factor responsible for stone recurrence. Our prevalidated study aimed to evaluate metabolic abnormalities associated with first-time uncomplicated renal stone formers (FTURSF). In this prospective, exploratory, time-bound, descriptive study, 30 first-time renal stone formers were evaluated for metabolic abnormalities. High-risk stone formers were excluded from the study. Data were collected in a predefined proforma, transferred to an Excel sheet, and analyzed using the Statistical Package for Social Sciences 20 and Epi Info 7. Fisher exact test, Mann-Whitney U test, paired t test, and Pearson correlation coefficient were used for statistical analyses. The mean age of the participants was 35.57 ± 11.07 years, with a male-to-female ratio of 1.72. The most common abnormality was a 24-hour urine volume of <2.5 L in 73.33% of the participants. One or more metabolic abnormalities were detected in 76.67% of the participants. Other common metabolic abnormalities detected were hypocitraturia (60%), hypercalciuria (16.67%), hyperoxaluria (13.33%), and hyperuricosuria (3.33%). Parathyroid adenoma was detected in one participant (3.33%). Our study documented significant metabolic abnormalities in FTURSF. Therefore, a simplified metabolic evaluation protocol should be adopted while evaluating FTURSF. Detection of an underlying metabolic abnormality would enable the early institution of preventive measures to reduce stone recurrence and related complications.

Association of non-Alcoholic Fatty Liver Disease with Urolithiasis detected on non-Contrast Computed Tomography

Background &amp; Objectives: We aimed to assess whether there is an association between urolithiasis and non-alcoholic fatty liver disease using non-enhanced computed tomography. Methods :This is a case control study done from October to December 2019, a total of 284 non-contrasts CT scans of reviewed. The subjects were assigned in to cases of non-alcoholic fatty liver group defined with lower average Hounsfield unit of liver than that of spleen and control involved non-fatty liver defined as patients whose Hounsfield of liver parenchyma higher than that of spleen. We determined the percentage of urolithiasis (patients having radiopaque stones in the urinary tract including kidneys, ureters or urinary bladder) in both groups and calculated their significance of relation. Results: The non-alcoholic fatty liver group involved 112 cases of which 67 (59.8%) male, 45 (40.2%) female and control of non-fatty liver group involved 172 cases; of which, 89 (51.8%) male, 83 (48.2%) female. The incidence of stone disease was significantly higher in non-alcoholic fatty liver (36.6%) than control group (12.2%) which statistically significant with increasing detection rate of renal stone (OR: 4.1, 95% CI, 2.28-7.54). The correlation was still significant when evaluated among males and females separately. Though the prevalence of stone among males (25.6%) is higher than females (17.2), yet it was not statistically significant. This is also true among males (41.8% stone) and females (28.9% stone) in case subjects. Conclusion: Non-alcoholic fatty liver has an association with significant increase in prevalence of urolithiasis than those without non-alcoholic fatty liver, that is can be considered an independent risk factor variable for renal stone formation.

Association between Renal Stones Sonographic Findings and Demographic Data among Patients at Riyadh Hospitals, Saudi Arabia

Background: Ultrasound is the primary imaging modality to identify renal stones (RS) in patients with acute flank pain. This study aimed to evaluate the presence, location, and size of RS diagnosed by ultrasound in association with age, gender, and BMI among patients at Riyadh hospitals. Methods and Results: In this case-control study, a total of 250 records (130/52% for males and 120/48% for females) from 2018 to 2019 were reviewed from January to March 2020 at different hospitals in Riyadh. In this study, 150(60%) records of patients with RS and 100(40%) records of patients without RS were collected to evaluate the risk factor for RS formation in the central area of Saudi Arabia. A designed data collection sheet containing all variables (demographic and sonographic) of the study was used. Demographic data included gender, age, and body mass index (BMI). Sonographic data included RS presence (yes, no), RS location (right kidney [RK], left kidney [LK], both kidneys), and RS size (small [&lt;0.5cm], average [0.5–1cm], and large [&gt;1cm]). The study found that RS were more common among males than females (P&lt;0.001). The results show that in normal BW, the frequency of stone presence was similar for RK and LK. In overweight patients, RS were more often observed in LK (P=0.000). We also found a significant association between BMI and RS size (P=0.049); the presence of smaller stones increases with BMI. There was no association between sonographic data and age (P&gt;0.05) Conclusion: Among patients at Riyadh hospitals, females are less affected by RS than males. Gender is a significant risk factor for the development of RS. The effect of BMI is obvious on renal stone location and size.

Dietary Determinants of Renal Calculi: A Case-Control Study From a Tertiary Care Hospital of Western Rajasthan.

Introduction Nephrolithiasis affects all countries of the world with an approximate global lifetime prevalence of 15-20%. In India, 12% of the total population is anticipated to have renal stone disease. This study was aimed at providing a relationship between various dietary factors in the formation of renal stones. Methods A case-control study was conducted among 207 patients (106 cases and 101 controls) attending the outpatient and inpatient departments of a tertiary care hospital in Jodhpur, Rajasthan. All the participants with confirmed renal stones by means of ultrasound and radiographic evaluation, aged 15-65 years were included as cases and were matched on age and gender with controls. Pearson chi-square test followed by binary logistic regression was used to assess significant associations. Results Out of all participants, 71.0% were males and 65.7% were from the age group 41-65 years.The study showed a statistically significant association between renal stones and high salt intake, reduced water intake, less consumption of milk and milk products, daily intake of tea, consumption of oxalate-rich foods and consumption of junk foods. Conclusion Dietary factors play an important role in the risk of the development of renal stones. Simple dietary modifications may significantly reduce the chances of the development of nephrolithiasis, especially in the vulnerable population.

ПОТЕНЦИАЛЬНЫЕ МАРКЕРЫ РЕЦИДИВИРОВАНИЯ МОЧЕКАМЕННОЙ БОЛЕЗНИ И РОЛЬ ИНГИБИТОРОВ КАМНЕОБРАЗОВАНИЯ ПРИ РЕЦИДИВИРУЮЩЕМ КАЛЬЦИЙ-ОКСАЛАТНОМ НЕФРОЛИТИАЗЕ

Nowadays urolithiasis (nephrolithiasis) is a common disease, which treatment is a serious task of health care ser- vices not only in Russia, but throughout the world. At the same time, stones of a calcium-oxalate nature are the most common stones in patients with this pathology – in about 70-80% of cases. It is also worth noting that this disease not only has rather painful manifestations, and its treatment requires large financial costs, but also has a complex multi- factorial multistage pathogenesis, understanding the mechanisms of which can provide a key to the development of the most successful therapy. Pathogenesis itself consists of several stages, such as nucleation with the formation of a crystallization center, crystal growth, aggregation and their attachment to the surface of epithelial cells.&#x0D; It is known that the human body contains various substances that affect the processes of stone formation. Thus, stone formation promoters facilitate their crystallization, and inhibitors prevent it. There is a delicate balance between promoters and inhibitors, and their imbalance is often a decisive factor in pathogenesis. By their chemical nature, inhibitors can be both inorganic and organic (proteins, glycosaminoglycans) substances. The latter are especially attracting attention, since at various concentrations they can act as both inhibitors and promoters of stone formation. To fully understand the mechanisms of calcium oxalate stone formation, this review analyzes current data on inhibitors of recurrent nephrolithiasis and their role in the pathophysiology of the process of renal stone formation.

Management of Urogynaecological Problems in Pregnancy and Postpartum Period during Covid

Background: Urogynaecological problems are the gynae related disorders of urinary system which affect women during pregnancy and postpartum period.Covid-19 also had an impact on these disorders. Objective: The main objective of this study is to find out how urogynaecological problems occur in pregnancy and postpartum period and how these problems were managed during covid 19. Study Design: Cross-sectional study Place and Duration: Gynaecology and Obstetrics department of Al-Nafees Medical College and Hospital, Islamabad, from 5th February 2020 to 6th August 2021. Method: We included 220 pregnant women in our study.Their age, body mass index, gestational age, mode of delivery, fetal age at the time of delivery were measured. Prevalence of urogynaecological problems in pregnant women was also noted. Among these 220 females, 50 females got infected with covid.We compared their complications with complications of pregnant women who weren’t infected with covid. Result: Body mass index of pregnant women with urogynaecological problems was 22 to 36 kg/m2. 12 to 14 kg weight increased during pregnancy.Gestational age at delivery was 38 to 42 weeks. Fetal weight was 2 to 4 kg at the time of birth. 62% women had vaginal mode of delivery while 38% had cesarian.Prevalence of urinary tract infections was 7% , stress urinary incontinence was 18 to 70%, uterine prolapse was 5 to 8% in pregnant women. 45% pregnant women had increased micturition frequency.Their were also some chances of formation of renal stones during pregnancy. Pregnant women who got infected with covid -19 had to face several other complications as well.These complications were managed with hygiene behaviour, balanced diet, exercise and medications. Conclusion: Urogynaecological problems are commonly found in pregnant women due to enlargement of kidneys and increased GFR during pregnancy. During pregnancy, uterus size increases which leads to compression of ureters and increased bacterial growth. Increased growth of bacteria causes urinary tract infections.Vaginal mode of delivery increases the risk of uterine prolapse.Covid-19 also had an impact on urogynaecological problems.These problems were managed during pandemic by avoiding direct contact. Keywords: Urogynecological problems, Pregnancy, Postpartum period, Covid-19

Inhibition of sodium-glucose cotransporter 2 suppresses renal stone formation

Background and aimsNephrolithiasis is a common renal disease with no effective medication. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, an anti-diabetic agent, have diuretic and anti-inflammatory properties and could prevent nephrolithiasis. Here, we investigated the potential of SGLT2 inhibition against nephrolithiasis using large-scale epidemiological data, animal models, and cell culture experiments. MethodsThis study included the data of diabetic patients (n = 1,538,198) available in the Japanese administrative database and divided them according to SGLT2 inhibitor prescription status. For animal experiments, renal calcium oxalate stones were induced by ethylene glycol in Sprague-Dawley rats, and phlorizin, an SGLT1/2 inhibitor, was used for the treatment. The effects of SGLT2-specific inhibition for renal stone formation were assessed in SGLT2-deficient mice and a human proximal tubular cell line, HK-2. ResultsNephrolithiasis prevalence in diabetic men was significantly lower in the SGLT2 inhibitor prescription group than in the non-SGLT2 inhibitor prescription group. Phlorizin attenuated renal stone formation and downregulated the kidney injury molecule 1 (Kim1) and osteopontin (Opn) expression in rats, with unchanged water intake and urine volume. It suppressed inflammation and macrophage marker expression, suggesting the role of the SGLT2 inhibitor in reducing inflammation. SGLT2-deficient mice were resistant to glyoxylic acid-induced calcium oxalate stone formation with reduced Opn expression and renal damages. High glucose-induced upregulation of OPN and CD44 and cell surface adhesion of calcium oxalate reduced upon SGLT2-silencing in HK-2 cells. ConclusionOverall, our findings identified that SGLT2 inhibition prevents renal stone formation and may be a promising therapeutic approach against nephrolithiasis.

Efficacy of chlorogenic acid against ethylene glycol-induced renal stone model: The role of NFKB-RUNX2-AP1-OSTERIX signaling pathway

Background and objectiveRenal tissue injuries by free radicals are an essential reason in pathogenesis of urinary tract stones. Ethylene glycol is one of the toxic agents which can causes to the increases in biosynthesis of reactive oxygen species and oxidative stress condition. Natural antioxidants have been reported to protective efficacy against renal stones formation. Accordingly, the aim of the current experiment was to identify the renal protective effect of chlorogenic acid as a well-prominent antioxidant on ethylene glycol-induced renal stone model targeting the NFKB-RUNX2-AP1-OSTERIX signaling pathway. Materials and methodsRenal stones model were established by ethylene glycol (Percent: 0.75) within the daily drinking water for rats. Treatment groups received cystone (750 mg/kg) and chlorogenic acid (100, 200, and 400 mg/kg, day: 15th to 28th, gavage). After 4 weeks, the renal function parameters (calcium, uric acid, creatinine, total protein, oxalate, and citrate) in plasma, urine, and renal tissue were measured. Moreover, oxidative stress factors and gene expression of NFKB, RUNX2, AP1, and OSTERIX were also evaluated. ResultsThe results showed improved renal function in chlorogenic acid-treated groups. The total proteins and creatinine excretion were decreased. Also the gene expression of oxidative stress pathway (NFKB-RUNX2-AP1-OSTERIX) were decreased which caused to increases of antioxidant enzymes. Conclusionsthe antioxidant activity increases by chlorogenic acid treatment may have a critical role in prevention of calcium oxalate formation via inhibition of the NFKB-RUNX2-AP1-OSTERIX signaling pathway.

Effect of Citrus Limon (L.), Citrus Aurantium And Citrus Medica On Ethylene Glycol Induced Urolithiasis In Rats

Introduction: Renal stone formation and the predominant chemical stone composition are age and gender dependent. The most common stones are struvite (magnesium ammonium phosphate), calcium oxalate, urate, cystine and silica. The most common type of kidney stones worldwide contains calcium. The process of forming stones in the kidney, bladder, and/or urethra (urinary tract) is called as Urolithiasis. Urinary calculi may cause obstruction, hydronephrosis, infection and hemorrhage in the urinary tract system. Citrus species were used in traditional practices as remedies for the urolithiasis have been well established in vivo-vitro test, clinical trial and effective use but are lacking well documented record. Citrus limon (L.) is tree with evergreen leaves and yellow edible fruits from the family Rutaceae. Citrus aurantiumL commonly called as bitter orange. Citrus medica Linn.,commonly known as a Citron in English and bijapura in Ayurvedic literature is shrub or small tree. All three are reported to use in treatment of wide panel of diseases like antiurolithic activity, stomach ache, vomiting antifungal and antibacterialetc. Urolithiasis was introduced by administration of ethylene glycol in rats. Standard drug treated group, the urinary outputs increased significantly. Body weight of all animals measured on day 0, 14 and 28 of calculi induction to assess the effect of treatment on body weight. The collection of urine from rats scheduled to be every seven days from calculi induction. C. aurantinum extract showed significantly increase in urinary output. The collected urine stored in 4ºC. The analysis of calcium, phosphate, magnesium, creatinine, uric acid, protein, urea nitrogen and oxalate recorded.300 mg/kg of combined extract of all three plants show significant result compare to individual plant response.

Aberrant glycosylation of osteopontin in a rat renal stone formation model: A preliminary study.

Aberrant glycosylation of osteopontin in a rat renal stone formation model: A preliminary study.

Nephrolithiasis: A Red Flag for Cardiovascular Risk.

Epidemiological evidence shows that nephrolithiasis is associated with cardiovascular (CV) morbidities. The association between nephrolithiasis and CV disease is not surprising because both diseases share conditions that facilitate their development. Metabolic conditions, encompassed in the definition of metabolic syndrome (MS), and habits that promote nephrolithiasis by altering urine composition also promote clinical manifestations of CV disease. By inducing oxidative stress, these conditions cause endothelial dysfunction and increased arterial stiffness, which are both well-known predictors of CV disease. Furthermore, the subtle systemic metabolic acidosis observed in stone formers with CV disease may have a pathogenic role by increasing bone turnover and leading to reduced mineral content and osteoporosis/osteopenia. Heart valves and/or coronary artery and aortic calcifications are frequently associated with reduced mineral density. This is known as the ‘calcification paradox’ in osteoporosis and has also been observed in subjects with calcium nephrolithiasis. Evidence supports the hypothesis that osteoporosis/osteopenia is an independent risk factor for the development of CV calcifications. In the long term, episodes of renal stones may occur from the onset of metabolic derangements/MS to arterial stiffness/atherosclerosis and CV morbidities. These episodes should be considered a warning sign of an ongoing and silent atherosclerotic process. The evaluation of cardiometabolic risk factors and MS components should be routine in the assessment of renal stone formers. This would allow for treatment and prevention of the development of CV complications, which are much more severe for the patient and for public health.

Fulvic Acid from Chestnut Forest as an Added Qualities to Spring Water: Isolation and Characterization from Fiuggi Waters

The aquifer of “mineral” water, historically known for its curative properties, is an identifying characteristic of the Anticolana valley. This area hosted a coppice chestnut forest for a long time. Under the forest, there is an important aquifer, historically renowned and widely recognized for preventing renal stone formation and or facilitating their expulsion. This mineral water pre- vents the formation of calcium oxalate and phosphate crystals in the kidney and promotes their dissolutions through soluble calcium complexes. The forest environment soil is particularly rich in humification products owing to the interaction of the rainwater–litter–soil system. The fulvic fraction is soluble in water under all pH conditions and enriches the water basin. We aimed to test these hypotheses and assess how the coppice chestnut forest is involved in fulvic acid production. Fulvic fractions isolated and purified from soil samples and mineral water (550 μg L−1) were analyzed by GC-MS, FTIR, and NMR. Data from different sources were compared, showing sufficient similarities to state that the fulvic acids isolated from the water come from the processes that take place between the stems and the chestnut litter. The chestnut forest provides enrichment to water quality, which is a distinctive piece of information in defining water enhancement strategies, establishing soil management and designating sustainable forest management.

16S rRNA gene sequencing reveals altered composition of gut microbiota in postoperative individuals with renal stones.

Renal stones are a common urological disease with high prevalence and recurrence rates. Characterizing gut microbiome profiles of first‐onset renal calculi patients, both before and after surgery, may provide valuable insights and identify potential biomarkers for the disease. In this study, we explored the associations between the gut microbiome and renal stone formation using 16S ribosomal RNA (rRNA) gene sequencing. In brief, 20 patients were recruited, and information on health and eating habits within the previous 1–3 months was collected upon admission. A total of 493 operational taxonomic units (OTUs) were detected in 40 specimens, with an average of 67,888 ± 827 reads per sample. The results of OTU‐based partial least squares discriminant analysis (PLS‐DA) analysis showed differences between RS1 (fecal specimen before surgery) and RS2 (one month later after surgery) groups, with a significantly higher level of OTU7 in the RS2 group. Taxonomy‑based comparisons of the gut microbiome showed differences in the flora composition, with the prevalence of Enterobacteriales, Enterobacteriaceae, Gammaproteobacteria and Escherichia being higher in the RS2 group and the prevalence of Pseudomonadaceae, Pseudomonadales and Pseudomonas being higher in the RS1 group. Correlation analysis showed that an increased prevalence of Enterobacteriaceae, Gammaproteobacteria and Escherichia associated with a decreased level of urea, and a decreased creatinine level was correlated with an increased prevalence of Escherichia. These data strongly suggest that the gut microbiome plays an important role in kidney stone formation, and these findings may provide new insights for the prevention, diagnosis, and treatment of renal stones.

Proteomic analysis of inhibitory protein profiles in the urine of children with nephrolithiasis: implication for disease prevention.

In this study we aimed to screen for the presence of biomarkers that are downregulated in children with nephrolithiasis (RS) compared to healthy controls (HC) using a proteomic approach. We hypothesized that RS and HC would display unique inhibitory protein profiles that could be used for comparative pathway analysis. This is a prospective, controlled, pilot study of pooled urine from RS (N = 30, 24 females, mean age 12.95 ± 4.03years) versus age- and gender-matched HC, using liquid chromatography-mass spectrometry. The criteria for protein selection were: (1) patient/control abundance ratio of < 0.5; and (2) ≤ 0.05 p-value for the Fisher's Exact Test. Results were confirmed by ELISA testing in individual samples. 67 proteins were downregulated in RS group, and 17 of those were significantly different compared to controls. Of those seventeen proteins, five (two actins, annexin A5, keratin 6B, and serpin B4) were completely absent in the urine of stone patients but were found in controls. The remaining twelve proteins were significantly less abundant in the patient's urine compared to healthy controls. Protein-protein interaction modeling of significant proteins identified syndecan-1 as the key node, a protein associated with adhesion pathways. ELISA analysis by subgroups showed statistically significant difference in the urinary excretion of osteopontin (5.1 ± 3.22ng/mg creatinine vs 14.1 ± 9.5ng/mg creatinine, p = 0.046) between stone patients with hypocitraturia and controls. Urinary osteopontin concentration was positively correlated with urinary citrate excretion (r = 0.417, p = 0.03). Children with RS have a different urinary inhibitory polypeptide profile compared to HC. Decreased urinary excretion of these proteins indicates their potential inhibitory role in renal stone formation, especially of the adhesion phase. Lower concentration of urinary osteopontin in children with nephrolithiasis and hypocitraturia suggests its potential involvement in the pathogenesis of this disease. Further characterization of these proteins in a larger sample is imperative.

Vinegar reduced renal calcium oxalate stones by regulating acetate metabolism in gut microbiota and crystal adhesion in rats.

Urolithiasis is a common urologic disease. Higher consumption of vinegar was associated with a lower risk of urolithiasis. Recent studies reported that disorder of gut microbiota and injury of the tight junction of renal tubular epithelial cells were associated with the formation of renal calcium oxalate (CaOx) stones. We aimed to explore the mechanism of vinegar reduced renal CaOx stone formation by regulating gut microbiota and the tight junction of renal tubular epithelial cells. Thirty Sprague-Dawley rats were randomly allocated to control group, model group and vinegar group. Rats in control group got 2ml/kg of sterile water by gavage. Model group rats were additionally supplied with drinking water with 1% (v/v) ethylene glycol (EG) every day. Rats in vinegar group had 1% (v/v) EG in drinking water and were gavaged with 2ml/kg of vinegar (5% acetate) every day. Vinegar reduced renal CaOx crystals and urinary oxalate. Vinegar increased the relative abundances of Ruminococcus gauvreauii, Ruminococcus torques, Ruminococcus-2, Moryella, Enterococcus, Alistipes, and Parabacteroides in the gut microbiota. Blood acetate increased in vinegar group. The renal tight junction occludin protein decreased in the model group and increased in the vinegar group. Studies in vitro verified that acetate could reverse the decline in occludin expression induced by CaOx crystals and inhibit CaOx crystal adhesion to cells. Vinegar reduced renal CaOx stones by regulating gut microbiota and increasing blood acetate to restore renal tight junction and reduce CaOx crystal adhesion.

4-PBA rescues hyperoxaluria induced nephrolithiasis by modulating urinary glycoproteins: Cross talk between endoplasmic reticulum, calcium homeostasis and mitochondria

AimUrinary glycoproteins such as Tamm Horsfall Protein (THP) and Osteopontin (OPN) are well established key regulators of renal stone formation. Additionally, recent revelations have highlighted the influence of Endoplasmic Reticulum (ER) and mitochondria of crucial importance in nephrolithiasis. However, till date conclusive approach highlighting the influence of ER stress on urinary glycoproteins and chaperone in nephrolithiasis remains elusive. Therefore, the present study was focussed on deciphering the possible effect of 4-PBA mitigating ER stress on urinary glycoproteins and calnexin (chaperone) with emphasis on interlinking calcium homeostasis in hyperoxaluric rats. Material and methodsPost 9 days of treatment, animals were sacrificed, and renal tissues were investigated for urinary glycoproteins, calnexin, calcium homeostasis, ER environment, redox status, and mitochondrial linkage. Key findings4-PBA appreciably reversed the altered levels of THP, OPN, and calnexin observed along with curtailing the disrupted calcium homeostasis when assessed for SERCA activity and intra-cellular calcium levels. Additionally, significant improvement in the perturbed ER environment as verified by escalated ER stress markers, disturbed protein folding-aggregation-degradation (congo red assay) pathway, and redox status was found post 4-PBA intervention. Interestingly, linkage of ER stress and mitochondria was established under hyperoxaluric conditions when assessed for protein levels of VDAC1 and GRP75. Significance4-PBA treatment resulted in rectifying the repercussions of ER-mitochondrial caused distress when assessed for protein folding/aggregation/degradation events along with disturbed calcium homeostasis. The present study advocates the necessity to adopt a holistic vision towards hyperoxaluria with emphasis on glycoproteins and ER environment.

Risk Factors of Nephrolithiasis in a Tertiary Care Hospital in Rawalpindi: A Descriptive Cross-Sectional Study.

BackgroundNephrolithiasis (renal stones) is the most common urological disease. Its prevalence is high in every part of the world. Several factors lead to renal stone formation. In Pakistan, nephrolithiasis prevalence is also high as Pakistan is located in a region which is known as the salt belt. However, nephrolithiasis and its possible risk factors are under-researched in Pakistan.ObjectiveThis study aims to identify the risk factors for nephrolithiasis among admitted patients with renal stones. This may lead to a reduction in renal stone incidence and its allied complications by the prevention of risk factors that would have a major role in renal stone formation.Material and methodsThis descriptive cross-sectional study was performed among the 143 admitted patients with renal stones in the urology ward of Benazir Bhutto Hospital, Rawalpindi, for approximately six months from November 2021 to April 2022. Non-probability convenient sampling and developed inclusion and exclusion criteria were used for the recruitment of patients. After elaborating on the objectives, the study data were collected by interviewers through a self-structured questionnaire. Descriptive analysis was carried out using SPSS version 25.0 (IBM Corp., Armonk, NY).ResultsNephrolithiasis was more prevalent among patients who had an age group range of 15-30 years (47.55%), male gender (56.65%), illiterate educational status (53.14%), lower socioeconomic status (66.43%), inadequate intake of water (61.53%), used tap water (56.64%), a habit of daily vegetable intake (65.04%), sedentary lifestyle (51.74%), family history of renal stones (57.34%), no diabetes mellitus (62.94%), no hypertension (52.45%), and overweight (48.23%).ConclusionIn brief, the age group of 15-30 years, male gender, illiteracy, lower socioeconomic status, insufficient water intake, tap water, high vegetables, inactive lifestyle, family history of nephrolithiasis, and a high BMI all increase the risk of nephrolithiasis.