Type Of Urolithiasis Research Articles

Antibacterial properties and urease suppression ability of Lactobacillus inhibit the development of infectious urinary stones caused by Proteus mirabilis

Infectious urolithiasis is a type of urolithiasis, that is caused by infections of the urinary tract by bacteria producing urease such as Proteus mirabilis. Lactobacillus spp. have an antagonistic effect against many pathogens by secreting molecules, including organic acids. The aim of the study was to determine the impact of Lactobacillus strains isolated from human urine on crystallization of urine components caused by P. mirabilis by measuring bacterial viability (CFU/mL), pH, ammonia release, concentration of crystallized salts and by observing crystals by phase contrast microscopy. Moreover, the effect of lactic acid on the activity of urease was examined by the kinetic method and in silico study. In the presence of selected Lactobacillus strains, the crystallization process was inhibited. The results indicate that one of the mechanisms of this action was the antibacterial effect of Lactobacillus, especially in the presence of L. gasseri, where ten times less P. mirabilis bacteria was observed, compared to the control. It was also demonstrated that lactic acid inhibited urease activity by a competitive mechanism and had a higher binding affinity to the enzyme than urea. These results demonstrate that Lactobacillus and lactic acid have a great impact on the urinary stones development, which in the future may help to support the treatment of this health problem.

Экскреция триптофана, лизина, триметиллизина, саркозина, холина и 4-пиридоксиновой кислоты с мочой при мочекаменной болезни

Introduction. The role of the organic matrix in urinary stones genesis in urolithiasis patients is still unclear. The presence of a large amount of protein in the urinary stones matrix suggests the participation of the protein matrix in lithogenesis. Research of the amino acids spectrum in urine is of great interest so far as amino acids are the part of the matrix proteins of the urinary stone. Material and methods. We analyzed urinary excretion of the following amino acids and low molecular weight compounds: tryptophan, lysine, trimethyllysine, sarcosine, choline and 4-pyridoxine acid. We used ultra-performance liquid chromatography in combination with a TQD mass spectrometer. Results. A higher level of excretion of choline and sarcosine is typical for patients with oxalate stones, compared with healthy people. Uric acid stone patients have high concentration of choline and extremely increased concentration of trimethyllysine in the urine unlike healthy individuals. Very low concentration of trimethyllysine, choline, sarcosine and higher excretion of tryptophan are specific for oxalate urolithiasis, in contrast to urate stone patients. Conclusion. The intensity of amino acids and low molecular weight compounds urinary excretion has characteristic features in patients with various types of urolithiasis and healthy individuals. Indicators of excretion of these amino acids and low molecular weight substances can serve as criteria for the activity of oxalate or urate lithogenesis along with the known metabolic lithogenic factors of urine. We can use it as additional target indicators to assess the success of anti-relapse treatment.

Characteristics and Types of Urolithiasis in the Eastern Region of Saudi Arabia: A Single-Center Retrospective Study.

IntroductionUrolithiasis is one of the most common conditions encountered in clinical practice with the prevalence increasing globally in the last few decades. Urolithiasis has been found to be more common in areas with a hot climate, such as Saudi Arabia. The aim of this study was to determine the characteristics and the types of urolithiasis most frequently found in the Eastern Region of Saudi Arabia.MethodsThis was a single-center retrospective cohort study based on data extracted from an electronic hospital information system (BESTCare) of all patients diagnosed with urolithiasis at King Abdulaziz Hospital, a tertiary care center in Saudi Arabia's Eastern Region. From January 2013 to December 2016, all adult patients aged 18 and up who presented with urinary calculi (renal and ureter) were included in the study.ResultsA total of 235 patients were reviewed, with a mean age of 48.52 years. Renal calculi were more prevalent in males (74.5%). Calcium oxalate was the predominant type (76%), followed by uric acid calculi (18%) and cystine calculi (4.8%). A small proportion (1.2%) was calcium phosphate calculi. The most frequently associated comorbidity was hypertension (17.9%). The majority (78.5%) had a stone removal through a ureteroscopy and 8.2% by percutaneous nephrolithotomy (PCNL). The mean stone size was 12.2 ± 9.91 mm, with a mean stone Hounsfield unit (HU) of 789.9. The mean urinary PH at stone incident was 6.77, and the mean creatinine level was 92.4mmol.ConclusionThis study showed that males were more affected by urolithiasis, compared to females in the Eastern Region. Furthermore, calcium oxalate was the predominant type. These findings are consistent with the literature and they highlighted the necessity for further studies in this area, to provide insight into the pathophysiology and incidence of renal calculi for improving patient care.

Zootherapeutics (Animal-based remedies) for urolithiasis: History, current scenario and future dimensions

Animals like plants are also medicinal agents for the prevention and cure of different health problems all over the world practically in about all human cultures. The concept of zootherapy is very old and has strong evidence of the medicinal use of animal resources. Different animals their body parts and preparations are used in folk medicines. Zootherapy reveals that medical practitioners have always considered animals as a source of surprising and numerous therapeutic effects. A high diversity of animals, their parts and derivative products are used and this is a heritage that could constitute a fundamental step for the discovery and isolation of natural extracts and new and low-cost alternative drugs from animals. About 12% of people in the world are affected by different types of urolithiasis and the recurrence rate in female is 47-60% and in male is 70-80%. According to WHO 75% population rely on traditional medicines for the prevention and cure of different diseases. Hence there is a need to concentrate on all folk natural products effective in urolithiasis for their pharmacological evaluation, isolation of single drug molecule responsible for anti-urolithiatic activity to developed suitable formulations used against urolithiasis.

Types of Renal Stones and its Variation with Age and Gender in a University Hospital of Nepal

Background Types of renal stones have profoundly changed in the last half-century, parallel to the change in lifestyle and dietary habit, with an increase of calcium stones. Among many lithogenic factors age and gender are considered to be associated with the types of renal stones. Studies evaluating the influence of age and gender on the distribution of the types of urinary calculi are scarce in Nepal. Objective To explore the influence of age and gender on different types of urolithiasis. Method This is a single center prospective study encompassing urolithiasis during a study period of 18 months. All the stone retrieved from the patients after surgery were sent for biochemical analysis of the stone. The result was then compared with the age and gender of the study population. Result Calculi from a total of 107 patients wereanalyzed (62 from malesand 45 from females). Mixed stones consisting of calcium oxalate and calcium phosphate werethe predominant constituent in 74.16% of stones, followed by uric acid, struvite and cystine stones. We found predominance of Calcium stones in males(47.66%) vs 36.44% in females and predominance of struvite stonesin females (7.47%) vs 3.73% in males. Age group of 21-40 years has the main burden of stone. Conclusion Being aware and having better knowledge of risk factors, composition and correlation with age and gender can provide personalized guidance to prevention and avoid recurrence of urolithiasis.

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects.

Globally, approximately 12% of the population is inflicted by various types of urolithiasis. Standard treatments are available both to avert and treat urolithiasis, but with significant adverse side effects. Pentacyclic triterpenes represent a group of naturally occurring compounds which holds immense potential as therapeutic for treating kidney stone. This review aims to provide an integrative description on how pentacyclic triterpenes can effectively treat calcium oxalate urolithiasis through various mechanisms such as antioxidant, anti-inflammatory, diuretic, and angiotensin-converting enzyme inhibition. Some of the pentacylic triterpenes which shows promising activities include lupeol, oleanolic acid, betulin, and taraxasterol. Moreover, future perspectives in the development of pentacyclic triterpenes in formulations/drugs for urinary stone prevention are highlighted. It is anticipated that compiled information would serve as a scientific baseline to advocate further investigations on the potential of pentacyclic triterpenes in urolithiasis remediation.

Уратный нефролитиаз – патогенез и возможности консервативного лечения

Urolithiasis is a widespread chronic disease; its prevalence has been steadily increasing over the past 50 years. Urolithiasis accounts for a large proportion urologic diseases, exceeded only by urinary tract infections and diseases of the prostate. Urate urolithiasis refers to a type of urolithiasis, characterized by the formation of kidney stones consisting of uric acid or its salts. In populations of industrialized countries, uric acid is the second or third most frequently occurring stone-forming substance. The article summarizes the data on the global prevalence of both urolithiasis as a whole and urate urolithiasis in particular. The authors provide a detailed overview of the formation of the current concept of the urate urolithiasis pathogenesis and the management of the disease. The main focus is placed on the possibilities and the role of litholytic (stone-dissolving) therapy for urate urolithiasis and the mechanisms of the action of citrate preparations.

Characteristics of urolithiasis in the dog population of Hungary from 2001 to 2012

The objective of this study was to describe the epidemiology of canine urolithiasis in Hungary in order to determine the annual incidence of urolithiasis and to identify breeds at risk for different types of urolithiasis. Data of a total of 2,543 canine uroliths analysed in the laboratory of the Budapest Urolith Centre were evaluated retrospectively from 2001 to 2012. Logistic regression was used to assess odds ratios for the proportion of each affected breed compared to those of crossbreeds. The annual incidence of urolithiasis was evaluated by the number of submissions compared to the estimated number of dogs in the population from which the samples originated. Epidemiologic data revealed a relatively high and increasing proportion of struvite urolithiasis. Statistical analysis of breed predispositions resulted in the detection of breeds not having been reported at risk (e.g. Bernese Mountain dog - struvite, Bichon Frise, Bolognese, Tibetan Terrier - purine, French Bulldog - cystine). Conflicting results were revealed for some other breeds previously described as being affected by certain types of urolithiasis (Chihuahua, Pekingese, Shih Tzu, English Cocker Spaniel). Regardless of the type of urolithiasis, its average cumulative incidence in the dog population of Hungary was found to be 1.76/10,000/year.

Diagnostic and Therapeutic Approach in Patients with Urinary Calculi

The natural history of urolithiasis includes the risk of recurrence and of the development of chronic kidney and/or bone disease, which is why a thorough clinical and metabolic evaluation of these patients is of the utmost importance at disease onset. This paper is aimed at identifying the type of urolithiasis, the related risk factors, and the corresponding treatment options. The diagnostic and therapeutic approach described here includes 1) accurate history taking to detect secondary nephrolithiasis and screen for the main risk factors for kidney and bone disease; 2) metabolic evaluation graded according to different complexity levels based on the severity of the disease and the presence of risk factors; 3) carrying out appropriate imaging procedures. The resulting information allows to plan treatment based either on general rules of lifestyle and diet, or on selected medical intervention, if necessary. This report, which is based on current guidelines, was produced by the Gruppo Italiano di Studio Multidisciplinare per la Calcolosi Renale. It is addressed to all professionals involved in the management of patients suffering from nephrolithiasis, first of all general practitioners, who often become involved immediately at the onset of the disease.

Ultrasonographic characteristics of urolithiasis in children exposed to melamine-tainted powdered formula

Since the outbreak of renal diseases among children who had consumed melamine-tainted powdered formula in 2008, urinary system ultrasound examination was carried out for these children at our hospital. This study aimed to investigate the ultrasonographic characteristics of urolithiasis caused by melamine-tainted powdered formula. From September 12 to October 9, 2008, urinary system ultrasound examination for children after consumption of melamine-tainted powdered formula was carried out at the Children's Hospital of Zhejiang University, China. A total of 15,577 infants and children were subjected to the examination. A questionnaire with items including demographic characteristics, history of exposure and clinical symptoms were completed before examination. Among the 15,577 children, 7988 were boys and 7,589 girls with age ranging from 1 month to 15 years (mean age, 22 months). Urolithiasis was found in 562 patients with an identification rate of 3.6%. Urolithiasis was identified mainly in the children aged 36 months or younger (88.6%). Unilateral kidney calculi were found in 431 children and bilateral kidney calculi in 131 children. Eleven of these children also had ureteric calculi, 1 had bladder calculi, 2 had urethral calculi, and 2 had gallbladder calculi. Fifteen children had urinary tract obstruction. Ultrasonographic characteristics of these melamine calculi were different from the calcium oxalate calculi, i.e., the lesions were less echogenic, had a more "sandy" appearance and were less dense. The posterior portion of the calculi could be observed and was accompanied with a feeble or absent acoustic shadow. Melamine-induced calculi were ultrasonographically less echogenic, sand-like and discrete; the posterior portion of the calculi was accompanied with a feeble or absent acoustic shadow. It might be a new type of urolithiasis in children.

Plasma oxalate level in pediatric calcium stone formers with or without secondary hyperoxaluria

Plasma oxalate (POx) concentration is significantly elevated in primary hyperoxaluria, severe renal failure or ethylene glycol poisoning. In these conditions, the degree of hyperoxalemia correlates with the severity of systemic calcium oxalate (CaOx) deposition and should be therefore carefully monitored. Although secondary hyperoxaluria (secHyOx) is a common finding in pediatric patients with kidney stone disease, very little is known about POx in this condition. We therefore evaluated POx level in 59 children and adolescence with calcium urolithiasis (34 confirmed by CaOx stone analysis and 25 children with a strong clinical suspicion of this type of urolithiasis), with or without "mild" secHyOx. A control group consisted of 41 healthy sex- and age-matched children. We found that POx was significantly increased in children with calcium urolithiasis and secHyOx compared to healthy children (9.16 +/- 3.60 vs. 6.42 +/- 2.53 micromol/l), but that was not the case in children with calcium urolithiasis but with normal urinary oxalate excretion (7.12 +/- 3.33 micromol/l). We conclude that POx may be slightly increased in some pediatric calcium stone formers with secHyOx, probably related to intestinal oxalate hyperabsorption.

UHF-dielectrometry of the urine in prognosis of aggregation stability

Dielectric permeability of the urine from healthy subjects and patients with various types of urolithiasis was studied using millimeter electromagnetic waves. The urine from healthy subjects and patients with urolithiasis differed in dielectric properties, specific water content, and structure of water. A relationship was revealed between aggregation stability of urine colloids and dielectric properties of the urine in millimeter-wave electromagnetic radiation.

Hypertension Associated To Urolithiasis

In a group of 900 hypertensive patients we analyze the prevalence and the treatment response in the sub-group with urolithiasis. The prevalence of urolithiasis was 13,7%, and the prevalence of urolithiasis by hypercalciuria and/or hyperuricosuria was 12.3%. The control level to the treatment in the last sub-group with thiazides and/or allopurinol was 59,5%. The hypertensive patients with this type of urolithiasis and without hypertension control with this treatment were the intolerant patients to thiazides and/or allopurinol (6,3%) and the obese hypertensive patients (34,2%). These data help to explain why the thiazide diuretics have been the antihypertensive drugs that have given better results in the ALLHAT study and they still are continuing in the current recommendations like first line antihypertensive drugs

Intérêt de la lithotritie extracorporelle dans l'hyperoxalurie primaire de type i

Background. -Application of extracorporal shock wave lithotripsy (ESWL) has revolutionized the management of many types of urolithiasis, including that observed in primary hyperoxaluria where surgical attempts to remove calculi sometimes result in worsening of renal function.Case reports. - Three unrelated patients aged 8, 10 and 11 years, respectívely, with type I primary hyperoxaluria, suffered from recurrent bouts of abdominal pain (two patients) or anemia (one patient). Two patients had chronic renal failure. Plain abdominal films and ultrasonography showed several large bilateral stones. ESWL was applied to the three patients permitting complete removal of stones following three sessions in one patient and partial removal following four sessions in the second patient who developed infection after the first session with transitory increase in creatinemia. Several sessions of ESWL failed to fragment stones in the third patient.Conclusion. - ESWL may represent a safe procedure for attempting stone removal inpatients with prirnary hyperoxaluria.

Urine and calculus amino acids in the different types of urolithiasis.

Urinary amino acid excretion levels were estimated by paper chromatography in 15 control subjects and 27 stone formers classified according to stone type: (a) 15 cases with calcium oxalate stones, either pure or mixed with calcium phosphate and/or uric acid; (b) 6 cases with pure uric acid stones and (c) 6 cases with magnesium-ammonium phosphate stones, either pure or mixed with ammonium urate, also the free amino acid contents of the calculi of different types were estimated. The data revealed that there was a significant decrease in the amino acid excretion in all stone formers; the individual amino acid patterns varied according to the type of stone formed. This decrement in amino acid excretion could be attributed to: (a) a metabolic defect in the pathway of glycine, especially in the calcium oxalate cases; (b) the precipitation and/or adsorption of the free amino acids on the material of the calculi, which is demonstrated in 10 calculi, and (c) to a lesser extent to bacterial infection.