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Yang YX, Xiang JC, Ye GC, Luo KD, Wang SG, Xia QD. Association of insulin resistance indices with kidney stones and their recurrence in a non-diabetic population: an analysis based on NHANES data from 2007-2018. Ren Fail 2025; 47:2490203. [PMID: 40275575 PMCID: PMC12035944 DOI: 10.1080/0886022x.2025.2490203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Revised: 03/06/2025] [Accepted: 04/01/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVE To systematically evaluate the association between insulin resistance indices and the risk of kidney stones and their recurrence in U.S. non-diabetic individuals, while identifying predictive indicators. MATERIALS AND METHODS This cross-sectional study analyzed data from the 2007-2018 NHANES. Five IR indices were calculated. Weighted logistic regression, restricted cubic spline, and mediation analyses were used to assess the independent associations between these indices and the risk of kidney stones and recurrence in non-diabetic individuals. RESULT This study of 9,605 non-diabetic participants showed an overall kidney stones incidence of 8.63% and a recurrence rate of 2.70%. Weighted logistic regression and RCS analyses revealed significant positive associations between METs-IR, HOMA-IR, TyG-BMI, and the risk of kidney stones and their recurrence. Every unit increase in METs-IR was linked to a 2% rise in the incidence of kidney stones (95% CI: 1.014-1.027, p < 0.001) and a 3.3% rise in recurrence (95% CI: 1.018-1.048, p < 0.001); each unit increase in HOMA-IR raised incidence by 5% (95% CI: 1.025-1.078, p < 0.001) and recurrence by 7.9% (95% CI: 1.041-1.118, p < 0.001). Adjusting for confounders shifted these relationships from nonlinear to linear (p > 0.05). METs-IR demonstrated the strongest diagnostic accuracy for predicting recurrence, with uric acid and vitamin D mediating associations between IR indices and the risk of kidney stones and their recurrence in non-diabetic individuals. CONCLUSION This study found that elevated IR indices (METs-IR, HOMA-IR, TyG-BMI) significantly increased kidney stone risk in a non-diabetic population. Serum uric acid and vitamin D mediated this association, with METs-IR best predicting kidney stones incidence and recurrence.
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Affiliation(s)
- Yu-Xuan Yang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia-Cheng Xiang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gui-Chen Ye
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kuang-Di Luo
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shao-Gang Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi-Dong Xia
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Garg M, Joseph P, Johnson H, Lawrence JV, Somani B, Rai BP, Philip J. Obesity and BMI score as risk factors for urolithiasis: a systematic review over 30 years. Curr Opin Urol 2025; 35:338-346. [PMID: 40325962 DOI: 10.1097/mou.0000000000001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2025]
Abstract
PURPOSE OF REVIEW To examine association between high BMI, obesity, and kidney stone disease (KSD). For this, systematic review of empirical studies was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) guidelines. Cochrane Library, EMBASE, MEDLINE, CINAHL, AMED, Emcare, Clinicaltrials.gov, and WHO ICTRP were searched for English language population-based studies published from inception to October 2024, including adults aged at least 18 years reporting on high BMI, obesity and overweight, with incidence of KSD. RECENT FINDINGS The search identified 943 records, of which 15 relevant articles with 97 645 participants and 17 158 cases in total were enrolled in the narrative synthesis. A high heterogeneity and imbalance were observed among baseline distribution of cohorts in most studies. Thirteen studies provided comparative data on stone occurrence in obese and nonobese participants, and on per-patient analysis, three studies demonstrated a lower risk (RR < 1; 95% CI: 0.78-1.03), four studies a higher risk (RR>1; 95% CI: 0.77-2.32), and six studies depicted similar risk (RR = 1; 95% CI: 0.94-1.06) of stone occurrence between the two cohorts. SUMMARY Evidence in this study suggests an association between high BMI, being overweight, obesity, and increased risk of developing kidney stone disease. In the context of optimizing treatment, KSD should be considered a metabolic disease, with treatment to include dietary regimes, exercise intervention alongside pharmacotherapy to help reduce renal stone disease recurrence risk, alongside managing associated chronic diseases such as hypertension, type 2 diabetes mellitus, and coronary artery disease.
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Affiliation(s)
- Megha Garg
- Honorary Research Associate, Bristol Urological Institute, Southmead Hospital, Westbury-on-Trym, Bristol
| | - Philip Joseph
- Leicester Medical School, University of Leicester, Leicester
| | - Hans Johnson
- Bristol Medical School, University of Bristol, Bristol
| | | | - Bhaskar Somani
- Professor of Urology, University Hospital Southampton NHS Foundation Trust, Southampton
| | | | - Joe Philip
- Consultant Urological Surgeon, Bristol Urological Institute, North Bristol NHS Trust, UK
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Chung M, Lin C, Chang C, Chang Y, Hsiao P, Lien C, Wu L, Wu M, Shieh J, Hung P, Chen H, Chung C. Use of Sodium-Glucose Transport Protein 2 Inhibitors and the Incidence of Urolithiasis: A Multi-Database and Cross-Country Study in Patients With Type 2 Diabetes Mellitus. Clin Pharmacol Ther 2025; 117:1775-1783. [PMID: 40059622 PMCID: PMC12087698 DOI: 10.1002/cpt.3626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2025] [Accepted: 02/14/2025] [Indexed: 05/20/2025]
Abstract
The benefits of sodium-glucose transport protein 2 inhibitor (SGLT2i) use on severe urolithiasis requiring surgery remains unclear. All patients with incident T2D in Taiwan National Health Institution databases (2016-2021) and TriNetX datasets (2014-2023) were retrospectively analyzed. The study analyzed a propensity score-matched pairs with T2D treated with SGLT2i or dipeptidyl peptidase 4 inhibitors (DPP4i). The primary outcome was the incidence of urolithiasis and urolithiasis requiring surgery during the study period. Urolithiasis diagnoses were identified using International Classification of Diseases diagnostic codes and categorized into upper and lower urinary tract stones. Cases of urolithiasis requiring surgery were determined by the presence of both diagnostic codes and surgical procedure codes within the same outpatient visit or hospitalization. Conditional and time-dependent Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During the study period, 5700 participants were diagnosed with urolithiasis, 1297 participants were urolithiasis requiring surgery in Taiwan NHIRD cohort 8438 participants with urolithiasis as well as 289 participants with urolithiasis requiring surgery were in the TriNetX cohort. Adjusted HRs of urolithiasis and urolithiasis requiring surgery were 0.82-fold (95% CI, 0.77-0.87), 0.72-fold (95% CI, 0.63-0.82) in Taiwan NHIRD, 0.84 (95% CI, 0.78-0.90), and 0.62 (95% CI, 0.44-0.88) in TriNetX cohort respectively. Similar protective associations with SGLT2i use against urolithiasis were observed across subgroups in both datasets from Taiwan NHIRD and TriNetX. In conclusion, SGLT2i might protect against kidney stones and severe cases requiring surgery in T2D patients.
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Affiliation(s)
- Mu‐Chi Chung
- Department of Post‐Baccalaureate Medicine, College of MedicineNational Chung Hsing UniversityTaichungTaiwan
- Division of Nephrology, Department of MedicineTaichung Veterans General HospitalTaichungTaiwan
- Division of Clinical Toxicology, Departmentof Medical ToxicologyTaichung Veterans General HospitalTaichungTaiwan
- Ph.D. Program in Translational MedicineNational Chung Hsing UniversityTaichungTaiwan
| | - Chia‐Yen Lin
- Department of UrologyTaichung Veterans General HospitalTaichungTaiwan
- School of MedicineChung Shan Medical UniversityTaichungTaiwan
- School of MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Chao‐Hsiang Chang
- Department of UrologyChina Medical University HospitalTaichungTaiwan
| | - Yi‐Huei Chang
- Department of UrologyChina Medical University HospitalTaichungTaiwan
| | - Po‐Jen Hsiao
- Department of UrologyChina Medical University HospitalTaichungTaiwan
| | - Chi‐Shun Lien
- Department of UrologyChina Medical University HospitalTaichungTaiwan
| | - Laing‐You Wu
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
| | - Ming‐Ju Wu
- Division of Nephrology, Department of MedicineTaichung Veterans General HospitalTaichungTaiwan
| | - Jeng‐Jer Shieh
- Institute of Biomedical SciencesNational Chung Hsing UniversityTaichungTaiwan
- Department of Education and ResearchTaichung Veterans General HospitalTaichungTaiwan
| | - Peir‐Haur Hung
- Department of Internal MedicineDitmanson Medical Foundation Chiayi Christian HospitalChiayiTaiwan
- Department of Applied Life Science and HealthChia‐Nan University of Pharmacy and ScienceTainanTaiwan
| | - Hsin‐Hua Chen
- Department of Post‐Baccalaureate Medicine, College of MedicineNational Chung Hsing UniversityTaichungTaiwan
- Ph.D. Program in Translational MedicineNational Chung Hsing UniversityTaichungTaiwan
- Division of Allergy, Immunology and Rheumatology, Department of MedicineTaichung Veterans General HospitalTaichungTaiwan
- Division of Clinical Informatics, Center for Quality ManagementTaichung Veterans General HospitalTaichungTaiwan
- Big Data CenterNational Chung Hsing UniversityTaichungTaiwan
| | - Chi‐Jung Chung
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
- Department of Medical ResearchChina Medical University HospitalTaichungTaiwan
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Chen P, Shan G, Zhang Y, Xia T. Both absolute and relative sugar-sweetened beverage intake are associated with kidney stones in U.S. middle-aged and young adults. World J Urol 2025; 43:244. [PMID: 40266421 DOI: 10.1007/s00345-025-05643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Accepted: 04/15/2025] [Indexed: 04/24/2025] Open
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) intake is currently a public health concern. However, the relationship between SSB intake and the risk of kidney stones in middle-aged and young populations has not been thoroughly investigated. METHODS The National Health and Nutrition Examination Survey (NHANES) database (for 2007-2016) was used. SSB intake was assessed using 24-hour dietary recall interviews and evaluated through two distinct metrics: (1) absolute intake, defined as the total energy derived from SSB, and (2) relative intake, expressed as the percentage of total daily energy intake contributed by SSB. Multivariable logistic regression models were used to investigate the association between SSB intake and the prevalence of kidney stones, with stratified and interaction analyses performed for covariates. All analyses accounted for sample weighting to ensure accurate representation. RESULTS The study analyzed data from 15,779 nationally representative participants, of whom 1,224 had kidney stones. After adjusting for potential covariates, both the absolute intake of SSB (per 100 kcal/d) and the relative intake (per 1%) were positively associated with the risk of kidney stones. The odds ratios (ORs) were 1.065 (95% confidence interval [CI]: 1.038, 1.093) and 1.015 (95% CI: 1.009, 1.022), respectively. Compared to individuals who do not consume SSB, kidney stones risk increased with absolute SSB intake across ascending tertiles: the ORs were 1.231 (95% Cl: 0.995, 1.523), 1.335 (95% Cl: 1.075, 1.658), and 1.664 (95% Cl: 1.353, 2.048) for the lowest to highest tertiles, respectively. The ORs corresponding to the respective tertiles of relative intake were 1.224 (95% CI: 0.991, 1.511), 1.394 (95% CI: 1.128, 1.723), and 1.626 (95% CI: 1.317, 2.009). This association remained generally stable across stratified analyses. Additionally, obesity status and alcohol consumption status significantly interacted with the relative SSB intake-kidney stones relationship. CONCLUSION In middle-aged and young adults, higher SSB intake is linked to a greater kidney stone risk, indicating that limiting consumption may aid in prevention.
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Affiliation(s)
- Peng Chen
- Department of Urology, Nanjing Gaochun People's Hospital (The Gaochun Affiliated Hospital of Jiangsu University), Nanjing, Jiangsu, 211300, China
| | - Guangmei Shan
- Department of Clinical Nutrition, Nanjing Gaochun People's Hospital (The Gaochun Affiliated Hospital of Jiangsu University), Nanjing, Jiangsu, 211300, China
| | - Yao Zhang
- Department of Thoracic Surgery, Nanjing Gaochun People's Hospital (The Gaochun Affiliated Hospital of Jiangsu University), Nanjing, Jiangsu, 211300, China
| | - Teng Xia
- Department of Thoracic Surgery, Nanjing Gaochun People's Hospital (The Gaochun Affiliated Hospital of Jiangsu University), Nanjing, Jiangsu, 211300, China.
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Ghelijli M, Salari-Moghaddam A, Aminianfar A, Moosazadeh M, Gholami F, Azadbakht M, Hosseini A, Soltani S. A cross-sectional study of the association between plant-based diet indices and kidney stones among Iranian adults. Sci Rep 2025; 15:13495. [PMID: 40251384 PMCID: PMC12008364 DOI: 10.1038/s41598-025-98370-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 04/10/2025] [Indexed: 04/20/2025] Open
Abstract
There are limited studies on the relationship between plant-based diet indices (PDIs) including plant-based diet index (PDI), healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI) and kidney stones (KS), especially in Middle Eastern populations. We aimed to investigate the relationship between these plant-based diet indices (PDI, hPDI, and uPDI) and KS in a large group of Iranian adults. This cross-sectional study was carried out on 9,839 adult participants aged 35-70 years. Dietary data were collected using a validated semi-quantitative 118-item food frequency questionnaire. The scoring method suggested by Satija et al. was applied to examine the adherence to the PDIs including PDI, hPDI, and uPDI. These indices are grounded in evidence linking plant-based foods to health outcomes such as obesity, diabetes, cancer, and cardiovascular disease. The history of KS was identified based on self-reported information provided by the participants. Approximately 16.4% (n = 1638) of study participants were found to have KS. After adjustment for a wide range of confounding variables, a significant positive association was observed between PDI and KS (OR: 1.17; 95% CI: 1.01-1.37). In the case of hPDI, we found no significant association between hPDI scores and risk of KS after adjustment for potential confounders (OR: 1.16; 95% CI: 0.98-1.38). Non-significant association was also observed for uPDI and risk of KS in the fully adjusted model (OR: 1.14; 95% CI: 0.95-1.35). In conclusion, findings of the present study showed that higher PDI score was positively associated with the risk of KS, whereas the hPDI and uPDI scores were not associated with the risk of KS. Further prospective studies are needed to establish causal relationships.
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Affiliation(s)
- Maryam Ghelijli
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Asma Salari-Moghaddam
- Department of Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Azadeh Aminianfar
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farhad Gholami
- Department of Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Azadbakht
- Department of Pharmacognosy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amirsaeed Hosseini
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Sanaz Soltani
- Department of Nutritional Sciences, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
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Cao M, Chen Y, Shen X. Association between ZJU index and kidney stone prevalence in the Chinese adult population: a retrospective propensity score-matched analysis. Urolithiasis 2025; 53:67. [PMID: 40186792 DOI: 10.1007/s00240-025-01741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Accepted: 03/25/2025] [Indexed: 04/07/2025]
Abstract
The study aimed to explore the association between the ZJU (Zhejiang University) index and the prevalence of kidney stones in Chinese adults. Electronic health records of individuals undergoing routine physical examinations at Wuhu Second People's Hospital between January 2021 and June 2024 were retrospectively analyzed. Participants were divided into kidney stone recurrence and non-recurrence groups. Data on biochemical parameters, hypertension, and diabetes history were collected, and group differences were assessed using the chi-square test or Kruskal-Wallis rank-sum test. Logistic regression, propensity score matching, and dose-response curve modeling were used to evaluate the relationship between the ZJU index and kidney stone prevalence. Among 5,104 participants aged over 18 years, 462 were diagnosed with kidney stones. After adjusting for confounders, a higher ZJU index was identified as an independent risk factor for kidney stone prevalence (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.02-1.08). Propensity score-matched analysis further confirmed this association (OR = 1.09, 95% CI: 1.04-1.13). Dose-response analysis revealed a positive linear relationship between the ZJU index and kidney stone recurrence. These findings suggest that elevated ZJU index levels are associated with a higher prevalence and recurrence of kidney stones, highlighting its potential as a clinical tool for identifying and managing at-risk patients.
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Affiliation(s)
- Man Cao
- Department of Nutrition, Wuhu City Second Peoplès Hospital Wuhu, Hefei, Anhui, China
| | - Yan Chen
- Department of Emergency Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Xudong Shen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
- Institute of Urology, Anhui Medical University, Hefei, China.
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Hefei, China.
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Liu CJ, Ho KT, Huang HS, Lu ZH, Hsieh MHC, Chang YS, Wang WH, Lai ECC, Tsai YS. Sodium glucose co-transporter 2 inhibitor prevents nephrolithiasis in non-diabetes by restoring impaired autophagic flux. EBioMedicine 2025; 114:105668. [PMID: 40138887 PMCID: PMC11986249 DOI: 10.1016/j.ebiom.2025.105668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 01/20/2025] [Accepted: 03/11/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Sodium-glucose cotransporter 2 inhibitors (SGLT2i) offer significant cardiovascular and kidney protection, independent of diabetes mellitus (DM). Recent cohort studies also suggest that SGLT2i can decrease the risk of nephrolithiasis in patients with DM. We aimed to use both animal models and human data to investigate whether SGLT2i can prevent nephrolithiasis and explored autophagy as a possible mechanism. METHODS We utilised SGLT2i, dapagliflozin (DAPA), on a glyoxylate (GOX)-induced calcium oxalate (CaOx) nephrolithiasis non-DM mouse model to test whether SGLT2i inhibited CaOx stone formation through modulating autophagy. Moreover, the clinical data retrieved from the National Health Insurance Research Database was analysed to confirm the findings from animal models. FINDINGS DAPA increased urine citrate, magnesium, pH, and decreased oxalate, effectively inhibiting CaOx stones in GOX mice. While autophagy was increased in the kidneys of GOX mice, as demonstrated by upregulated AMP-activated protein kinase (AMPK) and increased LC3B conversion; impaired autophagic flux was indicated by p62 accumulation. DAPA improved autophagy by downregulating mammalian target of rapamycin (mTOR), AMPK, and restoring autophagic flux. Rapamycin co-treatment preserved DAPA's nephrolithiasis inhibition, while hydroxychloroquine (HCQ) co-treatment abolished it. Finally, cohort data confirmed that SGLT2i reduced nephrolithiasis risk, but this protective effect disappeared if HCQ had been used within the prior year, suggesting that HCQ may compromise SGLT2i's protection against nephrolithiasis. INTERPRETATION SGLT2i, DAPA, inhibits nephrolithiasis by restoring impaired autophagic flux, and co-administration with autophagy inhibitor, HCQ, compromises SGLT2i's protection. FUNDING This research was funded by grants from the National Science and Technology Council, Taiwan (110-2314-B-006-023, 110-2320-B-006-017MY3, and 112-2314-B-006-058) and the research grants (NCKUH-11202005, -11210020) from the National Cheng Kung University Hospital, Tainan, Taiwan.
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Affiliation(s)
- Chan-Jung Liu
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan.
| | - Kaun-Ta Ho
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan
| | - Ho-Shiang Huang
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan
| | - Ze-Hong Lu
- Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan
| | - Miyuki Hsing-Chun Hsieh
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan; Population Health Data Center, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Shan Chang
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, 704302, Taiwan
| | - Wei-Hsuan Wang
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan; Population Health Data Center, National Cheng Kung University, Tainan, Taiwan.
| | - Yau-Sheng Tsai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan; Clinical Medicine Research Center, National Cheng Kung University Hospital, Tainan, 704302, Taiwan.
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Liu M, Gao M, Wu J, Zhu Z, Hu J, Chen H, Chen Z, Chen J. Metabolic Syndrome and the Risk of Kidney Stones: Evidence from 487 860 UK Biobank Participants. J Clin Endocrinol Metab 2025; 110:e1211-e1219. [PMID: 38701346 DOI: 10.1210/clinem/dgae295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/15/2024] [Accepted: 05/01/2024] [Indexed: 05/05/2024]
Abstract
CONTEXT While some studies have suggested an association between metabolic syndrome and kidney stones, the quality and level of evidence in these studies vary. OBJECTIVE Whether some individual characteristics and clustering of metabolic syndrome traits increase the risk of kidney stones has not been examined in a large-scale prospective cohort. MATERIALS We conducted a retrospective analysis of data from a prospective cohort of 487 860 UK Biobank participants who were free from kidney stones at baseline. The presence of metabolic syndrome was based on 5 criteria: abdominal obesity, high triglyceride levels, low high-density lipoprotein (HDL) cholesterol levels, high blood pressure (HBP), and type 2 diabetes mellitus (T2DM). Cox proportional hazards regression models were used to evaluate the association between metabolic syndrome and risk of kidney stones. RESULTS After an average follow-up period of 12.6 years, a total of 5213 of the 487 860 participants included in the UK Biobank study developed kidney stones. The partial traits of metabolic syndrome, including waist circumference (hazard ratio [HR]: 1.15; 95% CI, 1.10-1.20), HDL cholesterol (0.66; 95% CI, 0.55-0.79), HBP (1.11; 95% CI, 1.03-1.19), and T2DM (1.14; 95% CI, 1.04-1.21), were independently associated with the occurrence of kidney stones. The clustering of metabolic syndrome is significantly associated with kidney stone formation, and as the number of metabolic syndrome traits increases, the risk of kidney stones gradually increases. CONCLUSION Metabolic syndrome is a significant and independent risk factor for the development of kidney stones. This association suggests that kidney stones may represent a systemic disorder influenced by the interplay of various metabolic risk factors.
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Affiliation(s)
- Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Jian Wu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
- Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Jiao Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Zhiyong Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
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Xu Z, Ma M, Huang T, Lu R, Jin H, Fang Y, Xu M, Fang Y. Television viewing, oxidative stress, and kidney stone risk in males: a cross-sectional study with mediation analysis of the NHANES data (2011-2018 years). Int Urol Nephrol 2025; 57:929-938. [PMID: 39487905 DOI: 10.1007/s11255-024-04255-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 10/21/2024] [Indexed: 11/04/2024]
Abstract
PURPOSE To explore the association between television viewing time (TV-hours) and dietary oxidative balance score (DOBS) with the kidney stone risk in males. METHODS We analyzed age, poverty to income ratio, race, education, hypertension, diabetes, smoke, alcohol use, triglycerides, TV-hours, and DOBS data in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Multivariable logistic regression was uesd to evaluate the associations between TV-hours, lifestyle OBS (LOBS), DOBS, Total OBS (TOBS), and the risk of kidney stones. Interaction terms between subgroup measures were used to test for effect modification across subgroups. Mediation analysis was performed to explore the mediating effect of DOBS on the association between TV-hours and kidney stones. The restricted cubic spline (RCS) was applied to describe dose-response relationships between TV-hours and risk of kidney stones as well. RESULTS The study included 4167 males aged 20 and older, including 417 patients with kidney stones. The results showed that five or more TV-hours a day was associated with a higher risk of kidney stones [odds ratio (OR) = 1.16, (95% CI: 1.04-1.29), p = 0.01], and higher DOBS level was associated with a lower risk of kidney stones [OR = 0.97, (95% CI: 0.95-0.99), p = 0.004]. This association was remarkably consistent across TV-hours subgroups by age, race, alcohol use, hypertension and diabetes. According to the mediation analysis results, prolonged TV-hours is associated with an increased risk of kidney stones, this association is not mediated by DOBS. In other words, the impact of TV-hours on kidney stones risk is mainly a direct effect. When TV-hours is more than 2 hours, the odds ratio began to be greater than 1. CONCLUSIONS Overall, TV-hours was positively associated with kidney stones in males, whereas low DOBS was associated with kidney stones in males. This study suggests that an antioxidant diet and reduced television viewing time may be effective measures to prevent kidney stones in males.
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Affiliation(s)
- Zekun Xu
- Department of Urology Surgery, Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Min Ma
- Department of Urology Surgery, Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Ting Huang
- Department of Urology Surgery, Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Rihui Lu
- Department of Urology Surgery, Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Hangming Jin
- Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Yinfei Fang
- Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Min Xu
- Department of Urology Surgery, Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Yongjin Fang
- Jinhua Central Hospital, 365 Renmin Road, Jinhua, 321000, Zhejiang, People's Republic of China.
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10
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Choi J, Hwang G, Ji Y, Yoon H, Lee SJ. PFSH-Net: Parallel frequency-spatial hybrid network for segmentation of kidney stones in pre-contrast computed tomography images of dogs. Comput Biol Med 2025; 186:109609. [PMID: 39753026 DOI: 10.1016/j.compbiomed.2024.109609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 12/20/2024] [Accepted: 12/20/2024] [Indexed: 02/20/2025]
Abstract
Kidney stone is a common urological disease in dogs and can lead to serious complications such as pyelonephritis and kidney failure. However, manual diagnosis involves a lot of burdens on radiologists and may cause human errors due to fatigue. Automated methods using deep learning models have been explored to overcome this limitation. Veterinary images present additional challenges due to the various sizes of organs depending on different species, with particularly poor performance on smaller lesions. These challenges suggest the need for a robust deep learning model that can accurately detect various sizes of kidney stones and kidneys. Moreover, public datasets with high-quality CT annotations for dog lesions and organs are almost not available. To address these challenges, we introduce a parallel frequency-spatial hybrid network (PFSH-Net), specifically designed for detecting kidney stones in CT images of dogs. The PFSH-Net consists of an encoder-decoder architecture that simultaneously captures spatial and frequency domain features. Moreover, we propose a multi-scale fusion (MSF) module that integrates low-level and high-level representations in the spatial and frequency domains. We collected a veterinary CT dataset with high-quality labels annotated by expert veterinary radiologists, and this dataset is referred to as the JBNU-ACT dataset. The effectiveness of the proposed method is demonstrated using a real-world dataset, with performance improvements of 4.1366, and 0.6234 on the HD, and ASD metrics, respectively. Moreover, the generalization of the model is evaluated on the publicly available BTCV dataset by achieving the average DSC score of 0.7960, which outperforms the previous method. Our code is available at https://github.com/gyeongyeon-Hwang/veterinary-kidney-segmentation.
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Affiliation(s)
- Jiho Choi
- Division of Electronics and Information Engineering, College of Engineering, Jeonbuk National University, 567, Baekje-daero, Deokjin-gu, 54896, Jeonju, Republic of Korea.
| | - Gyeongyeon Hwang
- Division of Electronics and Information Engineering, College of Engineering, Jeonbuk National University, 567, Baekje-daero, Deokjin-gu, 54896, Jeonju, Republic of Korea.
| | - Yewon Ji
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, 79, Gobong-ro, 56443, Iksan, Republic of Korea.
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, 79, Gobong-ro, 56443, Iksan, Republic of Korea.
| | - Sang Jun Lee
- Division of Electronics and Information Engineering, College of Engineering, Jeonbuk National University, 567, Baekje-daero, Deokjin-gu, 54896, Jeonju, Republic of Korea.
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11
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Nazari A, Jamali Z, Soltani N, Khalili P, Esmaeili-Nadimi A, Kahnoji M, Abbasifard M, Vazirinejad R, Ayoobi F. Kidney stone and risk of cardiovascular diseases: a cross-sectional study in the southeast of Iran. BMC Nephrol 2025; 26:101. [PMID: 40000976 PMCID: PMC11863594 DOI: 10.1186/s12882-025-04018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 02/11/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Since the prevalence of kidney stones and cardiovascular diseases (CVD) is increasing globally and also in Iran, it is vital to assess the associations between both disorders. The current study aimed to investigate the association between kidney stones and the risk of CVD. METHODS This study was cross-sectional in design, which used the data of the Rafsanjan cohort study (RCS), a population-based Prospective epidemiological research study in Iran (PERSIAN) that recruited 10,000 participants of both genders aged 35-70 years from four urban and suburban areas of Rafsanjan. Demographic factors, medical history, personal habits, biochemical parameters including Fasting blood sugar (FBS), glomerular filtration rate (GFR), creatine (Cr), Blood urea nitrogen (BUN), urine specific gravity (USG), and lipids of the participants were collected according to standard protocols. RESULTS The results showed that the risk of CVD was higher in men (51.02%) than in women (48.98%). Also, the results showed the highest risk of CVD development for age ≥ 56 years old. The results were presented in about 31% of patients with kidney stones, 19.5% of patients with abnormal urine tests, 9.84% with Proteinuria, more than 33% with abnormal USG, and more than 94% of patients with abnormal GFR had CVD. The odds of CVD were increased in patients with kidney stones (22%), female (25%), and age ≥ 56 years old (24%). CONCLUSIONS There was a high prevalence of kidney stones and CVD risk factors, such as gender, age, and kidney stones that increased the risk of cardiovascular disease.
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Affiliation(s)
- Alireza Nazari
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Surgery, School of Medicine, Moradi Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Narjes Soltani
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Esmaeili-Nadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahmood Kahnoji
- Department of Internal Medicine, School of Medicine, Ali Ibn Abitaleb Educational and Tretment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mitra Abbasifard
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Reza Vazirinejad
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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12
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Wilson HE, Moe SM. You are what you eat-should it be all meat?: Impact of the carnivore diet on the risk of kidney stone development. Am J Clin Nutr 2025; 121:197-202. [PMID: 39753382 DOI: 10.1016/j.ajcnut.2024.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 11/18/2024] [Accepted: 11/21/2024] [Indexed: 02/07/2025] Open
Affiliation(s)
- Hannah E Wilson
- Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Sharon M Moe
- Indiana University School of Medicine, Division of Nephrology, Indianapolis, IN, United States
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13
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Shin A, Shin JY, Kang EH. Risk of Nephrolithiasis Associated With SGLT2 Inhibitors Versus DPP4 Inhibitors Among Patients With Type 2 Diabetes: A Target Trial Emulation Study. Diabetes Care 2025; 48:193-201. [PMID: 39666579 DOI: 10.2337/dc24-1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 10/16/2024] [Indexed: 12/14/2024]
Abstract
OBJECTIVE We aim to compare the risk of nephrolithiasis among type 2 diabetes patients who initiated sodium-glucose cotransporter 2 inhibitors (SGLT2is) versus dipeptidyl peptidase 4 inhibitors (DPP4is), individually within stone never- and ever-formers. RESEARCH DESIGN AND METHODS Using the 2010-2021 Korea National Health Insurance Service database, we conducted a population-based cohort study, comparing initiators of SGLT2is versus DPP4is. The primary outcome was incident nephrolithiasis. Osteoarthritis encounters served as a negative control outcome. After 1:1 propensity score (PS) matching in stone never- and ever-formers, pooled and individual hazard ratios (HRs), incidence rate difference (IRD), and 95% CIs were reported. Subgroup analyses by sex, age, thiazide co-use, and baseline cardiovascular risk were done. RESULTS The 17,006 PS-matched pairs of SGLT2i and DPP4i initiators were pooled from stone never-formers (105,378 pairs) and ever-formers (11,628 pairs). Over a mean of 654 days, the risk of nephrolithiasis was lower in SGLT2i initiators than in DPP4i initiators: 0.65 vs. 1.12 events per 100 person-years, HR 0.54 (95% CI, 0.50-0.57), IRD -0.46 (95% CI, -0.21 to -0.52). Among never-formers, the HR was 0.43 (95% CI, 0.39-0.48) and IRD was -0.32 (95% CI, -0.27 to -0.36). Among ever-formers, the HR was 0.64 (95% CI, 0.59-0.69) and IRD was -2.26 (95% CI, -1.77 to -2.76). Near-null associations were found for osteoarthritis encounters. Results were consistent across subgroups. CONCLUSIONS We found a lower risk of nephrolithiasis associated with SGLT2is versus DPP4is in stone never- and ever-formers. Despite a greater relative risk reduction in the former, the absolute risk reduction was greater in the latter.
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Affiliation(s)
- Anna Shin
- Medical Research Collaboration Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Eun Ha Kang
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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14
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Tan N, Zhang Y. Associations between dietary fatty acids and kidney stones. Sci Rep 2025; 15:2500. [PMID: 39833367 PMCID: PMC11747447 DOI: 10.1038/s41598-025-86850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 01/14/2025] [Indexed: 01/22/2025] Open
Abstract
Kidney stones represent a significant global health challenge, with dietary habits playing a crucial role in their formation. This study investigates the association between dietary fatty acid intake-specifically saturated (SFA), monounsaturated (MUFA), and polyunsaturated fatty acids (PUFA)-and the prevalence of kidney stones in a U.S. adult population, aiming to inform potential dietary prevention strategies. Data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2018 were analyzed, including 30,716 participants. Logistic regression models were used to assess the relationship between fatty acid intake and kidney stones prevalence, adjusting for demographic and health-related covariates such as age, sex, BMI, diabetes status, physical activity, and other dietary factors. Additional analyses were conducted to explore the effects of fatty acid intake as a percentage of total energy and the impact of various fatty acid ratios. Higher intakes of SFA, MUFA, and PUFA were associated with increased odds of kidney stones prevalence. Specifically, each 10 g/day increase in SFA, MUFA, and PUFA intake was linked to a 22% [OR = 1.22, 95% CI: 1.11-1.34, p = 0.002], 10% [OR = 1.10, 95% CI: 1.00-1.22, p = 0.052] and 21% [OR = 1.21, 95% CI: 1.10-1.33, p = 0.001] higher odds of kidney stones, respectively. These associations were generally consistent across various subgroups. Additional analyses examining fatty acid intake as a percentage of total energy and various fatty acid ratios yielded compatible findings. The findings suggest a modest association between higher dietary fatty acid intake and increased odds of kidney stones prevalence. While the observed odds increases were relatively small, these results highlight the importance of considering dietary fatty acid types in kidney stones prevention strategies. Future research is needed to further elucidate the underlying mechanisms and to refine dietary recommendations.
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Affiliation(s)
- Ning Tan
- Department of Urology, The Affiliated Second Hospital, Hengyang Medical school, University of South China, Hengyang, 421009, China
| | - Ya Zhang
- Department of Urology, The Affiliated Second Hospital, Hengyang Medical school, University of South China, Hengyang, 421009, China.
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15
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Wu M, He C, Yu H, Zhang Y, Tang L, Liu M, Gao M, Wu J, Zeng F, Chen H, Jiang S, Zhu Z. Therapeutic targets of antidiabetic drugs and kidney stones: A druggable mendelian randomization study and experimental study in rats. Eur J Pharmacol 2025; 987:177197. [PMID: 39662658 DOI: 10.1016/j.ejphar.2024.177197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 11/22/2024] [Accepted: 12/09/2024] [Indexed: 12/13/2024]
Abstract
Diabetes is known to increase the risk of kidney stones, but the influence of antidiabetic drugs on this risk remains uncertain. Genetic instruments for antidiabetic drugs were identified as variants, which were associated with both the expression of genes encoding target proteins of drugs and glycated hemoglobin level (HbA1c). Here, we investigated the effect of antidiabetic drugs on kidney stones in a mendelian randomization (MR) framework, and further explore the potential effect on CaOx stone rat models induced by glyoxylic acid. Genetically proxied thiazolidinediones (PPARG agonists) significantly reduced the risk of kidney stones (OR = 0.42; P=0.004) per 1-SD decrement in HbA1c, while no significant association was noted in sulfonylureas, SGLT2 inhibitors, or GLP-1 analogs. Other antidiabetic drugs were not analyzed due to unclear pharmacological targets or no identified instruments. Additionally, PPARG agonists pioglitazone ameliorated CaOx nephrocalcinosis in glyoxylic acid-induced rats. The summary-data-based MR (SMR) results showed that PPARG mRNA expression in blood or kidney was not associated with kidney stone risk, and thus we performed mediation MR of PPARG agonists, circulating metabolites, and kidney stones. Among 249 circulating metabolites, we identified an indirect effect of PPARG agonists on kidney stones through increasing phospholipids to total lipids ratio in very large VLDL, with a mediated proportion of 6.87% (P = 0.018). Our study provided evidence that PPARG agonists reduced the risk of kidney stones partially via regulating lipid metabolism, and PPARG agonists may be a promising study subject in clinical studies for the prevention of kidney stones.
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Affiliation(s)
- Maolan Wu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Cheng He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Hao Yu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Youjie Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Liang Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Jian Wu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Feng Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Shilong Jiang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; The Hunan Institute of Pharmacy Practice and Clinical Research, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, 06519, USA.
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16
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Rodríguez-Monsalve M, Durán-Poveda M, Gómez Dos Santos V, Burgos Revilla J, García-Criado E, Prieto D, Gil de Miguel Á, Sáenz-Medina J. Impact of Obesity on Hospitalization Burden of Urolithiasis in Spain Between 1997 and 2021. J Clin Med 2025; 14:381. [PMID: 39860386 PMCID: PMC11766420 DOI: 10.3390/jcm14020381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/01/2025] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
Background/Objective: The prevalence of kidney stones has increased, especially in industrialized countries. Obesity and metabolic syndrome have also risen significantly and are considered factors driving this trend. Our goal was to assess the hospitalization burden of kidney stones and identify epidemiological trends in Spain over the past 25 years. Additionally, this study analyzed the relationship between the data of kidney stone patients and obesity-coded diagnoses in hospital discharges. Methods: A retrospective observational study was conducted with the data from 1,070,192 patients hospitalized for urolithiasis between 1997 and 2021 using the Minimum Basic Data System. The hospitalization burden of lithiasis and its association with obesity was analyzed, alongside trend evaluations. The incidence of lithiasis in obese hospitalized patients versus all hospitalizations was compared. Mortality rates, length of stay, and the costs of lithiasis hospitalizations were evaluated to determine obesity's impact on lithiasis patients. Results: Kidney stone cases increased by 1.8% annually (CI 95%: 0.2-3.3), with a more pronounced 10.7% (CI 95%: 7.3-14.2) increase in obesity-related hospitalizations. Obesity increased the likelihood of lithiasis hospitalization by 15.6 times and was associated with higher hospitalization costs. However, obesity did not significantly affect hospital stay duration or mortality rates. Conclusions: The increasing burden of kidney stone hospitalizations in Spain is linked to rising obesity rates. Obesity contributes to higher hospitalization costs. Preventive strategies targeting obesity should be implemented to reduce the burden on healthcare systems.
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Affiliation(s)
- María Rodríguez-Monsalve
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, 28222 Madrid, Spain
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28933 Madrid, Spain
| | - Manuel Durán-Poveda
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28933 Madrid, Spain
| | | | | | - Elena García-Criado
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, 28222 Madrid, Spain
| | - Dolores Prieto
- Department of Physiology, Pharmacy School, Complutense University, 28040 Madrid, Spain
| | - Ángel Gil de Miguel
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28933 Madrid, Spain
| | - Javier Sáenz-Medina
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, 28222 Madrid, Spain
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28933 Madrid, Spain
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17
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Dai X, Chang Y, Hou Y. Associations between the conicity index and kidney stone disease prevalence and mortality in American adults. Sci Rep 2025; 15:902. [PMID: 39762499 PMCID: PMC11704305 DOI: 10.1038/s41598-025-85292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 01/01/2025] [Indexed: 01/11/2025] Open
Abstract
Kidney Stone Disease (KSD) is a prevalent urological condition, while abdominal obesity is on the rise globally. The conicity index, measuring body fat distribution, is crucial but under-researched in its relation to KSD and all-cause mortality. This study, using data from 59,842 participants in the NHANES (2007-2018), calculated the conicity index from waist circumference, height, and weight. Logistic regression and Cox models revealed a significant positive correlation: each 0.1 unit increase in the conicity index was linked to a 23% rise in KSD odds (OR: 1.23, 95% CI: 1.14, 1.35) and higher predictive ability compared to traditional measures (AUC = 0.619). In KSD patients, this increase corresponded to a 44% higher risk of all-cause mortality (HR: 1.44, 95% CI: 1.14, 1.82), and in non-KSD patients, a 53% increase (HR: 1.53, 95% CI: 1.37, 1.70). Serum albumin and Red Cell Distribution Width (RDW) partially mediated these relationships. Addressing central obesity could significantly lower the risks of KSD and mortality.
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Affiliation(s)
- Xianyu Dai
- Department of Urology, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun City, Jilin Province, China
| | - Yu Chang
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, China
| | - Yuchuan Hou
- Department of Urology, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun City, Jilin Province, China.
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18
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Qiu X, Xu Q, Ge H, Gao X, Huang J, Zhang H, Wu X, Lin J. Label-free detection of kidney stones urine combined with SERS and multivariate statistical algorithm. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2025; 324:125020. [PMID: 39213834 DOI: 10.1016/j.saa.2024.125020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/30/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
Kidney stones are a common urological disease with an increasing incidence worldwide. Traditional diagnostic methods for kidney stones are relatively complex and time-consuming, thus necessitating the development of a quicker and simpler diagnostic approach. This study investigates the clinical screening of kidney stones using Surface-Enhanced Raman Scattering (SERS) technology combined with multivariate statistical algorithms, comparing the classification performance of three algorithms (PCA-LDA, PCA-LR, PCA-SVM). Urine samples from 32 kidney stone patients, 30 patients with other urinary stones, and 36 healthy individuals were analyzed. SERS spectra data were collected in the range of 450-1800 cm-1 and analyzed. The results showed that the PCA-SVM algorithm had the highest classification accuracy, with 92.9 % for distinguishing kidney stone patients from healthy individuals and 92 % for distinguishing kidney stone patients from those with other urinary stones. In comparison, the classification accuracy of PCA-LR and PCA-LDA was slightly lower. The findings indicate that SERS combined with PCA-SVM demonstrates excellent performance in the clinical screening of kidney stones and has potential for practical clinical application. Future research can further optimize SERS technology and algorithms to enhance their stability and accuracy, and expand the sample size to verify their applicability across different populations. Overall, this study provides a new method for the rapid diagnosis of kidney stones, which is expected to play an important role in clinical diagnostics.
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Affiliation(s)
- Xinhao Qiu
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China
| | - Qingjiang Xu
- Department of Urology, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350001, China; Provincial Clinical Medical Colleges of Fujian Medical University, Fuzhou 350001, China
| | - Houyang Ge
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China
| | - Xingen Gao
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China
| | - Junqi Huang
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China
| | - Hongyi Zhang
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China
| | - Xiang Wu
- Department of Urology, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350001, China; Provincial Clinical Medical Colleges of Fujian Medical University, Fuzhou 350001, China.
| | - Juqiang Lin
- School of Opto-electronic and Communication Engineering, Xiamen University of Technology, Xiamen, Fujian, China.
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Nafadi IB, Alsulami AA, Halabi NF, Alsubhi AA, Maghrabi SW, Alshehri WS, Ramadan M, Khan A, Radi S. Kidney stone characteristics in diabetics versus nondiabetics at a tertiary care center in Saudi Arabia. Urol Ann 2025; 17:26-31. [PMID: 40051994 PMCID: PMC11881954 DOI: 10.4103/ua.ua_55_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 10/06/2024] [Indexed: 03/09/2025] Open
Abstract
Background Kidney stones can significantly impact individuals, but existing literature often overlooks the comprehensive effects by not considering the various factors such as stone size, presence of obstruction, and treatment methods, among those with and without diabetes. This study seeks to explore the relationship between diabetes and kidney stone formation, addressing these gaps in research. Methodology This cross-sectional study assesses the diverse impacts of kidney stones on adults diagnosed with type 2 diabetes mellitus and nondiabetic adults from 2019 to 2022 in Jeddah, Saudi Arabia. Institutional review board approval was secured for this research. Data collection occurred from December 1, 2022, to March 1, 2023, and the analysis was performed using SPSS software. Results The study included 254 adults diagnosed with kidney stones, 127 with type 2 diabetes, and 127 nondiabetics. Our study showed that the individuals with diabetes were more likely to have larger kidney stones than those without diabetes (13.12 mm vs. 10.53 mm, P = 0.03). Moreover, individuals with hypertension and dyslipidemia also had significantly larger stones. However, no significant difference was found between the two groups regarding the presence of obstruction and the treatment modality. Conclusion This study revealed that in Saudi Arabia, individuals with diabetes who also suffer from kidney stones tend to develop larger stones. In addition, these individuals frequently exhibit other comorbid conditions, including hypertension, dyslipidemia, obesity, and renal disease. The significance of these findings may inform future strategies for both primary and secondary prevention of kidney stones in diabetic patients.
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Affiliation(s)
- Ibrahim Basem Nafadi
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah Ahmed Alsulami
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Nawaf Faisal Halabi
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulrahman Abdullah Alsubhi
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sami Wessam Maghrabi
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Waleed Saad Alshehri
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Majed Ramadan
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Anwar Khan
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Suhaib Radi
- College of Medicine, King Saud Bin Abdelaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Medicine, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
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20
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Zhong Y, Zeng Q, Yi J, Long T, Peng J, Zhong L. Research trends and frontiers on risk factors of urinary stones: a bibliometric analysis from 2010 to 2023. Ren Fail 2024; 46:2440513. [PMID: 39681478 DOI: 10.1080/0886022x.2024.2440513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 11/14/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The occurrence of urinary stone disease (USD) is associated with several factors. However, no conclusive results have been reached regarding the treatment of USD risk factors. This study conducted a detailed bibliometric analysis of USD risk factors to determine research hotspots and provide future development directions. METHODS Articles and reviews on the USD risk factors published between 2010 and 2023 were retrieved from the Web of Science Core Collection. Co-occurrence and collaboration analyses of countries, institutions, authors, journals, references, and keywords were conducted using CiteSpace, VOSviewer, and R-Bibliometrix. RESULTS A total of 436 articles on USD risk factors were included in the study. China and the United States have emerged as the leading countries in this field, with the Mayo Clinic having the highest amount of publication output. Among all the authors, Ferraro PM had the highest number of publications, while Taylor EN was the highly cited author. The journal with the highest number of publications was UROLITHIASIS. Scales reported the reference with the highest burst strength. The current citation themes in research on USD risk factors were 'multifaceted relationship' and 'kidney stone disease recurrence'. 'Medical-management' was identified as a major keyword, indicating future research hotspots. CONCLUSION This study employed bibliometric methods to conduct a comprehensive visual analysis of USD risk factors to show publication trends and popular topics in this area over the past decade. The results provide a valuable reference for future research on the risk factors of USD.
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Affiliation(s)
- Yongfu Zhong
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
| | - Qing Zeng
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
| | - Jiayou Yi
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
| | - Tao Long
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
| | - Juanwen Peng
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
| | - Li Zhong
- Yichun Hospital of Traditional Chinese Medicine, Yichun, P. R. China
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21
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Prochaska M, Adeola G, Vetter N, Mirmira RG, Coe F, Worcester E. Insulin Resistance in Hypercalciuric Calcium Kidney Stone Patients. Kidney Med 2024; 6:100922. [PMID: 39634328 PMCID: PMC11615144 DOI: 10.1016/j.xkme.2024.100922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2024] Open
Abstract
Rational & Objective Diabetes and uric acid kidney stones are strongly associated. Patients with calcium kidney stones also have higher risk of developing diabetes compared with nonkidney stone patients yet this has not been further investigated. We aimed to characterize insulin resistance in calcium kidney stone patients. Study Design Observational. Setting & Population This study was performed in the University of Chicago Clinical Research Center. Kidney stone patients (N = 42) were selected for having idiopathic hypercalciuria and calcium stones with no other medical conditions, and controls (N = 27) were healthy. Exposures All participants presented to the Clinical Research Center in a fasting state and at least 2 timed fasting blood and urine collections were collected before a fixed breakfast. Six additional timed blood and urine collections were performed after breakfast. Outcomes We compared fasting and fed indices of insulin resistance between the groups. Analytic Approach We used t tests and multivariable linear regression models. A sensitivity analysis removing all patients who had ever been on a thiazide diuretic was also performed. Results In separate multivariable linear models, kidney stone patients had higher fasting serum insulin levels (24 (3-46 pmol/L), P = 0.03) and higher homeostatic model of insulin resistance (HOMA-IR) (1.0 (0.2-1.8), P = 0.02). In separate multivariable linear models, kidney stone patients had higher fed serum glucose levels (10 (2-18 mg/dL), P = 0.01). Results were similar in a sensitivity analysis removing all patients who had ever been on a thiazide diuretic. There were no differences in urine composition based on HOMA-IR levels. Limitations Single institution. Small sample size limited subanalyses by different calcium stone types. Conclusions Calcium kidney stone patients without diabetes or other medical conditions demonstrated signs of insulin resistance compared with healthy matched controls.
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Affiliation(s)
| | - Gloria Adeola
- Department of Medicine, University of Chicago, Chicago IL
| | - Noah Vetter
- Department of Medicine, University of Chicago, Chicago IL
| | | | - Fredric Coe
- Department of Medicine, University of Chicago, Chicago IL
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22
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Hua Y, Zhou Z, Miao S, Wang Z, Song R, Meng X. Exploring the molecular interactions between nephrolithiasis and carotid atherosclerosis: asporin as a potential biomarker. Urolithiasis 2024; 52:169. [PMID: 39589536 DOI: 10.1007/s00240-024-01665-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 11/09/2024] [Indexed: 11/27/2024]
Abstract
Increasing evidence suggested nephrolithiasis has a close linkage with carotid atherosclerosis (CAS), with Randall's plaque (RP) being a precursor to kidney stones. Our study aimed to examine the crosstalk genes and potential molecular mechanisms between RP and CAS. We obtained microarray data for RP and CAS from the Gene Expression Omnibus (GEO) and used weighted gene co-expression network analysis (WGCNA) and differential gene expression (DEG) analysis to identify shared genes. By integrating WGCNA and DEG analysis, Asporin (ASPN) was identified as the key gene connecting RP and CAS, with its diagnostic potential assessed via a receiver operating characteristic (ROC) curve. Immune infiltration studies showed a significant correlation between ASPN and various immune cells in RP and CAS. ASPN was found to be less expressed in RP and CAS tissues compared to normal tissues, as confirmed by immunohistochemistry (IHC) and quantitative reverse-transcription PCR (qRT-PCR). The rat model confirmed the human tissue findings. ASPN can elucidate the shared pathogenic mechanisms underlying the two conditions, including immune response and osteoblast differentiation.
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Affiliation(s)
- Yibo Hua
- Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, P.R. China
| | - Zijian Zhou
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200040, PR China
| | - Suyu Miao
- Department of Vascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, P.R. China
| | - Zijie Wang
- Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, P.R. China
| | - Rijin Song
- Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, P.R. China.
| | - Xianghu Meng
- Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, P.R. China.
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23
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Maddahi NS, Fotros D, Sohouli MH, Mozaffari-Khosravi H, Khayyatzadeh SS. Higher dietary insulin index is directly associated with the odd of kidney stones. Sci Rep 2024; 14:28302. [PMID: 39550437 PMCID: PMC11569153 DOI: 10.1038/s41598-024-79419-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 11/08/2024] [Indexed: 11/18/2024] Open
Abstract
Kidney stones or Nephrolithiasis are the most common health condition associated with the urinary system. Dietary factors stand as important factors in the occurrence and development of kidney stones. This study aimed to examine the potential link between dietary insulin index (DII) and dietary insulin load (DIL) with prevalence of kidney stones. This cross-sectional study was conducted among adults aged 30 to 75 years in the Shahedieh district of Yazd, Iran, over the period of 2015-2016. DII and DIL were calculated using a validated semi-quantitative food-frequency questionnaire and mathematical formula. Diagnosis of kidney stones is made on the basis of information obtained from self-reported questionnaire (Yes/ No). To explore the association between DII and DIL with the odds of kidney stones, logistic regression was employed in crude and adjusted models. A total of 4,829 participants were included in this study. Individuals in the last quartile of DIL had 214% higher odds of kidney stones in the crude model (OR: 2.14, 95% CI: 1.62-2.83; P-trend < 0.001); this association was remained significant after adjustments for confounding variables (OR: 1.44, 95% CI: 1.04-1.97; P-trend: 0.019). There was a direct significant relationship between DII and odds of kidney stones among third and forth quartiles of DII (OR: 1.52, 95% CI: 1.16-1.98, P-trend = 0.002); but this association disappeared for adjusted models. Higher DII and DIL were associated with an increased odd of renal stones. Large longitudinal study is required to clarify these associations.
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Affiliation(s)
- Niloofar Sadat Maddahi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Box 8915173160, Yazd, Iran
| | - Danial Fotros
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Mozaffari-Khosravi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Box 8915173160, Yazd, Iran
| | - Sayyed Saeid Khayyatzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Box 8915173160, Yazd, Iran.
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24
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Spasiano A, Treccani M, De Tomi E, Malerba G, Gambaro G, Ferraro PM. Characteristics and Yield of Modern Approaches for the Diagnosis of Genetic Causes of Kidney Stone Disease. Genes (Basel) 2024; 15:1470. [PMID: 39596670 PMCID: PMC11593538 DOI: 10.3390/genes15111470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/09/2024] [Accepted: 11/13/2024] [Indexed: 11/29/2024] Open
Abstract
BACKGROUND Kidney stone disease (KSD) is characterized by an increasing prevalence worldwide, representing an important clinical issue and a financial burden for healthcare systems. A KSD-causing monogenic variant is traditionally expected in up to 30% of children and 1-5% of adults forming stones, confirmed by a strong connection between a positive family history and KSD. The insufficient use of genetic testing in these patients is associated with a lack of perceived benefit and a scarce awareness of inherited kidney diseases. Genetic testing has important practical implications, such as the possibility of earlier diagnoses, familial counseling, and tailored therapy, based on the evaluation of fine-mapped pathogenic variants. Our aim is to analyze the current evidence on genetic testing in KSD patients to whom genetic tests were applied without strict a priori selection criteria, to provide an overview of its diagnostic yield and factors potentially affecting it (such as the age of KSD onset, a familial history of KSD, consanguinity, and extrarenal features). METHODS A literature review was performed, selecting original articles published in the last 10 years concerning genetic investigations in patients affected by nephrolithiasis or nephrocalcinosis. Available data were subsequently extracted and analyzed. RESULTS In total, 13 studies on 1675 patients (77% pediatric populations) were included; 333 patients were determined to be affected by a monogenic disorder, with an overall yield of about 20%. The likelihood of a positive genetic finding was much higher in pediatric (26%) than adult populations (8%). Cystinuria was the most common diagnosis in both populations. After the removal of conditions that could be identified with a stone composition analysis or urinary chemistry investigation, the diagnostic yield dropped to 19% among pediatric patients and below 5% for adults. CONCLUSIONS Genetic testing should be considered in KSD pediatric patients and in selected subgroups of adults with suggestive features when a diagnosis is not established after stone examination and blood as well as urine metabolic profiling.
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Affiliation(s)
- Andrea Spasiano
- Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.S.); (E.D.T.); (G.G.)
| | - Mirko Treccani
- Department of Neurosciences, Biomedicine and Movement Sciences, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy;
| | - Elisa De Tomi
- Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.S.); (E.D.T.); (G.G.)
| | - Giovanni Malerba
- GM Lab, Department of Surgery, Dentistry, Paediatrics and Gynaecology, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy;
| | - Giovanni Gambaro
- Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.S.); (E.D.T.); (G.G.)
| | - Pietro Manuel Ferraro
- Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.S.); (E.D.T.); (G.G.)
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25
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Prochaska ML, Zisman AL. Nephrolithiasis. ADVANCES IN KIDNEY DISEASE AND HEALTH 2024; 31:529-537. [PMID: 39577887 DOI: 10.1053/j.akdh.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 11/24/2024]
Abstract
Kidney stone prevalence is rapidly increasing worldwide, and decreasing stone growth and recurrence is critical to reducing morbidity. Preventative approaches vary with kidney stone type, so knowledge of stone composition and a thorough history and metabolic evaluation are necessary to individualize therapy. The cases presented herein highlight treatment strategies for the most common stone types seen in clinical practice with practical pearls for the nephrologist.
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Affiliation(s)
- Megan L Prochaska
- Department of Medicine, Section of Nephrology, University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Anna L Zisman
- Department of Medicine, Section of Nephrology, University of Chicago Pritzker School of Medicine, Chicago, IL.
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McCormick N, Yokose C, Lu N, Wexler DJ, Aviña-Zubieta JA, De Vera MA, Chigurupati S, Tan K, Chen C, McCoy R, Curhan GC, Choi HK. Comparative effectiveness of sodium-glucose cotransporter-2 inhibitors for recurrent nephrolithiasis among patients with pre-existing nephrolithiasis or gout: target trial emulation studies. BMJ 2024; 387:e080035. [PMID: 39477370 PMCID: PMC11524131 DOI: 10.1136/bmj-2024-080035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2024] [Indexed: 11/03/2024]
Abstract
OBJECTIVE To emulate target trials comparing recurrence of nephrolithiasis among patients with pre-existing nephrolithiasis (overall and stratified by concomitant gout) initiating sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus an active comparator. DESIGN Target trial emulation studies. SETTING Canadian population database, January 2014 to June 2022. PARTICIPANTS 20 146 patients with nephrolithiasis and type 2 diabetes, including those with concomitant gout at baseline, a high risk group. INTERVENTIONS Initiation of an SGLT-2 inhibitor or glucagon-like peptide-1 (GLP-1) receptor agonist, with a dipeptidyl peptidase-4 (DPP-4) inhibitor as alternative comparator. MAIN OUTCOME MEASURES The primary outcome was recurrent nephrolithiasis events ascertained from diagnoses during emergency department visits, hospital admissions, or outpatient visits. Secondary outcomes included nephrolithiasis resulting in hospital admission or emergency department visits and flare-up of gout, as well as a positive control outcome (genital infection) and negative control outcomes (osteoarthritis encounter and appendicitis). Poisson and Cox proportional hazards regression models were used (primary analyses), as well as overlap weighting. RESULTS After inverse probability of treatment weighting, 1924 recurrent nephrolithiasis events occurred among the 14 456 weighted patients who used an SGLT-2 inhibitor (105.3 per 1000 person years), compared with 853 events among the 5877 weighted patients who used a GLP-1 receptor agonist (156.4 per 1000 person years). The adjusted rate ratio was 0.67 (95% confidence interval (CI) 0.57 to 0.79) and rate difference was -51 (95% CI -63 to -40) per 1000 person years, with a number needed to treat (NNT) of 20. Among those with recently active nephrolithiasis, the absolute rate difference was 219 per 1000 person years (NNT of 5). Protective associations persisted for nephrolithiasis events that required emergency department visits, hospital admissions, or procedures, and when an SGLT-2 inhibitor was compared with a DPP-4 inhibitor (rate ratio 0.73 (0.68 to 0.78), rate difference -38 (-46 to -29) per 1000 person years (NNT of 26)). Protective associations also persisted among patients with nephrolithiasis and concomitant gout, with a rate ratio of 0.67 (0.57 to 0.79) and rate difference of -53 (95% CI -78 to -27) per 1000 person years versus a GLP-1 receptor agonist (NNT of 19), and 0.63 (0.55 to 0.72) and-62 (-81 to -42) per 1000 person years, respectively, versus a DPP-4 inhibitor (NNT of 16). Furthermore, SGLT-2 inhibitor use was associated with a lower rate of gout flare-ups (rate ratio 0.72, 0.54 to 0.95, rate difference -16, -31 to -1 per 1000 person years) compared with GLP-1 receptor agonists (0.65, 0.52 to 0.82, and -21, -33 to -9 per 1000 person years) compared with DPP-4 inhibitors. SGLT-2 inhibitor initiators showed higher risk of genital infection (eg, hazard ratio 2.21, 95% CI 1.68 to 2.90, and rate difference 13 per 1000 person years), but no altered risk of osteoarthritis encounter (0.87, 0.68 to 1.1, and -2 per 1000 person years) or appendicitis (1.07, 0.69 to 1.67, and 1 per 1000 person years). Results were similar when propensity score overlap weighting was applied. CONCLUSIONS The benefits associated with SGLT-2 inhibitor for patients with nephrolithiasis in these target trial emulations suggest they may be a useful addition to current treatments to simultaneously manage nephrolithiasis recurrence and comorbidities, including gout.
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Affiliation(s)
- Natalie McCormick
- Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Chio Yokose
- Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Na Lu
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Deborah J Wexler
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Diabetes Center, Massachusetts General Hospital, Boston, MA, USA
| | - J Antonio Aviña-Zubieta
- Arthritis Research Canada, Vancouver, BC, Canada
- Division of Rheumatology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Mary A De Vera
- Arthritis Research Canada, Vancouver, BC, Canada
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Saiajay Chigurupati
- Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kiara Tan
- Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Chixiang Chen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Rozalina McCoy
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- University of Maryland Institute for Health Computing, Bethesda, MD, USA
- Division of Gerontology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gary C Curhan
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hyon K Choi
- Rheumatology and Allergy Clinical Epidemiology Research Center, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Arthritis Research Canada, Vancouver, BC, Canada
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27
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Chou YH, Li CC, Wu WJ, Juan YS, Chien TM. Postmenopausal status increases the risk of uric acid stones. Exp Gerontol 2024; 196:112570. [PMID: 39233193 DOI: 10.1016/j.exger.2024.112570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/04/2024] [Accepted: 09/01/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVE This study investigated the impact of menopause on stone composition in women with urolithiasis. STUDY DESIGN A cross-sectional study was conducted from March 2013 to March 2018. Women with urolithiasis patients were divided into two groups according to their menopause status. MAIN OUTCOME MEASURES The clinical demographic characteristics, stone removal, stone composition, and urine chemistry were investigated. Univariate and multivariate survival analyses were performed to identify risk factors for the risk of uric acid stones. RESULTS Our study enrolled 1221 female patients with stone diseases, 783 (64.1 %) of whom were postmenopausal (66 patients surgically menopause and 717 patients naturally menopause). Postmenopausal women had higher rates of diabetes and hyperuricemia, a higher serum uric acid level, a higher urinary specific gravity, and a lower estimated glomerular filtration rate. Stone analysis revealed calcium oxalate stones in 66.2 % of the patients, apatite stones in 19.4 %, calcium oxalate and calcium phosphate stones in 7.7 %, uric acid stones in 4.4 %, struvite stones in 2.0 %, and brushite stones in 0.2 %. Postmenopausal women had a higher rate of uric acid stones. Multivariate analysis confirmed that postmenopausal status and hyperuricemia were independent risk factors of uric acid stones. Postmenopausal women required more invasive procedures to remove the stones, and they had lower self-voiding rates. CONCLUSIONS Postmenopausal women had higher rates of stone episodes, specifically related to uric acid stones. Given the prevalence and impact of chronic kidney diseases, factors that impede optimal renal function management in women must be identified to provide tailored treatment recommendations.
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Affiliation(s)
- Yii-Her Chou
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Chia Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung, Taiwan; Department of Urology, School of Postbaccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Jeng Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yung-Shun Juan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tsu-Ming Chien
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung, Taiwan; Department of Urology, School of Postbaccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Pricop C, Ivănuță M, Nikolic M, Puia D. Kidney Stones of Type I vs. Type II Diabetic Patients: Are There Any Differences? J Clin Med 2024; 13:6110. [PMID: 39458060 PMCID: PMC11508552 DOI: 10.3390/jcm13206110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 10/11/2024] [Accepted: 10/13/2024] [Indexed: 10/28/2024] Open
Abstract
Background: This study highlighted the differences between the biochemical compositions of urinary stones from patients with type 1 diabetes versus those with type 2 diabetes. Materials and Methods: This study included patients diagnosed with kidney stones and diabetes who were referred to the Urological Clinic of the Dr. C. I. Parhon Hospital in Iasi from April 2017 to April 2024. We analyzed the spectroscopic stone composition from 128 lithiasis patients treated in our Clinic. In the current study, the distribution of the biochemical composition of stones varied significantly between diabetic patients with type 2 diabetes, who formed primarily mixed uric acid stones, and diabetic patients with type 1 diabetes, who mainly developed pure uric acid stones (p < 0.001). Patients with uric acid stones had significantly higher mean creatinine values than the other stone types (p < 0.001). Urinary pH levels were abnormal for all biochemical subtypes of stones, indicating acidic urine. However, patients with uric acid stones had lower pH values than the group average. From the Kaplan-Mayer analysis, patients with pure uric acid stones had a shorter time to stone recurrence compared to patients with other biochemical types identified. Conclusions: These findings, which highlight the prevalence of pure uric acid stones in patients with type 1 diabetes and the impact of this on the strategy for dissolving pure stones, represent a significant advancement in understanding urinary lithiasis in diabetic patients.
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Affiliation(s)
- Cătălin Pricop
- “Grigore T. Popa”, Faculty of Medicine, University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.P.); (D.P.)
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
- Center for Morphological and Spectroscopic Analysis of Urinary Stones “Michel Daudon”, 700503 Iasi, Romania;
| | - Marius Ivănuță
- “Grigore T. Popa”, Faculty of Medicine, University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.P.); (D.P.)
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
- Center for Morphological and Spectroscopic Analysis of Urinary Stones “Michel Daudon”, 700503 Iasi, Romania;
| | - Mihaela Nikolic
- Center for Morphological and Spectroscopic Analysis of Urinary Stones “Michel Daudon”, 700503 Iasi, Romania;
- “Ion Ionescu de la Brad” Iasi University of Life Sciences, 700503 Iasi, Romania
| | - Dragoş Puia
- “Grigore T. Popa”, Faculty of Medicine, University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.P.); (D.P.)
- Department of Urology, “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania
- Center for Morphological and Spectroscopic Analysis of Urinary Stones “Michel Daudon”, 700503 Iasi, Romania;
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Dika Ž, Živko M, Kljajić M, Jelaković B. SGLT2 Inhibitors and Their Effect on Urolithiasis: Current Evidence and Future Directions. J Clin Med 2024; 13:6017. [PMID: 39408078 PMCID: PMC11478155 DOI: 10.3390/jcm13196017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 10/05/2024] [Accepted: 10/07/2024] [Indexed: 10/20/2024] Open
Abstract
Urolithiasis (UL) is increasingly prevalent due to rising cardiorenometabolic diseases, posing significant management challenges despite advances in urological techniques. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, primarily used for type 2 diabetes mellitus, chronic kidney disease, and heart failure, have emerged as a potential novel approach for UL treatment. These inhibitors may help reduce the risk of urolithiasis, particularly in patients with diabetes, by improving glycemic control and altering urinary chemistry, which are crucial factors in stone formation. However, the changes in urinary composition induced by SGLT2 inhibitors might also increase the risk of uric acid stone formation. This review evaluates the potential of SGLT2 inhibitors in managing UL, highlighting both the benefits and the risks. While these inhibitors show promise in reducing new and recurrent urinary stones in patients with diabetes, data on their effects in patients without diabetes who form stones are limited. Current human evidence largely comes from post hoc analyses of randomized controlled trials (RCTs) and large-scale database studies, with only one study providing detailed stone composition data. Experimental studies in animal models and cell lines have focused on calcium oxalate (CaOx) stones, showing that SGLT2 inhibitors specifically target CaOx stone formation and related renal inflammation. Although primarily studied for CaOx stones, their potential impact on other calcium-containing stones, such as calcium phosphate, remains promising. Further research is needed to explore their therapeutic potential and optimize treatment strategies.
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Affiliation(s)
- Živka Dika
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia;
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; (M.Ž.); (M.K.)
| | - Marijana Živko
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; (M.Ž.); (M.K.)
| | - Marina Kljajić
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; (M.Ž.); (M.K.)
| | - Bojan Jelaković
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia;
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; (M.Ž.); (M.K.)
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D’Amico M, Babayan RK, Wang DS, Wason S, Cozier YC. Clinical, Diagnostic, and Metabolic Characteristics Associated with Nephrolithiasis in the Black Women's Health Study. J Clin Med 2024; 13:5948. [PMID: 39408008 PMCID: PMC11477578 DOI: 10.3390/jcm13195948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 10/02/2024] [Accepted: 10/05/2024] [Indexed: 10/20/2024] Open
Abstract
Background/Objectives: Nephrolithiasis (kidney stones) is a frequently occurring urologic condition resulting in significant patient morbidity and healthcare costs. Despite the higher prevalence of metabolic risk factors for nephrolithiasis among Black women, there have been few epidemiologic studies of kidney stones focusing on this group. Methods: We describe demographic and health characteristics, diagnostics, and metabolic profiles of US Black women with self-reported kidney stones. The women were participants in the Black Women's Health Study (BWHS), a large prospective cohort of US Black women (median age 38 years) begun in 1995. Results: Among the 2750 BWHS participants who completed an online supplemental questionnaire assessing urologic health, 201 women reported nephrolithiasis. Of this number, 62% had completed ≥ 16 years of education, and 82% reported access to health care. Overall, 39% reported experiencing ≥ 2 stones in their lifetime, and 29% required surgery to treat the condition. Thirty-two percent reported having completed a metabolic evaluation, while 70% had undergone a CT scan to diagnose nephrolithiasis. The frequency of metabolic evaluation increased with the number of metabolic components reported: 3% (0 components) to 43% (3-4 components). Conclusions: Our findings are consistent with reports of lower rates of metabolic evaluation among Black patients despite their having multiple risk factors for nephrolithiasis. Further study is needed to identify the barriers and facilitators of metabolic and diagnostic workup of nephrolithiasis in Black women.
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Affiliation(s)
- Maria D’Amico
- Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
| | - Richard K. Babayan
- Department of Urology, Boston University/Boston Medical Center, 725 Albany St. Suite 3B, Boston, MA 02118, USA; (R.K.B.); (D.S.W.)
| | - David S. Wang
- Department of Urology, Boston University/Boston Medical Center, 725 Albany St. Suite 3B, Boston, MA 02118, USA; (R.K.B.); (D.S.W.)
| | - Shaun Wason
- Division of Urology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA;
| | - Yvette C. Cozier
- Slone Epidemiology Center at Boston University, Boston University Chobanian & Avedesian School of Medicine, 72 East Concord Street, L-7, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Talbot-3E, Boston, MA 02118, USA
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Shen Y, Zhu Z, Bi X, Shen Y, Shen A, Deng B, He Y, Wang W, Ding F. Association between insulin resistance indices and kidney stones: results from the 2015-2018 National Health and Nutrition Examination Survey. Front Nutr 2024; 11:1444049. [PMID: 39416649 PMCID: PMC11480067 DOI: 10.3389/fnut.2024.1444049] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/18/2024] [Indexed: 10/19/2024] Open
Abstract
Objective To explore the association between representative insulin resistance (IR) indices and the risk of kidney stone disease in an American adult population. The representative IR indices referred to metabolic score for IR (METS-IR), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride glucose-body mass index (TyG-BMI), visceral adiposity index (VAI), and homeostatic model assessment of IR (HOMA-IR). Methods We investigated adult participants who joined the 2015-2018 National Health and Nutrition Examination Survey (NHANES) and reported kidney stone histories. Weighted proportions, multivariable regression analysis, and restricted cubic splines were used to evaluate the associations between IR indices and kidney stones after their adjustment for gender, age, race, education, smoking status, alcohol drinking frequency, hypertension and diabetes status, physical activity level, water intake, and levels of calcium, cholesterol, and uric acid. Results A total of 19,225 participants were included. The weighted prevalence of kidney stone was 11.1%. A multivariable logistic regression model showed a dose-response relationship between the METS-IR and kidney stone [odds ratio (OR) = 1.02, 95% confidence interval (CI) (1.01, 1.04), p < 0.01]. A similar relationship was observed between the TyG-BMI and kidney stone after full adjustment [OR = 1.0, 95% CI (1.0, 1.01), p < 0.001]. Sex-stratified analyses revealed that the association between METS-IR and nephrolithiasis [OR = 1.03, 95% CI (1.01, 1.05), p < 0.01], and the association between TyG-BMI and nephrolithiasis [OR = 1.01, 95% CI (1.0, 1.01), p <0.001] was significant among the male participants in the fully adjusted model. Moreover, a significant association was found between the METS-IR levels and nephrolithiasis [OR = 1.03, 95% CI (1.01, 1.06), p < 0.01], and between the TyG-BMI levels and nephrolithiasis [OR = 1.01, 95% CI (1.0, 1.01), p < 0.05] among the diabetic participants after full adjustment. Furthermore, a potential nonlinear association was found between other IR indices (i.e., TG/HDL-C, VAI, and HOMA-IR) and the risk of kidney stone disease. Conclusion Higher METS-IR and TyG-BMI levels were associated with a higher risk of nephrolithiasis. Future investigations are required to identify the role of IR in the progress of kidney stone formation and to propose prevention measures and health guidelines.
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Affiliation(s)
- Yue Shen
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhu Zhu
- Department of Geriatrics, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Bi
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuqi Shen
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Aiwen Shen
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Deng
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yining He
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenji Wang
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Ding
- Department of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Hall JA, Brockman JA, Brejda JJ, Jewell DE. Metabolomic Changes Associated with AGXT2 Genotype Variants and Stone Formation in a Colony of Cats. Genes (Basel) 2024; 15:1264. [PMID: 39457388 PMCID: PMC11507365 DOI: 10.3390/genes15101264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 09/25/2024] [Accepted: 09/25/2024] [Indexed: 10/28/2024] Open
Abstract
OBJECTIVE The objective of this study was to assess serum chemistries and metabolomic parameters in cats with genetic variants of the alanine-glyoxylate aminotransferase 2 (AGXT2) gene to determine abnormalities associated with urolith formation and better understand effective approaches for the treatment of cats with uroliths. METHODS AGXT2 genotypes of 445 cats in the colony at Hill's Pet Nutrition, Inc. (Topeka, KS, USA) were assessed in a genome-wide association study. Additionally, the serum chemistries and metabolic profiles of each cat were determined, along with their lifetime history of stone incidence. Factor analysis was used as a data-reduction method for metabolites in order to perform statistical hypothesis testing and to select significant metabolites from the more than 600 serum metabolites identified. RESULTS Of the 82 cats forming stones in the colony (18.4%), the majority were calcium oxalate. Results showed that approximately one third of the cats with the AA variant of the AGXT2 gene have stones, that chronic kidney disease (CKD) is more common in cats with stones, and that having stones results in a shorter lifespan. A discriminant variable selection process was performed to determine the complete blood count, serum biochemistries, and serum metabolomic factors that best discriminated among the three genotypes (AA, AG, GG) and between cats forming stones and non-stone formers. Several of the highly ranked discriminating factors included metabolites related to decreased aminotransferase activity in cats with the AA variant of the AGXT2 gene. Another factor that ranked highly for discriminating between stone formers and non-stone formers contained lipid metabolites, consisting of multiple sphingomyelin species and cholesterol. CONCLUSIONS These findings support the results of feeding studies in cats, whereby CKD cats fed food supplemented with betaine and prebiotics have experienced an increase in total body mass, reduced uremic toxins, and altered sphingomyelin concentrations.
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Affiliation(s)
- Jean A. Hall
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
| | - Jeffrey A. Brockman
- Science & Technology Center, Hill′s Pet Nutrition, Inc., Topeka, KS 66617, USA;
| | - John J. Brejda
- Alpha Statistical Consulting, Inc., Lincoln, NE 68502, USA;
| | - Dennis E. Jewell
- Department of Grain Science and Industry, Kansas State University, Manhattan, KS 66506, USA;
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Uysal U, Sagir S, Baris Mogul C, Caner V, Tuncay OL. Expression Profiles of Claudin Gene Family Members in Patients With Recurrent Calcium Oxalate Kidney Stones. Cureus 2024; 16:e70354. [PMID: 39345805 PMCID: PMC11436386 DOI: 10.7759/cureus.70354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2024] [Indexed: 10/01/2024] Open
Abstract
INTRODUCTION In this study, we aimed to evaluate and compare the expression profiles of CLDN gene family members responsible for the mechanism of stone formation in patients with recurrent calcium oxalate stones and in a control group without a history of renal stones. METHODS Nineteen patients with recurrent calcium oxalate renal calculi who underwent percutaneous nephrolithotomy and 21 control patients without renal calculi who underwent surgery for other reasons were included in the study. The urinary calcium, oxalate, and citrate levels of the patients included in the study, as well as those in the control group, were within normal ranges. They did not have proteinuria in their urine. The biochemical parameters were also within normal limits. Biopsy samples taken from the intact renal cortex parenchymal tissue were consistent. Total RNA was isolated from biopsy samples and expression profiles of target genes (Claudin 1-4, 7, 8, 10, 14, 16, 18, 19) were determined by real-time polymerase chain reaction (PCR). RESULTS It was determined that CLDN1 gene expression in patients with recurrent calcium oxalate kidney stones was approximately four times higher than in the control group; this difference was statistically significant (p<0.050). CLDN1 expression was also strongly positively correlated with CLDN4 (r=0.642), CLDN7 (r=0.753) and CLDN14 (r=0.651) Conclusions: We thought that CLDN1 overexpression might play a role in the pathogenesis of recurrent calcium oxalate stone formation. CLDN1 together with CLDN2, CLDN4, CLDN7, and CLDN14 are also probably responsible for this pathogenesis.
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Affiliation(s)
- Umit Uysal
- Department of Urology, Mardin Training and Research Hospital, Mardin, TUR
| | - Süleyman Sagir
- Department of Urology, Mardin Artuklu University, Mardin, TUR
| | - Cansu Baris Mogul
- Department of Medical Biology, School of Medicine, Pamukkale University, Denizli, TUR
| | - Vildan Caner
- Department of Medical Genetics, School of Medicine, Pamukkale University, Denizli, TUR
| | - O Levent Tuncay
- Department of Urology, School of Medicine, Pamukkale University, Denizli, TUR
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Prochaska M, Ferraro PM, Taylor E, Curhan G. Chronic Fructose and Sucrose Intake and 24-Hour Urine Composition. KIDNEY360 2024; 5:1167-1177. [PMID: 39012708 PMCID: PMC11371344 DOI: 10.34067/kid.0000000000000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
Key Points Higher dietary intakes of fructose and sucrose are associated with lower 24-hour urine calcium. Higher dietary intakes of fructose and sucrose are associated with other modest changes in 24-hour urine composition. Background Consumption of sugar, including fructose and sucrose, is associated with higher risk of kidney stones. The association is believed to be because of an acute rise in urine calcium after sugar intake. However, the association between chronic sugar intake and urine composition is not known. Methods We conducted a cross-sectional analysis of dietary intake from a food frequency questionnaire and 24-hour urine collections from 6457 kidney stone- and non–stone-former participants from the Nurses' Health Study I (1,297), Nurses' Health Study II (4,053), and Health Professionals Follow-up Study (1,107). We used multivariate adjusted linear regression to examine the association between long-term intake of free fructose, total fructose, and sucrose and 24-hour urine composition. Results Higher free and total fructose and sucrose intakes were each associated with lower 24-hour urine calcium. Comparing the highest versus lowest quintiles, mean urine calcium was 23 (31–15) mg/d lower for free fructose (P -trend <0.001), 26 (34–18) mg/d for total fructose (P -trend <0.001), and 8 (17–1) mg/d for sucrose (P -trend 0.03). Higher total fructose intake was associated with slightly higher calcium phosphate supersaturation (P -trend 0.002), and higher sucrose intake was associated with higher calcium oxalate (P -trend 0.03) and calcium phosphate (P -trend <0.001) supersaturations. Differences in 24-hour urine calcium were similar between kidney stone- and non–stone-former participants. Conclusions In contrast to the acute rise in urine calcium previously seen in short-term studies, higher long-term intake of free and total fructose and sucrose was associated with lower 24-hour urine calcium excretion in those with and without a history of kidney stones. Other modest differences in urine composition were noted for each sugar. Future studies should test potential mechanisms for the observed lower 24-hour urine calcium with chronic sugar intake.
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Affiliation(s)
- Megan Prochaska
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Pietro Manuel Ferraro
- Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
| | - Eric Taylor
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
- Tufts University School of Medicine, Boston, Massachusetts
| | - Gary Curhan
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
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Cheng Y, Zheng H, Yin H, Yin D, Wang H, Wang Y, Tang Q, Gu S. Changes in metabolic overweight phenotypes over time and risk of nephrolithiasis: a cohort study. BMC Public Health 2024; 24:1898. [PMID: 39014388 PMCID: PMC11251252 DOI: 10.1186/s12889-024-19229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Overweight/obesity is considered an independent risk factor for nephrolithiasis, but little is known about its effect on nephrolithiasis according to metabolic health status. OBJECTIVES We aimed to investigate the association between various metabolic overweight phenotypes and the occurrence of nephrolithiasis. It also explores whether changes in these phenotypes over time influence the risk of nephrolithiasis. MATERIALS AND METHODS A total of 10,315 participants free of nephrolithiasis who underwent an annual health checkup from 2017 to 2022 were included in our prospective cohort study. They were categorized into four groups according to the presence of overweight and metabolic abnormalities (MA). The primary endpoint was the occurrence of renal stones. Multivariable Cox analysis was conducted to elucidate the relationship between metabolic overweight phenotypes and incident nephrolithiasis. RESULTS During a median follow-up duration of 4.02 years, nephrolithiasis occurred in 1,468 (14.23%) participants. In the full cohort, we observed that the 5-year cumulative incidences of nephrolithiasis were highest in the metabolically healthy overweight (MHO) and metabolically abnormal overweight (MAO) groups. The hazard ratios (HRs) for nephrolithiasis, relative to metabolically healthy normal weight (MHNW), ranged from 1.19 (95% CI:1.03-1.37; MHO) to 1.32 (95% CI:1.15-1.51; MAO). Furthermore, individuals with persistent MHO throughout follow-up were at a 1.42-fold increased risk of nephrolithiasis (P < 0.001), and 32.17% of individuals experienced changes in phenotype during follow-up. Among MAO subjects, those who transitioned to MHO and MHNW had a 26% and 45% lower risk of incident nephrolithiasis, respectively, compared to those who persisted in the MAO phenotype. CONCLUSION Individuals in the MHO and MAO groups exhibit an elevated risk of incident nephrolithiasis in this prospective cohort study. A significant proportion of nephrolithiasis cases may be potentially preventable through the appropriate management of metabolic risk factors for MAO subjects.
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Affiliation(s)
- Yang Cheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Zheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hongli Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Donghua Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Ying Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China.
| | - Qiang Tang
- School of Sports and Health, Nanjing Sport Institute, 8 Ling-Gu Temple Road, Nanjing, 210014, China.
- Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, China.
| | - Shouyong Gu
- Institute of Geriatric Medicine, Jiangsu Province Geriatric Hospital, 65 Jiang-Su Road, Nanjing, 210009, China.
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Sáenz-Medina J, Gómez Dos Santos V, Rodríguez-Monsalve M, Muriel-García A, Durán-Poveda M, Gómez del Val A, Burgos Revilla J, Prieto D. Cardiovascular and Cerebrovascular Morbidity in Patients with Urolithiasis: An Epidemiological Approach Based on Hospitalization Burden Data from 1997 to 2021. J Clin Med 2024; 13:3564. [PMID: 38930093 PMCID: PMC11204873 DOI: 10.3390/jcm13123564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/02/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Patients with kidney stones (KSFs) are known to have a heightened risk of coronary heart disease (CHD) or stroke. The objective of the present study was to describe the natural history of these complications through the longitudinal analysis of the hospitalizations due to kidney stones in Spain from 1997 to 2021. Methods: A retrospective longitudinal observational study was developed based on nationwide hospitalization data (minimum basic data base). Three different analyses were carried out. In the first step, the prevalence of coronary or cerebrovascular events in kidney stone hospitalizations was compared with the hospitalization burden of CHD or strokes related to the general population. In the second step, a survival analysis of the kidney stones-hospitalized patients using the Kaplan-Meier method was conducted. In the third step, a Cox regression was used to assess the influence of the classical comorbidities in the development of the lithiasic patients-cardiovascular disease. Results: Kidney stone-hospitalized patients exhibit a significantly higher risk of CHD (OR = 14.8 CI95%: 14.7-14.9) and stroke (OR = 6.7 CI95%: 6.6-6.8) compared to the general population across in all age groups, although they had less cardiovascular risk factors. A total of 9352 KSFs (1.5%) developed a coronary event within an average time of 78.8 months. A total of 2120 KSFs (0.33%) suffered a stroke in an average time of 71.1 months. Diabetes, hypertension, hyperlipidemia, and being overweight were identified as risk factors for developing CHD and stroke using a univariate and multivariate analysis. Conclusions: Our study confirms previous studies in which kidney stones must be considered as a risk factor for developing CHD or cerebrovascular disease. Preventive strategies should target patients with kidney stones and classical risk cardiovascular factors to mitigate modifiable conditions associated with cardiovascular diseases.
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Affiliation(s)
- Javier Sáenz-Medina
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, Calle Manuel de Falla, 1, 28222 Majadahonda, Spain;
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28922 Madrid, Spain; (M.D.-P.); (D.P.)
| | | | - María Rodríguez-Monsalve
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, Calle Manuel de Falla, 1, 28222 Majadahonda, Spain;
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28922 Madrid, Spain; (M.D.-P.); (D.P.)
| | - Alfonso Muriel-García
- Department of Clinical Biostatistics, Ramón y Cajal University Hospital, 28034 Madrid, Spain;
| | - Manuel Durán-Poveda
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28922 Madrid, Spain; (M.D.-P.); (D.P.)
| | - Alfonso Gómez del Val
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain;
| | - Javier Burgos Revilla
- Department of Urology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (V.G.D.S.); (J.B.R.)
| | - Dolores Prieto
- Department of Medical Specialties and Public Health, King Juan Carlos University, 28922 Madrid, Spain; (M.D.-P.); (D.P.)
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Yan B, Yu J, Fang Q, Qiu H, Shen C, Wang J, Li J, Huang Y, Dai L, Zhi Y, Li W. Association between kidney stones and poor sleep factors in U.S. adults. Medicine (Baltimore) 2024; 103:e38210. [PMID: 38758878 PMCID: PMC11098211 DOI: 10.1097/md.0000000000038210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/19/2024] [Indexed: 05/19/2024] Open
Abstract
The purpose of our study is to examine the correlation between sleep factors and the prevalence of kidney stones in US adults. A total of 34,679 participants from the National Health and Nutrition Examination Survey 2007 to 2018 were included in the analyses. Sleep data collection included: presleep factors (difficulty falling asleep, sleep onset latency), intra-sleep factors (risk index of obstructive sleep apnea, restless leg syndrome, difficulty maintaining sleep), post-sleep factors (daytime sleepiness, non-restorative sleep), sleep schedule and duration, and sleep quality. Logistic regression models were used to analyze the correlation between sleep factors and the prevalence of kidney stones. Among the 34,679 participants, the overall incidence of kidney stones was 9.3%. The presence of presleep factors (difficulty falling asleep [odds ratios [OR], 1.680; 95% CI, 1.310-2.150], prolonged sleep onset latency [OR, 1.320; 95% CI, 1.020-1.700]), intra-sleep factors (higher risk index of obstructive sleep apnea [OR, 1.750; 95% CI, 1.500-2.050], restless leg syndrome [OR, 1.520; 95% CI, 1.150-1.990], difficulty maintaining sleep [OR, 1.430; 95% CI, 1.130-1.810]), post-sleep factors (daytime sleepiness [OR, 1.430; 95% CI, 1.220-1.680], non-restorative sleep [OR, 1.400; 95% CI, 1.110-1.760]), short sleep duration (OR, 1.190; 95% CI, 1.080-1.310), mediate sleep quality (OR, 1.140; 95% CI, 1.020-1.290), and poor sleep quality (OR, 1.500; 95% CI, 1.310-1.720) are linked to the occurrence of kidney stones. However, short sleep onset latency, bedtime and wake-up time were not significantly associated with the prevalence of kidney stones. These findings showed positive associations between higher kidney stone prevalence and poor sleep factors.
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Affiliation(s)
- Benhuang Yan
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yu
- Department of Psychiatry, Shanghai 10th People’s Hospital, Anesthesia and Brain Research Institute, Tongji University, Shanghai, P.R. China
| | - Qiang Fang
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Heping Qiu
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chongxing Shen
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianwu Wang
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinjin Li
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuandi Huang
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linyong Dai
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Zhi
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weibing Li
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Mao X, Yang Y, Yang J, Chen M, Hao Z. Association between body roundness index and prevalence of kidney stone in the U.S: a study based on the NHANES database. BMC Urol 2024; 24:93. [PMID: 38643130 PMCID: PMC11031997 DOI: 10.1186/s12894-024-01433-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the potential association between the body roundness index (BRI) and kidney stone prevalence in adults in the United States. METHODS A cohort of participants from the National Health and Nutrition Examination Survey (NHANES) database spanning 2007-2018 were gathered for analysis. Logistic regression analyses, subgroup assessments, and calculations were employed to examine the potential link between BRI and kidney stone prevalence. RESULTS The study included 30,990 participants aged > 20 years, of which 2,891 declared a kidney stone history. After modulating all relevant confounding factors, each unit increase in the BRI was linked to a 65% increase in kidney stone prevalence (OR = 1.65, 95% CI: 1.47, 1.85). Sensitivity analyses conducted by categorizing the BRI into three groups revealed a 59% increase in kidney stone prevalence in the highest tertile BRI group compared to the lowest one (OR = 1.59, 95% CI: 1.42, 1.79). Furthermore, dose-response curves depicted a positive near-linear correlation between the BRI and the risk of kidney stone prevalence. CONCLUSION These findings suggest a clinically noteworthy positive correlation between higher BRI values and kidney stone prevalence among the studied US adult population. However, it is essential to acknowledge that the observed relationship does not establish a causal link.
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Affiliation(s)
- Xike Mao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yuehan Yang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Junping Yang
- Department of General Practice, Wuhu City SecondPeoplès Hospital, Wuhu, Anhui, China
| | - Mingwei Chen
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Zongyao Hao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China.
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Cheraghian B, Meysam A, Hashemi SJ, Hosseini SA, Malehi AS, Khazaeli D, Rahimi Z. Kidney stones and dietary intake in adults: a population-based study in southwest Iran. BMC Public Health 2024; 24:955. [PMID: 38575950 PMCID: PMC10993538 DOI: 10.1186/s12889-024-18393-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The prevalence of kidney stones is on the rise globally. Several risk factors, including lifestyle, contribute to the formation of kidney stones. Nevertheless, there is a contentious debate about the relationship between diet and kidney stones. Therefore, our study aimed to assess the relationship between macronutrients and micronutrients and the formation of kidney stones. METHODS This population-based cross-sectional study was conducted in the baseline phase of the Hoveyzeh Cohort Study, focusing on adults aged 35-70 in southwest Iran. The information on demographic characteristics, anthropometrics, kidney stone history, and food frequency was collected. Chi-square and t-tests were utilized to assess the relationship between categorical and numerical variables with kidney stones. The ANCOVA and logistic regression models were used to evaluate the relationships while controlling for confounding factors. RESULTS Among 10,009 participants, the overall prevalence of kidney stones was 18.77% (95% CI: 17.99-19.53). A higher intake of carbohydrates [OR = 1.02 (95% CI:1.002-1.03), p = 0.026] and copper [OR = 1.04 (95% CI:1.01-1.09), p = 0.025] were found to be associated with kidney stones. No associations were found between the other assessed macronutrients or micronutrients and kidney stones (p-tvalues > 0.05). CONCLUSION Our study's findings indicate a correlation between diet and the formation of kidney stones. However, the relationship between dietary factors and kidney stones is complex, and further research is needed.
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Affiliation(s)
- Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alipour Meysam
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Clinical Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dinyar Khazaeli
- Department of Urology, School of Medicine, Chronic Renal Failure Research Center Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zeng H, Liu Z, He Y, Chen H, He J, Liu M, Wu S, He H, Huang C, Xu R. Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04021-9. [PMID: 38564076 DOI: 10.1007/s11255-024-04021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi. METHODS We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins. RESULTS The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)]. CONCLUSIONS Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.
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Affiliation(s)
- Hongbo Zeng
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziyi Liu
- Department of Emergency Medicine, The Second Xiangya Hospital of Central-South University, Emergency and Difficult Diseases Institute of Central South University, Changsha, China
| | - Yunhui He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huixiang Chen
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingke Liu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuiqing Wu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiqing He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Changkun Huang
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Persaud SA, Jankie S, Andrews R, Varachhia S, Morris M. High Self-Reported Prevalence of Kidney Stones in Trinidad and Tobago: Results of a Cross-Sectional Online Survey. Cureus 2024; 16:e57651. [PMID: 38707028 PMCID: PMC11070117 DOI: 10.7759/cureus.57651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction No data exist on the prevalence of kidney stone disease in Trinidad and Tobago. Local clinicians have noted that the disease is very common, and this study represents the first attempt to investigate the prevalence of urolithiasis in these islands. Objectives The objective is to estimate the prevalence of kidney stone disease in Trinidad and Tobago and to investigate the epidemiology of the disease. Methods An online survey using the online tool Survey Monkey was distributed among members of the public via instant messaging and social media. The survey captured data relating to the stone status and demographics of respondents. Results 1225 patients completed the survey of whom 46.5% were males and 53.5% were females. Respondents were equally distributed throughout the country. 16.74% of those surveyed indicated that they were currently affected by stones confirmed by imaging. Kidney stones were more common among Trinidadians of East Indian ancestry (20.6% vs 10.6%). Positive correlations were established between kidney stones and the presence of hypertension, diabetes, and gout. Persons with kidney stones were more likely to have a family member with the disease - 45.6% vs 31.4% among those without kidney stones. Conclusion This study demonstrates a high self-reported prevalence of kidney stones in Trinidad and Tobago.
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Affiliation(s)
- Satyendra A Persaud
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Satish Jankie
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Roger Andrews
- Department of Physics, University of the West Indies, St Augustine, TTO
| | - Saleem Varachhia
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
| | - Michael Morris
- Faculty of Medical Sciences, University of the West Indies, St Augustine, TTO
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Wang JH, Bao EH, Chen GY, Liu Y, Yang L, Wang JJ, Liu Y, Zhu PY, Li T. A positive association between BMI and kidney stones among the diabetic population: a cross-sectional study from NHANES. World J Urol 2024; 42:142. [PMID: 38478086 DOI: 10.1007/s00345-024-04861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/08/2024] [Indexed: 01/04/2025] Open
Abstract
BACKGROUND In the past, research has shown that a higher body mass index (BMI) is one of the variables that increase the likelihood of kidney stones; however, no studies have found a connection between the two in the type II diabetic population. The purpose of this research is to reveal the association between BMI and kidney stones in the type II diabetic population. METHODS We selected demographic data, laboratory data, lifestyle, and medical history from the NHANES. Specifically includes age, gender, systemic immune-inflammation index (SII), poverty income rate (PIR), body mass index (BMI), kidney stones, education, coronary artery disease, smoking, and drinking. RESULTS BMI and kidney stones were shown to have a positive association in type II diabetics (blood sugar level > 7.0 mmol/L or diagnosed by a doctor) (OR = 1.021, 95% CI 1.008-1.033, P = 0.001), even after controlling for factors, such as age, gender, race, education level, coronary heart disease, smoking, and drinking. The subgroup analysis revealed a more significant positive association among the 67-80 years, female and Non-Hispanic White population. CONCLUSIONS There is a positive correlation between BMI and kidney stones among the type II diabetic population.
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Affiliation(s)
- Jia Hao Wang
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Er Hao Bao
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Gui Yuan Chen
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Ying Liu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Lin Yang
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Jun Ji Wang
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Yang Liu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China
| | - Ping Yu Zhu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China.
| | - Tao Li
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, 1 MaoYuan Nan Road, Nanchong, 637000, Sichuan, China.
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Chen HW, Lee JT, Wei PS, Chen YC, Wu JY, Lin CI, Chou YH, Juan YS, Wu WJ, Kao CY. Machine learning models for screening clinically significant nephrolithiasis in overweight and obese populations. World J Urol 2024; 42:128. [PMID: 38460023 DOI: 10.1007/s00345-024-04826-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/16/2024] [Indexed: 03/11/2024] Open
Abstract
PURPOSES Our aim is to build and evaluate models to screen for clinically significant nephrolithiasis in overweight and obesity populations using machine learning (ML) methodologies and simple health checkup clinical and urine parameters easily obtained in clinics. METHODS We developed ML models to screen for clinically significant nephrolithiasis (kidney stone > 2 mm) in overweight and obese populations (body mass index, BMI ≥ 25 kg/m2) using gender, age, BMI, gout, diabetes mellitus, estimated glomerular filtration rate, bacteriuria, urine pH, urine red blood cell counts, and urine specific gravity. The data were collected from hospitals in Kaohsiung, Taiwan between 2012 and 2021. RESULTS Of the 2928 subjects we enrolled, 1148 (39.21%) had clinically significant nephrolithiasis and 1780 (60.79%) did not. The testing dataset consisted of data collected from 574 subjects, 235 (40.94%) with clinically significant nephrolithiasis and 339 (59.06%) without. One model had a testing area under curve of 0.965 (95% CI, 0.9506-0.9794), a sensitivity of 0.860 (95% CI, 0.8152-0.9040), a specificity of 0.947 (95% CI, 0.9230-0.9708), a positive predictive value of 0.918 (95% CI, 0.8820-0.9544), and negative predictive value of 0.907 (95% CI, 0.8756-0.9371). CONCLUSION This ML-based model was found able to effectively distinguish the overweight and obese subjects with clinically significant nephrolithiasis from those without. We believe that such a model can serve as an easily accessible and reliable screening tool for nephrolithiasis in overweight and obesity populations and make possible early intervention such as lifestyle modifications and medication for prevention stone complications.
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Affiliation(s)
- Hao-Wei Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jung-Ting Lee
- School of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Pei-Siou Wei
- Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yu-Chen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jeng-Yih Wu
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-I Lin
- Health Management Center, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Yii-Her Chou
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Jeng Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Yao Kao
- Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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Paik JM, Tesfaye H, Curhan GC, Zakoul H, Wexler DJ, Patorno E. Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes. JAMA Intern Med 2024; 184:265-274. [PMID: 38285598 PMCID: PMC10825784 DOI: 10.1001/jamainternmed.2023.7660] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/21/2023] [Indexed: 01/31/2024]
Abstract
Importance Type 2 diabetes (T2D) is associated with an increased risk of kidney stones. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) might lower the risk of nephrolithiasis by altering urine composition. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US. Objective To investigate the association between SGLT2i use and nephrolithiasis risk in clinical practice. Design, Setting, and Participants This new-user, active comparator cohort study used data from commercially insured adults (aged ≥18 years) with T2D who initiated treatment with SGLT2is, glucagon-like peptide 1 receptor agonists (GLP-1RAs), or dipeptidyl peptidase 4 inhibitors (DPP4is) between April 1, 2013, and December 31, 2020. The data were analyzed from July 2021 through June 2023. Exposure New initiation of an SGLT2i, GLP-1RA, or DPP4i. Main Outcomes and Measures The primary outcome was nephrolithiasis diagnosed by International Classification of Diseases codes in the inpatient or outpatient setting. New SGLT2i users were 1:1 propensity score matched to new users of a GLP-1RA or DPP4i in pairwise comparisons. Incidence rates, rate differences (RDs), and estimated hazard ratios (HRs) with 95% CIs were calculated. Results After 1:1 propensity score matching, a total of 716 406 adults with T2D (358 203 pairs) initiating an SGLT2i or a GLP-1RA (mean [SD] age, 61.4 [9.7] years for both groups; 51.4% vs 51.2% female; 48.6% vs 48.5% male) and 662 056 adults (331 028 pairs) initiating an SGLT2i or a DPP4i (mean [SD] age, 61.8 [9.3] vs 61.7 [10.1] years; 47.4% vs 47.3% female; 52.6% vs 52.7% male) were included. Over a median follow-up of 192 (IQR, 88-409) days, the risk of nephrolithiasis was lower in patients initiating an SGLT2i than among those initiating a GLP-1RA (14.9 vs 21.3 events per 1000 person-years; HR, 0.69 [95% CI, 0.67-0.72]; RD, -6.4 [95% CI, -7.1 to -5.7]) or a DPP4i (14.6 vs 19.9 events per 1000 person-years; HR, 0.74 [95% CI, 0.71-0.77]; RD, -5.3 [95% CI, -6.0 to -4.6]). The association between SGLT2i use and nephrolithiasis risk was similar by sex, race and ethnicity, history of chronic kidney disease, and obesity. The magnitude of the risk reduction with SGLT2i use was larger among adults aged younger than 70 years vs aged 70 years or older (HR, 0.85 [95% CI, 0.79-0.91]; RD, -3.46 [95% CI, -4.87 to -2.05] per 1000 person-years; P for interaction <.001). Conclusions and Relevance These findings suggest that in adults with T2D, SGLT2i use may lower the risk of nephrolithiasis compared with GLP-1RAs or DPP4is and could help to inform decision-making when prescribing glucose-lowering agents for patients who may be at risk for developing nephrolithiasis.
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Affiliation(s)
- Julie M. Paik
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Helen Tesfaye
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Gary C. Curhan
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Heidi Zakoul
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Deborah J. Wexler
- Harvard Medical School, Boston, Massachusetts
- Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Elisabetta Patorno
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Gui Z, Yu L, Chen Y, Zhang M, He J, Hao Y. Study from the United States: increased prevalence of kidney stones in patients with high weight-adjusted waist index. Front Nutr 2024; 10:1171775. [PMID: 38299185 PMCID: PMC10828009 DOI: 10.3389/fnut.2023.1171775] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/13/2023] [Indexed: 02/02/2024] Open
Abstract
Objective Using data from NHANES 2007-2018, to examine the association between WWI (weight-adjusted waist index) index and prevalence of kidney stones. Methods Using multiple logistic regression analysis of the National Health and Nutrition Examination Survey (NHANES) 2007-2018, we evaluated the association between WWI index and the prevalence of kidney stones, followed by subgroup analysis of sensitive populations. Smooth curve fitting was used to determine whether there was a non-linear relationship between the WWI index and kidney stone prevalence, and threshold effect analysis was used to test this relationship. Results Among 29,280 participants, 2,760 self-reported renal calculi. After adjustment for all confounders, there was a positive association between WWI and kidney stone prevalence (OR = 1.20, 95% CI: 1.12, 1.28), and this positive association was stronger with increasing WWI (and P = 0.01 for trend). Our results indicate a non-linear positive correlation between WWI index and kidney stones, with the saturation threshold effect analysis and the most important threshold value at 11.02. According to subgroup analysis, WWI showed the strongest association with kidney stone prevalence in participants aged 20-39 years, males, other US ethnic groups, and participants without hypertension and diabetes. Conclusion Increased WWI is positively associated with increased incidence of kidney stones, and increased WWI is a high risk for kidney stones that should be treated with caution. This association should be more pronounced in people between the ages of 20 and 39 years, in men, in other US ethnic populations, and in participants who do not have hypertension or diabetes.
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Affiliation(s)
- Zhaohua Gui
- Division of Life Sciences and Medicine, Department of Pathology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Longshan Yu
- Division of Life Sciences and Medicine, Department of Emergency Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Yan Chen
- Department of General Practice, Wuhu City Second People’s Hospital, Wuhu, China
| | - Mingxun Zhang
- Division of Life Sciences and Medicine, Department of Pathology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Jie He
- Division of Life Sciences and Medicine, Department of Pathology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Yunwu Hao
- Department of Urology, Lu’an Hospital Affiliated of Anhui Medical University (Lu an City People’s Hospital), Lu’an, Anhui, China
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Manoharan V, Sharma G, Devana SK, Sharma S, Avti P, Chandramouli S. A prospective case-control study on the evaluation of oxidative stress in renal stone formers. Urolithiasis 2024; 52:18. [PMID: 38165517 DOI: 10.1007/s00240-023-01514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/26/2023] [Indexed: 01/03/2024]
Abstract
Association of increased oxidative stress (OS) with the pathophysiology of renal stone formation has not been explored greatly in the field of urolithiasis. In this prospective case-control study, we measured 24-h urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in patients with urolithiasis and compared them with matched healthy controls. We also measured 24-h urinary uric acid, calcium, oxalate, and citrate levels in patients with renal stone disease and studied their relation with urinary 8-OHdG levels. Seventy-five cases of renal stone disease and 75 well-matched controls were included. Median 24-h urinary 8-OHdG levels were significantly higher in cases compared to controls (7.6 vs. 3.7 µg/g of creatinine; p < 0.000). Receiver-operating curve (ROC) analysis for 8-OHdG between cases and controls revealed an area under the curve of 0.90. At 8-OHdG (µg/g of creatinine) value of 5 or more, a sensitivity and a specificity of 84% each were obtained. A positive correlation between 8-OHdG (µg/g of creatinine) and 24-h urinary oxalate level was noted (r = 0.461, p = 0.000). No correlation between 8-OHdG (µg/g of creatinine) and other variables was noted. On multivariate linear regression analysis, we noted 24-h urinary oxalate levels to be an independent predictor of urinary 8-OHdG levels. OS is significantly higher in patients with renal stone diseases compared to healthy controls. Urinary oxalate levels were significantly correlated with urinary 8-OHdG levels.
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Affiliation(s)
- V Manoharan
- Department of Urology, PGIMER, Chandigarh, India
| | - G Sharma
- Department of Urology, PGIMER, Chandigarh, India
| | - S K Devana
- Department of Urology, PGIMER, Chandigarh, India.
| | - S Sharma
- Department of Biochemistry, PGIMER, Chandigarh, India
| | - P Avti
- Department of Biophysics, PGIMER, Chandigarh, India
| | - S Chandramouli
- Department of General Surgery, PGIMER, Chandigarh, India
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Suarez Arbelaez MC, Nackeeran S, Shah K, Blachman-Braun R, Bronson I, Towe M, Bhat A, Marcovich R, Ramasamy R, Shah HN. Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States. Ann Med 2023; 55:2197293. [PMID: 37036830 PMCID: PMC10088970 DOI: 10.1080/07853890.2023.2197293] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/25/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases. MATERIALS AND METHODS Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p < .05. RESULTS BMI > 30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p < .05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p < .05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations. CONCLUSIONS MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease.Key messagesOverall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases.Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated.Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases.
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Affiliation(s)
| | - Sirpi Nackeeran
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Khushi Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruben Blachman-Braun
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isaac Bronson
- UMass Chann Medical School, University of Massachusetts, Amherst, MA, USA
| | - Maxwell Towe
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abhishek Bhat
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Marcovich
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hemendra N. Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Khan J, Shaw S. Risk of multiple lower and upper urinary tract problems among male older adults with type-2 diabetes: a population-based study. Aging Male 2023; 26:2208658. [PMID: 37256730 DOI: 10.1080/13685538.2023.2208658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
AIM This study explores the risk of diabetes-associated lower and upper urinary tract diseases among male older adults aged 45 and above in India. METHODS Longitudinal Ageing Study in India (LASI), 2017-2018 data was used in this study. The prevalence of various urinary tract problems and diabetes among male older adults was estimated by background characteristics using bivariate cross-tabulation. In addition, multivariate logistic regression was applied to examine the likelihood of urological disorders associated with diabetes. RESULT The prevalence of incontinence was highest among male older adults with diabetes, followed by kidney stones, benign prostatic hyperplasia, and chronic renal failure. Multivariate logistic regression estimation showed that men diagnosed with diabetes were 80% more likely to experience chronic renal failure, 78% more likely to suffer from incontinence, and 37% more likely to suffer from kidney stones than those without diabetes when controlling for various socio-demographic, behavioral, and co-morbidity status of the older adults. CONCLUSIONS The study findings suggest that diabetes is associated with multiple urinary complications among male older adults in India and needs more careful investigation of the phenomenon. Independent risk factors such as changes in lifestyle with regular monitoring and diagnosis may help to prevent the progression of diabetes and reduce the risk of diabetes-associated lower and upper urinary tract diseases among male older adults.
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Affiliation(s)
- Junaid Khan
- International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- International Institute for Population Sciences, Mumbai, India
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Courbebaisse M, Travers S, Bouderlique E, Michon-Colin A, Daudon M, De Mul A, Poli L, Baron S, Prot-Bertoye C. Hydration for Adult Patients with Nephrolithiasis: Specificities and Current Recommendations. Nutrients 2023; 15:4885. [PMID: 38068743 PMCID: PMC10708476 DOI: 10.3390/nu15234885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24 h urine volume, which, under physiological conditions, approximately reflects daily fluid intake. The aim of this study is to synthesize and highlight the role of hydration in the treatment of nephrolithiasis. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) and also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake to at least at 2.5 L/day to prevent stone formation, and even to 3.5-4 L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate, or magnesium content). Finally, some additional advice has to be given to avoid certain beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.
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Affiliation(s)
- Marie Courbebaisse
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Institut Necker Enfants Malades, Inserm U1151, F-75015 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Simon Travers
- Équipe Biologie, Lip(Sys)2, EA7357, UFR de Pharmacie, Université Paris-Saclay, F-91400 Orsay, France
- Clinical Chemistry Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France
| | - Elise Bouderlique
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Arthur Michon-Colin
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Michel Daudon
- Department of Multidisciplinary Functional Explorations, Tenon Hospital, AP-HP, F-75019 Paris, France
| | - Aurélie De Mul
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, F-69500 Bron, France
| | - Laura Poli
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
| | - Stéphanie Baron
- Faculté de Médecine, Université Paris Cité, F-75006 Paris, France
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
| | - Caroline Prot-Bertoye
- Physiology—Functional Explorations Department, Georges Pompidou European Hospital, AP-HP, F-75015 Paris, France (C.P.-B.)
- Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte (MARHEA), F-75015 Paris, France
- Centre de Référence des Maladies Rares du Calcium et du Phosphate, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, F-75006 Paris, France
- CNRS ERL 8228—Laboratoire de Physiologie Rénale et Tubulopathies, F-75006 Paris, France
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Lin G, Zhan F, Ren W, Pan Y, Wei W. Association between novel anthropometric indices and prevalence of kidney stones in US adults. World J Urol 2023; 41:3105-3111. [PMID: 37716933 DOI: 10.1007/s00345-023-04582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/15/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Our aim is to evaluate the relationship between prevalence of kidney stones (KS) and novel anthropometric indices (AHIs). METHODS Participants who participated in the KS questionnaire was extracted from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018.A series of covariates were also obtained. The novel AHIs include a body shape index (ABSI) and body roundness index (BRI). Weighted multivariable-adjusted logistic regression was performed to investigate the association of KS with AHIs. RESULTS After relative covariates were adjusted, a greater risk of KS for each z score increase in ABSI (OR = 1.13, 95%CI 1.05-1.22), and the risk of KS augmented by 19% for every 1 BRI z score added (OR = 1.19, 95%CI 1.11-1.27). The results from subgroup analysis showed that among adults aged 20-39 (OR = 1.31, 95%CI 1.04-1.65), male (OR = 1.14, 95%CI 1.02-1.28), the risk of KS is higher with the increase of each ABSI z score. Raising each BRI z score in those who were male aged 20-39 and 40-59 resulted in a higher risk of KS (aged 20-39: OR = 1.34, 95%CI 1.06-1.69; aged 40-59: OR = 1.29, 95%CI 1.09-1.53). In female aged 40-59, increasing each BRI z score led to a higher risk of KS (OR = 1.23, 95%CI 1.07-1.41). A linear association of ABSI z score with the risk of KS and a non-linear relationship between BRI z score and the risk of KS were discovered. CONCLUSION This study found that the novel AHIs was related to the risk of kidney stones, and can be used as important indicators to evaluate the risk of KS.
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Affiliation(s)
- Gaoteng Lin
- Department of Urology, The 900th Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Fangfang Zhan
- Department of Rehabilitation, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, Fujian, China
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350000, Fujian, China
| | - Wenjun Ren
- Department of Urology, The 900th Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Yan Pan
- Department of Laboratory Science, Lianshui People's Hospital of Kangda College Affiliated to Nanjing Medical University, Jiang Su, 223400, China
| | - Wanqing Wei
- Department of Urology, Lianshui People's Hospital of Kangda College Affiliated to Nanjing Medical University, Jiang Su, 223400, China.
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