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1.
Med Sci Monit ; 25: 4217-4224, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170122

RESUMO

BACKGROUND This study aimed to evaluate the risk factors associated with the development of urolithiasis in a population in Southern China. MATERIAL AND METHODS A questionnaire-based study was conducted between March 2017 to April 2018 that included 1,519 patients in Southern China and included questions on patient demographics, diet, and lifestyle. Patients were divided into the urolithiasis group who had urinary calculi and the control group. RESULTS There were 829 patients (54.6%) in the urolithiasis group and 690 patients (45.4%) in the control group. Using a chi-squared (χ²) test, 13 variables were found to be significantly associated with urolithiasis, including age, physical activity, and dietary factors that included high sodium, protein, fat, lean meat, vegetables, pickled food, fluid intake, drinking habits and tea consumption, and frequency and duration of physical exercise. Multivariate logistic regression analysis showed that dietary factors, including vegetables (OR, 0.856; 95% CI, 0.769-0.948), pickled foods (OR, 1.271; 95% CI, 1.030-1.357), and animal protein intake (OR, 1.138; 95% CI, 1.031-1.258), drinking strong tea (OR, 0.793; 95% CI, 0.702-0.897), fluid intake (OR, 0.758; 95% CI, 0.644-0.816), and duration of physical exercise (OR, 0.840; 95% CI, 0.808-0.973) were significantly associated with the occurrence of urolithiasis and were independent risk factors. CONCLUSIONS High consumptions of pickled foods and animal protein were the main risk factors for the development of urolithiasis in a population of southern China, but high fluid intake with a preference for strong tea, a diet of vegetables, and physical exercise were protective factors.


Assuntos
Urolitíase/epidemiologia , Urolitíase/etiologia , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Estudos de Casos e Controles , China/epidemiologia , Dieta , Ingestão de Líquidos , Comportamento Alimentar/etnologia , Feminino , Humanos , Estilo de Vida , Masculino , Carne , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Verduras
2.
Eur J Pediatr ; 178(6): 823-828, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30887213

RESUMO

Data regarding spontaneous resolution of mild hydronephrosis consist of different etiologies, and hence, it is heterogeneous. The aim of this study is to evaluate spontaneous resolution rates and the time to complete resolution of antenatally detected isolated hydronephrosis in patients with renal pelvis antero-posterior diameter (RPAPD) ≤ 20 mm. Retrospective chart review of patients who were admitted to our pediatric nephrology clinic for the evaluation of antenatal hydronephrosis between 2011 and 2017 was conducted. Patients that had hydronephrosis with RPAPD ≤ 20 mm, < SFU (Society for Fetal Urology) grade IV on initial postnatal evaluation, and ≥ 3 months of follow-up with at least two renal ultrasounds (US) were included. Complete resolution of hydronephrosis was regarded as SFU grade 0 with a RPAPD of < 7 mm. Patients with ureteric and lower urinary tract abnormalities were excluded. There were a total of 276 patients who met the inclusion criteria. Median follow-up was 16 months (range 3-96 months). Hydronephrosis completely resolved in 198 patients (71.7%). Surgery was not required in any of the patients; however, nine patients (3.3%) showed progression to higher grades of hydronephrosis or increase in AP diameter. Median time to complete resolution of hydronephrosis was 6 months (range 2-35 months) in our study. Those with AP diameter < 10 mm became normal in median of 5 months, while it took median 11 months for patients with AP diameter 10-20 mm to become normalized (p < 0.001).Conclusion: Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm would spontaneously resolve in 71.7% of the cases. Resolution may be expected to happen in 3 years, while the majority will take place in the first year of life. What is Known: • Antenatal hydronephrosis comprises an important amount of clinical visits. • Spontaneous resolution rates differ for various etiologies. What is New: • Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm completely resolves within 3 years in approximately 72% of the cases. • Resolution can be observed within the first year of life in most of the cases.


Assuntos
Progressão da Doença , Hidronefrose/patologia , Pelve Renal/patologia , Criança , Pré-Escolar , Feminino , Humanos , Hidronefrose/diagnóstico por imagem , Hidronefrose/epidemiologia , Lactente , Pelve Renal/diagnóstico por imagem , Masculino , Gravidez , Estudos Retrospectivos , Fatores de Tempo , Ultrassonografia Pré-Natal , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Urolitíase/diagnóstico , Urolitíase/epidemiologia , Urolitíase/etiologia
3.
Hum Cell ; 32(2): 83-87, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30783949

RESUMO

Renal hypouricemia (RHUC) is a disease caused by dysfunction of renal urate reabsorption transporters; however, diagnostic guidance and guidelines for RHUC have been lacking, partly due to the low evidence level of studies on RHUC. This review describes a world-first clinical practice guideline (CPG) and its first version in English for this condition. It was developed following the "MINDS Manual for Guideline Development" methodology, which prioritizes evidence-based medicine. It was published in Japanese in 2017 and later translated into English. The primary goal of this CPG is to clarify the criteria for diagnosing RHUC; another aim is to work towards a consensus on clinical decision-making. One of the CPG's unique points is that it contains textbook descriptions at the expert consensus level, in addition to two clinical questions and recommendations derived from a systematic review of the literature. The guidance shown in this CPG makes it easy to diagnose RHUC from simple blood and urine tests. This CPG contains almost all of the clinical foci of RHUC: epidemiology, pathophysiology, diagnostic guidance, clinical examinations, differential diagnosis, and complications, including exercise-induced acute kidney injury and urolithiasis. A CPG summary as well as a clinical algorithm to assist healthcare providers with a quick reference and notes from an athlete for both physicians and patients are included. We hope that this CPG will help healthcare providers and patients to make clinical decisions, and that it will promote further research on RHUC.


Assuntos
Guias de Prática Clínica como Assunto , Erros Inatos do Transporte Tubular Renal , Cálculos Urinários , Lesão Renal Aguda/etiologia , Algoritmos , Tomada de Decisão Clínica , Diagnóstico Diferencial , Medicina Baseada em Evidências , Exercício , Pessoal de Saúde , Humanos , Erros Inatos do Transporte Tubular Renal/diagnóstico , Erros Inatos do Transporte Tubular Renal/terapia , Cálculos Urinários/diagnóstico , Cálculos Urinários/terapia , Urolitíase/etiologia
4.
Urolithiasis ; 47(4): 357-363, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30805669

RESUMO

Higher blood pressures (mean systolic difference 16.8 mmHg) when compared to matched individuals are already reported in patients with calcium urolithiasis. We present the prevalence of hypertension and renal impairment in patients with cystinuria from our specialist single centre. We analysed our prospective database of adult patients with cystinuria who attend our cystinuria service. This included details of the medical and operative management of their disease. Descriptive statistics were used to analyse and present the data. 120 patients were included with a median age of 40 (19-76) years, 66 were male (55%) and 54 were female (45%). 54/120 patients (45%) were taking medications to prevent stone formation. 78% (94/120) patients reported having undergone one or more stone-related procedure. 59% (55/94) of these having required at least one PCNL or open procedure during their lifetime. Prevalence of hypertension was 50.8% (61/120), and double in males compared to females (62.1% vs. 37.0%, P = 0.0063). Mean baseline creatinine was 88.2 (49-153) µmol/l and eGFR was 77.6 (32-127) ml/min/1.73 m2. When categorized by CKD stage, only 24.6% (27% vs. 21%, M vs. F) patients had normal renal function (being an eGFR > 89 ml/min/1.73 m2). 57.6% patients were CKD stage 2 and 17.8% CKD stage 3. Females had a slightly greater incidence of renal impairment. All patients who have previously undergone a nephrectomy (n = 10) or have a poorly functioning kidney (n = 19) have renal impairment (CKD stage 2 or 3). Incidence of hypertension in patients with cystinuria is 51%, with a male preponderance. Only 25% of patients with cystinuria have normal renal function. This highlights the long-term cardiovascular and renal risks that the metabolic effects of cystinuria pose, in addition to the challenges of managing recurrent urolithiasis in a young population.


Assuntos
Cistinúria/complicações , Hipertensão/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Urolitíase/epidemiologia , Adulto , Idoso , Feminino , Taxa de Filtração Glomerular , Humanos , Hipertensão/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Recidiva , Insuficiência Renal Crônica/etiologia , Estudos Retrospectivos , Fatores Sexuais , Resultado do Tratamento , Urolitíase/etiologia , Urolitíase/terapia , Adulto Jovem
5.
PLoS One ; 14(1): e0208893, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30677034

RESUMO

BACKGROUND: To explore the differences of 24-hour urine compositions associated with urolithiasis between non- and postmenopausal females. METHODS: The 24-hour urine samples of female participants were collected from May 2013 to July 2014 along with national cross-sectional study of urolithiasis among adults aged ≥18 years in China. The exclusion criteria for the participants were: serum creatinine > 133µmol/L, with urinary tract infection, gout, hyperthyroidism, malignancy, had a history of cancer, kidney stones, enterectomy, had taken thiazide diuretics, allopurinol, vitamin supplement, potassium citrate or calcium supplements during the past two weeks. The compositions associated with urinary stone in 24-hour urine were measured and compared between non-and postmenopausal women. RESULTS: A total of 603 24-hour urine samples of female participants were analyzed. 354 women with a mean age of 52.5± 14.03 (range 19-84) years met the criteria, including 160 non-menopausal women and 194 postmenopausal women. Compared to the non-menopausal women, postmenopausal women had a lower secretion of citrate (p = 0.043), magnesium (p = 0.001) and creatinine (p = 0.001) in 24h urine. Multivariate linear regression analysis showed that the menopause status was associated with the changes in magnesium (p = 0.003) and creatinine (p = 0.002) secretion, whereas not with the changes in citrate (p = 0.402) secretion. CONCLUSIONS: Postmenopausal women have a significant lower secretion of magnesium in their 24-hour urine than non-menopausal ones. We suppose that might be associated with increased risk of urinary stone formation among postmenopausal women.


Assuntos
Cálculos Renais/etiologia , Cálculos Renais/urina , Pós-Menopausa/urina , Cálculos Urinários/etiologia , Cálculos Urinários/urina , Adulto , Idoso , Idoso de 80 Anos ou mais , Ácido Cítrico/urina , Creatinina/urina , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Magnésio/urina , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Urolitíase/etiologia , Urolitíase/urina
6.
Int J Urol ; 26(1): 7-17, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30151863

RESUMO

The objective of this study was to pool individual studies regarding the association of blood lipid profiles with urolithiasis to carry out a systematic review and meta-analysis. We searched MEDLINE, PubMed, Embase and Cochrane Library to identify the relevant studies up to November 2017. Studies that met all inclusion criteria were chosen, and a pooled analysis of the odds ratio between urolithiasis and dyslipidemia traits was calculated. A total of 11 observational studies (seven cross-sectional, three cohort, one case-control) with a total of 282 479 participants were examined. The overall pooled analysis of eight studies showed that high triglyceride was associated with increased estimated risk of urolithiasis (odds ratio 1.287, 95% CI 1.073-1.544; P = 0.007). Estimates of the total effect size were consistent in the sensitivity analysis. No evidence of publication bias was detected. The overall pooled analysis of nine studies showed low high-density lipoprotein was weakly associated with increased estimated risk of urolithiasis (odds ratio 1.171, 95% CI 1.010-1.358; P = 0.032). The sensitivity analysis showed conflicting results. No evidence of publication bias was detected. Three studies on the association between any dyslipidemia traits and urolithiasis showed a significant association (odds ratio 1.309, 95% CI 1.202-1.425; P < 0.001). The present meta-analysis showed that patients with higher triglyceride and lower high-density lipoprotein had an increased estimated risk of urolithiasis. A triglyceride-urolithiasis association was found to be more coherent and consistent compared with the high-density lipoprotein-urolithiasis association. Although somewhat contradictory results have been found, the meta-analysis is encouraging for evaluating urolithiasis as a systemic disorder. Further well-designed prospective randomized controlled or cohort studies are necessary to better elucidate the causal association of dyslipidemia and urolithiasis.


Assuntos
Dislipidemias/complicações , Triglicerídeos/sangue , Urolitíase/sangue , Urolitíase/etiologia , Humanos , Estudos Observacionais como Assunto
7.
Acta Biomed ; 89(9-S): 76-80, 2018 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-30561398

RESUMO

BACKGROUND AND AIM OF THE WORK: Historical studies have demonstrated that the prevalence of symptomatic nephrolithiasis is higher in patients with inflammatory bowel disease (IBD), compared to general population. The aim of the review was to analyze literature data in order to identify the main risk conditions described in literature and the proposed treatment. METHODS: A research on the databases PubMed, Medline, Embase and Google Scholar was performed by using the keywords "renal calculi/lithiasis/stones" and "inflammatory bowel diseases". A research on textbooks of reference for Pediatric Nephrology was also performed, with focus on secondary forms of nephrolithiasis. RESULTS: Historical studies have demonstrated that the prevalence of symptomatic nephrolithiasis is higher in patients with inflammatory bowel disease (IBD), compared to general population, typically in patients who underwent extensive small bowel resection or in those with persistent severe small bowel inflammation. In IBD, kidney stones may arise from chronic inflammation, changes in intestinal absorption due to inflammation, surgery or intestinal malabsorption. Kidney stones are more closely associated with Crohn's Disease (CD) than Ulcerative Colitis (UC) in adult patients for multiple reasons: mainly for malabsorption, but in UC intestinal resection may be an additional risk. Nephrolithiasis is often under-diagnosed and might be a rare but noticeable extra-intestinal presentation of pediatric IBD. Secondary enteric hyperoxaluria the main risk factor of UL in IBD, this has been mainly studied in CD, whether in UC has not been completely explained. In the long course of CD recurrent urolithiasis and calcium-oxalate deposition may cause severe chronic interstitial nephritis and, as a consequence, chronic kidney disease. ESRD and systemic oxalosis often develop early, especially in those patients with multiple bowel resections. Even if we consider that many additional factors are present in IBD as hypomagnesuria, acidosis, hypocitraturia, and others, the secondary hyperoxaluria seems to finally have a central role. Some medications as parenteral vitamin D, long-term and high dose steroid treatment, sulfasalazine are reported as additional risk factors. Hydration status may also play an important role in this process. Intestinal surgery is a widely described independent risk factor. Patients with ileostomy post bowel resection may have relative dehydration from liquid stool, which, added to the acidic pH from bicarbonate loss, is responsible for this process. In this acidic pH, the urinary citrate level excretion reduces. The stones most commonly seen in these patients contain uric acid or are mixed. In addition, the risk of calcium containing stones also increases with ileostomy. The treatment of UL in IBD involves correction of the basic gastrointestinal tract inflammation, restricted dietary oxalate intake, and, at times, increased calcium intake. Citrate therapy that increases both urine pH and urinary citrate could also provide an additional therapeutic benefit. Finally, patients with IBD in a pediatric study had less urologic intervention for their calculosis compared with pediatric patients without IBD.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Urolitíase/etiologia , Bicarbonatos/uso terapêutico , Criança , Citratos/uso terapêutico , Desidratação/complicações , Suscetibilidade a Doenças , Humanos , Inflamação , Doenças Inflamatórias Intestinais/fisiopatologia , Doenças Inflamatórias Intestinais/cirurgia , Síndromes de Malabsorção/etiologia , Síndromes de Malabsorção/fisiopatologia , Oxalatos/metabolismo , Risco , Urolitíase/tratamento farmacológico , Urolitíase/prevenção & controle
8.
Medicine (Baltimore) ; 97(45): e13099, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30407320

RESUMO

Buddhist priests lead a unique lifestyle, practicing asceticism, with a vegetarian diet. Such behavior may have an impact on clinical outcomes. Hence, we explored the mortality among Korean Buddhist priests as compared with the general population.This study is a single-center, retrospective study. Among the 3867 Buddhist priests who visited Dongguk University Gyeongju Hospital between January 2000 and February 2016, 3639 subjects were available for mortality data from Statistics Korea. Standardized mortality ratio (SMR) was computed for all causes of death and compared with the general population using national statistics in Korea. Information regarding end-stage renal disease (ESRD) was investigated from the Korean Society of Nephrology registry. Among the 3639 patients, the baseline laboratory results were obtained in 724 patients. Chronic kidney disease (CKD) was defined as dipstick proteinuria ≥1 or an estimated glomerular filtration rate <60 mL/min/1.73 m.The mean age was 50.0 ±â€Š12.5 years, and 51.0% were men. During the follow-up period for 31.1 ±â€Š35.6 months, 55 (7.6%) patients died. During the follow-up period, 3 (0.4%) and 23 (3.2%) patients developed ESRD and urinary stone, respectively. The SMR for all causes of death was 0.76 (95% confidence interval [CI] 0.57-0.99; men 0.91, 95% CI 0.65-1.23; women 0.52, 95% CI 0.28-0.87). Among 724 patients, 74 (10.2%) patients had CKD. The SMR for non-CKD patients (0.61, 95% CI 0.43-0.85) was significantly lower than the general population. Female and patients older than 50 years (0.74, 95% CI 0.55-0.98) had a significantly lower SMR. In the Cox proportional hazards model with adjustment, older age (adjusted HR 1.04, 95% CI 1.10-1.07) and presence of CKD (adjusted HR 2.55, 95% CI 1.07-6.06) were independently associated with increased all-cause mortality.Buddhist priests and especially Buddhist priests without CKD showed a significantly lower mortality compared with the general population.


Assuntos
Budismo , Insuficiência Renal Crônica/etnologia , Adulto , Fatores Etários , Idoso , Causas de Morte , Clero/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/terapia , Terapia de Substituição Renal/estatística & dados numéricos , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Urolitíase/epidemiologia , Urolitíase/etiologia
9.
Arch Esp Urol ; 71(7): 569-574, 2018 09.
Artigo em Espanhol | MEDLINE | ID: mdl-30198847

RESUMO

OBJECTIVES: Androgen deprivation therapy (ADT) in prostate cancer is associated with the appearance of different adverse effects. Among these effects, notable ones that may affect metabolism are osteoporosis and metabolic syndrome. The aim of this study is to analyse lithogenic risk markers three months after initiating treatment with LHRH analogue. METHODS: Pilot study encompassing 15 prostate cancer patients who were candidates for ADT, which they received in the form of quarterly doses of goserelin 10.8 mg. A blood and urine analyses for lithogenic risk, bone and metabolic markers were carried out, as was a study of metabolic syndrome criteria. Statistical analysis was performed with SPSS 17.0, taking P≤.05 to be statistically significant. RESULTS: Patients included in the study had a mean age of 72.46 ± 6.61 years. We observed a significant increase in the percentage of metabolic syndrome (20% versus 46.7%; P<.05) and insulin resistance index (1.87 versus 2.96; P=.01) at 3 months treatment. There was a notable increase in bone remodelling markers and significant increases in 24 h urinary calcium values (9.46 versus 14.57 mg/dl; P=.008), 24 h urinary calcium excretion index (0.10 versus 0.13 mg/dl GF [glomerular filtration]; P=.01) and the fasting calcium/ creatinine ratio (0.107 versus 0.195; P=.007), without any changes to other lithogenous risk markers. CONCLUSIONS: Androgen deprivation therapy can lead to the short-term appearance, primarily when fasting, of hypercalciuria in prostate cancer patients, possibly in association with bone metabolism.


Assuntos
Cálcio/urina , Neoplasias da Próstata/urina , Idoso , Antagonistas de Androgênios/uso terapêutico , Hormônio Liberador de Gonadotropina/análogos & derivados , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Fatores de Risco , Fatores de Tempo , Urolitíase/etiologia
10.
Medicine (Baltimore) ; 97(35): e12092, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30170429

RESUMO

There is growing evidence that nonalcoholic fatty liver disease (NAFLD) is associated with a higher risk of urolithiasis, but it has not yet been determined that this association is reproducible and consistent across different studies. We performed a systematic review and meta-analysis of these studies to examine the association between NAFLD and the risk of urolithiasis.We searched PubMed, EMBASE, and Google scholar using terms "fatty liver" (OR "non-alcoholic fatty liver disease" OR "non-alcoholic steatohepatitis" OR "NAFLD" OR "NASH") AND "urolithiasis" (OR "nephrolithiasis" OR "kidney stone" OR "urinary calculi" OR "renal colic" OR "urologic disease"). Observational studies in which NAFLD and urolithiasis were diagnosed by either ultrasonography or computerized tomography were included.A total of 7 observational studies with 226,541 individuals (24.7% with NAFLD) and 19,184 urolithiasis (8.5%). NAFLD was significantly associated with an increased risk of urolithiasis (random effect odds ratio, OR 1.73, 95% confidence interval, CI 1.24-2.40, I=94.5%). Sensitivity analyses revealed the robustness of the results. Egger test and Begg test suggested no publication bias (P > .05).NAFLD is associated with an increased risk of urolithiasis. Therefore, patients with NAFLD should be carefully monitored for the development of urolithiasis.


Assuntos
Hepatopatia Gordurosa não Alcoólica/complicações , Urolitíase/etiologia , Humanos , Fatores de Risco
11.
Arch. esp. urol. (Ed. impr.) ; 71(7): 569-574, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-178729

RESUMO

Objetivos: La terapia de deprivación androgénica en el cáncer de próstata se relaciona con la aparición de diferentes efectos adversos. En el ámbito metabólico destacan la aparición de osteoporosis y síndrome metabólico. El objetivo de este estudio es analizar los marcadores de riesgo litógeno a los 3 meses de haber iniciado tratamiento con análogo LHRH. Métodos: Estudio piloto que incluye a 15 pacientes con cáncer de próstata subsidiarios de tratamiento con deprivación androgénica que se realiza con goserelina 10,8 mg trimestral. Se realiza estudio en sangre y orina de marcadores de riesgo litógeno, marcadores óseos y metabólicos, así como estudio de criterios de síndrome metabólico. Análisis estadístico con programa SPSS 17.0, considerando p≤0,05 como significación estadística. Resultados: La edad media de los pacientes incluidos fue de 72,46 ± 6,61 años. Se observó un aumento significativo del porcentaje de síndrome metabólico a los 3 meses de tratamiento (20% versus 46,7%; p<0,05), así como del índice de resistencia a la insulina (1,87 versus 2,96; p=0,01). Destaca un aumento de los marcadores de remodelado óseo, así como un aumento significativo de la calciuria (9,46 versus 14,57 mg/dl; p=0,008), del índice de excreción urinario de calcio (0,10 versus 0,13 mg/dl FG; p=0,01) y del cociente calcio/creatinina de ayunas (0,107 versus 0,195; p=0,007), sin modificaciones en otros marcadores de riesgo litógeno. Conclusión: La terapia de deprivación androgénica puede inducir a corto plazo incremento de la calciuria, fundamentalmente de ayunas, en este tipo de pacientes en posible relación con alteración del metabolismo óseo


Objectives: Androgen deprivation therapy (ADT) in prostate cancer is associated with the appearance of different adverse effects. Among these effects, notable ones that may affect metabolism are osteoporosis and metabolic syndrome. The aim of this study is to analyse lithogenic risk markers three months after initiating treatment with LHRH analogue. Methods: Pilot study encompassing 15 prostate cancer patients who were candidates for ADT, which they received in the form of quarterly doses of goserelin 10.8 mg. A blood and urine analyses for lithogenic risk, bone and metabolic markers were carried out, as was a study of metabolic syndrome criteria. Statistical analysis was performed with SPSS 17.0, taking P≤.05 to be statistically significant. Results: Patients included in the study had a mean age of 72.46 ± 6.61 years. We observed a significant increase in the percentage of metabolic syndrome (20% versus 46.7%; P<.05) and insulin resistance index (1.87 versus 2.96; P=.01) at 3 months treatment. There was a notable increase in bone remodelling markers and significant increases in 24 h urinary calcium values (9.46 versus 14.57 mg/dl; P=.008), 24 h urinary calcium excretion index (0.10 versus 0.13 mg/dl GF [glomerular filtration]; P=.01) and the fasting calcium/ creatinine ratio (0.107 versus 0.195; P=.007), without any changes to other lithogenous risk markers. Conclusions: Androgen deprivation therapy can lead to the short-term appearance, primarily when fasting, of hypercalciuria in prostate cancer patients, possibly in association with bone metabolism


Assuntos
Humanos , Masculino , Idoso , Cálcio/urina , Neoplasias da Próstata/urina , Antagonistas de Androgênios/uso terapêutico , Hormônio Liberador de Gonadotropina/análogos & derivados , Projetos Piloto , Estudos Prospectivos , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Fatores de Risco , Fatores de Tempo , Urolitíase/etiologia
12.
Med Hypotheses ; 118: 34-35, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30037611

RESUMO

Urolithiasis has a high prevalence and recurrence rate, especially in developed countries, and is a major public health issue with a high socioeconomic cost. There are multiple causes of urolithiasis, including urinary tract infection (UTI). Infection stones (mainly composed of struvite) are associated with renal infections by urease-producing bacteria. However, there is limited knowledge about the role of UTIs in the formation of stones that are apparently not related with infection. We hypothesize that UTIs promote the formation of certain urolithiasis that appear to be non-infection stones. Some recent studies have reported the presence of bacterial growth in cultures of stones removed by endourological procedures. These findings have led to the hypothesis that UTIs have a role in the formation of stones that are apparently non-infection stones. It is unknown whether these UTIs promoted stone formation, or if the stones became infected after formation. Several in vitro studies and ultrastructural microscopic analyses of urolithiasis are consistent with our hypothesis. If our hypothesis is correct, it could have a great impact on the treatment of urolithiasis. Especially, early identification and treatment of renal infections could help to prevent septic events, which are frequently life-threatening. It could also help to reduce the recurrence of urolithiasis, and thereby reduce health care costs. In conclusion, some evidence suggests that UTIs have a role in the formation of some apparently non-infection urolithiasis. If this is so, it could have a great impact on the treatment and prevention of this disease.


Assuntos
Nefrolitíase/complicações , Nefrolitíase/etiologia , Infecções Urinárias/complicações , Custos de Cuidados de Saúde , Humanos , Cálculos Renais , Modelos Teóricos , Recidiva , Medição de Risco , Fatores de Risco , Cálculos Urinários , Urolitíase/complicações , Urolitíase/etiologia
13.
Pol Merkur Lekarski ; 44(262): 208-210, 2018 Apr 23.
Artigo em Polonês | MEDLINE | ID: mdl-29775451

RESUMO

Primary hyperparathyroidism is one of the most common endocrine diseases, however, it is rare in children. In most cases, it is caused by adenoma of these organs. Its most common complications include urolithiasis, nephrocalcinosis and osteoporosis. CASE REPORT: A 16-year-old patient was admitted to our Clinic because of his first-ever renal colic. The ultrasound examination revealed rightsided hydronephrosis caused by the presence of 9 mm stone in the upper part of the right ureter. In addition, the presence of 8 mm stone in the middle calyx of the left kidney was found. Due to the clinical picture, the patient was transferred to the urological department, where the effective ureterorenoscopic lithotripsy (URSL) was performed. Subsequent metabolic diagnostics showed hypercalcemia, hypophosphatemia, elevated levels of parathyroid hormone and hypercalciuria. In addition, the medical history revealed complicated, prolonged healing of a traumatic fracture of both bones of the left forearm in the last 12 months, requiring orthopedic treatment. Due to suspicion of primary hyperparathyroidism, parathyroid scintigraphy with MIBI scan by SPECT/ CT was performed. It revealed a focal lesion that could correspond to adenoma. The patient was referred to endocrinological care, but after 2 months he was readmitted to our Clinic, this time due to left renal colic. A left-sided ureteral stone was identified, which required another urological procedure. CONCLUSIONS: In differential diagnosis of urolithiasis in children, primary hyperparathyroidism should also be considered.


Assuntos
Hiperparatireoidismo Primário/complicações , Urolitíase/etiologia , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adolescente , Humanos , Hipercalcemia , Hipercalciúria , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/etiologia , Hipofosfatemia , Masculino , Hormônio Paratireóideo/sangue , Recidiva , Urolitíase/diagnóstico por imagem
14.
Saudi J Kidney Dis Transpl ; 29(2): 462-465, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29657221

RESUMO

Adenine phosphoribosyltransferase deficiency is a rare, inherited autosomal recessive disease presenting with 2,8-dihydroxyadenine (DHA) urolithiasis, DHA nephropathy, and chronic kidney disease. The presence of DHA crystals in urine and renal biopsy is pathognomonic of the disease. We report a 23-year-old female with acute renal failure and nephrotic proteinuria. Urinalysis showed reddish brown, round crystals with dark outline, and central spicules consistent with 2,8-DHA crystals. Renal biopsy showed membranous nephropathy and 2,8-DHA nephropathy. Our patient improved with liberal fluid intake, restriction of high adenine content foods, and oral xanthine dehydrogenase inhibitor febuxostat. Early diagnosis and initiation of treatment prevent renal complications.


Assuntos
Adenina Fosforribosiltransferase/deficiência , Adenina/análogos & derivados , Glomerulonefrite Membranosa/etiologia , Erros Inatos do Metabolismo/complicações , Síndrome Nefrótica/etiologia , Urolitíase/etiologia , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/urina , Adenina/urina , Biomarcadores/urina , Biópsia , Cristalização , Feminino , Glomerulonefrite Membranosa/diagnóstico , Glomerulonefrite Membranosa/urina , Humanos , Erros Inatos do Metabolismo/diagnóstico , Erros Inatos do Metabolismo/terapia , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/terapia , Síndrome Nefrótica/urina , Proteinúria/diagnóstico , Proteinúria/etiologia , Proteinúria/urina , Urinálise , Urolitíase/complicações , Urolitíase/diagnóstico , Urolitíase/terapia , Urolitíase/urina , Adulto Jovem
15.
J Vet Intern Med ; 32(3): 1268-1273, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29524246

RESUMO

BACKGROUND: Calcium carbonate is a common urolith type in small ruminants with no high-yield experimental model to evaluate animal susceptibility or preventative measure response. HYPOTHESIS: That novel plastic winged implants would allow accumulation and quantification of calcium carbonate calculus formation in goats on a high-calcium diet and identify individual variation between goats in the mass of calculi produced. ANIMALS: Eight nonpregnant 3- and 4-year-old Boer-cross does, weighing 22.3-39.5 kg, determined to be healthy based on physical examination, were used in these experiments. METHODS: Prospective cohort study for in vivo experimental model development. Implants were placed into the urinary bladder lumen in 8 goats over 2 evaluation periods. The alfalfa-based ration had a total ration Ca : P of 3.29 and 3.84 : 1, respectively. Urine was collected at 0, 28, 56, and 84 days in the 1st experiment; blood and urine at those timepoints in the 2nd experiment. For each evaluation period, the implants were removed 84 days after implantation and weighed. Accumulated calculi mass was calculated and compared between goats and was analyzed for composition. RESULTS: Implant retention was 100% and 86% in the 2 studies. All goats with retained implants accumulated calcium carbonate at a mean implant gain per day across studies ranging from 0.44 to 57.45 mg. Two goats accumulated (0.44-7.65 mg/day and 33.64 & 57.45 mg/day) significantly more urolith material than the cohort across both studies (P = .047). No routine analytes on blood or urine were found to be explanatory for the difference observed. CONCLUSIONS AND CLINICAL IMPORTANCE: These findings form a basis for implant and diet selection for use in future studies of urolithiasis development and for studies regarding individual susceptibility to urolithiasis.


Assuntos
Carbonato de Cálcio/metabolismo , Doenças das Cabras/etiologia , Urolitíase/veterinária , Animais , Carbonato de Cálcio/análise , Modelos Animais de Doenças , Feminino , Cabras , Próteses e Implantes , Bexiga Urinária , Cálculos Urinários/química , Cálculos Urinários/veterinária , Urolitíase/etiologia
16.
PLoS One ; 13(3): e0194019, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29522553

RESUMO

PURPOSE: Chronic pancreatitis (CP) can cause fat or bile acid malabsorption due to exocrine insufficiency. Fat or bile acid malabsorption has been reported to increase the risk of urolithiasis through increased intestinal oxalate absorption. However, no studies have reported an association between CP and urolithiasis. METHODS: We identified 15,848 patients (age: ≥20 years) diagnosed as having CP between 2000 and 2010 from the National Health Insurance Research Database as the study cohort. Beneficiaries without a history of CP were randomly selected and propensity-matched with the study cohort in a 1:4 ratio according to age; sex; comorbidities of hyperlipidemia, diabetes, obesity, hypertension, chronic obstructive pulmonary disease, alcohol-related illness, stroke, and coronary artery disease; and the index date. The prevalence of inflammatory bowel disease (0.44%), hyperparathyroidism (0.10%), or end stage renal disease (1.55%) in CP patients was low, but these comorbidities were also considered in the analysis. All patients were followed until the end of 2011 or withdrawal from the National Health Insurance program to determine the incidence of urolithiasis. RESULTS: The cumulative incidence of urolithiasis was higher in the CP cohort than that in the non-CP cohort (log-rank test, P < 0.001) with a 1.89-fold risk of urolithiasis (95% confidence interval [CI] = 1.74-2.06). The prevalence of CP was higher in men (81.9%) and in patients younger than 49 years (63.5%; mean age: 48.5 ± 15.3 years). CP was associated with the development of urolithiasis in each age group (≤49 years: aHR = 2.00, 95% CI = 1.81-2.22; 50-64 years: aHR = 1.71, 95% CI = 1.40-2.09; ≥65 years: aHR = 1.54, 95% CI = 1.20-1.98) and each sex (women: aHR = 2.10, 95% CI = 1.67-2.66; men; aHR = 1.86, 95% CI = 1.70-2.04). Among the patients without comorbidities, the rate of urolithiasis increased from 2.93/1,000 person-years in non-CP patients to 8.28/1,000 person-years in CP patients. Among the patients with comorbidities, the rate of urolithiasis increased from 6.12/1,000 person-years in non-CP patients to 10.9/1,000 person-years in CP patients. The contribution of CP to the relative risk of urolithiasis was greater in patients without comorbidities (without comorbidities: aHR = 2.81, 95% CI = 2.30-3.44) than in those with comorbidities (aHR = 1.76, 95% CI = 1.61-1.94). CONCLUSION: CP is associated with urolithiasis in this population-based cohort study. The contribution of CP to the relative risk of urolithiasis was even greater in patients with a lower risk of urolithiasis, such as those without other comorbidities. Our findings warrant a survey and education on urolithiasis for patients with CP.


Assuntos
Pancreatite Crônica/epidemiologia , Urolitíase/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Causalidade , Comorbidade , Intervalos de Confiança , Feminino , Humanos , Hiperparatireoidismo/epidemiologia , Incidência , Doenças Inflamatórias Intestinais/epidemiologia , Falência Renal Crônica/epidemiologia , Síndromes de Malabsorção/etiologia , Masculino , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Pancreatite Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Risco , Fatores de Risco , Taiwan/epidemiologia , Urolitíase/etiologia
17.
Int J Mol Sci ; 19(3)2018 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-29518971

RESUMO

Kidney stones are one of the oldest known and common diseases in the urinary tract system. Various human studies have suggested that diets with a higher intake of vegetables and fruits play a role in the prevention of kidney stones. In this review, we have provided an overview of these dietary plants, their main chemical constituents, and their possible mechanisms of action. Camellia sinensis (green tea), Rubus idaeus (raspberry), Rubia cordifolia (common madder), Petroselinum crispum (parsley), Punica granatum (pomegranate), Pistacia lentiscus (mastic), Solanum xanthocarpum (yellow-fruit nightshade), Urtica dioica (stinging nettle), Dolichos biflorus (horse gram), Ammi visnaga (khella), Nigella sativa (black-cumin), Hibiscus sabdariffa (roselle), and Origanum vulgare (oregano) have received considerable interest based on scientific evidence. Beside these dietary plants, phytochemicals-such as catechin, epicatechin, epigallocatechin-3-gallate, diosmin, rutin, quercetin, hyperoside, and curcumin-as antioxidant dietary phyto-phenols were found to be effective for the prevention of urolithiasis (the process of stone formation in the urinary tract). The main underlying mechanisms of these dietary plants and their isolated phytonutrients in the management of urolithiasis include diuretic, antispasmodic, and antioxidant activity, as well as an inhibitory effect on crystallization, nucleation, and aggregation of crystals. The results as presented in this review demonstrate the promising role of dietary plants and phytophenols in the prevention and management of kidney stones. Further investigations are required to confirm the safety and efficacy of these compounds.


Assuntos
Dieta , Cálculos Renais/prevenção & controle , Cálculos Renais/terapia , Plantas Comestíveis , Animais , Estudos Clínicos como Assunto , Suplementos Nutricionais , Gerenciamento Clínico , Avaliação Pré-Clínica de Medicamentos , Frutas , Humanos , Cálculos Renais/etiologia , Compostos Fitoquímicos/química , Compostos Fitoquímicos/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Prevenção Primária , Urolitíase/etiologia , Urolitíase/prevenção & controle , Urolitíase/terapia , Verduras
18.
Nutr Clin Pract ; 33(6): 897-901, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29570851

RESUMO

Short bowel syndrome (SBS) can lead to many complications related to the condition and its therapy. We describe 2 children with SBS who we believe are the second and third patients documented to have experienced both D-lactic acidosis and urolithiasis. We review aspects of these SBS complications and recent findings on the microbiome of patients with SBS that may predispose to these complications.


Assuntos
Acidose Láctica/etiologia , Disbiose/etiologia , Microbioma Gastrointestinal , Síndrome do Intestino Curto/complicações , Urolitíase/etiologia , Adolescente , Fezes , Feminino , Humanos , Lactente , Ácido Láctico/metabolismo , Lactobacillus/crescimento & desenvolvimento , Lactobacillus/metabolismo , Masculino , Síndrome
20.
Endocr Res ; 43(2): 106-115, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29400579

RESUMO

OBJECTIVE: Recent international guidelines suggest renal imaging to detect occult urolithiasis in all patients with asymptomatic primary hyperparathyroidism (PHPT), but data regarding their prevalence and associated risk factors are limited. We evaluated the prevalence and risk factors for occult urolithiasis. METHODS: Cross-sectional analysis of 96 asymptomatic PHPT patients from a university hospital in the United States with and without occult nephrolithiasis. RESULTS: Occult urolithiasis was identified in 21% of patients. Stone formers had 47% higher 24-hour urinary calcium excretion (p = 0.002). Although available in only a subset of patients (n = 28), activated vitamin D [1,25(OH)2D] was 29% higher (p = 0.02) in stone formers. There was no difference in demographics, BMI, calcium or vitamin D intake, other biochemistries, renal function, BMD, or fractures. Receiver operating characteristic curves indicated that urinary calcium excretion and 1,25(OH)2D had an area under the curve of 0.724 (p = 0.003) and 0.750 (p = 0.04), respectively. A urinary calcium threshold of >211mg/day provided a sensitivity of 84.2% and a specificity of 55.3% while a 1,25(OH)2D threshold of >91pg/mL provided a sensitivity and specificity of 62.5% and 90.0% respectively for the presence of stones. CONCLUSION: Occult urolithiasis is present in about one-fifth of patients with asymptomatic PHPT and is associated with higher urinary calcium and 1,25(OH)2D. Given that most patients will not have occult urolithiasis, targeted imaging in those most likely to have occult stones rather than screening all asymptomatic PHPT patients may be useful. The higher sensitivity of urinary calcium versus 1,25(OH)2D suggests screening those with higher urinary calcium may be an appropriate approach.


Assuntos
25-Hidroxivitamina D 2/sangue , Cálcio/urina , Hiperparatireoidismo Primário/diagnóstico , Urolitíase/diagnóstico , Urolitíase/metabolismo , Idoso , Estudos Transversais , Feminino , Humanos , Hiperparatireoidismo Primário/complicações , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Urolitíase/etiologia
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