Difference in urinary stone components between obese and non-obese patients

Chou, Yii‐Her; Su, Ching-Ming; Li, Ching-Chia; Liu, Chia-Chu; Liu, Mu-En; Wu, Wen‐Jeng; Juan, Yung‐Shun

doi:10.1007/s00240-010-0344-8

Cited by 46 publications

(39 citation statements)

References 32 publications

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“…Several studies have reported that obese patients have a higher risk of nephrolithiasis (21). The prevalence of uric acid and CaOx stones is higher in obese than in nonobese patients (22), possibly because of the inverse correlation between urine pH and body mass index (23). Previous studies reported that the association of obesity with nephrolithiasis is stronger in women than in men (24), and in the current cohort the percentage of women was higher in lowplaque group.…”

Section: Discussionmentioning

confidence: 43%

Distinguishing Characteristics of Idiopathic Calcium Oxalate Kidney Stone Formers with Low Amounts of Randall's Plaque

Wang

Krambeck²,

Williams

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background Overgrowth of calcium oxalate on Randall's plaque is a mechanism of stone formation among idiopathic calcium oxalate stone-formers (ICSFs). It is less clear how stones form when there is little or no plaque.Design, setting, participants, & measurements Participants were a consecutive cohort of ICSFs who underwent percutaneous nephroscopic papillary mapping in the kidney or kidneys containing symptomatic stones and a papillary tip biopsy from a representative calyx during a stone removal procedure between 2009 and 2013. The distribution of Randall's plaque coverage was analyzed and used to divide ICSFs into those with a high ($5%; mean, 10.5%; n=10) versus low (,5%; mean, 1.5%; n=32) amount of plaque coverage per papilla. Demographic and laboratory features were compared between these two groups.Results Low-plaque stone formers tended to be obese (50% versus 10%; P=0.03) and have a history of urinary tract infection (34% versus 0%; P=0.04). They were less likely to have multiple prior stone events (22% versus 80%; P=0.002) and had a lower mean 24-hour urine calcium excretion (187686 mg versus 291699 mg; P,0.01). Morphologically, stones from patients with low amounts of plaque lacked a calcium phosphate core by microcomputed tomography. Papillary biopsies from low plaque stone-formers revealed less interstitial and basement membrane punctate crystallization.Conclusions These findings suggest that other pathways independent of Randall's plaque may contribute to stone pathogenesis among a subgroup of ICSFs who harbor low amounts of plaque.

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Section: Discussionmentioning

confidence: 43%

Distinguishing Characteristics of Idiopathic Calcium Oxalate Kidney Stone Formers with Low Amounts of Randall's Plaque

Wang

Krambeck²,

Williams

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Recent investigations have mentioned that obesity is related with changes in the biochemical components of urine, including phosphate, oxalate, uric acid and citrate [2,3,5,9] . These biochemical changes may explain the association between obesity and urinary stone disease.…”

Section: Formationmentioning

confidence: 99%

“…Insulin resistance is one of the possible reasons [1] . Hyperinsulinemia and insulin resistance are more frequently observed in obese patients due to higher incidence of diabetes mellitus [3] . Insulin resistance may potentially result as a defect in ammonium production in the kidney and ability to excrete acid load, thus affecting urinary pH level [1,3] .…”

Section: Formationmentioning

confidence: 99%

“…Urolithiasis is a multifactorial disease and it has previously been speculated that there is an association between urolithiasis and obesity [1][2][3][4][5] . Recently, a common pathophysiology has been advocated for both diseases, since several investigations have mentioned that the prevalence of urolithiasis has been increasing in parallel with obesity [2,3,6] . Various lithogenic risk factors, including increased body mass index (BMI), low urinary volume, hypercalciuria, hyperoxaluria and hyperinsulinemia, are associated with obesity [7] .…”

Section: Introductionmentioning

confidence: 99%

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Urinary stone disease and obesity: Different pathologies sharing common biochemical mechanisms

Aydoğdu¹

2012

WJN

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The prevalence of urolithiasis is increasing in parallel with the escalating rate of obesity worldwide. It has previously been speculated that obesity is a potential risk factor for urinary stone disease. The possibility that common biochemical mechanisms underlie both obesity and urolithiasis is remarkable. Better understanding of possible common mechanisms of these diseases could potentially lead to a better management of urinary stone prevention. The prevention of urinary stone formation gives clinicians an acceptable reason to encourage lifestyle modification and weight loss through a regular diet. In this review, the association of obesity with urinary stone disease, possible common biochemical mechanisms, effects of dietary habits and weight loss on stone formation, as well as difficulties in surgical management of obese individuals with urolithiasis are discussed.

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“…A prior study by Chou et al 10 found no correlation between obesity and prevalence of calcium phosphate stones. However, the percentage of uric and calcium oxalate stones was also found to be higher in obese than non-obese patients.…”

Section: Discussionmentioning

confidence: 99%

Diuresis and Medical Expulsion Therapy With Extracorporeal Shock Wave Lithotripsy for Clearance of Renal Stone- A Clinical Study

Sinha¹

2017

jemds

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BACKGROUNDRenal stone has a global problem. People of all country of the world more or less suffer from Renal Stone or Urinary Calculus. It is prevalent in about all age and sex groups. It carries significant morbidity, mortality and imposes heavy financial load. It causes tremendous financial burden on health and medical care delivery system with changing lifestyle, environment and climate. Its prevalence is rising. It requires stress on preventive and curative aspect. Various procedures like Conventional Operation, Endoscopic Method, PCNL, URS and Extracorporeal Shock Wave Lithotripsy are used in practice. The ESWL was invented in 1980. It has various type of generation machines. It is operated by Technician, Surgeon and Urologist. It is not invasive and has low-risk procedure, but has incidence of residual fragments, microparticles, dust and crystals despite many advancements in Technology. So, Diuresis with oral and parenteral water and fluid and Medical Expulsion Therapy and excretion through passage of urine causes clearance in same procedure sessions with no extra cost. In outdoor patients of less than 2 mm diameter stone, Medical Expulsion Therapy was given. In indoor hospitalised patients of more than 2 to 20 mm diameter, MET, ESWL with diuresis were performed. MATERIALS AND METHODSStudy was performed between January 2015 and September 2015 in Lord Buddha Koshi Medical College and Hospital and Sri Krishna Salya Chikitsalaya, Saharsa (Bihar), after consent from Institutional Review Board and from patient for Examination, Investigation, Diagnosis, Treatment and Research and Study; 60 patients of various age and sex groups were undertaken. ESWL with Diuresis and Medical Expulsion Therapy and 10 patients of less than 2 mm diameter of stone under medical expulsion therapy. RESULTOutdoor-The medical expulsion therapy performed in less than 2 mm diameter stone of patient. The success rate is 98% and failure rate is 2%. Indoor-Patient wise analysis was done. Stones were 2 mm diameter to 20 mm diameter. Number of shockwaves from 2500 to 3000 MA was given. Breaking rate are 65% to 75%. Character of stones were firm and hard. Presence of fragment-Nil. Followup patient-75%. Forced diuresis by diuretics, hydrostatic pressure and osmotic pressure and Medical Expulsion Therapy were given. 95% was successful and 5% was failure. Need for reformation of stone-Nil. Session-Single. Cost-Same cost, no extra cost. CONCLUSIONESWL with Diuresis and Medical Expulsion Therapy to remove the concretion is an effective option for microparticles and crystal clearance. This is not an invasive therapy, might be a valuable alternative to the various invasive management modalities like Conventional Surgery, PCNL, URS and Endoscopy. KEYWORDSDiet -Drinking Water and Fluid -Intravenous Fluid -Medical Expulsion Therapy -ESWL -Diuresis -Renal Stone Clearance.HOW TO CITE THIS ARTICLE: Sinha RN. Diuresis and medical expulsion therapy with extracorporeal shock wave lithotripsy for clearance of renal stone-a clinical study.

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Difference in urinary stone components between obese and non-obese patients

Cited by 46 publications

References 32 publications

Distinguishing Characteristics of Idiopathic Calcium Oxalate Kidney Stone Formers with Low Amounts of Randall's Plaque

Distinguishing Characteristics of Idiopathic Calcium Oxalate Kidney Stone Formers with Low Amounts of Randall's Plaque

Urinary stone disease and obesity: Different pathologies sharing common biochemical mechanisms

Diuresis and Medical Expulsion Therapy With Extracorporeal Shock Wave Lithotripsy for Clearance of Renal Stone- A Clinical Study

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