Risk Of Stones Research Articles

Protein Intake and High Uric Acid Stone Risk

Rationale & ObjectiveWe evaluated the metabolic differences between pure and impure uric acid stone formers in this retrospective study of uric acid kidney stone formers diagnosed between 1996 and 2021. Study DesignDemographics and medical history were compared by chi-squared tests. 24-hour urine chemistries were compared using logistic regressions while controlling for demographics and comorbidities. Setting & ParticipantsPatients from Yale Urology and Nephrology Clinics with a documented kidney stone analysis containing uric acid were included. 4294 kidney stone formers had a stone analysis and 722 (16.8%) contained uric acid. Patients with all stone analyses ≥50% uric acid were allocated to the pure group, while patients with at least one stone analysis <50% uric acid were allocated to the impure group. ResultsAmong kidney stone formers, the prevalence of uric acid nephrolithiasis was 16.8%. Pure uric acid stone formers were more likely to be older, heavier, and were 1.5 times more likely to have chronic kidney disease. When controlling for age, sex, race, ethnicity, and body mass index, pure uric acid stone formers had lower urine pH and lower urine citrate normalized for creatinine. Additionally, they had a higher protein catabolic rate, urine urea nitrogen, and urine sulfur normalized for creatinine, all markers of dietary protein intake. These findings persisted after controlling for chronic kidney disease. LimitationsThis is a retrospective study from a single center. ConclusionsPure uric acid stone formation is more common with diminished kidney function; however, after controlling for kidney function, pure uric acid stone formation is associated with protein intake, suggesting that modifying protein intake may reduce risk.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of urinary stones in US adults: a cross-sectional NHANES study.

This study examines the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and urinary stones in American adults. We conducted a cross-sectional study utilizing the 2007-2018 National Health and Nutrition Examination Survey (NHANES) data set. The prevalence of urinary stones was determined based on patient-reported experiences of renal colic. We converted NHHR to natural logarithm (ln-NHHR) to align it better with our statistical analyses. Our analysis methods included weighted multivariate logistic regression, generalized additive model (GAM), and application of smoothed curves to better elucidate the association between ln-NHHR and the prevalence of urinary stones. In addition, we conducted subgroup analyses and employed multiple imputation for sensitivity analyses. This study involved a total of 30,903 participants, with a 9.97% prevalence of urinary stones and reported colic experience. Elevated ln-NHHR levels were linked with a higher likelihood of urinary stones (OR = 1.20, 95% CI 1.07-1.35). Smooth curve fitting revealed an inverted U-shaped relationship, pinpointing a significant increase in urinary stone risk at ln-NHHR levels below 1.43 (OR = 1.40, 95% CI 1.19-1.64, p < 0.001). Notably, this correlation was stronger among Non-Hispanic Whites and those married or living with a partner. Multiple imputation analyses strengthened the confidence in our results. Our findings suggest a reverse U-shaped association between urinary stone occurrence and NHHR level, with a positive association at ln-NHHR < 1.43. This correlation was more pronounced in the Non-Hispanic White population and among those married or living with a partner.

The Safety Profile of Vitamin D Supplements Using Real-World Data from 445,493 Participants of the UK Biobank: Slightly Higher Hypercalcemia Prevalence but Neither Increased Risks of Kidney Stones nor Atherosclerosis.

Background: Potential calcium-related adverse events of vitamin D supplement use have not been addressed in large-scale, real-world data so far. Methods: Leveraging data from the UK Biobank, encompassing 445,493 individuals aged 40-69, we examined associations of high 25-hydroxyvitamin (25(OH)D) levels ≥ 100 nmol/L and vitamin D supplementation with hypercalcemia (serum calcium > 2.6 mmol/L), kidney stones, and atherosclerosis assessments (pulse wave arterial stiffness index and carotid intima-medial thickness). Regression models were comprehensively adjusted for 49 covariates. Results: Approximately 1.5% of the participants had high 25(OH)D levels, 4.3% regularly used vitamin D supplements, and 20.4% reported regular multivitamin use. At baseline, the hypercalcemia prevalence was 1.6%, and 1.1% was diagnosed with kidney stones during follow-up. High 25(OH)D levels were neither associated with calcium-related adverse events nor atherosclerosis assessments. Vitamin D and multivitamin supplementation were associated with an increased prevalence of hypercalcemia (odds ratios and 95% confidence intervals: 1.46 [1.32-1.62] and 1.11 [1.04-1.18], respectively) but were neither associated with atherosclerosis nor future kidney stones. Conclusions: High 25(OH)D levels observable in routine care were not associated with any adverse outcome. Vitamin D users have a slightly higher prevalence of hypercalcemia, possibly due to co-supplementation with calcium, but without a higher atherosclerosis prevalence or risk of kidney stones.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stone: evidence from NHANES 2007–2018

BackgroundAs an innovative lipid parameter, NHHR (the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol) can serve as a valuable tool for assessing cardiovascular disease risk. Nevertheless, the relationship between NHHR and the risk of kidney stones remains unexplored.MethodsA cross-sectional survey utilized data from the National Health and Population Survey (NHANES) database in the United States spanning from 2007 to 2018. Distinct statistical analyses were applied, including weighted logistic regression, stratified and interaction analysis and restricted cubic spline curve (RCS) models, to examine the correlation between NHHR and the incidence of kidney stones.ResultsThis analysis encompassed 24,664 participants, with 9.63% reporting incidents of kidney stones. Following multivariate logistic regression and comprehensive adjustments, participants in NHHR quartile 4 (OR 1.34; 95% CI 1.12, 1.60, P < 0.01) exhibited a significantly increased risk of kidney stones compared to those in NHHR quartile 1 (Q1). The RCS result further illustrated a non-linear correlation between NHHR and the incidence of kidney stones. The result of subgroup analysis manifested that participants without diabetes had a higher risk of kidney stones when measured high NHHR levels compared those with diabetes (p for interaction < 0.05).ConclusionElevated NHHR levels were found to be associated with an increased risk of kidney stones. Based on these findings, NHHR appears to be a promising predictive indicator for the occurrence of kidney stones.

Inflammatory factors and the risk of urolithiasis: a bidirectional Mendelian randomization study.

Urolithiasis is a prevalent condition encountered in urology. Over the past decade, its global incidence has been on an upward trajectory; paired with a high recurrence rate, this presents considerable health and economic burdens. Although inflammatory factors are pivotal in the onset and progression of urolithiasis, their causal linkages remain elusive. Mendelian randomization (MR) is predicated upon genome-wide association studies (GWASs). It integrates bioinformatics analyses to reveal causal relationships between exposures and outcomes, rendering it an effective method with minimized bias. Drawing from a publicly accessible GWAS meta-analysis comprising 8,293 samples, we identified 41 genetic variations associated with inflammatory cytokines as instrumental variables. Outcome data on upper urinary tract stones, which included renal and ureteral stones (9,713 cases and 366,693 controls), and lower urinary tract stones, including bladder and urethral stones (1,398 cases and 366,693 controls), were derived from the FinnGen Consortium R9 dataset. By leveraging the bidirectional MR methodology, we aimed to decipher the causal interplay between inflammatory markers and urolithiasis. Our study comprehensively elucidated the association between genetic inflammatory markers and urolithiasis via bidirectional Mendelian randomization. Post-MR analysis of the 41 genetic inflammation markers revealed that elevated levels of circulating interleukin-2 (IL-2) (OR = 0.921, 95% CI = 0.848-0.999) suggest a reduced risk for renal stone disease, while heightened stem cell growth factor beta (SCGF-β) (OR = 1.150, 95% CI = 1.009-1.310) and diminished macrophage inflammatory protein 1 beta (MIP-1β) (OR = 0.863, 95% CI = 0.779-0.956) levels suggest an augmented risk for lower urinary tract stones. Furthermore, renal stone disease appeared to elevate IL-2 (β = 0.145, 95% CI = 0.013-0.276) and cutaneous T cell-attracting chemokine (CTACK) (β = 0.145, 95% CI = 0.013-0.276) levels in the bloodstream, whereas lower urinary tract stones were linked to a surge in interleukin-5 (IL-5) (β = 0.142, 95% CI = 0.057-0.226), interleukin-7 (IL-7) (β = 0.108, 95% CI = 0.024-0.192), interleukin-8 (IL-8) (β = 0.127, 95% CI = 0.044-0.210), growth regulated oncogene alpha (GRO-α) (β = 0.086, 95% CI = 0.004-0.169), monokine induced by interferon-gamma (MIG) (β = 0.099, 95% CI = 0.008-0.191) and macrophage inflammatory protein 1 alpha (MIP-1α) (β = 0.126, 95% CI = 0.044-0.208) levels. These discoveries intimate the instrumental role of IL-2 in the onset and progression of upper urinary tract stones. SCGF-β and MIP-1β influence the development of lower urinary tract stones. Urolithiasis also impacts the expression of cytokines such as IL-2, CTACK, IL-5, IL-7, IL-8, GRO-α, MIG, and MIP-1α. There is a pressing need for further investigation to ascertain whether these biomarkers can be harnessed to prevent or treat urolithiasis.

Association between obesity and risk of kidney stones: exploring the rule of life style factors

Introduction: Kidney stones are a prevalent health concern, with obesity recognized as a significant risk factor. Understanding the interplay between obesity and lifestyle factors in stone formation is crucial. This study investigates this association, focusing on dietary habits, fluid intake, physical activity, and medication use. Methods: A one-year prospective April 2023–March 2024 saw the conduct of a cohort study at the Pakistan Academy of Medical Sciences (PIMS) in Pakistan's Islamabad. 88 participants were enrolled, with baseline data including demographics, BMI, medical history, and lifestyle factors. Follow-up assessments monitored weight changes, urinary parameters, and kidney stone incidence. Multivariate regression analysis explored associations between obesity, lifestyle factors, and stone risk. Results: Obese participants exhibited higher comorbidity prevalence and medication use. Over the study, obese participants gained 3.7 kg, while non-obese lost 1.5 kg. Obese individuals had elevated urinary calcium and oxalate, and lower citrate levels. Kidney stone incidence was 16.7% in obese and 9.5% in non-obese participants. Multivariate analysis identified obesity, high animal protein intake, and low fluid consumption as significant predictors of stone risk among obese individuals. Conclusion: This study underscores the complex relationship between obesity, lifestyle factors, and kidney stone risk. Modifiable factors like dietary habits and fluid intake play crucial roles in stone formation. Insights from this research can inform targeted interventions to reduce stone burden and improve health outcomes in obese individuals.

High composite dietary antioxidant index is associated with reduced risk of kidney stones: a cross-sectional analysis of NHANES 2007-2020

The composite dietary antioxidant index (CDAI) is commonly utilized to assess antioxidant intake across diseases, but its association with kidney stones is unclear. We hypothesized that higher CDAI is associated with reduced kidney stone risk. Using National Health and Nutrition Examination Survey 2007-2020 data, we calculated CDAI based on vitamins A, C, E, selenium, zinc, and carotenoids intake in 29,280 adults. Stone formers had lower CDAI, with significant gender differences. Restricted cubic spline showed an L-shaped curve, with the steepest decline before CDAI of 1.449. In multivariate logistic regression, moderate and high CDAI tertiles were associated with reduced kidney stone odds compared to the lowest tertile (odds ratio [95% CI]): 0.85 [0.73, 0.99], P = .035 and 0.80 [0.66, 0.95], P = .014, respectively). Vitamin C had the highest negative correlation weight with kidney stones. Significant interactions were found for age and diabetes subgroups. In conclusion, higher CDAI may reduce kidney stone risk, especially with adequate vitamin C intake. Further cohort studies are warranted to confirm the causal association.

The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review.

Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.

Medical treatment of uric acid kidney stones.

The prevalence of uric acid stones increases regularly due to its high correlation with obesity, hypertension, metabolic syndrome, type 2 diabetes, and aging. Uric acid stone formation is mainly due to an acidic urinary pH secondary to an impaired urinary ammonium availability responsible for uric acid rather than soluble urate excretion. Alkalization of urine is therefore advocated to prevent uric acid crystallization and considered effective therapy. We report a large series of 120 patients with uric acid kidney stones who were successfully treated with potassium citrate (K-citrate) for stone dissolution without any urologic intervention to prevent stone recurrence, with a median 3.14 years followup. The K-citrate was diluted in 1.5 L of water, avoiding gastrointestinal disorders. Among 75 patients having stones in their kidney at initiation of therapy, a complete chemolysis was obtained in 88% of cases. Stone risk factors decreased under treatment, mainly due to increased diuresis, urinary pH, and citrate excretion. Treatment was stopped in only 2% of patients due to side effects, with no hyperkalemia onset despite a median urinary potassium increase of 44 mmol/day. Contrary to other reports, our data show that medical treatment of uric acid kidney stones is well-tolerated and efficient if regular monitoring of urinary pH is performed.

Evaluating the lipid accumulation product index as a predictor for kidney stone prevalence: insights from NHANES 2007-2018.

This study aimed to explore the relationship between the lipid accumulation product (LAP) index and kidney stone prevalence, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. An observational study was executed employing the NHANES dataset from 2007 to 2018. Analytical methods encompassed multivariate logistic regression, restricted cubic splines (RCS), subgroup analysis, and interaction tests. Predictions were made using the receiver operating characteristic (ROC) curve and the area under the curve (AUC) values. The analysis included 9744 adults aged 20years and older. Multivariate logistic regression identified a significant positive association between log2-transformed LAP (treated as a continuous variable) and kidney stone risk across all models, with odds ratios (ORs) exceeding 1 and p values less than 0.001. Categorically, ORs escalated with increasing LAP levels, indicating a dose-response relationship. The RCS analysis confirmed a linear positive correlation between log2-transformed LAP and kidney stone risk. Subgroup analyses revealed that the log2-transformed LAP-kidney stones relationship was consistent, unaffected by stratification across the examined variables. In addition, LAP index (AUC = 0.600) proved to be a more effective predictor of kidney stones compared to body mass index (AUC = 0.584). Elevated LAP levels are positively correlated with a higher incidence of kidney stones, signifying its potential as a risk marker for this condition. Future research should investigate the mechanisms underlying this relationship. LAP can be used as a new anthropometric index to predict kidney stones, and its predictive ability is stronger than body mass index.

The Plasma Metabolome and Risk of Incident Kidney Stones.

Information on metabolomic profiles in kidney stone formers is limited. To examine independent associations between plasma metabolomic profiles and the risk of incident, symptomatic kidney stones in adults, we conducted prospective nested case-control studies in two large cohorts. We performed plasma metabolomics on 1,758 participants, including 879 stone formers (346 from the Health Professionals Follow-up [HPFS] cohort, 533 from the Nurses' Health Study [NHS] II cohort) and 879 non-stone formers (346 from HPFS, 533 from NHS II) matched for age, race, time of blood collection, fasting status and (for NHS II) menopausal status and luteal day of menstrual cycle for premenopausal participants. Conditional logistic regression models were used to estimate the odds ratio of kidney stones adjusted for body mass index (BMI), hypertension, diabetes, thiazide use, and intake of potassium, animal protein, oxalate, dietary and supplemental calcium, caffeine, and alcohol. A plasma metabolite based score was developed in each cohort in a conditional logistic regression model with a lasso penalty. The scores derived in the HPFS ('KMS_HPFS') and the NHS II ('KMS_NHS') were tested for their association with kidney stone risk in the other cohort. A variety of individual metabolites were associated with incident kidney stone formation at prespecified levels of metabolome-wide statistical significance. We identified three metabolites associated with kidney stones in both HPFS and NHS II: beta-cryptoxanthin, sphingomyelin (d18:2/24:1, d18:1/24:2), and sphingomyelin (d18:2/24:2). The standardized KMS_HPFS yielded an OR for stones in the NHS II cohort of 1.23 (95% CI 1.05, 1.44). The standardized KMS_NHS was in the expected direction but did not reach statistical significance in HPFS (OR 1.16, 95% CI 0.97, 1.39). The findings of specific metabolites associated with kidney stone status in two cohorts as well as a plasma metabolomic signature offer a novel approach to characterize stone formers.

Association between chinese visceral adiposity index and risk of kidney stones in a health screening population: an ultrasonography based cross-sectional study

BackgroundObesity is an important risk factor for kidney stones(KS). Chinese Visceral Adiposity Index (CVAI), as a specific indicator for visceral obesity in the Chinese population, can more accurately assess the visceral fat content in Chinese individuals compared to Visceral Adiposity Index (VAI). However, the association between CVAI and risk for KS has not been studied.MethodsA total of 97,645 participants from a health screening cohort underwent ultrasound examinations for the diagnosis of kidney stones, along with measurements of their CVAI. Logistic regressions were utilized to determine the relationship between different quartiles of CVAI and the incidence of kidney stones. Simultaneously, subgroup analysis and the computation of dose-response curves were employed to pinpoint susceptible populations.ResultsAmong the participants, 2,888 individuals (3.0%) were diagnosed with kidney stones. The mean CVAI values ± standard deviation for the four groups were: Q1 (18.42 ± 19.64), Q2 (65.24 ± 10.39), Q3 (98.20 ± 9.11), and Q4 (140.40 ± 21.73). In the fully adjusted multivariable model, CVAI was positively correlated with urolithiasis (OR = 1.001; 95% CI = 1.000, 1.002). Compared with the first quartile of CVAI, the population in the fourth quartile of CVAI had a higher prevalence of kidney stones (OR = 1.231; 95% CI = 1.066, 1.415). Through subgroup analysis, a positive correlation between CVAI and the risk of kidney stones was found in non-smokers (OR = 1.001, 95%CI:1.000, 1.002), non-drinkers (OR = 1.001, 95%CI:1.000, 1.002), non-hypertensive subgroups (OR = 1.003, 95%CI:1.002, 1.003), and non-diabetes subgroups (OR = 1.001, 95%CI:1.000, 1.002).ConclusionThe findings suggest that CVAI could be a reliable and effective biomarker for assessing the potential risk of kidney stone prevalence, with significant implications for the primary prevention of kidney stones and public health.

The protective role of cardiovascular health against kidney stones: A study based on LE8 score

ObjectivesThe American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH)-Life's Essential 8 (LE8) score. Our objective was to investigate the correlation between levels of CVH, as determined by the LE8 score, and the risk of kidney stones among a representative sample of adults in the United States. MethodsWe included data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007–2016 for further analysis. The LE8 score, a comprehensive measurement ranging from 0 to 100, was used to evaluate overall CVH and classified into three categories: low (0–49), moderate (50–79), and high (80–100) CVH. Logistic regression was employed to assess the association between the LE8 score and kidney stones. Furthermore, sensitivity analysis was conducted to validate the findings, and the presence of a non-linear relationship was examined using restricted cubic spline (RCS) regression methods. ResultsA total of 19,988 participants were included in this study (weighted mean age, 47.99 years; 95 % confidence interval [CI]: 47.46–48.53 years), with 10,319 being female (weighted percentage, 51.98 %; 95 % CI: 51.26–52.71 %) and 1923 identified as having kidney stones (weighted percentage, 9.95 %; 95 % CI: 9.41–10.53 %). In the fully-adjusted multivariable model, higher LE8 scores were associated with prevalence of self-reported kidney stones (odds ratio [OR] for a 10-unit increase in score, 0.86; 95 % CI: 0.82–0.91), presenting a linear dose-response relationship. Compared to the low CVH group, participants in the moderate and high CVH groups exhibited a lower prevalence of kidney stones (OR = 0.80; 95 % CI: 0.69–0.92; OR = 0.54; 95 % CI: 0.43–0.69, respectively). Similar trends were observed when assessing the association between health behavior scores and kidney stones. Moreover, the negative correlation between the LE8 score and the prevalence of kidney stones was markedly more pronounced in various stratified analyses. ConclusionOur study suggests that a higher level of CVH, as assessed by the LE8 metrics, is independently associated with a lower prevalence of self-reported kidney stones in a linear relationship. Further research, particularly through longitudinal or intervention studies, is required to establish whether actively promoting optimal CVH levels can effectively reduce the incidence of kidney stones.

Association between monocyte to high-density lipoprotein cholesterol ratio and kidney stone: insights from NHANES.

The ratio of monocyte to high-density lipoprotein cholesterol (MHR) has surfaced as a novel biomarker indicative of inflammation and oxidative stress. The aim of our study was to evaluate the association between MHR and the risk of kidney stones. This study analyzed data from individuals aged 20-79 who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The MHR was assessed as the exposure variable, while a self-reported history of kidney stones was used as the outcome variable. The independent relationship between MHR and the risk of kidney stones was thoroughly evaluated. This study included 28,878 participants, and as the quartile range of the MHR increased, the proportion of kidney stones also rose progressively (7.20% to 8.89% to 10.88% to 12.05%, P<0.001). After adjusting for confounding factors, MHR was independently associated with an increased risk of kidney stones (OR=1.31, 95%CI=1.11-1.54, P=0.001), also independent of some common inflammatory indices. Subgroup analysis suggested that the relationship between MHR and kidney stones was more pronounced in female and individuals aged 20-49. Further restricted cubic spline (RCS) analysis indicated a nonlinear relationship between MHR and the risk of kidney stones. Our results indicate a positive correlation between MHR and an increased risk of kidney stones in US adults, underscoring the need for further large-scale prospective cohort studies to validate these findings.

Association between oxidative balance score and kidney stones: data from the national health and nutrition examination survey (NHANES)

PurposeSome studies have found that the pathological formation of kidney stones is closely related to injury and inflammatory response. Behaviors such as dietary composition, physical activity, obesity and smoking can all affect the body’s oxidative stress levels. In order to evaluate the effects of various diets and lifestyles on the body’s oxidative and antioxidant systems, an oxidative balance score was developed. To investigate whether the OBS is associated with the development of kidney stones.MethodsData were taken from the National Health and Nutrition Examination Survey (NHANES) from 2007–2018, followed by retrospective observational studies. The association between kidney stones and OBS was analyzed using survey-weighted logistic regression by adjusting for demographics, laboratory tests, and medical comorbidity covariates. The oxidative balance score is calculated by screening 16 nutrients and 4 lifestyle factors, including 5 prooxidants and 15 antioxidants, based on prior information about the relationship between oxidation levels in the body and nutrients or lifestyle factors.ResultsA total of 26,786 adult participants were included in the study, of which 2,578, or 9.62%, had a history of nephrolithiasis. Weighted logistic regression analysis found an association between OBS and kidney stones. In the fully tuned model, i.e., model 3, the highest quartile array of OBS was associated with the lowest quartile array of OBS (OR = 0.73 (0.57, 0.92)) with the risk of kidney stone (p = 0.01), and was statistically significant and remained relatively stable in each model. At the same time, the trend test in the model is also statistically significant. With the increase of OBS, the OR value of kidney stones generally tends to decrease.ConclusionsThere is an inverse correlation between OBS and kidney stone disease. At the same time, higher OBS suggests that antioxidant exposure is greater than pro-oxidative exposure in diet and lifestyle, and is associated with a lower risk of kidney stones

Dieta ketogeniczna a ryzyko kamicy nerkowej

Dieta ketogeniczna a ryzyko kamicy nerkowej

A cross-sectional analysis of the relationship between the non-high density to high density lipoprotein cholesterol ratio (NHHR) and kidney stone risk in American adults

BackgroundRecent interest in the Non-High Density to High Density Lipoprotein Cholesterol ratio (NHHR) has emerged due to its potential role in metabolic disorders. However, the connection between NHHR and the development of kidney stones still lacks clarity. The primary goal of this research is to explore how NHHR correlates with kidney stone incidence.MethodsAn analysis was conducted on the data collected by the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, focusing on adults over 20 years diagnosed with kidney stones and those with available NHHR values. Employing weighted logistic regression and Restricted Cubic Spline (RCS) models, NHHR levels’ correlation with kidney stone risk was examined. Extensive subgroup analyses were conducted for enhanced reliability of the findings.ResultsThe findings indicate a heightened kidney stone risk for those at the highest NHHR levels relative to those at the lowest (reference group). A notable non-linear correlation of NHHR with kidney stone incidence has been observed, with a significant P-value (< 0.001), consistent across various subgroups.ConclusionA clear link exists between high NHHR levels and increased kidney stone risk in the American adult population. This study highlights NHHR’s significance as a potential indicator in kidney stone formation.

#1964 Diagnosis performance of urine oxalate/creatinine ratio for hyperoxaluria screening

Abstract Background and Aims Primary and secondary hyperoxaluria is characterized by significantly elevated urinary oxalate levels, increased risk of kidney stones, nephrocalcinosis, and chronic kidney disease. Patients with enteric hyperoxaluria are especially at high-risk populations. However, identifying hyperoxaluric individuals within these populations remains challenging due to difficulties in obtaining complete urine collections. This study aims to evaluate the diagnostic performance of the urine oxalate/creatinine ratio to improve the screening of hyperoxaluria. Method We pooled data from an adult tertiary renal exploration center, including living donors, short bowel syndrome patients, bariatric surgery patients, and individuals with nephrolithiasis or other nephrological issues undergoing 24-hour urine analysis. We assessed the relationship between the urine oxalate/creatinine ratio and 24-hour oxalate excretion. The diagnostic performance of the ratio was analyzed using ROC curves, and an optimal diagnostic threshold was established. Results Of the 1485 initially included adult patients reported in Table 1, 37% lacked complete urine collections, resulting in a study population of 974 individuals (453 females, 521 males, median age 48 years, median renal function 97 ml/min/1.73 m²). Nineteen percent had hyperoxaluria, with a higher prevalence in females (25% vs. 13% in males). Median 24-hour oxaluria was 548 (432,740) µmol/d in the diseased group and 244 (188,309) µmol/d in the healthy group. A strong correlation (Spearman's rank correlation rho= 0.8, p &amp;lt; 0.001) was found between the urine oxalate/creatinine ratio and 24-hour oxalate excretion. ROC curves for both genders exhibited similar performance, with an optimal threshold for the entire population yielding an AUC of 0.97 (0.962-0.981). The diagnostic threshold for maximum sensitivity was an oxalate/creatinine ratio of 0.025 mmol/mmol (Sensitivity = 1, Specificity = 0.65, PPV = 0.4, NPV = 1), while for maximum specificity, it was an oxalate/creatinine 0.074 mmol/mmol (Sensitivity= 0.31, Specificity = 1, PPV = 1, NPV = 0.862). The optimal diagnostic threshold chosen by the minimum distance from the left-upper corner was an oxalate/creatinine 0.034 mmol/mmol (Sensitivity= 0.92, Specificity = 0.91, PPV = 0.69, NPV = 0.98) (Fig. 1). Conclusion The urine oxalate/creatinine ratio demonstrates excellent diagnostic performance and is efficient in screening hyperoxaluric patients within high-risk populations. However, the positive predictive value is insufficient to be a standalone reliable diagnostic test. Therefore, 24-hour urine oxalate measurement remains necessary for diagnosis.

#2827 Beyond the scale: unveiling the kidney stone risk after bariatric surgery

Abstract Background and Aims Nephrolithiasis is a prevalent condition, with calcium oxalate being the primary component found in kidney stones. Both obesity and gastric bypass surgery pose as risk factors for nephrolithiasis. Malabsorptive bariatric procedures alter 24-hour urine profiles, leading to increased urinary oxalate and reduced urinary citrate levels. This study aims to evaluate the risk factors for calcium oxalate lithiasis in a population after gastric bypass surgery at our center. Method We performed a monocentric retrospective study to evaluate hyperoxaluria and urinary lithiasis in patients who underwent gastric bypass surgery between 2020 and 2021. We assessed urinary oxalate excretion, urinary citrate excretion, and urinary sodium excretion between 4 and 28 months after surgery. To confirm the adequacy of the collection, a comparison was made with the expected urinary creatinine value (20 to 25 mg/kg ideal weight for men and 15 to 20 mg/kg ideal weight for women). We developed a risk score: citraturia &amp;lt; 288 mg/24 h (1 point); oxaluria &amp;gt; 45 mg/L (1 point) and natriuresis &amp;gt; 97.75 mmol/24 h (1 point). Patients were classified as without risk (0 points), at low risk (1 point), at high risk (2 points), and at very high risk (3 points). Additionally, the patients’ historical incidence of lithiasis was examined, both preoperatively and postoperatively, using clinical records. Post-surgery assessments included imaging evidence of lithiasis (when available) or clinical episodes of renal colic. Results Fifty-six patients underwent a 24-hour urine collection. Twenty-two were excluded due to incomplete urine collection, determined by the expected urinary creatinine value and a time lapse exceeding 28 months between surgery and analytical assessment. The median time elapsed between surgery and analytical evaluation was 9.5 months [IQR 6.3 - 12] months. A total of 34 patients were included in the study, 8.8% were male and the median age of the patients was 51.5 [IQR 42.3–57.8] years. The median body mass index decreased from 43.1 [IQR 39.7–46.3] kg/m2 before to 31.8 [IQR 28.6–35.7] kg/m2 six months after surgery. The low risk for calcium oxalate lithiasis in the examined patient sample was 52.9% (n = 18); high risk 20.6% (n = 7), no risk 26.5% (n = 9) and very high risk 0%. We detected 3 (8.8%) patients with concentration hyperoxaluria, 20 (58.8%) patients with natriuresis &amp;gt; 97.75 mmol/24 h and 8 (23.5%) patients with reduced urinary citrate levels. All patients exhibited normal kidney function. The median follow-up duration was 27 months. Out of the total number of patients, only 3 reported renal colic episodes, and imaging evidence of lithiasis was found in just 2 of them before surgery. Among those with a risk score &amp;gt; 0, only 1 had a history of lithiasis. Throughout the follow-up period, none of the patients experienced new lithiasis post-surgery. Regarding the limitations of our study, we highlight the relatively brief duration of follow-up, which may pose challenges in comprehensively evaluating outcomes such as lithiasis. Additionally, the absence of imaging screening represents a notable constraint, impeding the comprehensive assessment of patients with asymptomatic lithiasis. Conclusion This study concludes that within the bariatric surgery population, a specific subgroup is at an elevated risk for renal lithiasis. Recognizing this subgroup promptly and instituting heightened preventive measures may prove advantageous within this demographic.

Association between daily sitting time and kidney stones based on the National Health and Nutrition Examination Survey (NHANES) 2007-2016: a cross-sectional study.

Kidney stones are among the most common urological conditions affecting ~9% of the world population. Although some unhealthy diets and unhealthy lifestyles are reportedly risk factors for kidney stone, the association between daily sitting time and kidney stone has not been explored. This large-scale, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database 2007-2016. Kidney stone history and daily sitting time were retrieved from the questionnaire and 24hour (h) recall interviews. Logistic regression and subgroup analysis were conducted to investigate the association. The analysis was further stratified by vigorous recreational activity. A total of 19188 participants aged ≥20 years with complete information were included in this study. The overall prevalence of kidney stone was 9.6%. Among participants without vigorous recreational activity, a trend towards an increasing prevalence of kidney stone was observed with increased daily sitting time. However, the trend was not observed in individuals who participated in vigorous recreational activity, as they experienced a decreased risk of kidney stone despite having a daily sitting time of 6-8h (crude model OR=0.659, 95% CI: 0.457-0.950, P =0.028), indicating that vigorous recreational activity may partially attenuate the detrimental effect of prolonged sitting time. Our study revealed an increasing trend of prevalence of kidney stone with increased daily sitting time among the population not performing vigorous recreational activity despite the difference was nonsignificant. Vigorous recreational activity may modify the association between daily sitting time and kidney stone. More prospective cohort studies are warranted to further examine this association.