Risk Of Calcium Oxalate Stones Research Articles

Association between metabolic syndrome and calcium oxalate stone risk in Chinese individuals: a nomogram prediction model.

ObjectiveThis retrospective study explored the association between calcium oxalate (CaOx) stones and metabolic syndrome. It also developed and validated a nomogram to aid in the prediction of CaOx stones.MethodsThis case-control study enrolled 150 patients with CaOx stones and 635 individuals without urolithiasis from October 2016 to October 2018. Student’s t-test, the chi-squared test, and logistic univariate and multivariate regression analyses were used. A nomogram for prediction of CaOx stones was established based on independent associated factors. The concordance index and calibration curves were plotted to determine nomogram accuracy.ResultsFemale sex, age ≥66 years, blood pressure (systolic pressure ≥130 mmHg and/or diastolic pressure ≥85 mmHg), and blood uric acid level independently influenced the risk of CaOx stones, according to multivariate logistic regression analysis; these factors were included in the nomogram. The concordance index was 0.701 (95% confidence interval: 0.658–0.737). The standard curve showed a robust fit with the calibrated predictive curve.ConclusionsFemale sex, age ≥66 years, elevated blood pressure, and blood uric acid level independently influenced the risk of CaOx stones. Our nomogram for the prediction of CaOx stones may provide a clinical basis for the assessment of CaOx stone and facilitate early prevention efforts.

PSIII-36 Increased viscosity enhances water intake and reduces risk of calcium oxalate stone formation in cats

Abstract The control of liquid intake in cats is especially of interest as there is a significant risk of urinary tract stone formation due to their high urinary solute density. Calcium oxalate stone formation is not easily mitigated by dietary manipulation. This study investigated if increasing water viscosity (282 vs 2.9 centipoise; means throughout are viscous water followed by control cats) improved voluntary intake of water and calcium oxalate stone risk. Twelve cats (7 neutered males, 5 spayed females) from 3 to 8 years of age with an average weight 4.7 kg were monitored for 4 months. Each cat spent 2 months consuming viscous water and two months consuming normal water in a crossover design. Water consumption was measured through loss of weight from each pet’s water bowl with an additional bowl of the consumed viscosity placed in the room for evaporative loss measurements. A urine calcium oxalate titrimetric test (COT) was performed to evaluate the risk of calcium oxalate stone formation. In brief, the [Ca+2]/(added Oxalate-2) ratio is calculated (per liter). An increasing index value denotes samples at greater risk of calcium oxalate crystallization. The ratio represents the concentration of ionized calcium and the amount of oxalate that is added to initiate crystallization. The results showed that cats drinking viscous water had a significant increase in water consumption (79.9 vs 65.6 grams P = 0.014). There was a reduction in urine specific gravity (1.042 vs 1.052 P = 0.016), fractional excretion of calcium (0.197 vs 0.280 P = 0.036), urinary calcium concentration (49.8 vs 61.8 ppm P < 0.01) and in stone risk as measured by COT (35.5 vs 82.4 P = 0.029). In conclusion, these data show that there is an increased intake of water when cats are offered water with increased viscosity and increased viscosity was associated with an improvement in measurements of oxalate stone risk.

The Association of Household Food Insecurity and the Risk of Calcium Oxalate Stones.

Food insecurity has been defined as 'limited or uncertain availability of nutritionally adequate and safe foods', which associated with adverse health consequences in human. Another alarming condition, which is related to several comorbidities is kidney stone. This study aimed to determine the association of household food insecurity and developing kidney stones (calcium oxalate) in adults referred to medical centers of Babol. This case-control study included 200 participants 18-65 years of ages (100 cases, 100 controls). An 18-items food insecurity questionnaire (USDA), a valid and reliable 147-item food frequency questionnaire (FFQ) and demographic characteristics were obtained via interviewing. Sixty eight percent of cases and 40% of controls were food insecure, respectively. Food insecurity was significantly associated with the risk of kidney stone (P < .05). Furthermore, body mass index (BMI) and family history of kidney stone were significantly associated with the risk of kidney stones (P < .05). Food insecurity and BMI were significantly associated with the kidney stone, which shows the importance of availability of nutritionally adequate and safe foods in prevention of the kidney stone.

Kidney Stones After Bariatric Surgery: Risk Assessment and Mitigation.

Obesity is rampant across the spectrum of age, gender, and race in the Unites States. Paralleling this epidemic, kidney stone prevalence is also rising, affecting nearly 1 in 11 individuals. Bariatric surgical procedures, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), are the most effective weight loss options for morbidly obese or severely obese individuals with comorbidities. A number of studies have linked kidney stone development to bariatric surgical history, particularly RYGB, which portends up to a threefold increase in calcium oxalate stone risk compared with age-matched, obese controls. Stone development after malabsorptive (RYGB) and restrictive (SG) bariatric procedures are driven primarily by alterations in 24-h urine profiles, such as increased urinary oxalate, decreased urine volume, and reduced urinary citrate levels-all of which have been linked to increased kidney stone risk. What clinical recommendations, if any, can be given to reduce kidney stone risk in bariatric kidney stone patients? This review provides not only updated stone incidence and 24-h urine data in this population, but also reassurance-the metabolic alterations that result from bariatric surgery can be successfully mitigated by increased provider awareness, patient education, and a combination of dietary and pharmacological adjustments.

Association Study of Klotho Gene Polymorphism With Calcium Oxalate Stones in The Uyghur Population of Xinjiang, China.

The aim of the present study was to investigate the correlation between Klotho gene polymorphisms andcalcium oxalate stones in Xinjiang Uyghur people. We compared 128 patients with calcium oxalate stones (case group) and 94 healthypeople (control group), detected the genotype and allele distributions of single-nucleotide polymorphisms (SNPs)of the Klotho gene (rs3752472, rs650439, and rs1207568) by reverse transcription polymerase chain reaction. The distributions of the genotype and allele frequencies of the SNPs were consistent with the Hardy-Weinberg equilibrium in the two groups. There were statistically significant differences between the genotype andallele distributions of rs3752472 between the case and control groups; the allele frequencies in the case/controlgroups were C = 240 (93.7%)/151 (80.3%) and T = 16 (6.3%)/37 (19.7%). There was no statistically significantdifference in the genotype distribution of rs650439 between the case and control groups, but there was a differencein the allele distribution; the allele frequencies in the case/control groups were A = 202 (78.9%)/143 (57.2%) andT = 54 (21.1%)/107 (42.8%). There were no statistically significant differences in genotype and allele distributionsbetween the case and control groups of rs1207568; the allele frequencies in the case/control groups were C = 194(71.3%)/145 (77.1%) and T = 78 (28.7%)/43 (22.9%). In rs3752472, the risk for patients with the C and A allelesincreased by 3.675 and 2.799 times, respectively. The rs3752472 and rs650439 SNPs are related to the risk of calcium oxalate stones in Xinjiang Uyghurpeople, and might be one of the risk factors.

Probiotic properties of Oxalobacter formigenes: an in vitro examination.

Oxalobacter formigenes (O. formigenes) is a nonpathogenic, Gram-negative, obligate anaerobic bacterium that commonly inhabits the human gut and degrades oxalate as its major energy and carbon source. Results from a case-controlled study suggested that lack of O. formigenes colonization is a risk factor for recurrent calcium oxalate stone formation. Hence, O. formigenes colonization may prove to be an efficacious method for limiting calcium oxalate stone risk. However, challenges exist in the preparation of O. formigenes as a successful probiotic due to it being an anaerobe with fastidious growth requirements. Here we examine in vitro properties expected of a successful probiotic strain. The data show that the Group 1 O. formigenes strain OxCC13 is sensitive to pH<5.0, persists in the absence of oxalate, is aerotolerant, and survives for long periods when freeze-dried or mixed with yogurt. These findings highlight the resilience of this O. formigenes strain to some processes and conditions associated with the manufacture, storage and distribution of probiotic strains.

Association of calcium oxalate stones and gene Klotho polymorphism in Uighur population of Xinjiang region

Objective To investigate the association of calcium oxalate stones and Klotho gene polymorphism in Uighur population of Xinjiang region. Methods Klotho gene polymorphisms was genotyped by Polymerase chain reaction-restriction fragment length polymorphism analysis(PCR-RFLP) method in 128 cases of patients with calcium oxalate stones(patient group)and 94 cases of normal people(control group)and the allele distribution and comparative analysis of genetype and was performed. Results Single Nucleotide Polymorphism(SNP)rs3752472,SNP rs650439 SNP rs1207568 of Klotho gene were detected, in patient group and control group, the genotype distribution of the three locis are in compliance with Hardy-Weinberg equilibrium.For Klotho gene rs3752472 polymorphism, the statistical results of its genotype was odds ratio(OR)= 3. 707, 95% confidence interval(CI):1. 861-7. 384,χ2= 14. 912, P 0. 05, the statistical results of its allele was OR= 2. 799, 95% CI: 1. 893-4. 138,P 0. 085, the statistical results of its allele was OR= 0. 738, 95% CI: 0. 480-1. 134, P> 0. 05, allele frequencies of patient/control group were C= 194 (71. 3%)/145(77. 1%), T= 78(28. 7%)/43(22. 9%). Conclusion The rs3752472 polymorphism of klotho gene is associated with the risk of calcium oxalate urolithiasis in Xinjiang region,and may be one of risk factors in the pathogenesis of calcium oxalate stones, In addition, the Klotho gene SNP polymorphism of rs650439 allele distribution was statistically significant, the rs650439 polymorphism may be associated with pathogenesis of calcium oxalate, and A allele carriers had higher risk of calcium oxalate stones. Key words: Calcium oxalate stones; Klotho gene; Single nucleotide polymorphism; Uighur

MP33-03 OXALOBACTER FORMIGENES COLONIZATION NORMALIZES OXALATE EXCRETION IN A GASTRIC BYPASS MODEL OF HYPEROXALURIA

You have accessJournal of UrologyStone Disease: Basic Research I1 Apr 2015MP33-03 OXALOBACTER FORMIGENES COLONIZATION NORMALIZES OXALATE EXCRETION IN A GASTRIC BYPASS MODEL OF HYPEROXALURIA Benjamin Canales and Marguerite Hatch Benjamin CanalesBenjamin Canales More articles by this author and Marguerite HatchMarguerite Hatch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.564AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Compared to obese controls, patients who undergo Roux-en-Y gastric bypass (RYGB) surgery for weight loss have up to 4-fold increase in calcium oxalate stone risk, driven primarily by post-operative hyperoxaluria. The probiotic Oxalobacter formigenes (OF) has been demonstrated to reduce urinary oxalate excretion by degrading intraluminal oxalate in addition to promoting enteric oxalate elimination. The objective of the study was to examine the effect of OF colonization on urinary oxalate excretion and intestinal oxalate transport in an established hyperoxaluric RYGB animal model. METHODS Obese male Sprague Dawley rats underwent sham (n=10) or RYGB (n=18) surgery and were maintained post-operatively on low oxalate (1.5%) and low fat (10%) containing diets. After 10 weeks, half of the animals were randomized to gavage containing OF wild rat strain (OXWR). Urine and stool were collected weekly to determine oxalate and colonization status, respectively. At 20 weeks post-operatively, [14C]-oxalate fluxes and electrical parameters were measured in vitro across isolated distal colon tissue mounted in Ussing chambers. RESULTS All rats gavaged with OXWR were confirmed colonized at the time of flux studies. Urinary oxalate excretion remained low and unchanged in sham animals regardless of colonization status (mean 3.54 ± 0.59 umol/day). RYGB + OXWR animals had significant reductions in their urinary oxalate excretion after gavage (24.94 ± 9.4 vs 6.85 ± 3.0 umol/day, p<0.001) while uncolonized RYGB animals showed no significant difference in urinary oxalate (17.2 ± 4.2 vs 14.0 ± 3.3, p=0.62). Compared to sham, the RYGB procedure increased intestinal tissue permeability of oxalate by 36% and transcellular [14C]-oxalate net secretion more than 2-fold. When compared to non-colonized RYGB, RYGB + OXWR animals had 46% increase in net oxalate efflux with no significant changes in tissue permeability. CONCLUSIONS In our model, RYGB-related hyperoxaluria can be reduced to that of sham controls by OF colonization because of a dual action of the bacteria. OF colonization enhanced net secretion of oxalate across the large intestine. Because intestinal permeability was similar between both RYGB groups, the mechanism for this change in urinary oxalate appears to be primarily due to luminal oxalate degradation by OF resulting in a reduction of passive oxalate absorption across the distal colon. This in vivo study suggests that OF colonization may benefit RYGB patients with hyperoxaluria and warrants a clinical trial in patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e373-e374 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Canales More articles by this author Marguerite Hatch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Association of serum biochemical metabolic panel with stone composition.

To determine the association of the basic metabolic panel with stone type. The present study was a retrospective review of 492 stone formers with both stone composition analysis and basic metabolic panel available. Analysis of a basic metabolic panel across stone types was carried out using Fisher's exact test and analysis of variance. Multinomial logistic regression was used to predict stone type based on a basic metabolic panel. A total of 272 (55%) patients had predominantly calcium oxalate stones, 100 (21%) had uric acid stones, 93 (19%) had calcium phosphate stones, 16 (3%) had mixed stones and 11 (2%) had other types of stones. Uric acid stone formers had the highest serum glucose, blood urea nitrogen and creatinine levels. Calcium oxalate stone formers had the highest serum sodium. No significant differences in mean serum calcium levels across different stone types were identified. The predicted risk of uric acid stone over the other stone types increased with an increase in serum glucose and decreased with an increase in carbon dioxide levels. The predicted risk of calcium oxalate stones increased with an increase in serum sodium and chloride levels. The predicted risk of calcium phosphate and oxalate stones over the other stone types increased with an increase in serum calcium levels. The overall accuracy of the basic metabolic panel alone to predict stone type was 59%. A basic metabolic panel alone or in combination with 24-h urinalysis and demographics does not accurately predict stone type. However, it can be used in combination with other variables to predict stone composition.

Association study of DGKH gene polymorphisms with calcium oxalate stone in Chinese population

Diacylglycerol kinase eta (DGKH) participates in regulating the intracellular concentrations of two bioactive lipids, diacylglycerol and phosphatidic acid. With the emerging evidence of a novel regulatory function for diacylglycerol kinase and diacylglycerol in transplasmalemmal calcium ion influx, the present study was designed to investigate the association between DGKH genetic polymorphisms and calcium oxalate stone. 507 patients with calcium oxalate stone and 505 healthy cohorts as control were entered in this prospective study. Three tag single nucleotide polymorphisms (rs4142110, rs180870 and rs17646069) were investigated. Genotyping was carried out by iPLEX Gold for MassARRAY system. Our results showed that rs4142110 was associated with risk of calcium oxalate stone and hypercalciuria (P < 0.05). The T allele, CT genotype, TT genotype, and the combined T variant genotype (TT + CT) of rs4142110 significantly decreased calcium oxalate stone risk (P < 0.05). Rs180870 also showed significant association in genotype distributions between cases and controls (P = 0.042). Hypercalciuria was more prevalent in stone formers (P = 0.010). These findings implicate a link between nucleotide variant of DGKH and a cause for a complex-trait disease, calcium oxalate stone. Similar relationship might also exist between polymorphism of DGKH and hypercalciuria.

The Impact of Dietary Calcium and Oxalate Ratios on Stone Risk

To determine whether the ratio of dietary calcium and oxalate consumption at mealtime affects gastrointestinal oxalate absorption and urinary oxalate excretion. A study was conducted with 10 non-stone-forming adults placed on controlled diets with daily calcium and oxalate contents of 1000 and 750 mg, respectively. Subjects consumed a balanced calcium/oxalate ratio diet for 1 week, observed a minimum 1-week washout period, and subsequently consumed an imbalanced calcium/oxalate ratio diet for one week. Urine specimens were collected on the last 4 days of each diet. Outcome measures included urinary creatinine, calcium, and oxalate as well as the Tiselius index for assessing urinary calcium oxalate supersaturation. Total daily calcium excretion, oxalate excretion, and Tiselius index were similar between balanced and imbalanced dietary phases. There were significant differences in calcium excretion (mg/g creatinine) between balanced and imbalanced diets in the 1-6 PM (83.1 vs 110.2, P <.04), 6-11 PM (71.3 vs 107.2, P <.02), and 11 PM-8 AM collections (55.0 vs 41.8, P <.02). There was significantly higher oxalate excretion on the balanced diet in the 1-6 pm time period (28.1 vs 16.7, P <.01). There were no differences in the Tiselius index in these collections. These results demonstrate that the sequence of ingesting relatively large amounts of oxalate does not significantly affect calcium oxalate stone risk if the recommended daily quantity of dietary calcium is consumed.

YW2-10 Impact of Dietary Calcium and Magnesium on Urinary Oxalate and Risk of Calcium Oxalate Stones (Young Urologist Research Workshop)

YW2-10 Impact of Dietary Calcium and Magnesium on Urinary Oxalate and Risk of Calcium Oxalate Stones (Young Urologist Research Workshop)

The influence of a high-oxalate/low-calcium diet on calcium oxalate renal stone risk factors in non-stone-forming black and white South African subjects.

To evaluate the influence of a high-oxalate/low-calcium diet on calcium oxalate stone risk factors in both black South Africans (who are largely immune to kidney stones) and white South Africans (in whom stones are more common). Urinary and dietary variables were examined in 11 black and 11 white South African men. None of the subjects had had a kidney stone or any metabolic illness. Their normal domestic food intake was assessed using a semiquantitative food frequency questionnaire. Subjects were given a standardized high-oxalate/low-calcium diet for 3 days; 24-h urine samples were collected before the protocol and during the final day. The samples were analysed using routine modern laboratory techniques. The urine analysis data were used to calculate the Tiselius risk index and the relative urinary supersaturations of calcium oxalate, uric acid and calcium phosphate. Urine analysis showed an intriguing anomaly; black subjects had significantly higher urinary pH and oxalate values than whites (6.50 vs 6.21 and 0.23 vs 0.14 mmol/24 h, respectively), while their urinary citrate was lower (1.47 vs 3.69 mmol/24 h). In addition, the Tiselius risk index and relative supersaturation of calcium oxalate were higher in black subjects. These results are contrary to those which might have been reasonably expected when comparing stone-free and stone-prone groups. After the dietary protocol, the only urinary variable which changed significantly was urinary oxalate, which increased by 57% in whites. Factors which are conventionally used to assess stone risk (pH, oxaluria, citraturia, relative supersaturation) are not helpful in identifying why South African blacks are relatively immune to stones. We suggest that relatively lower oxalate absorption rates may be a physiological feature of this racial group.