Carboxymethylated Desmodium styracifolium polysaccharide reduces the risk of calcium oxalate kidney stone formation by inhibiting crystal adhesion and promoting crystal endocytosis.

The inhibition of cell surface crystal adhesion and an appropriate increase in crystal endocytosis contribute to the inhibition of kidney stone formation. In this study, we investigated the effects of different degrees of carboxymethylation on these processes. An injury model was established by treating human renal proximal tubular epithelial (HK-2) cells with 98.3 ± 8.1 nm calcium oxalate dihydrate (nanoCOD) crystals. The HK-2 cells were protected with carboxy (-COOH) Desmodium styracifolium polysaccharides at 1.17% (DSP0), 7.45% (CDSP1), 12.2% (CDSP2), and 17.7% (CDSP3). Changes in biochemical indexes and effects on nanoCOD adhesion and endocytosis were detected. The protection of HK-2 cells from nanoCOD-induced oxidative damage by carboxymethylated Desmodium styracifolium polysaccharides (CDSPs) is closely related to the protection of subcellular organelles, such as mitochondria. CDSPs can reduce crystal adhesion on the cell surface and maintain appropriate crystal endocytosis, thereby reducing the risk of kidney stone formation. CDSP2 with moderate -COOH content showed the strongest protective activity among the CDSPs.

Thiazides for kidney stone recurrence prevention.

PURPOSE OF REVIEW: Kidney stones are the most common condition affecting the kidney, and characterized by a high rate of recurrence. Thiazide and thiazide-like diuretics (thiazides) are commonly prescribed to prevent the recurrence of kidney stones. This review offers a comprehensive up-to-date assessment of the evidence supporting the use of thiazides for kidney stone recurrence prevention, highlights potential harms associated with treatment, and identifies areas of knowledge that require further investigation. RECENT FINDINGS: The clinical routine to prescribe thiazides for kidney stone prevention has recently been challenged by the findings of the large NOSTONE trial that failed to show superiority of hydrochlorothiazide at doses up to 50 mg daily over placebo in preventing a composite of clinical or radiological recurrence in patients at high risk of recurrence. Yet, adverse events such as new onset diabetes mellitus and gout were more common in patients receiving hydrochlorothiazide compared to placebo. As demonstrated by a novel meta-analysis presented in this review encompassing all randomized placebo-controlled trials with thiazide monotherapy, current trial evidence does not indicate that thiazide monotherapy is significantly better than placebo in preventing kidney stone recurrence. SUMMARY: Given the limited efficacy and possible adverse effects, we advocate for a restrictive use of thiazides for kidney stone recurrence prevention. Clearly, there remains a high unmet medical need for effective, targeted therapies to prevent recurrence of kidney stones.

Leveraging behavioral modification technology for the prevention of kidney stones.

PURPOSE OF REVIEW: The purpose of this review is to examine the use of technology to help promote and maintain behaviors that decrease stone recurrence. RECENT FINDINGS: Behavior change is a complex process with various interacting components. Recent developments have sought to utilize technology in combination with behavioral change techniques to promote behavior that lowers stone recurrence risk. Smart water bottles are becoming a popular way to accurately measure fluid intake with variable impact on adherence to the recommended daily fluid intake. Mobile apps have also been explored as a method to improve fluid intake. Interventions that combine smart water bottles, mobile apps, and behavioral change techniques have shown the most promise in promoting increased daily fluid intake. Other technologies, such as smart pill dispensers and hydration monitors, have potential applications in promoting behavioral change for stone disease but have yet to be evaluated for this purpose. SUMMARY: There is a limited number of studies exploring technology as a means to promote and maintain behaviors that decrease urinary stone recurrence. Future research is needed to elucidate how to maximize the potential of these technologies and better understand which behavioral change techniques best promote habit formation for the prevention of stones.

[Change in the prevention of kidney stones]. / Lithiase rénale, un changement de paradigme?

Kidney stone is one of the most frequent disorders of the urinary tract. Once the stone has passed, the management should be oriented on prevention. If changes in lifestyle and diet should be implemented in a true therapeutic education of the patient, prescription of drugs has been recently challenged by the NOSTONE trial. This randomized controlled trial did not show any benefit of hydrochlorothiazide in the prevention of recurrence of kidney stone event in patients with calcium-containing stone. Therefore, prescription of thiazide in the sole purpose of decreasing kidney stone recurrence should be limited and the risk/benefit of this treatment should be carefully balanced for each case.

La maladie rénale lithiasique est une des affections les plus fréquentes de l'axe urinaire. Une fois l'expulsion du calcul obtenue, la prise en charge est orientée sur la prévention. Si les modifications diététiques et comportementales doivent être implémentées dans le cadre d'une véritable éducation thérapeutique, la prescription de traitements médicamenteux préventifs est remise en question par l'étude NOSTONE. Cette étude randomisée contrôlée n'a pas montré de bénéfice de l'hydrochlorothiazide dans la prévention de la récidive des calculs à contenu calcique. Dès lors, la prescription de thiazide en monothérapie dans le but de diminuer les récidives de calculs doit être limitée et le risque/bénéfice soigneusement évalué dans chaque cas.

Promoting fluid intake to increase urine volume for kidney stone prevention: Protocol for a randomized controlled efficacy trial of the sipIT intervention.

BACKGROUND: Risk of kidney stone recurrence can be reduced by increasing fluid intake and urine production but most patients fail to adhere to recommended clinical guidelines. Patients have indicated that common barriers to fluid intake include a lack of thirst, forgetting to drink, and not having access to water. We developed the sipIT intervention to support patients' fluid intake with semi-automated tracking (via a mobile app, connected water bottle and a smartwatch clockface that detects drinking gestures) and provision of just-in-time text message reminders to drink when they do not meet the hourly fluid intake goal needed to achieve the recommended volume. This trial evaluates the efficacy of sipIT for increasing urine output in patients at risk for recurrence of kidney stones. METHOD/DESIGN: Adults with a history of kidney stones and lab-verified low urine production (<2 L/day) will be randomly assigned to receive either usual care (education and encouragement to meet fluid intake guidelines) or usual care plus the sipIT intervention. The primary outcome is 24-h urine volume; secondary outcomes include urinary supersaturations, past week fluid intake, and experienced automaticity of fluid intake. Outcomes will be assessed at baseline, 1 month, 3 months, and 12 months. CONCLUSIONS: The sipIT intervention is the first to prompt periodic fluid intake through integration of just-in-time notifications and semi-automated tracking. If sipIT is more efficacious than usual care, this intervention provides an innovative treatment option for patients needing support in meeting fluid intake guidelines for kidney stone prevention.

Beneficial roles of gastrointestinal and urinary microbiomes in kidney stone prevention via their oxalate-degrading ability and beyond.

Formation of calcium oxalate (CaOx) crystal, the most common composition in kidney stones, occurs following supersaturation of calcium and oxalate ions in the urine. In addition to endogenous source, another main source of calcium and oxalate ions is dietary intake. In the intestinal lumen, calcium can bind with oxalate to form precipitates to be eliminated with feces. High intake of oxalate-rich foods, inappropriate amount of daily calcium intake, defective intestinal transporters for oxalate secretion and absorption, and gastrointestinal (GI) malabsorption (i.e., from gastric bypass surgery) can enhance intestinal oxalate absorption, thereby increasing urinary oxalate level and risk of kidney stone disease (KSD). The GI microbiome rich with oxalate-degrading bacteria can reduce intestinal oxalate absorption and urinary oxalate level. In addition to the oxalate-degrading ability, the GI microbiome also affects expression of oxalate transporters and net intestinal oxalate transport, cholesterol level, and short-chain fatty acids (SCFAs) production, leading to lower KSD risk. Recent evidence also shows beneficial effects of urinary microbiome in KSD prevention. This review summarizes the current knowledge on the aforementioned aspects. Potential benefits of the GI and urinary microbiomes as probiotics for KSD prevention are emphasized. Finally, challenges and future perspectives of probiotic treatment in KSD are discussed.

Carboxymethylated Rhizoma alismatis polysaccharides reduces the risk of calcium oxalate stone formation by reducing cellular inflammation and oxidative stress.

This study aims to elucidate the mechanism and potential of Rhizoma alismatis polysaccharides (RAPs) in preventing oxidative damage to human renal proximal tubule epithelial cells. The experimental approach involved incubating HK-2 cells with 100 nm calcium oxalate monohydrate for 24 h to establish a cellular injury model. Protection was provided by RAPs with varying carboxyl group contents: 3.57%, 7.79%, 10.84%, and 15.33%. The safeguarding effect of RAPs was evaluated by analyzing relevant cellular biochemical indicators. Findings demonstrate that RAPs exhibit notable antioxidative properties. They effectively diminish the release of reactive oxygen species, lactate dehydrogenase, and malondialdehyde, a lipid oxidation byproduct. Moreover, RAPs enhance superoxide dismutase activity and mitochondrial membrane potential while attenuating the permeability of the mitochondrial permeability transition pore. Additionally, RAPs significantly reduce levels of inflammatory factors, including NLRP3, TNF-α, IL-6, and NO. This reduction corresponds to the inhibition of overproduced pro-inflammatory mediator nitric oxide and the caspase 3 enzyme, leading to a reduction in cellular apoptosis. RAPs also display the ability to suppress the expression of the HK-2 cell surface adhesion molecule CD44. The observed results collectively underscore the substantial anti-inflammatory and anti-apoptotic potential of all four RAPs. Moreover, their capacity to modulate the expression of cell surface adhesion molecules highlights their potential in inhibiting the formation of kidney stones. Notably, RAP3, boasting the highest carboxyl group content, emerges as the most potent agent in this regard.

Magnesium Decreases Urine Supersaturation but Not Calcium Oxalate Stone Formation in Genetic Hypercalciuric Stone-Forming Rats.

BACKGROUND/AIMS: Hypercalciuria is the most common identifiable risk factor predisposing to CaOx stone formation. Increased oral magnesium intake may lead to decreased CaOx stone formation by binding intestinal Ox leading to decreased absorption and/or binding urinary Ox to decrease urinary supersaturation. This study assessed the effect of oral magnesium on 24-h urine ion excretion, supersaturation, and kidney stone formation in a genetic hypercalciuric stone-forming (GHS) rat model of human idiopathic hypercalciuria. METHODS: When fed the oxalate precursor, hydroxyproline, every GHS rat develops CaOx stones. The GHS rats, fed a normal calcium and phosphorus diet supplemented with hydroxyproline to induce CaOx, were divided into three groups of ten rats per group: control diet with 4.0 g/kg MgO, low MgO diet (0.5 g/kg), and high MgO diet (8 g/kg). At 6 weeks, 24-h urines were collected, and urine chemistry and supersaturation were determined. Stone formation was quantified. RESULTS: The GHS rats fed the low and high Mg diets had a significant reduction and increase, respectively, in urinary Mg compared to those fed the control diet. Dietary Mg did not alter urine Ca excretion while the low Mg diet led to a significant fall in urinary Ox. Urine supersaturation with respect to CaOx was significantly increased with low Mg, whereas urine supersaturation was significantly decreased with high Mg. There was no effect of dietary Mg on stone formation within 6 weeks of treatment. CONCLUSION: Dietary magnesium decreases urine supersaturation but not CaOx stone formation in GHS rats.

Urinary stone in infants; should vitamin D prophylaxis be stopped?

BACKGROUND: This study investigated the effect of the discontinuation of vitamin D supplementation on kidney stone formation in children under 2 years of age. METHODS: This study involved a retrospective analysis of two patient groups. The first group comprised postoperative patients who were stone-free, while the second group consisted of asymptomatic patients with kidney stones. The patients who discontinued vitamin D supplementation and those who continued were compared in terms of stone formation and stone size progression. The data collected included patient characteristics, stone size measurements, and laboratory results. RESULTS: The findings showed that the discontinuation of vitamin D supplementation was not associated with kidney stone formation or the progression of stone size in either group. For patients who were stone-free on ultrasonography 1 month after the operation, according to the 12-month ultrasonography evaluation, in the group that discontinued vitamin D, 42 (78%) patients had no stones, 6 (11%) patients had stones larger than 3 mm, and 6 (11%) patients had microlithiasis. However, in the group that continued vitamin D, 49 (72%) patients were stone-free, 10 (15%) patients had stones larger than 3 mm, and 9 (13%) patients had microlithiasis. There was no difference between the groups in terms of stone status at 12 months (p = 0.76). For patients with asymptomatic kidney stones, the initial stone sizes were similar between the groups (p = 0.74). During the 6th month of ultrasound, the changes in stone size were 1.76 ± 1.81 mm and 1.79 ± 1.75 mm for the two groups, respectively (p = 0.9). During the 12-month ultrasound measurement, the changes in stone size were 1.98 ± 2.93 mm and 2.60 ± 2.48 mm for the two groups, respectively (p = 0.09). CONCLUSIONS: We believe that more research is needed to make definitive recommendations regarding vitamin D prophylaxis in infants with kidney stones. Although the first objective of our study is not conclusively proven with the current findings, we recommend continued vitamin D prophylaxis in infants with urolithiasis.

Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study.

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.

Analysis of Dietary Patterns Associated with Kidney Stone Disease Based on Data-Driven Approaches: A Case-Control Study in Shanghai.

The main objective of this study was to analyze dietary patterns using data-driven approaches and to explore preventive or risk dietary factors for kidney stone disease (KSD). A case-control matching study was conducted in adults (n = 6396) from a suburb of Shanghai. A food frequency questionnaire was used to assess the consumption of various types of food, and B-ultrasound was used to identify kidney stones. Principal component analysis and regression were used to generate dietary patterns and further explore the relationship between dietary patterns and KSD. LASSO regression and post-selection inference were used to identify food groups most associated with KSD. Among males, the "balanced but no-sugary-beverages pattern" (OR = 0.78, p < 0.05) and the "nuts and pickles pattern" (OR = 0.84, p < 0.05) were protective dietary patterns. Among females, "high vegetables and low-sugary-beverages pattern" (OR = 0.83, p < 0.05) and "high-crustaceans and low-vegetables pattern" (OR = 0.79, p < 0.05) were protective dietary patterns, while the "comprehensive pattern with a preference for meat" (OR = 1.06, p < 0.05) and "sugary beverages pattern" (OR = 1.16, p < 0.05) were risk dietary patterns. We further inferred that sugary beverages (p < 0.05) were risk factors and pickles (p < 0.05) and crustaceans (p < 0.05) were protective factors.

The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review.

Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.

Effects of thiazides and new findings on kidney stones and dysglycemic side effects.

Thiazide and thiazide-like diuretics (thiazides) belong to the most frequently prescribed drugs worldwide. By virtue of their natriuretic and vasodilating properties, thiazides effectively lower blood pressure and prevent adverse cardiovascular outcomes. In addition, through their unique characteristic of reducing urine calcium, thiazides are also widely employed for the prevention of kidney stone recurrence and reduction of bone fracture risk. Since their introduction into clinical medicine in the early 1960s, thiazides have been recognized for their association with metabolic side effects, particularly impaired glucose tolerance, and new-onset diabetes mellitus. Numerous hypotheses have been advanced to explain thiazide-induced glucose intolerance, yet underlying mechanisms remain poorly defined. Regrettably, the lack of understanding and unpredictability of these side effects has prompted numerous physicians to refrain from prescribing these effective, inexpensive, and widely accessible drugs. In this review, we outline the pharmacology and mechanism of action of thiazides, highlight recent advances in the understanding of thiazide-induced glucose intolerance, and provide an up-to-date discussion on the role of thiazides in kidney stone prevention.

Targeting urinary calcium oxalate crystallization with inulin-type AOFOS from Aspidopterys obcordata Hemsl. for the management of rat urolithiasis.

ETHNOPHARMACOLOGICAL RELEVANCE: Calcium oxalate crystals play a key role in the development and recurrence of kidney stones (also known as urolithiasis); thus, inhibiting the formation of these crystals is a central focus of urolithiasis prevention and treatment. Previously, we reported the noteworthy in vitro inhibitory effects of Aspidopterys obcordata fructo oligosaccharide (AOFOS), an active polysaccharide of the traditional Dai medicine Aspidopterys obcordata Hemsl. (commonly known as Hei Gai Guan), on the growth of calcium oxalate crystals. AIM OF THE STUDY: To investigated the effectiveness and mechanism of AOFOS in treating kidney stones. MATERIALS AND METHODS: A kidney stones rats model was developed, followed by examining AOFOS transport dynamics and effectiveness in live rats. Additionally, a correlation between the polysaccharide and calcium oxalate crystals was studied by combining crystallization experiments with density functional theory calculations. RESULTS: The results showed that the polysaccharide was transported to the urinary system. Furthermore, their accumulation was inhibited by controlling their crystallization and modulating calcium ion and oxalate properties in the urine. Consequently, this approach helped effectively prevent kidney stone formation in the rats. CONCLUSIONS: The present study emphasized the role of the polysaccharide AOFOS in modulating crystal properties and controlling crystal growth, providing valuable insights into their potential therapeutic use in managing kidney stone formation.

High composite dietary antioxidant index is associated with reduced risk of kidney stones: a cross-sectional analysis of NHANES 2007-2020.

The composite dietary antioxidant index (CDAI) is commonly utilized to assess antioxidant intake across diseases, but its association with kidney stones is unclear. We hypothesized that higher CDAI is associated with reduced kidney stone risk. Using National Health and Nutrition Examination Survey 2007-2020 data, we calculated CDAI based on vitamins A, C, E, selenium, zinc, and carotenoids intake in 29,280 adults. Stone formers had lower CDAI, with significant gender differences. Restricted cubic spline showed an L-shaped curve, with the steepest decline before CDAI of 1.449. In multivariate logistic regression, moderate and high CDAI tertiles were associated with reduced kidney stone odds compared to the lowest tertile (odds ratio [95% CI]): 0.85 [0.73, 0.99], P = .035 and 0.80 [0.66, 0.95], P = .014, respectively). Vitamin C had the highest negative correlation weight with kidney stones. Significant interactions were found for age and diabetes subgroups. In conclusion, higher CDAI may reduce kidney stone risk, especially with adequate vitamin C intake. Further cohort studies are warranted to confirm the causal association.

Effect of magnesium oxide or citrate supplements on metabolic risk factors in kidney stone formers with idiopathic hyperoxaluria: a randomized clinical trial.

Magnesium is one of the recommended treatments for calcium stone formers (CSFs) with hyperoxaluria. In this study, we compared the effect of magnesium oxide (MgO) or magnesium citrate (MgCit) with placebo on 24-hour urine (24-U) metabolites and the calcium oxalate supersaturation index (CaOx SS). In a randomized, double-blind, placebo-controlled clinical trial, 90 CSFs with idiopathic hyperoxaluria were recruited from a tertiary stone prevention clinic. Patients were randomly assigned into three groups: 120 mg MgO, 120 mg MgCit or placebo (supplements were taken three times per day, with meals). Finally, 76 patients were included in the final analysis. Analyses of 24-U were performed at baseline and after eight weeks. Study outcomes included changes in 24-U oxalate, magnesium, citrate, and CaOx SS. Dietary factors were controlled by 24-hour food recalls. Repeated measure ANOVA was used to compare the results. After the intervention, both MgO and MgCit supplements decreased 24-U oxalate excretion (-8.13±16.45 in the MgO group and -16.99±18.02 in the MgCit group) and CaOx SS compared to the placebo, with the effects of MgCit reaching statistical significance (p=0.011 and p=0.010, respectively). An increasing trend was observed for 24-U magnesium and citrate excretion without significant differences among groups. Interestingly, MgCit exhibited a significantly greater inhibitory effect on 24-U oxalate in patients with normal urine magnesium levels (p=0.021). Clinically, both MgO and MgCit reduced 24-U oxalate and CaOx SS compared to placebo. However, MgCit demonstrated a greater effect, especially in patients with normal urine magnesium levels.

CCR2 antagonist attenuates calcium oxalate-induced kidney oxidative stress and inflammation by regulating macrophage activation.

C-C chemokine receptor type 2 (CCR2) is a monocyte chemokine associated with oxidative stress and inflammation. Kidney stones (KS) are composed of calcium oxalate (CaOx), which trigger renal oxidative stress and inflammatory. This study aims to evaluate the effects of CCR2 on KS in vivo and in vitro. Eight-week-old male C57BL/6J mice were intraperitoneally injected with glyoxylate (GOX) daily to establish a KS model, and along with CCR2 antagonist (INCB3344) treatment on days 2, 4, and 6. The results showed that CCR2 antagonist reduced renal injury markers (blood urea nitrogen and serum creatinine), alleviated renal tubular injury and CaOx crystal deposition. CCR2 antagonist also decreased CCR2 expression induced by GOX treatment and increased Nrf2 expression. GOX treatment promoted malondialdehyde (MDA) production, decreased glutathione (GSH) content, and inhibited catalase (CAT) and superoxide dismutase (SOD) activity, however, CCR2 antagonist attenuated the above effects of GOX. CCR2 antagonist had inhibitory effects on GOX-induced inflammatory cytokine expression (IL1B, IL6 and MCP1), and inhibited apoptosis by increasing Bcl-2 expression and decreasing Bax and cleaved-caspase 3 expression. In vitro experiments were performed by co-culture model of CaOx-induced damaged HK-2 cells and macrophage-like THP-1 cells. CCR2 antagonist inhibited CaOx-induced THP-1 cell M1 polarization by decreasing the TNF-α, IL6 and iNOS levels, and further alleviated CaOx-induced oxidative stress damage, inflammatory response and apoptosis of HK-2 cells. The study suggests that CCR2 antagonist may be resistant to CaOx crystals-induced oxidative stress and inflammation by inhibiting macrophage M1 polarization.

Conhecimento da população portadora de doença renal calculosa sobre os fatores de risco associados à urolitíase / Awareness of the population with calculus kidney disease about the risk factors associated with urolitiasis / Conocimiento de la población con enfermedad renal por cálculo sobre los factores de riesgo asociados a la urolitiasis

Introdução: A litíase urinária é uma doença que ocorre devido à formação de cálculos no aparelho urinário, especialmente os compostos por oxalato de cálcio. Sua prevalência vem aumentando, variando de 5 a 15% na população adulta ocidental, tendo aspectos genéticos e ambientais como fatores de risco para seu surgimento. Objetivo: Verificar o conhecimento da população portadora de doença renal calculosa sobre os fatores de risco associados à urolitíase buscando correlacionar variáveis sociodemográficas ao número de acertos. Material e Método: Foi realizado um estudo do tipo transversal de caráter descritivo com abordagem qualitativa, incluindo 84 indivíduos que tenham sido submetidos a tratamento de ureterolitíase. O trabalho foi desenvolvido por meio do envio de questionários em plataformas digitais. Resultados: A idade média dos participantes foi de 39,8 anos, sendo que 40 indivíduos (50,6%) não possuíam comorbidades e 56 deles (66,7%) afirmaram que receberam informação a respeito de como prevenir a formação de novos cálculos no trato urinário. Em relação aos fatores predisponentes, 67 indivíduos (79,8%) acreditaram que certos alimentos e bebidas poderiam afetar o risco de formação de cálculos no trato urinário. Além disso, 67 pacientes (79,8%) da amostra estariam dispostos a promover mudanças dietéticas e de estilo de vida, caso elas reduzissem o risco de incidência de doença calculosa no trato urinário. Conclusão: Dessa forma, ressalta-se a importância de estabelecimento de uma comunicação médico-paciente efetiva de modo a promover melhoras no desempenho dos indivíduos acerca dos fatores de risco para doença calculosa.(AU)

Introduction: Urinary lithiasis is a disease that occurs due to the formation of stones in the urinary tract, especially those composed of calcium oxalate. Its prevalence has been increasing, ranging from 5 to 15% in the Western adult population, with genetic and environmental aspects as risk factors for its emergence. Objective: Verify the knowledge of the population with calculus kidney disease about the risk factors associated with urolithiasis seeking to correlate sociodemographic variables to the number of hits. Material and Method: A cross-sectional study of descriptive character with a qualitative approach was carried out, including 84 individuals who have undergone treatment of ureterolithiasis. The work was developed by sending questionnaires on digital platforms. Results: The average age of the participants was 39.8 years, 40 individuals (50.6%) did not have comorbidities and 56 of them (66.7%) stated that they received information about how to prevent the formation of new stones in the urinary tract. Regarding predisposing factors, 67 individuals (79.8%) believed that certain foods and beverages could affect the risk of formation of stones in the urinary tract. In addition, 67 patients (79.8%) of the sample would be willing to promote dietary and lifestyle changes if they reduced the risk of incidence of calculus disease in the urinary tract. Conclusion: Thus, we emphasize the importance of establishing effective medical-patient communication in order to promote improvements in the performance of individuals about risk factors for computed disease.(AU)

Introducción: La litiasis urinaria es uma enfermedad que se produce por la formación de cálculos en las vías urinarias, especialmente los compuestos por oxalato de cálcio. Su prevalência ha ido em aumento, oscilando entre el 5 y el 15% en la población adulta occidental, siendo los factores genéticos y ambientales para su aparición. Objetivo: Verificar el conocimiento de la población con enfermedad renal calculosa sobre los factores de riesgo asociados a la urolitiasis, buscando correlacionar variables sociodemográficas com el número de aciertos. Materiales y métodos: Se realizó un estudio descriptivo transversal con abordaje cualitativo, en el que se incluyeron 84 individuos en tratamiento por ...(AU)

Simultaneous use of oxalate-degrading bacteria and herbal extract to reduce the urinary oxalate in a rat model: A new strategy

ABSTRACT Objective: Urinary stones with oxalate composition can cause kidney failure. Recent findings evidenced that probiotics are effective in reducing oxalate absorption in these subjects based on their high colonic absorption levels at baseline. The purpose of this study was to evaluate the effect of the simultaneous use of oxalate-degrading bacteria, Urtica dioica and T. terrestris extract in reducing urinary oxalate. Materials and Methods: Anti-urolithiatic activity of Urtica dioica and T. terrestris extract and probiotic by using ethylene glycol induced rat model. In this study, 4 strains of Lactobacillus and 2 strains of Bifidobacterium and also 2 strains of L. paracasei (that showed high power in oxalate degrading in culture media) were used. Male Wistar rats were divided into four groups (n=6). The rats of group-I received normal diet (positive control group) and groups-II (negative control group), III, IV rats received diet containing ethylene glycol (3%) for 30 days. Groups III rats received Urtica dioica and T. terrestris extract. Groups IV rats received extracts + probiotic for 30 days. Findings: The results show that the use of herbal extracts (Urtica dioica and T. terrestris) reduced the level of urinary oxalate and other parameters of urine and serum. Also, the accumulation of calcium oxalate crystals in the kidney tissue was significantly reduced. Conclusion: Considering that the formation of calcium oxalate crystals can cause inflammation and tissue damage in the kidney, the use of herbal extracts with oxalate degrading bacteria can be a new therapeutic approach to preventing the formation of kidney stones.