Risk Of Renal Stones Research Articles

Bidirectional association between gallstones and renal stones: Two longitudinal follow-up studies using a national sample cohort

The present study evaluated the associations between gallstones and renal stones using a national sample cohort of the Korean population. The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. We designed two different longitudinal follow-up studies. In study I, we extracted gallstone patients (n = 20,711) and 1:4-matched control I subjects (n = 82,844) and analyzed the occurrence of renal stones. In study II, we extracted renal stone patients (n = 23,615) and 1:4-matched control II subjects (n = 94,460) and analyzed the occurrence of gallstones. Matching was performed for age, sex, income, region of residence, and history of hypertension, diabetes mellitus, and dyslipidemia. Crude and adjusted hazard ratios (HRs) were calculated using a Cox proportional hazards model, and the 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to age and sex. The adjusted HR of renal stones was 1.93 (95% CI = 1.75–2.14) in the gallstone group (P < 0.001). The adjusted HR of gallstones was 1.97 (95% CI = 1.81–2.15) in the renal stone group (P < 0.001). The results were consistent in all subgroup analyses. Gallstones increased the risk of renal stones, and renal stones increased the risk of gallstones.

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge regarding Dietary Awareness to reduce the risk of Renal Stones among the People of Mehsana City

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge regarding Dietary Awareness to reduce the risk of Renal Stones among the People of Mehsana City

Hypocitraturia Contributing to Nephrolithiasis in a Patient with CYP24A1 Gene Mutation

Objective: There have been several case reports of hypercalcemia due to mutation in CYP24A1, which encodes an enzyme that controls the catabolism of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D to inactive forms. These patients develop nephrolithiasis, nephrocalcinosis, and eventually renal insufficiency. We describe a patient with hypercalcemia and nephrolithiasis due to CYP24A1 mutation with other co-existing factors for renal stone formation. Methods: A literature search was conducted using the PubMed and Google Scholar databases for CYP24A1 mutation and hypercalcemia. Publications were selected based the quality of the data and clinical relevance. Results: CYP24A1 mutation may lead to hypercalcemia, hypercalciuria, and renal stone formation; however, other risk factors for renal stone formation such as urinary citrate, sodium, oxalate, and uric acid levels need to be evaluated. Conclusions: This case highlights the need to evaluate for other renal stone risk factors in patients with CYP24A1 mutation.

Dietary Guidelines to Reduce the Risk of Renal Stones

Kidney stones (urolithiasis or calculi) are found to be lodged in the urinary tract namely kidney, ureters, bladder or urethra. The production of protein metabolism leaves uric acid, phosphate and oxalates, sodium, calcium and magnesium. A urine concentrate with calcium phosphate and ammonium phosphate predisposes stone formation. The occurrence of kidney stone may be an outcome of different nutritional status, dietary habits and environmental factor such as temperature and humidity and other factors of occupation, infection of urinary tract, hereditary, vitamin A and vitamin B6 deficiency and hyperthyroidism. Dietary guidelines deals the foods included and avoided specifically based on the types of stones.

Shape-dependent cellular toxicity on renal epithelial cells and stone risk of calcium oxalate dihydrate crystals

Renal epithelial cell injury causes crystal retention and leads to renal stone formation. However, the effects of crystal shape on cell injury and stone risk remain unclear. This study compared the cytotoxicity degrees of calcium oxalate dihydrate (COD) crystals having different shapes toward human kidney proximal tubular epithelial (HK-2) cells to reveal the effect of crystal shape on cell injury and to elucidate the pathological mechanism of calcium oxalate kidney stones. The effects of exposure to cross-shaped (COD-CS), flower-like (COD-FL), bipyramid (COD-BD), and elongated–bipyramid (COD-EBD) COD crystals on HK-2 cells were investigated by examining the cell viability, cell membrane integrity, cell morphology change, intracellular reactive oxygen species, mitochondrial membrane potential (Δψm), and apoptotic and/or necrotic rate. Crystals with large (100) faces (COD-EBD) and sharp edges (COD-CS) showed higher toxicity than COD-BD and COD-FL, respectively. COD crystal exposure caused cell membrane rupture, upregulated intracellular reactive oxygen, and decreased Δψm. This series of phenomena ultimately led to a high apoptotic rate and a low necrotic rate. Crystals with large active faces have a large contact area with epithelial cell surface, and crystals with sharp edges can easily scratch epithelial cells; these factors could promote crystal adhesion and aggregation, thus increasing stone risk.

Nephrolithiasis

The term nephrolithiasis, often used synonymously with urolithiasis, refers to the formation of solid concretions consisting of both protein and crystalline materials in the lumen of the urinary tract. These calculi, or “stones,” become symptomatic when they cause acute obstruction, and as such, there are an unknown but probably large number of individuals with nephrolithiasis who are subclinical, without signs or symptoms. This review covers the pathophysiology, stabilization and assessment, diagnosis, and treatment of nephrolithiasis. Figures show ultrasound images of a stone with shadowing, a stone with a twinkling artifact, hydronephrosis, and a stone with shadowing at the ureterovesicular junction and a computed tomographic (CT) image showing a renal calculus at the ureterovesicular junction. Tables list drug-induced renal calculi, the proportion of stones spontaneously passing depending on size category as identified on CT, diagnostic test characteristics for renal colic diagnosis, the clinical prediction rule for the risk of renal stones, an example of the theoretical probability of stone disease using Moore and colleagues’ risk stratification, pooled test characteristics, bayesian analysis, and important pathology diagnosed on CT scan in the investigation of flank pain in four studies. Key words: kidney stone, nephrolithiasis, renal calculus, renal stone, urolithiasis This review contains 5 highly rendered figures, 6 tables, and 75 references.

Prediction of renal crystalline size distributions in space using a PBE analytic model. 1. Effect of microgravity-induced biochemical alterations.

An analytical Population Balance Equation model is developed and used to assess the risk of critical renal stone formation for astronauts during future space missions. The model uses the renal biochemical profile of the subject as input and predicts the steady-state size distribution of the nucleating, growing, and agglomerating calcium oxalate crystals during their transit through the kidney. The model is verified through comparison with published results of several crystallization experiments. Numerical results indicate that the model is successful in clearly distinguishing between 1-G normal and 1-G recurrent stone-former subjects based solely on their published 24-h urine biochemical profiles. Numerical case studies further show that the predicted renal calculi size distribution for a microgravity astronaut is closer to that of a recurrent stone former on Earth rather than to a normal subject in 1 G. This interestingly implies that the increase in renal stone risk level in microgravity is relatively more significant for a normal person than a stone former. However, numerical predictions still underscore that the stone-former subject carries by far the highest absolute risk of critical stone formation during space travel.

Presentation of Hypoparathyroidism: Etiologies and Clinical Features.

Understanding the etiology, diagnosis, and symptoms of hypoparathyroidism may help to improve quality of life and long-term disease outcomes. This paper summarizes the results of the findings and recommendations of the Working Group on Presentation of Hypoparathyroidism. Experts convened in Florence, Italy, in May 2015 and evaluated the literature and recent data on the presentation and long-term outcomes of patients with hypoparathyroidism. The most frequent etiology is surgical removal or loss of viability of parathyroid glands. Despite precautions and expertise, about 20-30% of patients develop transient and 1-7% develop permanent postsurgical hypoparathyroidism after total thyroidectomy. Autoimmune destruction is the main reason for nonsurgical hypoparathyroidism. Severe magnesium deficiency is an uncommon but correctable cause of hypoparathyroidism. Several genetic etiologies can result in the loss of parathyroid function or action causing isolated hypoparathyroidism or a complex syndrome with other symptoms apart from those of hypoparathyroidism or pseudohypoparathyroidism. Neuromuscular signs or symptoms due to hypocalcemia are the main characteristics of the disease. Hyperphosphatemia can contribute to major long-term complications such as ectopic calcifications in the kidney, brain, eye, or vasculature. Bone turnover is decreased, and bone mass is increased. Reduced quality of life and higher risk of renal stones, renal calcifications, and renal failure are seen. The risk of seizures and silent or symptomatic calcifications of basal ganglia is also increased. Increased awareness of the etiology and presentation of the disease and new research efforts addressing specific questions formulated during the meeting should improve the diagnosis, care, and long-term outcome for patients.

Bone metabolism and renal stone risk during International Space Station missions

Bone loss and renal stone risk are longstanding concerns for astronauts. Bone resorption brought on by spaceflight elevates urinary calcium and the risk of renal stone formation. Loss of bone calcium leads to concerns about fracture risk and increased long-term risk of osteoporosis. Bone metabolism involves many factors and is interconnected with muscle metabolism and diet. We report here bone biochemistry and renal stone risk data from astronauts on 4- to 6-month International Space Station missions. All had access to a type of resistive exercise countermeasure hardware, either the Advanced Resistance Exercise Device (ARED) or the Interim Resistance Exercise Device (iRED). A subset of the ARED group also tested the bisphosphonate alendronate as a potential anti-resorptive countermeasure (Bis+ARED). While some of the basic bone marker data have been published, we provide here a more comprehensive evaluation of bone biochemistry with a larger group of astronauts. Regardless of exercise, the risk of renal stone formation increased during spaceflight. A key factor in this increase was urine volume, which was lower during flight in all groups at all time points. Thus, the easiest way to mitigate renal stone risk is to increase fluid consumption. ARED use increased bone formation without changing bone resorption, and mitigated a drop in parathyroid hormone in iRED astronauts. Sclerostin, an osteocyte-derived negative regulator of bone formation, increased 10–15% in both groups of astronauts who used the ARED (p<0.06). IGF-1, which regulates bone growth and formation, increased during flight in all 3 groups (p<0.001). Our results are consistent with the growing body of literature showing that the hyper-resorptive state of bone that is brought on by spaceflight can be countered pharmacologically or mitigated through an exercise-induced increase in bone formation, with nutritional support. Key questions remain about the effect of exercise-induced alterations in bone metabolism on bone strength and fracture risk.

Adapt or Perish.

H. G. Wells was trained as a biologist and influenced by Darwin and his concepts of evolution. He succinctly summarizes these concepts as “Adapt or perish, now as ever, is nature's inexorable imperative.” However, even in his wildest dreams of science fiction, Wells would find the environmental

Effects of Hydration and Calcium Supplementation on Urine Calcium Concentration in Healthy Postmenopausal Women

Objective: The aim of this study was to determine whether calcium supplementation, compared with placebo, increases urine calcium concentrations to levels indicative of increased renal stone risk, and the role that fluid intake, as indicated by urine volume, may play in mitigating this risk.Methods: This is a secondary analysis of data from a randomized placebo-controlled trial of 500 mg/d calcium supplementation to prevent bone loss. Subjects were 240 white postmenopausal women age 40 to 70 years in good general health. Effects of supplementation on 1-year changes in 24h urine calcium concentration and urine volume were examined.Results: Both treatment group and urine volume were strong independent predictors of urine calcium concentration (p < 0.001). Among subjects with urine volume under 2 L/24 h, more than half of placebo subjects were at lowest risk for renal stones compared with less than 35% of calcium-supplemented subjects. Among those with higher urine volumes, all placebo subjects and more than 80% of calcium supplemented subjects were at lowest risk.Conclusions: The increased risk of renal stones with calcium supplement use may be largely eliminated with adequate fluid intake, but older adults may not spontaneously consume adequate fluids to minimize this risk and should be counseled to do so.

MP41-13 VITAMIN D REPLACEMENT IN RECURRENT RENAL STONE FORMERS WITH HYPERCALCIURIA DOES NOT INCREASE URINE CALCIUM EXCRETION OR RENAL STONE GROWTH

You have accessJournal of UrologyStone Disease: Medical Therapy1 Apr 2015MP41-13 VITAMIN D REPLACEMENT IN RECURRENT RENAL STONE FORMERS WITH HYPERCALCIURIA DOES NOT INCREASE URINE CALCIUM EXCRETION OR RENAL STONE GROWTH Luke McGuinness, Robert Calvert, and Vinita Mishra Luke McGuinnessLuke McGuinness More articles by this author , Robert CalvertRobert Calvert More articles by this author , and Vinita MishraVinita Mishra More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1641AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Reduced vitamin D levels are found in up to 50% of recurrent renal stone patients. Reluctance to replace vitamin D in these patients exists due to a theoretical risk of increased intestinal calcium absorption and subsequent renal excretion. Recent evidence suggests that increased absorption might be offset by increased bone deposition with no effect on urine excretion. We aim to assess the effect of pharmacological correction of low vitamin D in hypercalciuric renal stone formers compared to those with adequate vitamin D in a metabolic stone clinic. METHODS Retrospective review of 30 recurrent renal stone formers with hypercalciuria was undertaken. Serum 25 hydroxyvitamin D (25OHD) and 24hr urine biochemistry were measured in all patients at baseline and during follow-up. Renal stone growth was assessed with abdominal x-rays. Hypercalciuria was treated with diet and diuresis advice and pharmacotherapy (thiazide/ potassium citrate/allopurinol). Those with low 25OHD levels (¡Ü50nmol/L) were prescribed vitamin D replacement (VDR). Outcomes of 24hr urine biochemistry and new stone growth were compared between those on VDR (n= 17) and those with adequate 25OHD levels (n= 13). RESULTS Nine patients (30%) had vitamin D deficiency (¡Ü30nmol/L), 8 (27%) had insufficiency (>30 and ¡Ü50nmol/L) and 13 (43%) had adequate levels (>50nmol/L). 17 patients were prescribed vitamin D replacement (mean duration 14 months). 13 patients with adequate levels had mean follow-up of 22 months. No significant difference in baseline 24hr urine biochemistry was seen. Patients on VDR had an increase in 25OHD (33.6 to 74.7nmol/L, p<0.001) whilst 24hr urine calcium levels reduced non-significantly (9.33 to 8.78mmol/24hr, p>0.1). Patients with adequate 25OHD level (64.7nmol/L) had a significant decrease in urinary calcium (10.6 to 8.28mmol/24hr, p=0.003). No other significant changes were seen on urine biochemistry. The mean decrease in urine calcium in those on VDR (0.43mmol/24hr) compared to those with adequate 25OHD (2.28mmol/24hr) was not significant (p=0.15). 10 patients had new stone growth; 6 patients (35%) on VDR and 4 patients (31%) with adequate 25OHD (p>0.5). CONCLUSIONS Low vitamin D levels are present in more than half of hypercalciuric stone formers. Vitamin D replacement does not adversely affect urine calcium levels in patients with low vitamin D status or increase renal stone risk compared to those with adequate levels. Furthermore a beneficial effect may exist due to increased bone mineralisation but further evaluation is required. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e505 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luke McGuinness More articles by this author Robert Calvert More articles by this author Vinita Mishra More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Nephrolithiasis in Transfusion-Dependent Pediatric Patients

Background: The prolonged survival in patients with beta thalassemia major and other transfusion dependent disorders has exposed the multi-organ effects of multiple transfusions and chelation therapy. Renal deficits were described with the focus on tubular and glomerular function. Nephrolithiasis has not been systematically explored in these patients. Contributing factors to stone formation may include hypercalcuria, abnormal vitamin D homeostasis, and proximal tubulopathy.Objective: We analyzed hematologic and nephrologic parameters of 22 transfusion- dependent pediatric patients to investigate contributors to nephrolithiasis.Methods: The study included patients with beta thalassemia major (TM) (13), transfusion-dependent beta thalassemia intermedia (TDTI) (4), Diamond-Blackfan anemia (DBA) (3), other transfusion-dependent hemoglobinopathies (2). Patients’ ages were from 4-20 years (overall median -11 years, TM/TDTI median - 11.5, DBA median - 7.5 years). At the time of analysis 11 received iron chelation with deferasirox, 8 with combined desferoxamine & deferiprone, 2 with combined desferoxamine & deferasirox and one patient received desferoxamine alone. All patients had previously been treated with deferasirox alone and due to either significant adverse events or failure to control iron overload were switched to an alternate regimen. Seven patients were treated with vitamin D supplements for a median of 3 years (range: 0.2-4.3), 6 patients received vitamin D+calcium for a median of 4.5 years (range: 4.3-10). Venous blood samples, 24-hour urine collections and spot urine samples were collected to assess urine chemistry, vitamin D metabolism, electrolytes and renal function. Renal sonography and directed computerized tomography were used to diagnose nephrolithiasis/nephrocalcinosis.Results: Three patients, all with TM/TDTI, had symptomatic and radiographically identified renal stones, an additional TM patient had symptomatic nephrocalcinosis (Table 1). Among the entire cohort hypercalcuria was identified in 75% with increased Ca/Cr in 68%. 25(OH)D3 was abnormal in 81% of patients, mostly in the "insufficient" range (25-75 mmol/L). No significant relationship between presence of nephrolithiasis and chelation regimen, Ca mg/kg/d, Ca/Cr, renal fractional excretion (Fe) of phosphate (FePhos(, FeNa, FeUA, oxalate, cystein, citrate, 25(OH)D3, or treatment with vitamin D± calcium was identified, possibly in part due to the small sample size.Conclusions: The incidence rate of nephrolithiasis in our pediatric transfusion-dependent population was 1000x that published in various pediatric populations. Hypercalcuria and relatively low vitamin D levels were found in the majority of our patients, notably in all with nephrolithiasis. All 4 patients with nephrolithiasis/calcinosis were ≥ 13 years old, receiving vitamin D±calcium supplements and had received deferasirox chelation. Of note none of the patients not receiving vitamin D±calcium therapy presented with renal stones or calcinosis. The pathophysiology of nephrolithiasis/calcinosis is unclear among these adolescents; however the role of vitamin D±calcium supplemental therapy and the contribution of deferasirox must be further studied to find the proper formulation needed to maintain bone health without increasing the risk for renal stones.Abstract 4895. Table 1-Characteristics of patients with nephrolithiasis/nephrocalcinosisPatientDiagnosesAge at onset (years)Chelation (at onset)Duration of vitamin D+Ca supplement (years)Low vitamin D levels (mmol/L)Urine calcium (mg/kg/d) 1TM/NL16DFX2.3+7.62TM/NL16DFX5-6.93TDTI/NL13DFO&DFP (prior DFX)0.25 (vitamin D only)+4.44TM/NC18DFX4+2.7TM-thalassemia major, TDTI-transfusion-dependent thalassemia intermedia, NL-nephrolithiasis, NC-nephrocalcinosis, DFX-deferasirox, DFO-desferoxamine, DFP-deferiprone, Ca-calcium,normal values: vitamin D>75mmol/L, urine calcium<4mg/kg/d DisclosuresNo relevant conflicts of interest to declare.

Sex-specific responses of bone metabolism and renal stone risk during bed rest.

The purpose of this study was to directly assess sex differences in bone loss, bone biochemistry, and renal stone risk in bed rest. Bed rest simulates some spaceflight effects on human physiology and can be used to address the potential existence of sex‐specific effects on bone metabolism and renal stone risk in space. We combined data from the control subjects in five head‐down‐tilt bed rest studies (combined n = 50 men, 24 women) of differing durations (14–90 days). All subjects were healthy volunteers. Mean age was 35 ± 9 years for women and 33 ± 8 years for men. The main outcome measures were bone density and biochemistry, and renal stone risk chemistry. Before bed rest began, men had higher bone mineral density and content (P < 0.001), and excreted more biomarkers of bone resorption and calcium per day than did women (P < 0.05). These differences remained during bed rest. A number of urine chemistry analytes increased (e.g., calcium) or decreased (e.g., sodium, citrate, and urine volume) significantly for men and women during bed rest. These changes may predispose men to higher stone risk. Men and women do not have substantially different responses to the skeletal unloading of bed rest.

Bone metabolism and renal stone risk during bed rest for men and women (257.8)

Bed rest is a model to simulate and study the human physiological adaptations to spaceflight, for example changes in bone metabolism and renal stone formation. On Earth, the incidence of osteoporosis in women is about double that of men while the incidence of stone formation is more likely in men. These sex specific differences lead to logical questions about the existence of sex‐specific effects during spaceflight that can be tested in the bed rest model. In this study, we combined data from five bed rest studies (n=50 men, 24 women) ranging in duration from 14 ‐ 90 days to assess sex differences in bone loss, bone biochemistry, and renal stone biochemistry. Prior to bed rest, men had higher bone mineral density and content (P &lt; 0.001), and excreted 30 % more biomarkers of bone resorption (i.e., collagen crosslinks) and 20 % more calcium per day than did females (P &lt;0.05). These offsets remained throughout the duration of the bed rest periods. Urine renal stone biochemistry was significantly altered for both men and women during bed rest, resulting in men having an increased renal stone risk compared to the general population. Actual renal stone risks in these studies were reduced by maintaining a high amount of fluid intake (&gt;2.5 L/d). These results indicate that overall both men and women are equally affected by the skeletal unloading of bed rest.

Men and women in space: bone loss and kidney stone risk after long‐duration space flight (257.3)

Bone loss on Earth is more prevalent in women than men, leading to the assumption that women may be at greater risk from bone loss during flight. Until recently, the number of women having flown long‐duration missions was too small to allow any type of statistical analysis. We report here data from 42 astronauts on long‐duration missions to the International Space Station, 33 men and 9 women. Bone mineral density (dual‐energy X‐ray absorptiometry), bone biochemistry (from blood and urine samples), and renal stone risk factors were evaluated before and after flight. Data were analyzed in two groups, based on available resistance exercise equipment. The response of bone mineral density to flight was the same for men and women, and the typical decrease in bone mineral density (whole body and/or regional) after flight was not observed for either sex for those using an Advanced Resistive Exercise Device. Bone biochemistry, specifically markers of formation and resorption, generally responded similarly in male and female astronauts. The response of urinary supersaturation risk to space flight was not significantly different between men and women, although risks were typically increased after flight in both groups and risks were generally greater in men than in women before and after flight. Overall, the bone and renal stone responses of men and women to space flight were not different.Grant Funding Source: Funded by the NASA Human Research Program.

Men and Women in Space: Bone Loss and Kidney Stone Risk After Long-Duration Spaceflight

Bone loss, a key concern for long-duration space travelers, is typically considered a female issue. The number of women who have flown long-duration space missions is now great enough to allow a quantitative comparison of changes in bone and renal stone risk by sex. Participants were 42 astronauts (33 men and 9 women) on long-duration missions to the International Space Station. Bone mineral density (by dual-energy X-ray absorptiometry) and biochemical markers of bone metabolism (from blood and urine samples) were evaluated before and after flight. Data were analyzed in two groups, based on available resistance exercise equipment. Missions were 49 to 215 days in duration, flown between 2000 and 2012. The bone density response to spaceflight was the same for men and women in both exercise groups. The bone mineral density response to flight was the same for men and women, and the typical decrease in bone mineral density (whole body and/or regional) after flight was not observed for either sex for those using an advanced resistive exercise device. Biochemical markers of bone formation and resorption responded similarly in male and female astronauts. The response of urinary supersaturation risk to spaceflight was not significantly different between men and women, although risks were typically increased after flight in both groups, and risks were greater in men than in women before and after flight. The responses of men and women to spaceflight with respect to these measures of bone health were not different.

Gallstones increase the risk of developing renal stones: a nationwide population-based retrospective cohort study

This study identifies the effects of gall stone on the risks of developing renal stone in a nationwide cohort study. Studies on the association between gall stone and renal stone are scarce. We identified patients with gallstones using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We selected a comparison cohort, random frequency-matched by age, sex and index year, from the general population. We analyzed the risk of renal stones by using Cox proportional hazards regression models for sex, age and comorbidities. Of the 23.74 million people in the database, we followed 25 258 gallstone patients (54.5% female) and 101 029 control patients. The risk of developing renal stones was 1.68-fold greater in gallstone patients, compared with patients without gallstones after adjusting for age, sex and comorbidities. The substantially increased risk of renal stones was also significant in gallstone patients regardless of comorbidities. In the follow-up period <1 year, the adjusted hazard ratio was 2.51 (95% CI = 2.25-2.80) compared to non-gallstone group. The cumulative incidence of renal stone in the gallstone group was higher than in the non-gallstone group (P < 0.0001, in the log-rank test). This nationwide cohort study demonstrates that the risk of renal stones is significantly higher in gallstone patients, compared with the general population. This study provides information to enable physicians to implement adequate prevention measures to decrease both stones formation.

Vitamine D et rein

Calcitriol and analogs inhibit renin-angiotensin system, which has a pivotal role in glomerular and tubulo-interstitial damages and proteinuria, and inhibit NF-κB activation which is known to play an important role in renal diseases by promoting inflammation and fibrogenesis. Vitamin D presents interesting pleiotropic effects for the CKD patient (reduction of mortality, antiproteinuric effect and anti-inflammatory properties). "Native" vitamin D (cholecalciferol or ergocalciferol) administration in these patients also decrease parathyroid hormone levels. Native vitamin D administration in CKD patients is safe and does not lead to increased risk of vascular calcification, despite the known hypercalcemic and hyperphosphoremic properties of the molecule in its active form. Native vitamin D administration is not associated with an increased risk of renal stones, at pharmacological doses and without important concomitant administration of calcium salts. In the field of renal transplantation, experimental studies show that vitamin D analogs have a protective role against acute rejection but clinical studies remain mainly observational.

Panel Downplays Vitamin D, Calcium for Many Older Women

Panel Downplays Vitamin D, Calcium for Many Older Women