Renal Stone Risk Assessment During Space Shuttle Flights

Whitson, Peggy A.; Pietrzyk, Robert A.; Pak, Charles Y.C.

doi:10.1016/s0022-5347(01)68240-5

Cited by 77 publications

(41 citation statements)

References 17 publications

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“…Nutrient content of the in-flight foods were calculated from food chemical data generated by the Johnson Space Center Water and Food Analytical Laboratory. Net alkali absorption (NAE, mEq/24 h) was derived from urinary values as previously described [8, 12]. …”

Section: Methodsmentioning

confidence: 99%

“…Recent evidence from NASA and the Russian space program has shown that humans exposed to the microgravity environment of space have a greater risk for developing renal stones [6, 7, 8]. The majority of renal stones formed here on Earth are composed of calcium oxalate or a mixture of calcium oxalate and calcium phosphate.…”

Section: Introductionmentioning

confidence: 99%

“…This increased risk occurs in most crewmembers during both short (less than 21 days) duration [6, 8]or long duration (greater than 100 days) missions [7], this paper]. Despite a screening program for potential risk factors prior to flight, ten renal stone episodes among crewmembers have been documented in the U.S. space program and the Russian space program has reported one in-flight renal stone occurrence.…”

Section: Introductionmentioning

confidence: 99%

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The Risk of Renal Stone Formation during and after Long Duration Space Flight

Whitson

Pietrzyk

Моруков

et al. 2001

Nephron

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Background: The formation of a renal stone during space flight may have serious negative effects on the health of the crewmember and the success of the mission. Urinary biochemical factors and the influence of dietary factors associated with renal stone development were assessed during long duration Mir Space Station missions. Methods: Twenty-four-hour urine samples were collected prior to, during and following long duration space flight. The relative urinary supersaturation of calcium oxalate, calcium phosphate (brushite), sodium urate, struvite and uric acid were determined. Results: Changes in the urinary biochemistry of crewmembers during long duration spaceflight demonstrated increases in the supersaturation of the stone-forming salts. In-flight hypercalciuria was evident in a number of individual crewmembers and 24-hour dietary fluid intake and urine volume were significantly lower. During flight, there was a significant increase in brushite supersaturation. Conclusions: These data suggest acute effects of space flight and postflight changes in the urinary biochemistry favoring increased crystallization in the urine. The effects of dietary intake, especially fluid intake, may have a significant impact on the potential for renal stone formation. Efforts are now underway to assess the efficacy of a countermeasure to mitigate the increased risk.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Risk of Renal Stone Formation during and after Long Duration Space Flight

Whitson

Pietrzyk

Моруков

et al. 2001

Nephron

Self Cite

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“…In the space environment, this risk of calculi formation is increased both in-and postflight by multiple metabolic factors (28,29). Osteoclastic activity is dramatically increased and grossly results in a one to one and a half percent loss of bone mass per month (11,13).…”

Section: Discussionmentioning

confidence: 99%

“…This results in the hypercalciuria of microgravity. Additionally, hypocitraturia, low urine pH, a 10%-15% decrease in plasma volume and lower urine volume (12,28,29) resulting from the microgravity environment also predispose to stone formation. This has resulted in one in-flight urinary calculus and more then ten post-flight calculi in the combined Russian and US space flight experience.…”

Section: Discussionmentioning

confidence: 99%

Medullary Sponge Kidney and Urinary Calculi: Aeromedical Concerns

Jones¹,

Cherian²,

Barr³

et al. 2008

aviat space environ med

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Abstract:Medullary Sponge Kidney (MSK) is a benign disorder associated with renal stones in 60% of patients. Patients frequently have episodic painless hematuria but are otherwise asymptomatic unless renal calculi or infections complicate the disease. Nephrolithiasis is a relative, but frequently enforced, contraindication to space or other high performance flight.Two case reports of asymptomatic NASA flight crew with MSK and three cases of military aviators diagnosed with MSK are reviewed, all cases resulted in waiver and return to flight status after treatment and a vigorous follow up and prophylaxis protocol. MSK in aviation and space flight necessitates a highly case-by-case dependent evaluation and treatment process to rule out other potential confounding factors that might also contribute to stone formation and in order to re-qualify the aviator for flight duties.

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Space Physiology

Beckers

Verheyden

Aubert

2006

Wiley Encyclopedia of Biomedical Engineering

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Space exploration has been a dream of humankind ever since Baron von Münchausen, Jules Verne, Tsiolkovsky, Goddard, and many others. However, this intriguing environment is not without risks. The human body has developed over the past thousands of years in the constant presence of gravity. When this gravitational force is no longer acting on the body, changes occur. Some of these changes occur immediately; others progress only slowly. In the past 40 years of human space flight (first orbital flight by Yuri Gagarin in April 1961), several hazards for the human body have been identified. Bone mineral density is lost, and muscle atrophy and cardiovascular deconditioning occur. These changes in human physiology have to be reversed again when astronauts return to Earth. This reversal can cause adaptation problems, especially after long‐duration space flights. Also the reaction of the human physiology to radiation in space poses a huge risk at this moment. To make long‐duration space flight possible, we must understand the mechanisms of physiological adaptation. Only with this knowledge can effective countermeasures be developed.

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Renal Stone Risk Assessment During Space Shuttle Flights

Abstract: Prepared for submission to d. Urologyhttps://ntrs.nasa.gov/search.jsp?R=19970003315 2018-05-11T07:02:30+00:00Z

Cited by 77 publications

References 17 publications

The Risk of Renal Stone Formation during and after Long Duration Space Flight

The Risk of Renal Stone Formation during and after Long Duration Space Flight

Medullary Sponge Kidney and Urinary Calculi: Aeromedical Concerns

Space Physiology

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