Urolithiasis Disease Research Articles

Himalayan Citrus jambhiri juice reduced renal crystallization in nephrolithiasis by possible inhibition of glycolate oxidase and matrix metalloproteinases.

Citrus fruits are a very rich source of electrolytes and citric acid. They have been used traditionally for treating urinary ailments and renal stones. Citrus jambhiri is indigenously used as a diuretic. Present study aimed at establishing the antiurolithiatic potential of the juice of Citrus jambhiri fruits along with the elucidation of the mechanism involved in the urolithiasis disease defying activity. The antiurolithiatic activity was established by means of nucleation, growth and aggregation assay in the in vitro settings and by means of ethylene glycol mediated calcium oxalate urolithiasis in the male Wistar rats. Docking studies were performed in an attempt to determine the mechanism of the antiurolithiatic action. Present study revealed the role of C. jambhiri fruit juice in reducing nucleation, growth and aggregation of calcium oxalate crystals by possible reduction in the urinary supersaturation relative to calcium oxalate and raising the zeta potential of the calcium oxalate crystals. C. jambhiri fruit juice treatment in experimental rats produced significant amelioration of hypercalciuria, hyperoxaluria, hyperphosphaturia, hyperproteinuria, hyperuricosuria, hypocitraturia and hypomagnesiuria and ion activity product of calcium oxalate. It exhibited nephroprotection against calcium oxalate crystals induced renal tubular dilation and renal tissue deterioration. Docking studies further revealed high binding potential of the phytoconstituents of C. jambhiri viz. narirutin, neohesperidin, hesperidin, rutin and citric acid with glycolate oxidase and matrix metalloproteinase-9. C. jambhiri fruit juice possesses excellent antiurolithiatic activity. The study reveals antiurolithiatic mechanism that involves restoration of equilibrium between the promoters and inhibitors of stone formation; and inhibition of matrix metalloproteinases and glycolate oxidase.

The impacts of metabolic syndrome on the risk of severe urolithiasis.

Metabolic syndrome (MetS) is significantly correlated with urolithiasis. However, few studies have evaluated the severity of urolithiasis. This study aimed to investigate the relationship of MetS with severe urolithiasis disease (SUD). The data of 910 patients with urolithiasis in the Department of Urology, Second Hospital of Tianjin Medical University from June 2020 to May 2021 were retrospectively collected. The patients were divided into two groups according to the severity of urolithiasis, and the relationships of MetS and its components with SUD were evaluated. The results showed 605 SUD and 272 Mets patients. Multiple regression analysis showed that middle age, male gender, and MetS increased the risk of SUD, whereas serum magnesium decreased it (P < 0.05). Further analysis revealed that the odds ratio (OR) of SUD increased with MetS grade (0-4) (1.029-2.117). Grade 4 patients had a 2.1-fold higher risk of SUD than grade 0 patients (OR 2.117; 95% CI 1.053-4.256; P = 0.035); hypertension and dyslipidemia were most strongly associated with SUD among the four MetS features (P < 0.05). Additionally, calcium oxalate was the most predominant stone component (78.7%) in the SUD(+) group, which also had stones with higher uric acid and lower calcium oxalate dihydrate levels than those of the SUD(-) group (P < 0.05). Our study concluded that SUD is more common in middle-aged men, MetS is an independent risk factor for SUD. The more severe the MetS, the higher the risk of SUD, in which hypertension and dyslipidemia play major roles.

Biomedical applications of L-alanine produced by Pediococcus acidilactici BD16 (alaD+).

L-alanine possesses extensive physiological functionality and tremendous pharmacological significance, therefore could be considered as potential ingredient for food, pharmaceutical, and personal care products. However, therapeutic properties of L-alanine still need to be addressed in detail to further strengthen its utilization as a viable ingredient for developing natural therapeutics with minimum side effects. Thus, the present study was aimed to explore the anticipated therapeutic potential of L-alanine, produced microbially using a lactic acid bacterial strain Pediococcus acidilactici BD16 (alaD+) expressing L-alanine dehydrogenase enzyme. The anticipated therapeutic potential of L-alanine was assessed in terms of anti-proliferative, anti-bacterial, and anti-urolithiatic properties. Anti-bacterial assays revealed that L-alanine successfully inhibited growth and in vitro proliferation of important human pathogens including Enterococcus faecalis, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Streptococcus mutans, and Vibrio cholerae in a concentration-dependent manner. Current investigation has also revealed its significant anti-proliferative potential against human lung adenocarcinoma (A549; IC50 7.32μM) and mammary gland adenocarcinoma (MCF-7; IC50 8.81μM) cells. The anti-urolithiatic potential of L-alanine was augmented over three different phases, viz., nucleation inhibition, aggregation inhibition, and oxalate depletion. Further, an in vitro cell culture-based kidney stone dissolution model using HEK293-T cells was also established to further strengthen its anti-urolithiatic potential. This is probably the first in vitro cell culture-based model which experimentally validates the immense therapeutic efficacy of L-alanine in treating urolithiasis disease. KEY POINTS: • Assessment of therapeutic potential of L-alanine produced by LAB. • L-alanine exhibited significant anti-proliferative and anti-bacterial activities. • L-alanine as potential anti-urolithiatic agent.

Retrospective epidemiological study of urolithiasis in western Algeria over a period of 50\xa0years

BackgroundUrolithiasis is a pathology that changes with time and with the evolution of human societies. The prevalence of this pathology has gradually increased during the last decades, especially because of dietary changes.MethodsThis work is a retrospective descriptive epidemiological study of the temporal type carried out at the level of the urology service of the University Hospital Center of Oran between the first January 1965 and December 31, 2014. The objectives of this work are to study the epidemiological profile of urolithiasis and to determine the evolutionary trend of the disease over time.ResultsThis study confirms some current data in the direction of an increase in surgical activity concerning the treatment of urinary stones. The analysis over time shows us a significant decrease (p < 0.01) in the male predominance between 1965 and 2014 with a M/F ratio which decreased from 3.09 to 1.82, as well as an increase in the average age, rising from 28.8 years in the period 1965–1974 to 48.3 years between 2005 and 2014.ConclusionThe analysis of epidemiological data is essential to better evaluate the evolution of the urolithiasis disease, which was affirmed in our study, where a constant evolution of the characteristics of the disease was revealed, testifying the change of the socio-economic level in Algeria.

Morphological Changes of the Ureter in Patients with Ureterolithiasis Depending on the Duration of Clinical Manifestations

Urolithiasis (URL) is a common urological disease that often appears in the population, has a high recurrent rate and a significant impact on the social status of the population. Almost half of patients with URL disease are people with ureteric stones, 95% of which have secondary genesis. The main methods of treatment of such patients are extracorporeal shock-wave lithotripsy (ESWL) and ureterolithotripsy (URS). It is important in these cases to determine morphological changes (inflammation, edema, sclerosis, necrosis, etc.) that appear in the ureter in the placement of the stone and may reduce the effectiveness of minimally invasive treatment or/and removal of fragments during URS. The objective: studying morphological changes of the ureter wall in patients with ureterolithiasis in the zone of the calculus in dependence of the duration of clinical manifestations. Materials and methods. We have studied histological changes of the ureter wall in the location of the stone in patients with ureterolithiasis. We explored the ureter wall in patients depending on duration of typical manifestations of ureterolithiasis, which were 7-en days long, 30 days, and more than 2 months. Results. If the stone in the ureter is up to 7 days, it does not cause significant microscopic changes of the ureter wall. If the stone been in the ureter during 1 month, more significant morphological changes are determined with desquamation of the urothelium, edema and inflammatory changes in the submucosal membrane. In case of the duration of the calculi in the ureter is more than 2 months, we noted the exfoliation of the urothelium with the denudation of the basement membrane. In the submucosal layer there is an edema, diffuse disorganization of connective tissue fibers, fragments of growth of granulation tissue and dense connective tissue in the form of separate layers. Conclusion. With increasing duration of the disease in the wall of the ureter increases the manifestations of inflammatory, sclerotic and necrotic changes. Such changes have a direct impact on the quality of visualization of the calculus during endoscopic interventions, the rate of fragmentation and extraction (elimination) of fragments, as a consequence, increase the overall duration of the operation and the risk of intra- and postoperative complications.

Knowledge, awareness and dietary practice on urolithiasis among general population in Kuantan, Pahang, Malaysia: Preliminary findings.

Background: To date, no studies have been published at evaluating the level of knowledge, awareness and practice of dietary, particularly regarding to urolithiasis in patients or the general population. This study aims to provide basic information on the level of knowledge, awareness and dietary practice among general population in Kuantan, Pahang.Design and Methods: The respondents (n=30) were conveniently recruited within 10 kilometers radius of Kuantan city. The data were obtained using semi-guided administered questionnaires, which consists of four parts: socio-demographic data, lifestyle and clinical history (Part A); attitude and awareness on dietary practice regarding urolithiasis (Part B); food frequency questionnaire on urolithiasis (Part C) and level of knowledge on urolithiasis (Part D).Results: Majority of the respondents were women (70%), Malay (83.3%), mean age of 33.97 (±9.27), married (63.3%), completed higher education level (60%), working with government sector (33.3%) and have fixed monthly income (53.3%). Some of them had hypertension (n=4), diabetes (n=1), gout (n=1) and intestinal problem (n=1). Majority (80%) claimed having no family history of urolithiasis, consumed alcohol (10%), exercise with average frequency 2-3 times/week (46.7%) and heard about urolithiasis from healthcare worker (46.7%). The respondents’ awareness about urolithiasis is considered to be good [81.23 (±9.98)] but having poor knowledge score [2.70 (±1.149)]. Majority preferred whole meal bread, white rice, chicken meat, mackerel fish, chicken egg, apple, carrot, mustard leave and fresh milk in daily intake. Lesser plain water intake than standard requirement was noticed among respondents. Seasoning powder was commonly used for seasoning.Conclusions: Generally, the general population of Kuantan, Pahang was aware of urolithiasis disease but needed more information on dietary aspect in terms of knowledge and food choice.Significance for public healthThe result of this study provided fundamental findings on the level of knowledge, attitude and dietary practice (KAP) among the general population in Malaysia, particular in Kuantan, Pahang. Based on the literature reviews, most of the results focused on the epidemiological findings on the occurrence of urolithiasis. There were limited findings on KAP conducted locally, among the general population, patients alongside the healthcare professionals. Therefore, the self-developed instrument used in the current study has a future potential to be duplicated and utilized in the previously mentioned population.

Seasonal variation in the incidence of acute renal colic.

Urolithiasis is a prevalent medical disease affecting the general population. Many epidemiological studies reported an association between a geographic area with a high mean daily temperature and urolithiasis disease. However, it is unclear if the seasonal variation in a high temperature geographical area will affect the acute presentation of renal colic to the emergency department. The aim of this study was to identify the effect of the seasonal variation on the presentation with acute urolithiasis disease. The design was a retrospective chart review, using the database in King Abdulaziz Medical City that was retrieved by the data management office in King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia. The study period was from January 26, 2016, to the end of December 2019. All patients who presented with renal colic, and diagnosed with urolithiasis using a noncontrast-enhanced computed tomography scan, have been included. A total of 1057 patients were included in this study. The majority (71.24%, n = 753) were male, and the mean age was 42.33 ± 16.12 years. The highest proportion presented in summer (31.22%), followed by spring (26.87%), fall (24.12%), and winter (17.79%). The majority of the sample (84.77%) presented with ureteral stones, and 15.23%with kidney stones. Most of the sample (78.33%) had no history of previous stone formation, with 21.67% being current stone former. The acute presentation with urolithiasis is higher during summer, followed by spring, fall, and winter. A public educational program is highly recommended to increase awareness about stone formation and the appropriate avoidance methods. To this end, additional research is required to understand the stone composition and appropriate methods to avoid developing urolithiasis.

Inhibition of Mineralization of Urinary Calcium Phosphate Stones by Sodium Pyrophosphate

To understand the biological importance of sodium pyrophosphate and its applicability as inhibitors in urolithiasis disease, we have studied the inhibition efficiency of sodium pyrophosphate towards the mineralization of urinary stone forming minerals like calcium phosphate, in aqueous as well as urinary medium. An attempt has been made to unfold, tentatively, the mechanism of inhibition by this inhibitor. It was Observational experiment. The Study was Conducted in the chemistry lab of university department of chemistry, B N Mandal University, Madhepura (Bihar) An experimental model was designed by taking the salt forming solutions, the whole operation took about 40-50 min. At the end the contents of beaker were digested in a hot water bath, cooled to room temperature and centrifuged in small volumes. The total centrifugate was collected and Calcium and carbonate content of the centrifugate of calcium carbonate mineralization experiments were determined. Sodium pyrophosphate has a moderate inhibition efficiency towards calcium carbonate mineralization. At 0.05 M concentration, sodium pyrophosphate has a net inhibition of 30 % which is 26.65 % more than that of water (blank). Compared to water the percentage inhibition increased by 795.52%. With decreasing concentrations of sodium pyrophosphate, the inhibition efficiency decreases. At very low concentration (0.01 M) its inhibition is only slightly higher than that of water. In urinary medium sodium pyrophosphate seems to function as a better inhibitor of phosphate mineralization. At 0.05 M concentration, sodium pyrophosphate has a net inhibition of 89.22 % which is 75.36 % more than that of urine. It is observed that sodium pyrophosphate solution, under different concentrations, exhibits moderate to good efficiency of inhibition towards mineralization of urinary stone forming minerals like calcium carbonate in aqueous as well as urinary medium.

Bioactive ingredients screening and antibacterial activity of Citrus aurantifolia leaf extract against some enteric isolates

Background: The Citrus aurantifolia from revealed so many activities on human ailments; anti-bacterial, anti-diabetic, anti-fungal, antihypertensive, antilipidemia, antioxidant and ant platelet activities. It has been used in the treatment of cardiovascular and urolithiasis disease and act as a fertility promoter as well. The present research aimed to screen the bioactive ingredients and determined the activity of the C. aurantifolia leaf extracts against the isolates. Methods: The antibacterial activity of ethanolic and aqueous extracts of leaves of Citrus aurantifolia was analyzed using standard procedure of various concentrations of ethnolic and aqueous extracts viz; 50,40,30,20,10mg/ml respectively.The bacterial isolates were; Escherichia coli and Pseudomonas aeruginosa. Results: The leaves of the plant showed a very considerable inhibition zones against the isolates as well as the commercial antibiotic discs, which denotes the activity of the plants as compared. The inhibition zones showed activities on the highest concentrations i.e. at 40mg/ml and 50mg/m of C. aurantifolia ethanolic extract against E. coli (15mm and 20mm) P. aeruginosa (5mm and 15mm). Conclusion: The C. aurantifolia leaf extract was active on the highest concentrations to E. coli and P. aeruginosa due to the fact that, the bioconstituents found were active.

Bioactive ingredients screening and antibacterial activity of Citrus aurantifolia leaf extract against some enteric isolates

The Citrus aurantifolia from revealed so many activities on human ailments; anti-bacterial, anti-diabetic, anti-fungal, antihypertensive, antilipidemia, antioxidant and ant platelet activities. It has been used in the treatment of cardiovascular and urolithiasis disease and act as a fertility promoter as well. The present research aimed to screen the bioactive ingredients and determined the activity of the C. aurantifolia leaf extracts against the isolates. The antibacterial activity of ethanolic and aqueous extracts of leaves of Citrus aurantifolia was analyzed using standard procedure of Various concentrations of ethnolic and aqueous extracts viz; 50,40,30,20,10mg/ml respectively.The bacterial isolates were; Escherichia coli and Pseudomonas aeruginosa.The leaves of the plant showed a very considerable inhibition zones against the isolates as well as the commercial antibiotic discs, which denotes the activity of the plants as compared. The zones include: (20.0mm at 50mg/ml on E. coli and 15.0mm on P. aeruginosa at 50mg/ml) ethanolic extract of C. aurantifolia shown and also revealed that, E. coli (30, 40, 50mg/ml) and no zone of inhibition were shown on P. aeruginosa except at 30mg/ml. It has been recommended as the good plant species to inhibitthe growth of some enteric species.

Parathyroid hormone-related protein as predictor of urolithiasis disease development

Background. The present article studies a possible role of parathyroid hormone-related protein (PTHrP) in urolithiasis pathogenesis.Aim. To consider PTHrP level as a predictor of the urolithiasis development.Material and methods. We presented an analysis of treatment in 79 patients with primary and recurrent nephrolithiasis that had underwent surgical treatment in the Uronephrological Center of Scientific Research Institute – Ochapovsky Regional Clinical Hospital #1, Krasnodar from 2017 to 2019. All observed patients were divided in two groups: patients with primary and recurrent nephrolithiasis. A group of 10 relatively healthy people was included in the study as well. All patients and conditionally healthy people had a test for blood parameters; in particular, the level of parathyroid hormone-related protein was assessed in order to compare the indicators in all three groups.Conclusions. The PTHrP level was showed to be statistically significantly different in patients with urolithiasis from the group with relatively healthy people. Groups with primary and recurrent nephrolithiasis show not difference in the level of PTHrP. Further studies are necessary to consider this protein as one of the predictors of urolithiasis and study its role in the pathogenesis of nephrolithiasis.

Urinary exploration of metabolism: nutrition assessment, urolithiasis and tubulopathy

The SFBC working group aimed to deal with biological tests outside the french nomenclature that may be useful in the context of urinary exploration of metabolism. This section will be divides into three parts: 1) nutritional assessment using urinary urea; 2) metabolic assessment of urolithiasis; 3) exploration of tubulopathies. National and international recommendations support the evaluation of nutritional status from urea measurements in urine and dialysate with the following indications: primary metabolic evaluation of urolithiasis patients, monitoring of protein intake in chronic renal failure stage 3 or stage 5D with residual diuresis. For the management of the urolithiasis disease, biomedical tests recommended by the national and international guidelines are the measurement of the urinary density using refractometry in the primary metabolic evaluation as well as the determination of oxalemia in the diagnosis (patients with GFR< 30 mL/min/1.73 m2) and follow-up (patients with GFR< 60 mL/min/1.73 m2) of primary hyperoxaluria. The determination of the bicarbonaturia is retained for the in depth exploration of urolithiasis and tubular acidosis. The measure of chlore in urine is used to evaluate the volume status during metabolic alkalosis and to calculate the urinary anionic gap during metabolic acidosis.

Peculiarities of course of the urolithiasis disease in patients with a solitary kidney and concomitant diabetes mellitus type II

Objective. To analyze the cases histories of urolithiasis disease and its course peculiarities in patients with a solitary kidney, unilateral urolithiasis and concomitant diabetes mellitus type II.&#x0D; Маterials and methods. Retrospective analysis of the cases histories was conducted in 109 patients, suffering urolithiasis disease with concomitant diabetes mellitus type II, of them in 31 patients a solitary kidney was present (Group I), in 78 - unilateral nephrolithiasis (Group II).&#x0D; Results. There was established, that even in adequately corrected hyperglycemia in the patients, having a solitary kidney, the risk for unfavorable course of urolithiasis disease and diabetes mellitus type II is higher, than in patients, having both functioning kidneys. The majority of patients, having a solitary kidney, owe the lowered velocity indices of glomerular filtration and glomerular hyperfiltration, proteinuria and arterial hypertension, what, even in presence of diabetes mellitus with the middle severity course, constitutes a high risk for rapid lowering of renal function.&#x0D; Conclusion. In the urolithiasis disease in the patients with a solitary kidney and concomitant diabetes mellitus type II there have an objectively proven risk for progressing of chronic renal disease. The necessity for the multidisciplinary approach realization of the urologists and endocrinologists activities in determination of personified schemes of treatment in these patients is substantiated.

Assessment of nutriom in treatment of urolithiasis disease

In recent years in the world has registered a steady increase of urolithiasis disease (UD). Currently it is possible to identify the causes of stone formation and reduce the number of relapsing stones by assessing the chemical composition of the stone and examining the biochemical parameters of urine and blood. It is also necessary to evaluate the stereotype of the patient’s diet among other things. One of the most effective and common methods for assessing the dietary stereotype is questionnairring. To study the interrelation between the dietary stereotype and the UD was performed by the questionnaire - Questionnaire on the assessment of the stereotype of nutrition (QASN) by Lopatkin Urology Scientific Research Institute. The questionnaire is freely available on the Internet at www.nethealth.ru in the testing section. The QASN contains questions about the daily use of a particular group of products. All food products are divided into subgroups according to trade classification. Each group includes products that are the most often sold and used on the territory of the Russian Federation. After completing the questionnaire it calculates the number of elements used per day. The norms of consumption of each substance calculates for 1 kg of body weight of the patient and calculating automatically when the patient is filling in the column “body weight”. The obtained data are compared with the average daily consumption rate of these elements in the average person. In the event of detection of abnormalities in one or several parameters it is concluded that there are significant changes in the dietary pattern.

A great contributor to the French urological science: Michel Daudon

Abstract The 40 years of Michel Daudon’s working life in the field of urolithiasis are difficult to sum up in a few lines. His knowledge, expertise and publications in the fields of biology, chemistry, nephrology, and eventually urology have contributed to make him a national and international recognized researcher in the understanding of the complex mechanisms of urolithogenesis. His great collaboration with the community of nephrologists, kidney physiologists, biologists, and urologists, seniors or in training, has widely contributed to improve modern and complete treatments of urolithiasis, which is at the origin of complicated urinary stones causing severe consequences on renal function and true public health problems. His hard working, his willingness, and the clarity of his presentations contributed to make him a national and international recognized lecturer in France and North Africa, where he created a network connecting laboratories with clinicians. Always looking forward in his scientific field, he has established links with approved research teams, making them interested in working on urolithiasis, even though research on urolithiasis disease seems to be less important than research on cancer.