Idiopathic calcium oxalate urolithiasis: risk factors and conservative treatment

Lewandowski, Sonja; Rodgers, Allen L.

doi:10.1016/j.cccn.2004.03.009

Cited by 72 publications

(36 citation statements)

References 160 publications

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“…In order to reduce urinary calcium concentrations, the animal protein intake needs to be 0.8-1 g/kg body weight daily, proteins 40 have to be derived from other sources, and calcium intake has to be sufficiently high. Recent studies show no advantage of dairy, egg and vegetable proteins over animal proteins, although a vegetarian diet is associated with less urinary excretion of uric acid [7] .…”

Section: Animal Proteinsmentioning

confidence: 99%

“…Both magnesium oxide and calcium bicarbonate significantly reduced intestinal oxalate absorption compared with the 13.5% in controls. The drop in urinary Mg/Ca ratio after magnesium oxide supplements correlates inversely with stone formation [7,54] .…”

Section: Magnesiummentioning

confidence: 99%

“…Endogenous oxalate is synthesized through two metabolic pathways: the ascorbate pathway supplies 40% and the glyoxalic pathway, which is derived from glycine and glycolate metabolism, provides the remaining 40-50% [7] .…”

Section: Vegetable Proteinsmentioning

confidence: 99%

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Prevention of Stone Disease

Porena

Guiggi

Micheli³

2007

Urol Int

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In recent years stone disease has become more widespread in developed countries. At present the prevalence is 5.2 and 15% of men and 6% of women are affected. The increase is linked to changes in lifestyle, eating patterns and obesity which has become very common. The ‘metabolic syndrome’ includes all the diseases, e.g. hypertension, lipid imbalances, type 2 diabetes mellitus, gout and cardiovascular disease, which are concomitant in the majority of stone formers. Dietary patterns, besides leading to stone formation, also determine stone chemistry. With a diet that is rich in oxalates, calcium oxalate will constitute 75% of stones, struvite 10–20%, uric acid 5–6% and cystine 1%. As approximately 50% of patients with stones suffer recurrences, metabolic and/or pharmacological prophylaxis is recommended.

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Section: Animal Proteinsmentioning

confidence: 99%

Section: Magnesiummentioning

confidence: 99%

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Prevention of Stone Disease

Porena

Guiggi

Micheli³

2007

Urol Int

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“…Cystinuria is an autosomal recessive trait caused by mutations in SLC3A1 or SLC7A9 gene resulting in an inborn error in transport of urinary cystine, ornithine, lysine and arginine (commonly known as COLA) that subsequently initiate cystine stone formation. Stone formation without any identifiable clinical causes is labeled "idiopathic," which is commonly observed in the CaOx formers [149]. However, it has been suggested that genetic screening should be performed in the previously classified idiopathic calcium UL in order to certainly rule out an underlying genetic susceptibility [148].…”

Section: Urolithiasismentioning

confidence: 99%

Oxidative Stress in Urolithiasis

Boonla¹

2018

Reactive Oxygen Species (ROS) in Living Cells

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Oxygen is absolutely essential for the survival of our life. However, metabolic consumption of oxygen inevitably yields reactive oxygen species (ROS). Imbalance of ROS production and antioxidant capacity causes oxidative stress that potentially damages biomolecules leading to cell injury and death. In fact, ROS have two-faceted functions. Under physiologic condition, ROS function as signaling molecules and participate in maintaining redox balance. In pathology, ROS induce oxidative stress that critically involves in the development of several diseases including urolithiasis (UL). UL or urinary stone disease is a common urologic condition in all countries with progressively increasing prevalence. Most of UL are multifactorial with polygenic susceptibility and highly recurrent nature. Formation of urinary stones is driven by supersaturation of urinary lithogenic ions, and calcium oxalate (CaOx) is the most prevalent stone type. Oxidative stress clearly plays an active role in UL development. In vitro, lithogenic crystals induce ROS generation in renal tubular cells leading to oxidative stress, cell injury and release of inflammatory mediators. In nephrolithic rats, oxidative stress and CaOx deposit are gradually increased in the rats' kidneys. Intervention with antioxidants efficiently reduces oxidative damage and crystal deposits. Human studies show that patients with UL have increased oxidative stress and renal tubular injury relative to the non-stone-forming individuals. Increased oxidative lesions and inflammation are observed in the stone-containing kidneys of the patients. Furthermore, renal fibrosis mediated through tubular epithelial-mesenchymal transition is observed in kidneys of stone patients. Increased renal fibrosis is significantly associated with decreased kidney function. From therapeutic point of view, nutraceutical regimens that are able to reduce oxidative stress may be clinically useful alternatives for preventing stone formation and recurrence. This chapter has an intention to provide a basic knowledge of ROS generation and oxidative stress and up-to-date research findings of oxidative stress in UL based on the published articles as well as the author's studies.

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“…The recurrence rate ranges from 35% within 5 years and after first treatment to 74% within 10 years (Uribarri et al, 1989). A number of medical treatments have been reported to prevent the recurrence of urinary stone, including encouraging patients to take more fluid, nutrient supplements and diet control (Lewandowski et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Wu-Ling-San formula prophylaxis against recurrent calcium oxalate nephrolithiasis- a prospective randomized controlled trial

Lin

Lin³

et al. 2013

Afr. J. Trad. Compl. Alt. Med.

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Wu-Ling-San (WLS) formula has been proved to prevent calcium oxalate nephrolithiasis both in vitro and in vivo. This is the first prospective, randomized and placebo-controlled clinical trial of WLS in calcium oxalate nephrolithiasis prevention. All patients who enrolled were asked to drink enough fluid to urinate at least 2 L daily during the study period. A 24-hour urine collection was performed to establish the baseline levels of multiple urinary parameters before taking the medicine. The patients were randomized and divided into two groups. The medication group took 2 gm WLS formula three times daily for 1 month. The control group took 2 gm placebo three times daily for 1 month. A 24-hour urine collection was performed to evaluate multiple urinary and serum parameters from all patients during the study period. A total of 39 patients were enrolled and 28 patients completed the study. Fourteen patients were allocated to WLS group and 14 patients to placebo group. After treatment, the mean urine output level increased to 2796.4  525.7 ml/day (percentage of change, 13.9 %) in the WLS formula group. With placebo therapy, the mean decreased slightly to 2521.4  762.7ml/day (percentage of change, -5.7 %). The percentage of change was significantly different between the two groups (independent t-test, P=0.02). No patient complained of side effects, such as fatigue, dizziness, musculoskeletal symptoms, or gastrointestinal disturbance. WLS formula is a promising adjunct to surgical and medical management of kidney stones. Active therapy with WLS formula has a positive effect on diuresis without leading to electrolyte imbalance.

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Idiopathic calcium oxalate urolithiasis: risk factors and conservative treatment

Cited by 72 publications

References 160 publications

Prevention of Stone Disease

Prevention of Stone Disease

Oxidative Stress in Urolithiasis

Wu-Ling-San formula prophylaxis against recurrent calcium oxalate nephrolithiasis- a prospective randomized controlled trial

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