Risk Factors For Urolithiasis Research Articles

Bariatric Surgery and Risk of Urolithiasis: A Review

Obesity is a global epidemic for which dietary and lifestyle modifications alone are ineffective treatment strategies. Subsequently, more patients are opting for bariatric surgery, which has better success rates in weight loss and improvement of obesity-related comorbidities. These procedures involve anatomic alterations of the gastrointestinal tract resulting in either restriction of intake or malabsorption of nutrients. While obesity itself is an independent risk factor for urolithiasis, bariatric surgery may also adversely affect stone risk. Restrictive procedures appear to have the lowest risk, whereas malabsorptive procedures are associated with the highest risks of stone formation. Stone prevention strategies including dietary manipulation are critical in the management of the patients who have had bariatric surgery.

The role of reactive oxygen species derived from different NADPH oxidase isoforms and mitochondria in oxalate-induced oxidative stress and cell injury

Hyperoxaluria is a risk factor for urolithiasis and can cause renal epithelial cell injury secondary to oxidative stress. Reactive oxygen species (ROS) produced during cell damage originate from different sources and play different roles. Here, we explored the potential sources of ROS production and investigated the role of ROS from various sources in oxalate-induced oxidative stress and cell injury in normal rat kidney-52 epithelial (NRK-52E) cells. Oxalate-induced injury was assessed by lactate dehydrogenase (LDH) release experiments. 2,7-dichlorodihydrofluorescein diacetate and mitoSOX Red were used to determine the intracellular and mitochondrial ROS (mtROS) production, respectively. The expression level of Nox4, Nox2, and p22 protein was detected by Western blotting to observe the effect of oxalate on nicotinamide adenine dinucleotide phosphate oxidase (NADPH) oxidase (Nox). Furthermore, a specific NADPH oxidase subtype inhibitor and targeted mitochondrial antioxidants were used to preliminarily identify the role of ROS from different sources in renal tubular epithelial cell injury induced by oxalate. We found that oxalate inhibited cell viability, induced LDH release, and prompted intracellular and mitochondrial ROS (mtROS) production. Oxalate also decreased the protein expression level of Nox4 and increased the protein expression level of p22. Mitochondria were also a source of ROS production. In addition, Nox2 inhibitor or mtROS scavenging prevented oxalate-induced cell injury, reversed by an inhibitor of Nox4/1. We concluded that ROS from different sources might play different roles in oxalate-induced renal tubular epithelial cell injury. We also identified new potential targets for preventing or alleviating oxalate-induced renal tubular epithelial cell injury.Graphic abstract

POS-460 THE PREVALENCE OF HYPERURICEMIA IN PATIENTS WITH URINARY STONES AND HYPERURICOSURIA OR NORMAL URICOSURIA

Urolithiasis is associated with significant morbidity. The major stones type is calcium oxalate (74%), while 7-10% of all urolithiasis cases are uric acid stones. The data are conflicting on the significance of hyperuricemia or hyperuricosuria in urolithiasis formation and on the requirement for hyperuricemia medical treatment in order to prevent stones. It is not clear whether hyperuricemia coincident with normal uricosuria is a risk factor for urolithiasis and should be treated.

Analysis of clinical manifestations, risk factors and diagnostic procedures in children with urolithiasis

The incidence of urolithiasis in the paediatric population has grown in recent years. Aim: The aim of this study was to analyse clinical symptoms, risk factors and diagnostic procedures in children with urolithiasis. Materials and methods: We conducted a questionnaire study (supplemented with an analysis of medical records) in a group of 49 children diagnosed with urolithiasis, including 17 patients from the department of paediatrics at the time of the first metabolic evaluation, and 32 patients hospitalised in a one-day department of paediatric urology prior to extracorporeal shock wave lithotripsy. Results: Urolithiasis occurred in children in the study group at the age of 9.3 ± 4.9 years and manifested with abdominal pain (69.4%), vomiting (18.4%) and haematuria (10.2%); urolithiasis was diagnosed accidentally in 14.3% of patients. All patients developed renal stones (bilateral in 20.4%); 28.6% of patients additionally presented with ureteral stones, and 6.1% with bladder stones. Urolithiasis was accompanied by urinary tract infection in 44.9% of patients. The most common risk factors for urolithiasis included positive family history (75.5%), low fluid intake (51%), urinary tract infection (42.9%) and overweight/obesity (28.6%). Among patients admitted for extracorporeal shock wave lithotripsy, only 65.6% of children underwent nephrological consultation. Slightly more than a half of these patients underwent metabolic diagnosis, with exhausted evaluation in 7 cases and incomplete metabolic assessment in 5 cases. The chemical composition of stones was analysed in 22.4% of patients. Conclusions: Abdominal pain and vomiting are the most common clinical symptoms in children with urolithiasis. The paper presents modifiable risk factors and shows the need for improvement in metabolic evaluation of urolithiasis.

PD14-10 EFFECT OF MALNUTRITION ON THE RISK OF UROLITHIASIS

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I (PD14)1 Sep 2021PD14-10 EFFECT OF MALNUTRITION ON THE RISK OF UROLITHIASIS Takuma Narita, Shingo Hatakeyama, Teppei Okamoto, Toshikazu Tanaka, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Shigeyuki Nakaji, and Chikara Ohyama Takuma NaritaTakuma Narita More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Teppei OkamotoTeppei Okamoto More articles by this author , Toshikazu TanakaToshikazu Tanaka More articles by this author , Hayato YamamotoHayato Yamamoto More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto More articles by this author , Shigeyuki NakajiShigeyuki Nakaji More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001990.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is limited evidence in the available literature regarding the association between nutritional status and urolithiasis. We investigated whether nutritional status is associated with urolithiasis. METHODS: We retrospectively investigated 1305 patients with symptomatic urolithiasis and 2800 community-dwelling individuals who participated in a comprehensive health survey. We evaluated nutritional status using the Geriatric Nutritional Risk Index (GNRI). The GNRI is calculated using body mass index (BMI) and serum albumin levels (ALB) based on the formula: 14.89×ALB+41.7×(BMI/22), and a low GNRI suggests malnutrition. We compared age, sex, serum parameters, comorbidities, and GNRI scores between the urolithiasis and control groups. Multivariate logistic regression analysis was used to determine independent risk factors for urolithiasis. RESULTS: Significant intergroup differences were observed in age, sex, estimated glomerular filtration rate (eGFR), serum uric acid level (UA), diabetes mellitus (DM), hypertension (HTN), cardiovascular disease, and GNRI scores (Fig.1). Multivariate logistic regression analysis revealed that age <60 years, UA >6.0 mg/dL, HTN, sex, DM, eGFR <60 mL/min/1.73 m2 (odds ratio [OR] 5.4, 95% confidence interval [CI] 4.5–6.6), and GNRI <98 (OR 9.5, 95% CI 7.1–12.5) were independent risk factors for urolithiasis (Fig. 2). CONCLUSIONS: Our results suggest that malnutrition is an independent risk factor for urolithiasis. Further investigation is required to conclusively establish the association between malnutrition and the risk of urolithiasis. Source of Funding: This study was supported by the Japan Society for the Promotion of Science KAENHI (Grant Numbers 20K18130 and 20K09517) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e219-e220 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takuma Narita More articles by this author Shingo Hatakeyama More articles by this author Teppei Okamoto More articles by this author Toshikazu Tanaka More articles by this author Hayato Yamamoto More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto More articles by this author Shigeyuki Nakaji More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement Loading ...

The correlation between demographic factors and urolithiasis composition in a tertiary hospital

Introduction: Urolithiasis is the formation of biomineral stones in the urinary tract, kidneys, and bladder. The formation of stones (uroliths) is still a multifactorial and complex phenomenon that has not been clearly understood; this cannot be attributed to a multifactorial leading to increased excretion of stone-forming components. Renal stones' etiology is still not well understood. Some studies stated that demographics in the population have a strong correlation as a risk factor for urolithiasis. This study was aimed to know the correlation between demographic factors in society and urolithiasis composition in the Aceh population between the year 2018 to 2020.Methods: This study included 52 patients diagnosed clinically and radiographically with their first episode of urolithiasis at Dr. Zainoel Abidin General Hospital, Aceh, Indonesia, from 2018 to 2020. All samples were first characterized using Fourier Transform Infrared spectroscopy (FTIR) to obtain the mineralogical compositions.Results: Obtained 52 patients diagnosed with urolithiasis were aged 3-67 years, with most patients (27 patients; 51,92%) were aged 45-64 years old. The mean age of the subjects of this study is 45,52 + 13,90. Of the 52 patients included in this study, 37 patients (71,15%) were male, and 15 patients (28,85%) were female. Of 52 patients, 22 (42,31%) presented with one stone only. Of 52 patients, most of the uroliths consisted of Calcium oxalate monohydrate (Whewellite), which is presented in 27 (51,92%) patients, followed by uric acid (Uricite) in 19 (36,54%) patients.Conclusion: most of the urolithiasis patients were aged 45-64 years. The ratio of male to female patients was found to be 2:1. Most of the patients presented with one stone only. Most of the uroliths consisted of Calcium oxalate monohydrate (Whewellite) as the main composition, followed by uric acid (Uricite).

Nutrition and Kidney Stone Disease.

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.

Risk factors for urolithiasis

Risk factors for urolithiasis Abstract. The prevalence and incidence of kidney stones has continuously increased over the last years. Recent evidence suggests that kidney stones have a substantial morbidity including chronic kidney disease and end stage kidney disease as well as significantly increased risk for cardiovascular diseases. Thus, risk stratification - especially of high-risk patients - is mandatory in the management of kidney stone patients. There is a huge variety in risk factors for nephrolithiasis including general factors (such as young age at manifestation, familial disposition), genetic or acquired diseases with risk of stone formation, drugs etc. Several prediction scores have been developed to assess recurrence risk in kidney stone formers. However, only very few studies have investigated these tools and more evidence is needed in future to proof if these scores reliably predict stone recurrence risk.

Influence of drinking water from water supply systems on the occurrence of urolithiasis in residents of the Primorsky territory in 1991–2015

Introduction. The imbalance of macroelements in the soft low-mineralized drinking water of the Primorsky Territory water supply systems can be a risk factor for developing many somatic diseases in the population. Aim: hygienic identification of the mineral composition components of drinking water, posing a risk factor for urolithiasis in children, adolescent, and adult populations over a 25-year follow-up period. Methods include identification of formal statistical relationships between mean annual content of iron, silicon, manganese, calcium, magnesium, sodium, total hardness in drinking water (534 water pipes and 1929 wells), and incidence of urolithiasis in the population (34 administrative areas) by rank correlation analysis, identification cause-effect relations on medical-statistical and hygienic criteria, assessment of the geographical distribution of the attributive risk of urolithiasis at the population level. Results. The relation “cause-effect” has been established between the paired ratio of calcium and magnesium in drinking water and incidence of urolithiasis in adults, adolescents, and children. Increased concentrations of silicon, manganese, and iron in drinking water do not affect the studied incidence level. The maximum risk of urolithiasis in the population is mainly located in the North and East of the Primorsky Territory. Conclusions. An imbalance of calcium and magnesium against a background of magnesium deficiency in tap and well water is the priority risk factor of aquatic origin for urolithiasis in the Primorsky Territory; the features of the geographical distribution of the immediate risk of urolithiasis among the population make it possible to form a scientifically based plan for the sequence of implementation of primary prevention measures for this disease in the region.

Urolithiasis in dogs: Evaluation of trends in urolith composition and risk factors (2006‐2018)

BackgroundUrolithiasis is a common and often recurrent problem in dogs.ObjectiveTo evaluate trends in urolith composition in dogs and to assess risk factors for urolithiasis, including age, breed, sex, neuter status, urolith location, and bacterial urolith cultures.Sample PopulationA total of 10 444 uroliths and the dogs from which they were obtained.MethodsThe laboratory database at the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from dogs between January 2006 and December 2018. Mineral type, age, breed, sex, neuter status, urolith location, and urolith culture were recorded. Trends were evaluated and variables compared to evaluate risk factors.ResultsCalcium oxalate (CaOx) and struvite‐containing uroliths comprised the majority of all submissions from dogs, representing 47.0% and 43.6%, respectively. The proportion of CaOx‐containing uroliths significantly decreased from 49.5% in 2006 to 41.8% in 2018 (P = .006), with no change in the proportion of struvite‐containing urolith submissions. Cystine‐containing uroliths comprised 2.7% of all submissions between 2006 and 2018 and a significant nonlinear increase in this mineral type occurred over time (1.4% of all submissions in 2006 to 8.7% in 2018; P < .001). Of all cystine‐containing uroliths, 70.3% were from intact male dogs. Age, breed, and sex predispositions for uroliths were similar to those previously identified.Conclusions and Clinical ImportanceAlthough calcium oxalate‐ and struvite‐containing uroliths continue to be the most common uroliths submitted from dogs, a decrease in the proportion of CaOx‐containing uroliths and an increase in the proportion of cystine‐containing uroliths occurred during the time period evaluated.

Analysis of 7866 feline and canine uroliths submitted between 2014 and 2020 in the Netherlands

Analysis of large datasets of uroliths is necessary to illustrate the prevalence and risk factors of urolithiasis. Furthermore, it may help to improve treatment and prevention of urolithiasis. In this study, 7866 uroliths (44.5% feline and 55.5% canine) from veterinary practitioners in the Netherlands between 2014 and 2020 were analysed. Between 2014 and 2020 the distribution over the different types of uroliths remained similar over time. Female cats, obese cats, Domestic Shorthair cats, female dogs, and large breed dogs had an increased risk for struvite. Neutered cats, all cat breeds except Domestic Shorthair, neutered dogs, male dogs, intact male dogs, and small breed dogs had an increased risk for calcium oxalate urolithiasis. Cystine and urate were found predominantly in male dogs. Dalmatians were at highest risk for urate urolithiasis. The findings of this study in the Netherlands were similar to findings in previous studies from different countries. However, urate urolithiasis in the English Cocker Spaniel and cystine urolithiasis in the Yorkshire Terrier were new associations. Body condition score, information about recurrence of urolithiasis, medical history, and diet history should be included in submission sheets in the future to explore other possible associations.

Clinico-Pathological Study of Urolithiasis with Special Reference to Urinary pH & Urinary Culture

Introduction- Urinary stone disease is one of the most common afflictions of modern society.It has been describedsince antiquity. With westernization of global culture, the site of stone formation has migrated from the lower to upperurinary tract. Urinary tract stones start to form in a kidney and may enlarge in a ureter or the bladder. Depending onlocation of stone, it may be called a renal stone, ureteral stone, bladder stone or uretheral stone.Aim and Objectives-To study the correlation of clinco-pathological factors in urolithiasis with special reference tourinary pH and urinary culture.To study the relationship of age, sex, socio-economic, in incidence of urinary calculi formation.To study the clinical presentation of urinary tract stone.To study the importance & significance of urinary pH and urinary infection in patients of urolithiasis.Material & Methods-The present study design will be of a prospective study, all the patients diagnosed asurinarylithiasis, in surgical OPD and admitted in surgical ward, of SRMS-IMS, Bareilly.1-Inclusion Criteria- All the patients diagnosed as urinarylithiasis, reported In surgical OPD and admitted in surgicalward of SRMS, IMS, Bareilly.2-Exclusion Criteria A-History of any surgery for urinary lithiasis.B-Urinary stone in congenital urinary disorders.3-Sample Size- 100 Patients.Results and Conclusions-With the precise knowledge on epidemiological profile on urolithiasis, the involvedrisk factors and knowledge of the stone constituents, it may be necessary to take certain precautionary steps likeimproving socioeconomic status, literacy, inculcating hygienic habits, avoiding and treating urinary tract infection,maintaining asepsis during urinary catheterization / instrumentation and low calcium containing diet, which may allprobably decrease the incidence and morbidity of patients suffering from urolithiasis. The patients with an episodeof stone disease or with a family history of the same are at high risk and should be closely screened for presence ofmetabolic disorders and routinely followed up to prevent further recurrences.Discussion-Urinary tract calculus disease affects people in the most productive years of their life, and more commonlyseen in males of lower socioeconomic status.Urinary tract infection is a very important independent risk factor forurolithiasis Urea splitting bacteria e.g. Proteus and non-urease containing bacteria e.g. E. Coli, both have a role inurolithiasis. Urinary ph is a very important independent risk factor for urolithiasis, in my study ph was slightly acidic.And alkaline urine patients had struvite (infection) stones.

Prevalence of and risk factors for urolithiasis in Croatian patients with hemophilia.

Urolithiasis may be more prevalent in patients with hemophilia (PWH) than in age-matched non-hemophilic males. We conducted a cross-sectional evaluation of 92 adult PWH at University Hospital Center Zagreb. The primary objective was to investigate the frequency of urolithiasis in adult PWH, and the secondary objective was to determine associated risk factors. Urolithiasis was diagnosed by ultrasound and other patient- and hemophilia-related parameters were recorded. The prevalence of urolithiasis was significantly higher among PWH than the reported prevalence in the general Croatian population (10.9% vs 5.9%; P = 0.042). Similarly, the incidence of urolithiasis during the course of the disease was significantly higher than the estimated cumulative lifetime incidence of urolithiasis in the Croatian population (25% vs 12%; P = 0.001). Multivariate analysis showed that arterial hypertension, the presence of inhibitors, hypercalciuria and hyperbilirubinemia were independent predictors of current urolithiasis (P < 0.05), and that hematuria (P = 0.051) and prior urinary infections (P = 0.059) were also relevant factors.Urolithiasis is a significant burden in adult PWH. Identifying associated risk factors might help in establishing strategies for earlier recognition and more successful prevention and treatment of urolithiasis.

An observational, prospective and comparative study to assess metabolic abnormality in patients of urolithiasis in paediatric age group in a tertiary care center of Bihar

Introduction: In paediatric age group urolithiasis is less common with overall occurrence rate of only 2-3% of total cases. Children with urolithiasis are related with significant morbidity. Different metabolic parameters either serum or urinary gets deranged in urolithiasis. Evaluation of these parameters help in identification and diagnosis of children who are at increased risk for recurrent stone formation and can be prevented by treating these abnormalities. In this study serum and urinary metabolic risk factors for urolithiasis in children were evaluated, observed and compared. Materials and Methods: This was an observational, prospective and comparative study on fifty (n=50) children with confirmed diagnosis of urolithiasis below 12 years of either sex. Dietary history, water intake and results of laboratory findings (Serum, urinary parameters and stone analysis) were recorded, evaluated, tabulated and analysed using GraphPad Instat Software. All urine samples were obtained from patients without dietary restrictions. Results: Out of 50 children, 35 (70%) and 15 (30%) were male and female respectively. Twenty-three participants were below five years of age. On dietary habits low calcium intake and high calcium intake was seen in 60% (n=30) and 14% (n=7) respectively. 64% (n=32) children had low 24-hour urine volume due to low water intake. 64% (n=32) children had metabolic abnormality and out of them serum abnormality was found in 21 and 24-hour urinary metabolic abnormality seen in 11 children. Hypocalcaemia with normal PTH and secondary hyperparathyroidism was seen in 85.71% (n=18) and 14.29% (n=3) of children respectively. Out of 11 children with urinary metabolic abnormality, hypocitruria (n=6) was the most common followed by hypercalciuria (n=3). Stone analysis was done in 20 patients, out of which majority (n=11, 55%) of the children had calcium oxalate stone. Conclusions: Predominant finding from this study was low urine volume seen due

Risk factors for urolithiasis in patients with Crohn's disease.

To study the risk factors for urolithiasis in patients with Crohn's disease. This retrospective study included 1071 patients with Crohn's disease who were treated at a single center. Data pertaining to the following variables were analyzed: sex; age; type of Crohn's disease; number of intestinal resections; residual small intestine length; ileostomy; history of glucocorticoid therapy; and duration of Crohn's disease treatment. Of the 1071 patients, 34 (28 male and six female) had urolithiasis (urolithiasis group) and 1037 (711 male and 326 female) did not (non-urolithiasis group). The median residual small intestine length measured in the urolithiasis group (280.0cm) was significantly shorter than that in the non-urolithiasis group (342.5cm; P<0.01). Significantly more patients in the urolithiasis group (14/34) received steroid medication than those in the non-urolithiasis group (213/1037; P<0.01). On multivariate analysis, male sex (odds ratio 3.15; P<0.05), history of glucocorticoid therapy (odds ratio 3.07; P<0.05), and shorter residual small intestine length (odds ratio 0.99; P<0.01) were risk factors for the development of urolithiasis in patients with Crohn's disease. Our results suggest that male sex, history of glucocorticoid therapy, and shorter residual small intestine length are risk factors for urolithiasis in patients with Crohn's disease.

Risk factors for urinary stone

Urolithiasis is one of the most common urologic diseases in Korea. The annual incidence of urolithiasis in Korea has increased over time. Understanding the epidemiology and risk factors for urolithiasis is essential for patient care and prevention. The purpose of this review was to summarize the recent literature regarding the risk factors for urolithiasis. The available Korean-population-based trials were enrolled in this study. The peak incidence age was the fifth to sixth decades in Korea. There has been a persistent male predominance in the prevalence and incidence of stone disease. The gender gap has continuously narrowed over the world. Climate and seasonal variations, such as temperature and humidity, have a profound effect on the development of urolithiasis. Various dietary factors, including calcium, sodium, animal protein, and oxalate, play an important role in the development of urolithiasis. Dehydration is a wellknown risk factor for stone disease. Many metabolic diseases can affect urolithiasis, including obesity, hypertension, diabetes, gout, and metabolic syndrome. The fast-moving super-aged society and global warming can increase stone disease burden in the near future. To prevent and reduce stone diseases, clinicians should understand the risk factors affecting stone formation.

Metabolic syndrome and urolithiasis: a case-control study.

The estimate for metabolic syndrome (MS) worldwide is above 20%; MS it has been linked to urolithiasis. To determine the association between the components of MS as risk factors for urolithiasis in the adult population of Yucatán, Mexico. Case-control study with a sample size of 85 subjects per group, paired by age and sex; patients with urolithiasis (stones > 5 mm) and controls without urolithiasis. Diagnosis was verified by ultrasound. Blood pressure, weight, height, waist circumference, serum triglycerides, HDL cholesterol, glycemia, and urinalysis were determined. International Diabetes Federation criteria were used for the MS diagnosis. Subjects with kidney damage, endocrinopathies and consumption of steroid drugs were excluded. Descriptive statistics, association analysis and risk calculation were performed. One hundred and seventy subjects were included, 83.5% were women and 52.4% presented MS. Was observed an association between urolithiasis and MS (odds ratio [OR]: 2.7; 95% confidence interval [95% CI]: 1.4-5.1; p = 0.001), hypertriglyceridemia (OR: 1.9; 95% CI: 1.06-3.66; p = 0.021) and high blood pressure (OR: 2.5; 95% CI: 1.2-4.8; p = 0.004). The analysis showed that a higher quantity of MS components increases the risk of urolithiasis (p = 0.004). MS increased in 2.7-fold the risk of urolithiasis. Hypertriglyceridemia and high blood pressure are MS components that increased the risk of urolithiasis.

The Relationship between Ambient Temperature and Renal Disease Morbidity in Vietnam: A Case-Crossover Study

Background/Aim: Under a warming climate, increasing concerns are focused on impacts of high temperatures on health. This project aims to assess relationships between temperature and humidity and renal disease morbidity in Vietnam.Methods: We obtained daily hospital admission data (2000-2015) from 14 provincial and city hospitals across Vietnam, along with province-level weather data. Using a case-crossover design, we assessed relationships between temperature (daily mean, maximum, and minimum temperature, and heat index), relative humidity, and heatwave events and urolithiasis, acute renal disease, and other renal disease. We evaluated lagged and cumulative effects. To evaluate effects of prolonged extreme heat, we analyzed heatwave days defined as three or more consecutive days with daily maximum temperature ≥ 95th percentile, starting with the third day.Results: This study included 107,266 cases of renal disease during warm seasons. In same-day models, higher temperatures were significantly associated with increased urolithiasis risk, but not with increased risk for acute or other renal diseases. The odds ratios (OR) for urolithiasis generally decreased with increasing lag days. Among cumulative measures, 4-day average temperature showed the strongest association with urolithiasis. Our optimal model included 4-day average temperature and same-day heatwave day. For urolithiasis, the OR per 5ºC increase in 4-day average of mean temperature was 1.18 (95% confidence interval: 1.07,1.30), and the OR for being a heatwave day was 1.13 (1.04, 1.23). Results for maximum temperature, minimum temperature and heat index models were similar.Conclusions: Exposure to high temperature is a risk factor for urolithiasis. This effect is not limited to temperature on the same day, but extends to previous days. The greatest risk is conferred by cumulative exposure in the past four days, with a same-day heatwave day adding to the risk.

Elevated non-high-density lipoprotein cholesterol corresponds to a high risk of nephrolithiasis in children

BackgroundDyslipidemia contributes to the development of nephrolithiasis in adults; however its relationship to urolithiasis in children remains debatable, and will be clarified in the present work.MethodsA case–control study was performed involving 58 pediatric patients diagnosed with upper urinary tract stones as well as 351 controls. Age, gender, body mass index (BMI), serum calcium, serum uric acid, blood glucose, blood lipids, and compositions of stones were compared.ResultsAccording to the univariate analysis, uric acid was higher (P < 0.01) but serum calcium lower in the stone group than the control (P < 0.05). As for the blood lipids, non-high-density lipoprotein cholesterol (non-HDL-c) was significantly higher in the stone group as compared to the control (P < 0.01), while total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol did not show statistical difference between the two groups. In the multivariate analysis, only non-HDL-c and serum uric acid were increased in the stone group (P = 0.003 and P = 0.008). In the stone compositions’ analysis, serum uric acid and non-HDL-c were associated with percentage of uric acid and pure calcium oxalate stones, respectively.ConclusionNon-high-density lipoprotein cholesterol may act as a lipid risk factor for urolithiasis in children.

P0169DYSFUNCTION OF ABCG2, URATE TRANSPORTER, IS RELATED WITH UROLITHIASIS

Abstract Background and Aims Urolithiasis is one of the rapidly increasing diseases in developed countries. It has been reported that urolithiasis is related with lifestyles, diet, obesity, climate and chronic diseases including hyperuricemia, diabetes mellitus, metabolic syndrome, chronic kidney disease et cetera. Among them, hyperuricemia is the leading cause of urolithiasis. ATP–binding cassette subfamily G member 2 (ABCG2), urate transporter, excretes uric acid in the kidney and the intestinal tract and ABCG2 dysfunction increases a risk of hyperuricemia. In this study, we investigated the estimated ABCG2 function by common two dysfunctional variants, Q126X (rs72552713) and Q141K (rs2231142), in patients with urolithiasis, and we evaluated the relation between urolithiasis and ABCG2 dysfunction. Method One hundred and ninety-seven urolithiasis patients without gout (150 males and 47 females) were enrolled. Q126X totally abolishes ABCG2 function, while Q141K reduces its function by about 50%. Since these two SNPs do not link each other and two SNPs do not exist on same chromosome, these two are regarded as independent risks. Namely, based on the genotype of Q126X and Q141K, it can be divided into three categories: a full functional group, a 75% functional group and a ≦50% functional group. Serum uric acid levels and amount of urinary uric acid were measured. Renal uric acid handling of the patients was classified into renal uric acid underexcretion type or renal uric acid overload type based on uric acid clearance and amount of urinary uric acid. Stone composition was analysed, if it had been possible. Results ABCG2 function of the patients was evaluated as follows: 82 patients, ABCG2 full function (41.6%); 78 patients, 75% function (39.6%); 37 patients, ≦50% function (18.8%). 155 patients were classified into renal uric acid underexcretion type, 13 patients were classified into renal uric acid overload type and 2 patients were classified into normal type (27 patients have not had 24-hour urine biochemical test). Stone composition analysis was performed for 136 patients; calcium oxalate stone was identified in 107 patients and uric acid stone in 29 patients. In this study, 58.4 % of the patients with urolithiasis had some ABCG2 dysfunction as against 49.8 % of the healthy individuals previously reported (p=0.0246). In addition, the ratio of subjects with urolithiasis having 50% or less of ABCG2 function was higher than healthy individuals significantly (OR=1.773, p=0.007). The high ratio of ABCG2 dysfunctional patients with urolithiasis suggested that ABCG2 dysfunction is a risk factor for urolithiasis. In the patients with urolithiasis, renal uric acid underexcretion type accounted for about 90% of the patients. This means that this type accelerated urolithiasis as well as hyperuricosuria. Conclusion ABCG2 dysfunction and renal uric acid underexcretion type were suggested to be a risk factor for urolithiasis.