Risk Of Stones Research Articles

Prevalence of metabolic abnormalities in patients having the risk of recurrent renal stones

Prevalence of metabolic abnormalities in patients having the risk of recurrent renal stones

Efficacy of Intraoperative Cholangiography versus Preoperative Magnetic Resonance Cholangiography in Patients with Intermediate Risk for Common Bile Duct Stones

Efficacy of Intraoperative Cholangiography versus Preoperative Magnetic Resonance Cholangiography in Patients with Intermediate Risk for Common Bile Duct Stones

Retracted: Efficacy of Super-Mini-PCNL and Ureteroscopy in Kidney Stone Sufferers and Risk Factors of Postoperative Infection.

[This retracts the article DOI: 10.1155/2022/4733329.].

Profil mikroskopis sedimen urin pada kondisi glukosuria di Laboratorium Klinik Prodia, Banda Aceh

Background: Laboratory examination of urine (urinalysis) is crucial in establishing various diagnoses. Urine examination can be done through macroscopic examination, including color, clarity, and microscopic examination of urine sediment (U-sed) and urine chemical examination such as glucose. Urine sediment is insoluble elements such as erythrocytes, leukocytes, epithelial cells, thorax, bacteria, crystals, fungi, and parasites originating from the blood, kidneys, and urinary tract. Glucosuria is a condition where glucose is found in the urine, and when excessive >180 mg/dL can experience hyperglycemia, the impact is to damage the capillary blood vessels in the kidneys. U-sed is used to identify sediment elements that can be used to detect kidney and urinary tract abnormalities.Objectives: This study aims to determine the U-sed profile in glucosuria at Prodia Clinical Laboratory, Banda Aceh.Methods: Descriptive research using an experimental design and analyzing secondary data from patients with glucosuria and referred for U-sed examination at Prodia Clinical Laboratory, Banda Aceh Branch. The study was conducted in Mai 2022, with a total sample size of 24 respondents. Microscopic examination U-sed data was processed in stages starting from editing, coding, entry, and cleaning data. Data were only analyzed descriptively using frequency distribution.Results: The results of the study of the U-sed profile in patients with glucosuria conditions were abnormal flat epithelial cells (50,0%), the occurrence of leukocyturia (67,7%), the occurrence of hematuria (70,8%), and other sediments that were above normal only 25,0% of patients. Thus, the U-sed profile in patients with glucosuria conditions may be pathological such as infection, inflammation, and stones in the urinary tract.Conclusion: Some of the MSU profile data in patients who performed laboratory examinations at Prodia Banda Aceh showed above-normal threshold values, such as the data of flat epithelial cells, leukocytes, erythrocytes, and some other sentiments that were above normal had a low frequency. Patients who perform urine tests are at risk of infection and inflammation of the urinary tract and even the risk of kidney stones.

Cancer risk in bladder diverticula: a large institutional analysis of risk and management.

Bladder diverticula (BD) are usually asymptomatic, but may increase the risk of infections, stones, or malignancy, likely due to urinary stasis within the BD. We aim to characterize the risk of bladder cancer (BC) within diverticula. Retrospective review was conducted of patients diagnosed with BD between 1994 and 2021 at a single institution. Cancer risk was characterized using descriptive statistics and multivariable logistic regression as appropriate. We identified 764 patients with mean age 68years, the majority of whom were male (87%) and Caucasian (86%). Of this total, 13.3% (102/764) had a diagnosis of BC and 35.3% of this subset (36/102) had definitive cancer within the BD. Diverticulectomy or partial cystectomy was performed in 13.6% (104/764), 76% of whom were preoperatively presumed to have benign disease. Surgical patients were younger and had larger BD. Of the 79 patients who underwent diverticulectomy without preoperative suspicion for cancer, 5 were incidentally diagnosed with BC on final pathology. On multivariable logistic regression, male gender [odds ratio (OR) = 2.6, p = 0.03] and increasing age (OR = 1.02, p = 0.03) were independent risk factors for BC diagnosis. Indwelling catheter, recurrent urinary tract infections (UTIs), and bladder stones did not affect the risk of BC. The majority of patients with BD are not managed with surgery. BC is identified in a small but considerable proportion of patients with BD, with an even lower rate of incidentally diagnosed cancer among those undergoing BD surgery. Male gender and increasing age increased the risk of BC diagnosis.

Calcium and vitamin D supplements for the treatment and prevention of osteoporosis. Should it be widely used?

Osteoporosis is the most common age-related skeletal diseases, which is characterized by the rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of osteoporosis is attributed to its complications, which increase disability and mortality rates mostly among older people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. Thus, for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D have been questioned because some randomized clinical trials have reported only a weak positive effect of calcium with or without vitamin on reducing fragility fracture risks. On the contrary, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to the co-administration of calcium and vitamin D supplements, other recent data suggested that calcium supplementation has potential adverse cardiovascular effects. This study focused on the evidence regarding the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.

Bile acid profiles in choledocholithiasis and their ability to predict common bile duct stone recurrence after endoscopic retrograde cholangiopancreatography treatment.

This study aimed to explore the alteration of bile acid (BA) profiles in patients with choledocholithiasis (CDC) and construct a prediction model for evaluating the risk of common bile duct stone (CBDS) recurrence after endoscopic treatment. A total of 320 patients (218 with CDC and 102 with nonneoplastic polyps) were enrolled. The serum BA profiles were compared between groups. Both diagnostic score of CDC and prognostic risk score of CBDS recurrence based on BAs were established by least absolute shrinkage and selection operator regression. A nomogram model was developed combining the risk score with clinical factors selected by Cox regression analysis. The BA profiles of patients with CDC were different from those of controls, which was mainly exhibited by an increase in conjugated BAs and the ratio of primary to secondary BA and a decrease in the hydrophobic BA ratio. The diagnostic model effectively distinguished patients with CDC from controls with an area under the curve of 0.763. Patients with CDC with a low BA risk score exhibited a high possibility of stone recurrence-free survival. The hazard ratios of history of cholecystectomy, multiple stones (n ≥ 2), bile duct angulation ≥132.7, and low BA risk score were 2.43, 4.18, 0.42, and 0.31, respectively. The serum BA profiles were altered in patients with CDC and could be used to distinguish patients with CDC from controls. The nomogram model developed for predicting the risk of CBDS recurrence in patients with CDC after endoscopic retrograde cholangiopancreatography treatment had high accuracy and clinical usability.

HPB P50 Prediction and Management of Choledocholithiasis in Gallstone Related Disease

Abstract Background Acute cholecystitis, pancreatitis and cholangitis are common presentations to the general surgery on-call shift, the management of which can be complicated by evidence of choledocholithiasis. Risk scoring systems exist to help guide the requirement for further imaging or endoscopy for these patients. Our audit reviewed the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for choledocholithiasis prediction and associated management guidelines against current practices at a tertiary hospital to assess how well common practice matches guideline recommendations based on choledocholithiasis risk. Our aim was to assess how current practice for investigation of possible choledocholithiasis interlinks with CBD stone risk scoring systems, whether risk scoring is useful in management of a gallstone related disease risk and if a choledocholithiasis risk prediction tool could optimize resource usage. Methods We retrospectively identified a cohort of patients presenting acutely to the surgical unit over a three-month period with symptoms suggestive of cholecystitis, cholangitis or pancreatitis. Patients were identified from prospectively maintained, electronic records of surgical in-patients and on-call surgical patient lists. Patients meeting local guideline criteria for diagnosis of pancreatitis (serum lipase greater than 3 times the upper limit of normal or CT confirmed pancreatic inflammation) or Tokyo Guidelines 2018 for diagnosis of cholecystitis and cholangitis were included. Those with non-gallstone pathology, previous cholecystectomies and incomplete data were excluded. Patients were categorized into respective risk strata according to the ASGE scoring system and their ongoing management was compared against those guidelines. Subgroup analyses on outcomes and complications for those in each risk strata and in those with age over 55 years of elevated bilirubin as risk factors were also performed. Results 78 patients were identified with 13 categorized as high-risk, 46 intermediate risk and 19 low-risk. 12 of 13 patients (92%) at high risk had evidence of choledocholithiasis on MRCP, CT or USS. 10 of 12 patients (83%) subsequently had a definitive ERCP or preceding cholecystectomy. No low-risk patient had evidence of choledocholithiasis on imaging. 90% of this group have had or are awaiting cholecystectomy. 1 patient, who declined cholecystectomy, re-presented 8 months later with choledocholithiasis. Within the intermediate risk category, there was greater discrepancy in the predictive value of choledocholithiasis. 17 of 46 (37%) patients had an MRCP or EUS with 4 having choledocholithiasis and all going on to have duct clearance. 29 patients (63%) did not have MRCP or EUS, instead receiving either USS, CT or both. 2 patients in this group were unfit for further procedure and received no further imaging, 2 patients had evidence of choledocholithiasis and 25 had no evidence of choledocholithiasis. To date 12 patients have had or are awaiting a cholecystectomy and a further 12 have declined or were not fit for cholecystectomy. 8 patients were stratified as intermediate risk on age >55 alone with no patients having evidence of choledocholithiasis. Conclusions Although based on a small retrospective study, risk prediction using the ASGE scoring tool works effectively in high and low risk patient cohorts, but appears to over predict choledocholithiasis in the intermediate risk group, particularly when based on age alone. Patients with high risk of choledocholithiasis should proceed to duct clearance without further imaging, whilst low risk patients can proceed directly to cholecystectomy. Over investigation dictated by the guidelines for the intermediate risk group is likely to lead to poor compliance as shown in our dataset and may lead to increased burden on imaging services, particularly in hospitals serving more elderly populations.

Is the visceral adiposity index a potential indicator for the risk of kidney stones?

To determine whether the visceral adiposity index (VAI) was linked to the risk of kidney stones (KS) in the representative U.S. adults. We investigated 59842 participants who joined the 2007-2018 National Health and Nutrition Examination Survey. The association between the visceral adiposity index (VAI) and KS was identified by logistic regression analysis. Meanwhile, the subgroup analysis as well as the calculation of dose-response curves were also utilized to identify sensitive groups. Data from 29384 participants were available, including 2781 self-reported ever experiencing KS diseases. Overall, the VAI was 0.74 (0.70, 0.78) in the KS group, while 0.55 (0.52, 0.57) in the control group. After adjusting for confounders, the prevalence of KS increased by 13% for each unit of VAI increment (OR = 1.13, 95% CI: 1.08, 1.19). Moreover, a linear relationship was found between the VAI and the prevalence of KS. By subgroup analysis, we found that a positive correlation between VAI and the risk of KS both in male (OR=1.14, 95%CI:1.07, 1.22) and female (OR=1.14, 95%CI:1.05, 1.24), White (OR=1.20, 95%CI:1.11, 1.28) and other race, all aged subgroups, nonhypertensive (OR=1.06, 95%CI:1.08, 1.25) and nondiabetic subgroups (OR=1.14, 95%CI:1.07, 1.21). Elevated VAI was strongly associated with KS in representative U.S. adults, which may be a promising indicator for the risk of kidney stones.

Tea intake and risk of kidney stones: A mendelian randomization study

ObjectivesObservational studies indicate that tea intake is associated with a decreased risk of kidney stones. Here we performed a mendelian randomization (MR) analysis to evaluate whether this association is causal. MethodsForty-four independent genetic variants strongly associated with tea intake were identified from a large genome-wide association study, including 448 060 individuals of the UK Biobank. We additionally obtained genome-wide association study summary statistics for kidney stones from the FinnGen consortium (5985 cases and 253 943 controls) and UK Biobank (6536 cases and 388 508 controls). Random-effect inverse variance weighted regression was used to evaluate causal estimates. The random-effect inverse variance weighted estimates based on the FinnGen consortium and UK Biobank were meta-analyzed using fixed-effects meta-analysis. Other MR methods, including MR-Egger, weighted median, weighted mode, and MR–Pleiotropy RESidual Sum and Outlier, were also performed to test the robustness of our results. ResultsIn a combined sample of 12 521 cases and 642 451 controls, the inverse variance weighted analysis indicated that genetically predicted tea intake was causally associated with a decreased risk of kidney stones (odds ratio = 0.47; 95% CI, 0.34–0.66; P < 0.001). This association was consistent in other MR methods. ConclusionsThis study suggests that tea intake may be causally associated with a decreased risk of kidney stones.

Clinical Effectiveness of Calcium Oxalate Stone Treatments

Introduction: Lowering kidney stone risk and urine calcium oxalate supersaturation is a primary clinical focus for kidney stone prevention and can be achieved with multiple strategies. Common strategies include advice to increase fluid intake, restrict dietary sodium, or prescribing a thiazide-type diuretic. We investigated how physicians make these decisions in real-world practice and evaluate their efficacy based on 24-h urine collections. Methods: We reviewed medical charts for 203 kidney stone formers with idiopathic calcium stones from University of Chicago Kidney Stone Clinic between 2005 and 2020. Patients had three 24-h urines before an initial pre-treatment clinic visit and one follow-up 24-h urine. We analyzed changes in urine composition based on treatment advice using t tests and ANOVA. Results: Patients who received advice to increase fluid intake had lower urine volume at baseline (1.5 vs. 2.5 L/day, p < 0.001) and larger increase in urine volume at follow-up (0.6 vs. 0.1 L/day, p < 0.001) compared to those who did not receive the advice. Patients who were advised to restrict dietary sodium had a higher urine sodium at baseline (208 vs. 139 mEq/day, p < 0.001), a larger reduction in urine sodium (−28 vs. 13 mEq/day, p = 0.002), and larger reduction in urine calcium (−74 vs. −28 mg/day, p = 0.005) compared with those not advised to restrict dietary sodium. Patients started on a thiazide had a higher baseline urine calcium (281 vs. 213 mg/day) and larger reduction in urine calcium (−83 vs. −9 mg/day, p < 0.001) compared with patients not started on a thiazide. In combination, thiazide prescriptions with dietary sodium restriction reduced urine calcium by 99 mg/day and reduced calcium oxalate supersaturation from 8.0 to 5.5 and calcium phosphate supersaturation from 1.4 to 1.0. Conclusion: Providers use 24-h urine data to guide treatment strategy decisions. These strategies achieved the intended effects on urine composition and lowered kidney stone risk.

Promosi Kesehatan “Peduli Kesehatan Ginjal Remaja” Pada Peserta Didik SMA Muhammadiyah 2 Pontianak

In this era of the industrial revolution 4.0, there are many teenagers whose attitudes and behavior are very caring. Health problems that are quite vulnerable to adolescents are fluid balance problems, because adolescents are more active in physical activities and there are also changes in metabolism in the body so that the need for fluids increases. The Indonesian Regional Hydration Study (THIRST) research suggests that 46.1% of the Indonesian population is mildly dehydrated, where adolescents have a higher level of mild dehydration (49.5%) than adults (42.5%), increase the risk of kidney stones, urinary tract infections, colon cancer, constipation, obesity, cerebral vascular stroke, and other disorders. The target of this activity is 23 students from SMA Muhammadiyah 2 Pontianak. The output of the activity is an increase in the cognitive aspects, attitudes and behavior of students in maintaining the health of the kidney organs. The activity was carried out with a Health Education approach. After being given health education, there was an increase in knowledge of the majority of students.

Pegcetacoplan Corrects Hyperbilirubinemia in Both Untreated Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) and in Patients with PNH Who Previously Received Eculizumab

Background Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired disease characterized by complement-mediated hemolysis and thrombosis. It results from loss of the glycosylphosphatidylinositol-linked complement-inhibitor proteins CD55 and CD59 that inhibit early and late complement proteins, respectively, on red blood cell (RBC) membranes. In untreated patients, formation of the C5b-9 membrane attack complex results in chronic intravascular hemolysis (IVH) and acute hemolytic attacks. Treatment with the C5 inhibitors eculizumab (ECU) and ravulizumab inhibits IVH and unmasks extravascular hemolysis (EVH), which is due to C3b-mediated opsonization of RBCs and their clearance by the reticuloendothelial system. This can result in unconjugated (indirect) hyperbilirubinemia, leading to jaundice and scleral icterus when plasma bilirubin levels reach 2.0-3.0 mg/dL. As in other conditions with EVH (eg, sickle cell disease), bilirubin gallstones have been reported in patients with PNH treated with C5 inhibitors. Pegcetacoplan (PEG), a C3 inhibitor that controls IVH and EVH, is approved in the US for the treatment of adults with PNH. We hypothesized that PEG could control hyperbilirubinemia in PNH patients, reducing jaundice and the risk of gallstone formation. Methods This post hoc analysis evaluated 16- and 26-week data from 2 Phase 3 randomized controlled trials. PEGASUS (NCT03500549) evaluated patients with hemoglobin <10.5 g/dL despite stable ECU treatment for 48 weeks; patients received PEG or ECU for 16 weeks. PRINCE (NCT04085601) evaluated PEG therapy for 26 weeks in patients who were untreated with complement inhibitors. Mean and median total and indirect bilirubin values were calculated at baseline and at the end of the treatment period for patients treated with PEG and ECU in PEGASUS and with PEG in PRINCE. Total bilirubin plasma levels were categorized as normal (<1.1 mg/dL), intermediate (1.1-3.0 mg/dL), and high (>3.0 mg/dL). The main endpoint was the distribution of bilirubin categories at baseline compared with the end of the treatment period and probability of normalization as analyzed by Bowker's test of symmetry. Patients were excluded from the analysis if they did not have both a baseline and end of treatment bilirubin value for analysis. Results In PEGASUS, 74 of 80 patients (PEG, n=36; ECU, n=38) had evaluable bilirubin data; 30 of 35 PEG-treated patients were evaluable from PRINCE. At baseline, 85% (n=63) of patients in PEGASUS had abnormal bilirubin values and 26% (n=20) had high bilirubin values. In PRINCE at baseline, 87% had abnormal bilirubin values, and 23% had high bilirubin values. The hyperbilirubinemia was primarily of the indirect form (TABLE). At 16 weeks, 72% of patients treated with PEG in PEGASUS had normal bilirubin values compared with 16% of patients treated with ECU. In PRINCE, 83% of patients treated with PEG had normal bilirubin at 26 weeks; none had high bilirubin values. The shifts toward normalization in bilirubin categorization (FIGURE) were statistically significant (p<0.0001) for patients on PEG therapy in both PEGASUS and PRINCE. Continued treatment with ECU was not associated with a significant change in bilirubin (p=0.39). In PEGASUS, the normalization rate was 71% (n=22/31; exact 95% CI: 52%, 86%) for PEG and 9% (n=3/32; exact CI: 2%, 25%) for ECU. In PRINCE, the normalization rate was 81% (n=21/26 patients; exact CI: 61%, 93%) after PEG treatment. Conclusions This post hoc analysis found a high prevalence of abnormal bilirubin values at baseline in patients with PNH who were treated with a C5 inhibitor or were untreated. Treatment with PEG significantly improved bilirubin levels, with the majority of patients shifting to normal values. Conversely, bilirubin levels did not improve with continued ECU treatment. These findings suggest that long-term treatment with PEG reduces the signs and symptoms of hyperbilirubinemia, improving jaundice, and decreasing the risk of bilirubin stones and associated complications (eg, biliary sepsis and pancreatitis) in patients with PNH. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The relationship between ethylene oxide levels in hemoglobin and the prevalence of kidney stones in US adults: an exposure-response analysis from NHANES 2013-2016.

Exposure to ethylene oxide may cause a number of diseases. The purpose of this study was to investigate whether there is an association between hemoglobin ethylene oxide (HbEO) and the risk of developing kidney stones in US adults. We analyzed 3348 patients from the National Health and Nutrition Survey (NHANES) 2013-2016 and conducted a cross-sectional study. Dose-response analysis curves of restricted cubic spline function, multiple logistic regression, and subgroup analysis were used to investigate the association between HbEO and the risk of kidney stones. Logistic regression models were used to analyze the correlation between HbEO and kidney stones. Among the 3348 participants, 3016 people self-reported having a kidney stone. After adjusting for age, sex, race, marital status, education level, diabetes, vigorous recreational activity, moderate recreational activity, body mass index, blood urea nitrogen, creatinine, eGFR, and uric acid, we found a positive association between HbEO and the risk of kidney stones. We divided patients into four groups based on quartiles of HbEO levels and performed multifactorial logistic regression after adjusting for confounders, which showed that the incidence of kidney stones increased with increasing HbEO concentrations compared with Q1 (Q2, OR = 0.922, 95% CI, 0. 657-1.295, P = 0.639; Q3, OR = 1.004, 95% CI, 0.713-1.414, P = 0.983; Q4, OR = 1.535, 95% CI, 1.114-2.114, P = 0.009). High levels of HbEO were positively correlated with the risk of kidney stone development and could be used as an indicator of kidney stone prevention.

The Reciprocal Relationship between Osteoporosis and Renal Stones.

Previous studies have proposed an association between osteoporosis and renal stones. The current analyses intended to investigate the bidirectional relationship between osteoporosis and renal stones. The ≥40-year-old population in the National Health Insurance Service-Health Screening cohort (2002-2015) was analyzed. In study I, 67,811 patients with osteoporosis and 67,811 control I participants were matched. The hazard ratio (HR) of osteoporosis for renal stones was calculated using stratified Cox proportional hazard models. In study II, 25,261 patients with renal stones and 101,044 control II participants were matched. The HR of renal stones for osteoporosis was estimated using stratified Cox proportional hazard models. In study I, 3.4% (2276/67,811) of osteoporosis patients and 2.5% (1696/67,811) of control I participants had renal stones. Osteoporosis patients had a 1.36 times higher HR for renal stones than control I participants (95% confidence intervals [CI] = 1.28-1.45). In study II, 9.2% (2319/25,261) of renal stone patients and 7.6% (7658/101,044) of control II participants had osteoporosis. Renal stone patients had a 1.26 times higher HR for osteoporosis than control II participants (95% CI = 1.21-1.32). Adults with osteoporosis had a higher risk of renal stones. Moreover, adults with renal stones had a higher risk of osteoporosis.

Lipid Profile Increased the Risk of Incident Kidney Stones in a Population-Based Cohort Study

Lipid Profile Increased the Risk of Incident Kidney Stones in a Population-Based Cohort Study

ODP102 Indicators for the effects of calcimimetics on hypercalcemia in the elderly patients with primary hyperparathyroidism.

Abstract Primary hyperparathyroidism (PHPT) is the most common disorder causing hypercalcemia, in which parathyroid hormone (PTH) is excessively secreted from a parathyroid tumor. PHPT occurs mainly in elderly women, and patient with PHPT present symptoms including nephrolithiasis, bone fracture, and cognitive impairment or can be asymptomatic. Excessive secretion of PTH leads to elevated serum levels of alkaline phosphatase as well as calcium and decreased serum inorganic phosphate level. Parathyroid surgery is the only established treatment, and the treatment reduces elevated serum levels of calcium and PTH, increases bone mineral density, reduces the occurrence of bone fractures, and decreases the risk of renal stones. However, some PHPT patients, especially elderly patients, refuse to undergo surgical therapy for various reasons including perceived risk. Calcimimetic treatment, including cinacalcet and evocalcet administration, has also been reported to be effective for reducing serum calcium level in patients with PHPT. However, the relationship between the efficacy of calcimimetic treatment for PHPT and patient characteristics related to the effectiveness of calcimimetics remains to be elucidated. To investigate the relevance of clinical parameters to the effectiveness of calcimimetics for PHPT, we retrospectively analyzed patients with PHPT who received calcimimetic treatment in our department. We included nine patients including 8 females (88.9%) and one male (11.1%) in the study. The median age of the patients was 81 years (interquartile range (IQR): 61-86 years). Laboratory tests before calcimimetic treatment revealed that median level of serum corrected calcium (cCa) was high (11.1 (IQR: 10.5-12.7) mg/dL), serum inorganic phosphate was low (2.3 (2.3-2.4) mg/dL), and plasma intact PTH was high (251. 0 (198.3-498.5) pg/mL). The fractional excretion of calcium was higher than 1% (1.3% (1.12-1.48%)), %tubular reabsorption of phosphate was low (79.9% (77.1-83.9%)), nephrogenous cyclic adenosine monophosphate (cAMP) was high (3.4 (2.4-4. 0) nmoL/dL GF), and urinary cAMP was normal (4.3 (4. 0-5.3) μmoL/day). Median reduction rate of serum cCa level due to calcimimetic treatment was 5.8% (0-13.4%) at the first follow-up (median treatment duration: 22 (20-29) days). Notably, reduction rate of serum cCa level had significant correlations with age (R=0.95), dual energy X-ray absorptiometry % young adult mean (DEXA %YAM) in the femoral neck (R=-0.92), and urinary cAMP level (R=-0.85). Thus, the present study suggested that elevated serum cCa levels may be reduced by treatment with calcimimetics more effectively in PHPT patients of relatively advanced age, patients with low DEXA %YAM, and patients with low urinary cAMP. Presentation: No date and time listed

Kidney stone risk reduction and size reduction utilizing medical plants

Kidney stone risk reduction and size reduction utilizing medical plants

Kidney stone risk reduction and size reduction utilizing medical plants

Kidney stones are not only a widespread problem now, but have been for centuries. Many of the plants used historically have now been found to be effective in reducing risk and reducing stone size in modern clinical trials. Both reducing stone size and reducing recurrence of stones after removal are important. Certain medical plants have been shown to slow the formation of calcium oxalate crystals. Several of these medical plants also have antioxidant and antimicrobial effects. The plants with the best clinical trials and supporting preclinical data showing effectiveness in reducing kidney stone formation and recurrence are Nigella sativa (black cumin seed), Dolichos biflorus (horse gram), Crataeva nurvala (varuna bark), and Tribulus terrestris (Gokshura). Some of these medical plants have been compared to tamsulosin (Flomax®) and potassium citrate for safety and effectiveness. Reviewed here are 11 medical plants with good clinical data, as well as 24 more plants with preclinical data or historical use.

The association between caffeine intake and risk of kidney stones: A population-based study.

BackgroundAlthough many studies have proven the beneficial effects of caffeine on human health, the association between caffeine intake and the risk of kidney stones is limited in large epidemiologic studies.ObjectivesWe aimed to investigate the association between caffeine intake and the risk of kidney stones.MethodsA total of 30,716 participants (with weight numbers of 204, 189, and 886) with a history of kidney stone were included in this analysis. All data were survey-weighted, and corresponding logistic regression models were performed to examine the associations between caffeine intake and the risk of kidney stones.ResultsIn a fully adjusted model, a per-quartile increase in caffeine intake was associated with a 5.32% decreased risk of kidney stones. In the subgroup analysis, the multivariate-adjusted odds ratios (95% confidence intervals) of the risk of kidney stones for per-quartile increments in caffeine intake were 0.9650 (0.9643, 0.9656) for men, 0.9320 (0.9313, 0.9327) for women, 0.9384 (0.9378, 0.9389) for white race individuals, 1.0281 (1.0270, 1.0292) for nonwhite race individuals, 0.9460 (0.9455, 0.9465) for overweight/obese individuals, and 0.9314 (0.9303, 0.9324) for non-overweight individuals, 0.9100 (0.9094, 0.9105) for caffeine from coffee, and 1.0021 (1.0013, 1.0029) for caffeine from non-coffee sources.ConclusionCaffeine intake was negatively associated with the risk of kidney stones. In subgroup analyses, the negative association of caffeine with kidney stone risk was only found in white individuals. In addition, the decreased risk was found higher in women and non-overweight individuals. Especially for women, white individuals and non-overweight individuals. The protective effect of caffeine intake from coffee on stone formation was more significant than that of caffeine from non-coffee sources.