Urinary Stone Risk Research Articles

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.

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.

Analysis of metabolic syndrome in bilateral upper urinary tract stones: A retrospective study of 3905 cases

Bilateral upper urinary tract stones are significantly related to renal function damage. However, few studies characterized the risk factors of bilateral upper urinary tract stones. We retrospectively enrolled 3905 patients with urinary tract stones from March 2019 to March 2022 at the Second Hospital of Tianjin Medical University. Patients were divided into two groups according to the location of the stones, and the related data were evaluated. In this study, 2485 unilateral and 1420 bilateral stone patients were included. Multivariate logistic regression analysis showed that BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and metabolic syndrome (Mets) were independent risk factors for bilateral stone formation(P < 0.05). Based on these results, we construct a discrimination model. This model revealed good discrimination with an area under the receiver operating characteristic curves of 0.617, and the sensitivity and specificity were 0.592 and 0.586, respectively. Furthermore, the number of Mets components increased the risk of bilateral upper urinary tract stones. Hypertension, hyperglycemia, and low HDL level were strongly associated with bilateral upper urinary tract stones (P < 0.05). Patients with 5 components Mets had 1.89-fold higher risk of bilateral upper urinary tract stones than those with 1 component Mets (OR 3.381; 95 % CI 1.221–9.360; P = 0.013). Additionally, male patients with Mets had higher risk of bilateral upper urinary tract stones than female patients. Our analysis revealed that eight clinical factors were associated with the formation of bilateral upper urinary tract stones, namely BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and Mets. This study could help clinicians adjust treatment strategies for high-risk patients with bilateral upper urinary tract stones.

24-Hour Urinary Chemistries and Kidney Stone Risk

Rationale & ObjectiveMost previous studies of the relationship between urinary factors and kidney stone risk have either assumed a linear effect of urinary parameters on kidney stone risk or implemented arbitrary thresholds suggesting biologically implausible “all-or-nothing” effects. In addition, little is known about the hierarchy of effects of urinary factors on kidney stone risk. This study evaluated the independent associations between urine chemistries and kidney stone formation and examined their magnitude and shape. Study DesignProspective cohort study. Setting & ParticipantsWe analyzed 9,045 24-hour urine collections from 6,217 participants of the Health Professionals Follow-Up Study and Nurses’ Health Studies I and II. ExposuresUrine volume and pH, and concentrations of calcium, citrate, oxalate, potassium, magnesium, uric acid, phosphorus, and sodium. OutcomeIncident symptomatic kidney stones. Analytical ApproachMultivariable logistic regression analysis incorporating restricted cubic splines to explore potentially non-linear relationships between urinary factors and the risk of forming a kidney stone. Optimal inflection point analysis was implemented for each factor and dominance analysis was performed to establish the relative importance of each urinary factor. ResultsEach urinary factor was significantly associated with stone formation except for urine pH. Higher urinary levels of calcium, oxalate, phosphorus, and sodium were associated with a higher risk of stone formation, whereas higher urine volume, uric acid, citrate, potassium, and magnesium were associated with a lower risk. The relationships were substantially linear for urine calcium, uric acid, and sodium. In contrast, the magnitudes of the relationships were modestly attenuated at levels above the inflection points for urine oxalate, citrate, volume, phosphorus, potassium, and magnesium. Dominance analysis identified three categories of factors' relative importance: higher (calcium, volume and citrate), intermediate (oxalate, potassium and magnesium) and lower (uric acid, phosphorus and sodium). LimitationsPredominantly white participants, lack of information on stone composition. ConclusionsUrine chemistries have complex relationships and differential relative associations with the risk of kidney stone formation.

Surgical procedure and recurrence of upper urinary tract stone: a national-wide study based on hospitalized patients.

This study aimed to investigate the influence of surgical intervention on recurrence risk of upper urinary tract stone and compare the medical burden of various surgical procedures. This study analyzed data from patients with upper urinary tract stone extracted from a national database of hospitalized patients in China, from January 2013 to December 2018. Surgical recurrence was defined as patients experience surgical procedures for upper urinary tract stone again with a time interval over 90days. Associations of surgical procedures with surgical recurrence were evaluated by Cox regression. In total, 556,217 patients with upper urinary tract stone were included in the present analysis. The mean age of the population was 49.9 ± 13.1years and 64.1% were men. During a median follow-up of 2.7years (IQR 1.5-4.0years), 23,012 patients (4.1%) had surgical recurrence with an incidence rate of 14.9 per 1000 person-years. Compared to patients receiving open surgery, ESWL (HR, 1.59; 95% CI 1.49-1.70), URS (HR, 1.38; 95% CI 1.31-1.45), and PCNL (HR, 1.11; 95% CI 1.06-1.18) showed a greater risk for surgical recurrence. Patients receiving ESWL had the shortest hospital stay length and the lowest cost among the 4 procedures. Compared with open surgery, ESWL, URS, and PCNL are associated with higher risks of surgical recurrence for upper urinary tract stone, while ESWL showed the least medical burden including both expenditure and hospital stay length. How to keep balance of intervention efficacy and medical expenditure is an important issue to be weighed cautiously in clinic practice and studied more in the future.

Contrasting Response of Urine Stone Risk to Medical Treatment in Calcium Oxalate versus Calcium Phosphate Stone Formers.

Randomized controlled trials have shown that both thiazide diuretics and potassium citrate (K-Cit) can prevent calcium stone recurrence, but most participants formed calcium oxalate stones (CaOx). While thiazides are expected to lower stone risk for calcium phosphate (CaP) stones, the effect of K-Cit on risk for CaP stones is unclear. To study the impact of common calcium stones treatments, we analyzed the 24-hour urines of CaOx and CaP stone formers (SF) by 4 treatment types: Lifestyle, K-Cit, Thiazide, or Both medications. Patients treated with thiazides reduced urine calcium in both CaOx (M = -74.4, SD = 94.6 mg/day) and CaP SF (M = -102, SD = 99.7 mg/day), while those on K-Cit had no change in urine calcium. Among CaOx SF, urine citrate rose in patients administered K-Cit with or without thiazide, but citrate did not rise significantly in CaP SF. Urine pH rose in all CaOx SF, but among CaP SF only rose in patients receiving K-Cit. CaOx supersaturation (SS) decreased in all patients who received Thiazide, and decreased among CaOx SF treated with K-Cit. CaP SS decreased in both CaOx SF (M = -0.46, SD = 0.86) and CaP SF (M = -0.76, SD = 0.85) treated with Thiazide except CaOx SF who received Both. Patients treated with K-Cit alone increased CaP SS in CaOx SF (M = 0.25, SD = 0.79). Patients treated with Thiazide lowered urine calcium and SS in both stone groups. Patients treated with K-Cit had no significant changes in urine calcium and had a decrease in CaOx SS in CaOx SF. The study raises questions about the best preventive treatment for patients with CaP stones and suggests that K-Cit may not confer the same benefits on CaP SF as it does on CaOx SF.

Influence of dietary components on the risk of urinary tract stones

Urinary tract stones are a common condition that significantly reduces quality of life. A proper diet is an important factor in the prevention and treatment of lithiasis and, for this reason, dietary interventions have become an essential part of treatment.In our review of the literature, we analysed the individual components of diet in terms of the risk of developing urinary tract stones.A number of dietary guidelines have been developed to reduce lithogenic factors in the urine, such as calcium oxalate, calcium phosphate and uric acid. Current guidelines recommend increasing the intake of fluids, increasing the intake of fruit and vegetables, using a balanced calcium supplementation and limiting the supply of sodium and especially animal protein. Based on these recommendations, a vegetarian diet containing dairy products combined with calcium supplementation appears to have the lowest risk of developing urinary stones. However, there are still many uncertainties in this area, and research needs to continue and be expanded to include the influence of diet type on the risk of lithiasis. This will allow us to gain a better understanding of the factors influencing the disease process and to create clear guidelines in the field of urolithiasis in the future.

Causal effects of circulating lipids and lipid-lowering drugs on the risk of urinary stones: a Mendelian randomization study.

Previous studies have yielded conflicting findings regarding the association between circulating lipids and lipid-lowering drugs with urinary stones, and the causal relationship between the two remains inconclusive. This study aimed to assess the causal relationship between circulating lipids (Triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], apolipoprotein A [APOA], apolipoprotein B [APOB] and Pure hypercholesterolaemia), lipid-lowering drugs (HMGCR [HMG-CoA reductase] inhibitors and PCSK9[Proprotein Convertase Subtilisin/Kexin Type 9] inhibitors) and the risk of urinary stones, using genetic data. Genetic instrumental variables (GIVs) for circulating lipids and lipid-lowering drugs were obtained from the UK Biobank and existing literature. Outcome data were extracted from a genetic association database with 3,625 urinary stone cases and 459,308 controls. Two-sample MR analysis, employing the TwoSampleMR software package in R 4.2.3, was conducted to assess the associations between multiple exposures. The primary outcome was determined using the inverse variance weighted (IVW) method for the causal relationship between exposure and outcome, while additional methods such as MR-Egger, weighted median, simple mode, and weighted mode were utilized as supplementary analyses. Robustness of the Mendelian Randomization (MR) analysis results was assessed through leave-one-out analysis and funnel plots. The MR analysis revealed a significant association between elevated TG levels per 1 standard deviation and the occurrence of urinary stones (odds ratio [OR]: 1.002, 95% confidence interval [CI]: 1.000-1.003, P = 0.010). However, no significant association was observed between factors other than TG exposure and the risk of urinary stone occurrence across all methods(LDL-C: [OR], 1.001; 95% [CI], 1.000-1.003, P=0.132;HDL-C: [OR], 0.999; 95% [CI], 0.998-1.000, P=0.151;APOA:[OR] being 1.000 (95% [CI], 0.999-1.001, P=0.721;APOB: [OR] of 1.001 (95% [CI], 1.000-1.002, P=0.058;Pure hypercholesterolaemia: [OR] of 1.015 (95% [CI], 0.976-1.055, P=0.455) and lipid-lowering drugs (HMGCR inhibitors: [OR], 0.997; 95% [CI], 0.990-1.003, P=0.301 and PCSK9 inhibitors:[OR], 1.002; 95% [CI], 1.000-1.005, P=0.099). Our findings provide conclusive evidence supporting a causal relationship between an increased risk of urinary stones and elevated serum TG levels. However, we did not find a significant association between urinary stone occurrence and the levels of LDL-C, HDL-C, APOA, APOB, Pure hypercholesterolaemia and lipid-lowering drugs.

Awareness of Urinary Stone Risk Factors Among the Adult Population of Jazan, Saudi Arabia: A Cross-Sectional Study.

Urolithiasis, a common clinical condition, has seen a global increase in prevalence in recent years. Urinary stones are common in hot climate areas like Saudi Arabia. This study aimed to assess the prevalence and awareness of risk factors for urinary stones in Jazan, Saudi Arabia. A cross-sectional study was conducted among 1000 Jazan adults between January and June 2022. A questionnaire was used to collect data on sociodemographics, urinary stone diagnosis, and awareness of risk factors. The overall prevalence of diagnosed urinary stones was 140 (14.0%). The prevalence was higher among patients who were older, married, had higher education, and were employees (all P<0.001). Participants who believed that hot weather (p = 0.012), sleeve gastrectomy (p = 0.049), and Saxenda injections (p = 0.000) increased the risk of stones had a higher prevalence. No association was found between stones and othersociodemographic factorsordietary habits. The main sources of knowledge were the internet (426, 42.6%) and education (155, 15.5%). The prevalence of urinary stones in Jazan is considerable (14.0%). Certain sociodemographic factors and beliefs about risk factors were associated with higher prevalence. Improving public awareness about the prevention and risk factors for urinary stones is crucial to controlling this health problem in high-risk communities.

Adherence to Potassium Citrate and Changes in 24-Hour Urine Stone Risk Parameters

Adherence to Potassium Citrate and Changes in 24-Hour Urine Stone Risk Parameters

Establishment of a new predictive model for the recurrence of upper urinary tract stones.

To construct a nomogram for evaluation of the recurrence risk of upper urinary tract stones in patients. We retrospectively reviewed the clinical data of 657 patients with upper urinary tract stones and divided them into stone recurrence group and non-recurrence group. Blood routine, urine routine, biochemical, and urological CT examinations were searched from the electronic medical record, relevant clinical data were collected, including age, BMI, stones number and location, maximum diameter, hyperglycemia, hypertension, and relevant blood and urine parameters. The Wilcoxon rank-sum test, independent sample t test, and Chi-square test were used to preliminarily analyze the data of the two groups, then LASSO and logistic regression analysis were used to find out the significant difference indicators. Finally, R software was used to draw a nomogram to construct the model, and ROC curve was drawn to evaluate the sensitivity and specificity. The results showed that multiple stones (OR: 1.832, 95% CI 1.240-2.706), bilateral stones (OR: 1.779, 95% CI 1.226-2.582), kidney stones (OR: 3.268, 95% CI 1.638-6.518), and kidney ureteral stones (OR: 3.375, 95% CI 1.649-6.906) were high risk factors. And the stone recurrence risk was positively correlated with creatinine (OR: 1.012, 95% CI 1.006-1.018), urine pH (OR: 1.967, 95% CI 1.343-2.883), Apo B (OR: 4.189, 95% CI 1.985-8.841) and negatively correlated with serum phosphorus (OR: 0.282, 95% CI 0.109-0.728). In addition, the sensitivity and specificity of the prediction model were 73.08% and 61.25%, diagnosis values were greater than any single variable. The nomogram model can effectively evaluate the recurrence risk of upper urinary stones, especially suitable for stone postoperative patients, to help reduce the possibility of postoperative stone recurrence.

The effect of nutritional factors on urolithiasis: A case-control study.

Urolithiasis, a prevalent chronic kidney disease affecting all age groups, can be influenced by nutritional factors. The incidence of urolithiasis in Asian countries ranges from 1% to 19.1%, attributed to geographical and lifestyle differences. In Iran, several risk factors, including ethnicity, dietary habits, gender, and age, are associated with urolithiasis. This study aimed to assess the impact of nutritional factors on kidney and urinary tract stone formation. This case-control study enrolled 127 newly diagnosed urolithiasis patients, and 127 matched healthy participants between February to May 2017. Exclusion criteria included diabetes and acute or chronic renal failure. Data were collected using the Food Frequency Questionnaire (FFQ) and analyzed using chi-square and logistic regression tests. Water (95% CI: 0.09-0.89, OR=0.28), natural juices (95% CI: 0.10-0.65, OR=0.53), mineral water (95% CI: 0.05-0.64, OR=0.18), legumes (95% CI: 0.00-0.38, OR=0.032), butter, cream, or peppermint (95% CI: 0.09-0.95, OR=0.30), and ice cream (95% CI: 0.07-0.54, OR=0.203) had a significant protective effect against kidney and urinary tract stone formation. Conversely, tea consumption (95% CI: 1.15-7.99, OR=4.70), beverages (95% CI: 4.45-23.32, OR=23.32), coffee (95% CI: 1.63-11.78, OR=4.39), bread (95% CI: 1.1-10.59, OR=3.37), meat (95% CI: 1.01-8.01, OR=2.85), liver (95% CI: 3.37-488.90, OR=40.58), fish (95% CI: 2.89-216.39, OR=25.03), and various canned foods (95% CI: 1.34-10.25, OR=3.70) were significantly associated with kidney and urinary tract stone risk. These findings showed that the risk of urinary stones formation had a significant relationship with dietary habits. Therefore, the correct dietary pattern and sufficient fluid consumption may play an important role in preventing urinary stones.

V03-12 CLEAN INTERMITTENT CATHETERIZATION: A PATIENT EDUCATION VIDEO

You have accessJournal of UrologyCME1 Apr 2023V03-12 CLEAN INTERMITTENT CATHETERIZATION: A PATIENT EDUCATION VIDEO Yu Zheng, Victoria Norausky, Iryna Crescenze, and Anne Cameron Yu ZhengYu Zheng More articles by this author , Victoria NorauskyVictoria Norausky More articles by this author , Iryna CrescenzeIryna Crescenze More articles by this author , and Anne CameronAnne Cameron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003241.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Clean intermittent catheterization (CIC) was first described in 1972 by urologist Jack Lapides and continues to be the preferred method of bladder management for patients who cannot safely empty their bladder independently. CIC is usually taught by nursing staff in the clinic, but patients often need additional visits to reinforce catheterization techniques for them to perform CIC independently. Here we present a patient-focused educational video reviewing the process of CIC. METHODS: With the assistance of nursing staff and an animation team, we developed a 7-minute patient-focused education video that reviews the process of CIC. The script was developed for the audience at a 5th grade reading level. We used similar terminology that the nursing staff would use with patients when they are teaching CIC. RESULTS: We developed a 7-minute patient-focused education video that reviews proper techniques require for patietns to perform CIC. Additionally, the video reinforces why some patients need to perform CIC and discusses the decreased risk of urinary tract injections, bladder stones, and urethral erosion for patients whose bladders are managed with CIC compared to bladder management with a foley catheter or a suprapubic tube. Furthermore, we explain the French sizing system of catheters and various commercially available catheters including coude tipped catheters and self-lubricating catheters. Lastly, we suggest useful techniques patients can use if they have trouble with catheterization. This includes holding the penis on stretch or using a coude catheter in men and positioning techniques and mirrors to help females find their urethral opening. CONCLUSIONS: CIC is the preferred method for bladder management in patients who cannot safely empty their bladder independently. Our patient friendly video can reinforce techniques for CIC and answer several questions on CIC that patients may have forgotten to ask during their clinic visit to learn CIC. Source of Funding: Craig Nielsen Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e249 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yu Zheng More articles by this author Victoria Norausky More articles by this author Iryna Crescenze More articles by this author Anne Cameron More articles by this author Expand All Advertisement PDF downloadLoading ...

National analysis of urinary cadmium concentration and kidney stone: Evidence from NHANES (2011-2020).

The association between urinary cadmium and kidney stone risk is inconsistent in previous studies, which needs further exploration. This study was performed to explore the association between urinary cadmium and kidney stone. Data from the National Health and Nutrition Examination Survey (2011-2020) were included and further analyzed. Urinary cadmium was stratified into quartiles with quartile 1 (Q1: 0.025-0.104 μg/L) and quartile 4 (Q4: 0.435-7.581 μg/L). Further weighted logistic regression was adopted to evaluate the association between urinary cadmium and kidney stone. A subgroup analysis was used to verify the findings. The non-linear association was examined using the restricted cubic spline (RCS) regression. A total of 9,056 adults aged 20 years and above were included in this study. In the fully adjusted model, an increased risk of kidney stones was identified for quartile 2 (OR = 1.40, 95% CI = 1.06-1.84, P < 0.05), quartile 3 (OR = 1.18, 95% CI = 0.88-1.59, P > 0.05), and quartile 4 (OR = 1.54, 95% CI = 1.10-2.06, P < 0.05). A similar association was found between continuous cadmium increase and OR of kidney stones in the fully adjusted model (OR = 1.13, 95% CI = 1.01-1.26, P < 0.05). The RCS also indicated a non-linear association between urinary cadmium concentration and kidney stone risk (P for non-linear < 0.001). In summary, cadmium exposure is identified as a risk factor for kidney stones in this study. Their non-linear association makes demands on early intervention for the cadmium-exposed population. Medical interventions for kidney stone prevention should take cadmium exposure into account.

The Association between Aortic Calcification Index and Urinary Stones: A Cross-Sectional Study.

Background: It is believed that vascular calcification and urinary stones may possibly have a shared mechanism. However, the association between vascular calcification and urinary stones is largely unexplored. Using the aortic calcification index (ACI) as a clinical indicator of vascular calcification, the present study aimed to examine the association between the ACI and urinary stones. Methods: This cross-sectional study included 282 patients hospitalized for either urinary stones or other urological diseases from January 2020 to December 2021 at the Department of Urology and Lithotripsy in Peking University People’s Hospital. Among them, 137 and 145 patients were divided into the stone group and the non-stone group. Multivariable logistic regression analysis was performed to examine the association between the ACI and urinary stones. The restricted cubic splines model was used to further explore the dose–response relationship between the ACI and urinary stones. Results: The median (Q1–Q3) age of the study population was 59.0 (47.0–67.0) years. After adjusting coronary heart disease, triglycerides, glucose, serum creatinine, uric acid, urea, calcium, and eGFR, the ACI was independently associated with urinary stones (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03–1.11) in a linear dose–response pattern (p for non-linearity =0.153). Age was found to interact with the effect of the ACI on urinary stones (p for interaction <0.001). Conclusions: This study found that the ACI was independently associated with urinary stones in a linear dose–response manner. Our results indicate that the ACI might be a helpful indicator for identifying populations at risk for urinary stones.

MP26-10 CLINICAL AND METABOLIC FACTORS AFFECTING RELATIVE PROPORTION OF CALCIUM OXALATE MONOHYDRATE AND DIHYDRATE IN PURE CALCIUM OXALATE STONES

You have accessJournal of UrologyCME1 May 2022MP26-10 CLINICAL AND METABOLIC FACTORS AFFECTING RELATIVE PROPORTION OF CALCIUM OXALATE MONOHYDRATE AND DIHYDRATE IN PURE CALCIUM OXALATE STONES Mohammad Hout, Vedant Acharya, Madhumita Parmar, Ruben Blachman Braun, Jonathan Katz, Robert Marcovich, and Hemendra Shah Mohammad HoutMohammad Hout More articles by this author , Vedant AcharyaVedant Acharya More articles by this author , Madhumita ParmarMadhumita Parmar More articles by this author , Ruben Blachman BraunRuben Blachman Braun More articles by this author , Jonathan KatzJonathan Katz More articles by this author , Robert MarcovichRobert Marcovich More articles by this author , and Hemendra ShahHemendra Shah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002569.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Calcium oxalate stone are the commonest variety of urinary calculi. Patients contain varying amount of its sub-types- calcium oxalate monohydrate and dihydrate. Few studies from past demonstrate varying metabolic defects in patients with both sub-types. The aim of present study was to study influence of various clinical and metabolic factors on relative proportion of calcium oxalate monohydrate and dihydrate in pure calcium oxalate stones. METHODS: We retrospectively examined stone analysis report of all patients who underwent endourological procedure for stone removal at our center from Jan 2017 to December 2019. Stones made of pure calcium oxalate with varying proportion of its subtypes were identified. Patient with combination of calcium oxalate with other components were excluded from study. Chart review was performed of all this patient to identify those who had 24-hour urinary stone risk profile done within 3 month of stone analysis and prior to start of medical management of stone. Statistical analysis was performed using SPSS 24. Correlational analysis between stone composition and clinical and metabolic variables was performed with the Spearman test. RESULTS: Of 120 calcium oxalate stones, 66 contained > 60% monohydrate and 8 contained > 60% dihydrate. The mean age in patients with dihydrate stone was 39.6 + 17 and monohydrate was 55.3 + 14.6. (P=0.002). Correlation analysis suggested that age, BMI and urinary Ph. Calcium oxalate saturation, brushite saturation and uric acid saturation were found to have significant co-relation with percentage of calcium oxalate dihydrate or calcium oxalate monohydrate stone composition (Figures 1 and 2). CONCLUSIONS: Calcium oxalate dihydrate stones former are younger and have lower BMI than those with monohydrate stones. Similarly as urinary Ph become more alkaline, the relative proportion of dihydrate increases. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e442 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammad Hout More articles by this author Vedant Acharya More articles by this author Madhumita Parmar More articles by this author Ruben Blachman Braun More articles by this author Jonathan Katz More articles by this author Robert Marcovich More articles by this author Hemendra Shah More articles by this author Expand All Advertisement PDF DownloadLoading ...

Effect of a low-calorie diet on 24-hour urinary parameters of obese adults with idiopathic calcium oxalate kidney stones.

ABSTRACTPurpose:to evaluate the effect of low-calorie diet on 24-hour urinary metabolic parameters of obese adults with idiopathic calcium oxalate kidney stones.Materials and Methods:Adult idiopathic calcium oxalate stone formers, with body mass index (BMI) ≥30kg/m2 and a known lithogenic metabolic abnormality, were submitted to low-calorie diet for twelve weeks. After enrolment, anthropometric measures, serum exams, 24-hour urinary metabolic parameters and body impedance were collected one month prior to dietary intervention and at the end of twelve weeks. Correlations between weight loss, waist circumference loss, fat loss and variation in 24-hour urinary lithogenic parameters and calcium oxalate urinary supersaturation (CaOx SS) as per Tiselius equation were analysed.Results:From January 2017 to January 2018, 39 patients were enrolled to participate in this study. Median (range) prescribed diet was 1300 (1100-2100) Kcal/day. Mean age was 51.7±11.0 (29-68) years old and 69.2% were female. 30.8% of the participants shifted from obesity to BMI <30kg/m2 and none to BMI <25kg/m2. A significant correlation was found between baseline 24-hour urinary oxalate and weight (p=0.018) and BMI (p=0.026). No correlation was found between variation of weight, waist circumference, fat mass and 24-h urinary stone risk factors or CaOx SS.Conclusions:Short-term modest weight loss induced by twelve weeks of low-calorie diet is not associated with a decrease of 24-hour urinary lithogenic parameters in idiopathic calcium oxalate stone formers. Calcium oxalate urinary stone formation is probably multifactorial and driven by other factors than weight.

PE45 - Mucosal Exclusion stitch - A simple and effective solution to mitigate the risk of urinary stones in stapled ileal conduit

PE45 - Mucosal Exclusion stitch - A simple and effective solution to mitigate the risk of urinary stones in stapled ileal conduit

MP07-11 OMEPRAZOLE LOWERS 24-HOUR URINARY MAGNESIUM EXCRETION IN PATIENTS WITH A HISTORY OF UROLITHIASIS: SINGLE CENTER EXPERIENCE

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP07)1 Sep 2021MP07-11 OMEPRAZOLE LOWERS 24-HOUR URINARY MAGNESIUM EXCRETION IN PATIENTS WITH A HISTORY OF UROLITHIASIS: SINGLE CENTER EXPERIENCE Kristina L. Penniston, Shuang Li, Stephen Y. Nakada, and R. Allan Jhagroo Kristina L. PennistonKristina L. Penniston More articles by this author , Shuang LiShuang Li More articles by this author , Stephen Y. NakadaStephen Y. Nakada More articles by this author , and R. Allan JhagrooR. Allan Jhagroo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001980.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urine magnesium (Mg) inhibits calcium oxalate (CaOx) stone formation. While highly variable, 24h urine Mg (UMg) is typically >2-fold higher than oxalate. Proton pump inhibitors, used for gastroesophageal reflux disease and peptic ulcer, inhibit active intestinal Mg absorption by interfering with transcellular cation channels. Alterations in Mg absorption are balanced by changes in renal Mg reabsorption. We hypothesized that patients taking omeprazole (OM) have lower UMg. METHODS: With IRB approval, we evaluated sequential patients with a history of urolithiasis seen in our multidisciplinary stone clinic or individually by the registered dietitian nutritionist (RDN). We documented clinical parameters, and OM dosage and duration of treatment if prescribed. We used 24h urine collections from patients′ initial encounters in stone clinic or with the RDN (ie, collected while naive to preventive therapy). Power analysis demonstrated the need for ≥240 subjects in order to identify significant differences in UMg for patients taking and not taking OM. RESULTS: Between 7/15/2020 and 1/15/2021, 325 patients were seen. We excluded for: no history of urolithiasis (n=9); no 24h urine collection prior to starting prevention (n=15); 24h urine creatinine <500 mg or >3,000 mg; initiation of pharmacological and/or nutrition therapy prior to starting OM (n=20). Patients (n=276) were 43% female and 91% white Caucasian. At their most recent clinical encounters, they were 58±14 y; calculated BMI was 31±8.2. Patients taking OM (OM+) for >3 months (n=45) took 24±8.2 mg/d (median 20 mg) and were taking it for 7.3 (median 6.4) y. Compared to those not taking OM (OM-; n=231), OM+ patients had lower UMg (figure). There were no differences for any other 24h urine stone risk parameters. As bowel disease is known to affect UMg, we examined this as a potential confounder. Though prevalence of bowel disease was different (figure), the prevalence of UMg ≤70 mg/d was not (figure; p=0.39, Chi square), suggesting bowel disease was not a confounder. CONCLUSIONS: Patients taking OM may absorb less Mg and have lower UMg, increasing their risk for CaOx stone recurrence. Studies are needed that investigate whether Mg supplementation reverses low UMg in patients taking OM and whether CaOx stone risk or recurrence is affected. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e143-e143 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristina L. Penniston More articles by this author Shuang Li More articles by this author Stephen Y. Nakada More articles by this author R. Allan Jhagroo More articles by this author Expand All Advertisement Loading ...

Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia

Background: Urinary tract stones are common in patients with benign prostatic hyperplasia (BPH); therefore, an imaging test is needed for patients who have risk factors for the formation of urinary tract stones. The purpose of this study was to explore the factors associated with the presence of urinary tract stones in patients with BPH as information to conduct imaging tests.Methods: A cross-sectional quantitative analytic study was conducted on medical records of patients with BPH, both with and without urinary tract stones, or patients with urinary tract stones registered at the Department of Urology, Dr. Hasan Sadikin General Hospital, Indonesia, from 2015 to 2018. Data on age, body mass index, hypertension, use of antihypertensive drugs, diabetes mellitus, and hyperuricemia were collected and analyzed using the Mann-Whitney, Chi-square, Fisher exact test, and multivariate logistic regression statistical test to compare variables between BPH with and without urinary tract stones.Results: In total, 235 BPH patients were registered, of whom 74 (31.5%) had urinary tract stones. The median age was 64 years old. There was a relationship between age (p=0.030), diabetes mellitus (p=0.043), and the occurrence of urinary tract stones in patients with BPH. The most dominant risk factor was diabetes mellitus (OR=3.000, 95%CI 1.03-8.69).Conclusions: Age and diabetes mellitus are the risk factors for urinary tract stones in patients with BPH. BPH patients with diabetes mellitus are at a 3-fold risk for urinary tract stones. Diabetes mellitus in BPH patients is an indication to conduct imaging tests.