The Stone Clinic Effect in Patients With Idiopathic Calcium Urolithiasis

Hosking, Denis H.; Erickson, Stephen B.; Berg, C. J. Van Den; Wilson, David M.; Smith, Lynwood H.

doi:10.1016/s0022-5347(17)51711-5

Cited by 205 publications

(77 citation statements)

References 21 publications

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“…In addition, we detected significant heritability for urinary osmolality and volume, which could implicate genetic regulation of thirst. This may not be entirely surprising, because low urinary volume has been a consistent risk factor for stone disease in many studies over the years (38).…”

Section: Discussionmentioning

confidence: 96%

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Lieske

Turner

Edeh

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Kidney stones and their risk factors aggregate in families, yet few studies have systematically estimated heritabilities and genetic correlations of the numerous urinary traits associated with risk of kidney stones.Design, setting, participants, & measurements Twenty-four-hour urine samples were collected from the Genetic Epidemiology Network of Arteriopathy cohort of families in Rochester, Minnesota, to measure urinary determinants of supersaturation. Diet was assessed using the Viocare food frequency questionnaire. Heritabilities and genetic correlations among the urinary traits were estimated using variance components methods.Results Samples were available from 811 individuals (344 men, 467 women; mean age 6669 years). Age, sex, and weight were significantly correlated with the majority of urinary traits. Many urine excretions (calcium, magnesium, citrate excretion) had strong evidence for heritability (P,0.01) both before and after adjusting for the identified covariates. Among significantly heritable urinary traits, genetic factors explained 20%-36% of interindividual variation after adjustment for covariates. Urinary calcium excretion was significantly genetically correlated with urinary magnesium and with urinary citrate excretion (P,0.05). Although eGFR influenced many urinary traits, controlling for eGFR did not greatly affect estimated heritabilities.Conclusions Evidence from this cohort suggests a strong heritable component to many urinary nephrolithiasis risk factors. Further study of genetic influences on urinary traits relevant for kidney stone pathogenesis is warranted.Clin J Am Soc Nephrol 9: 943-950, 2014.

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Section: Discussionmentioning

confidence: 96%

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Lieske

Turner

Edeh

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…The "stone clinic effect" and successive role of dietary measures in reducing stone recurrence rates is well described. 15 A recent meta-analysis highlighted the importance of fluids in reducing stone recurrence, with a risk reduction in stone formation of 60-80%. 16 Unfortunately, less than 10% of high-risk renal stone patients undergo a metabolic evaluation.…”

Section: Discussionmentioning

confidence: 99%

Compliance of the recurrent renal stone former with current best practice guidelines

Bos

Kim

Hoogenes

et al. 2017

CUAJ

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Introduction: Patient compliance to best practice guidelines is a significant factor in preventing renal stone recurrence. While patient compliance has been historically poor, there remains a paucity of data in the renal stone setting. We evaluated compliance of the recurrent renal stone former with current Canadian Urological Association (CUA) best practice guidelines. Methods: A prospective, cross-sectional study design was used to evaluate patient compliance. Recurrent renal stone former patients were consecutively recruited from McMaster's Institute of Urology and completed a one-time questionnaire developed in accordance with CUA best practice guidelines. Questionnaire sections included: 1) demographics; 2) interaction(s) and satisfaction with their healthcare provider; and 3) knowledge, attitudes, and compliance with best practices. Results: A total of 300 patients were enrolled in the study; 55.3% were men, 69.5% had a history of stone surgery, while 23.7% had a positive family history. Participants perceived satisfactory education from their urologist and primary care physician 82.7% and 59.7% of the time, respectively (p<0.05). Nearly a quarter of patients (22.8%) perceived their stone disease to be severe and 67.1% of patients believed in the efficacy of preventative stone measures. Overall, 45.8% of patients were compliant with CUA best practice guidelines. The majority of patients (72.6%) complied with high fluid intake, the most critical stone preventative practice. Conclusions: Consistent with previous studies, compliance to dietary recommendations in this evaluation of recurrent stone formers was low. Study findings may be attributed to insufficient knowledge translation, lack of perceived disease severity, and/or patient uncertainty in the importance of preventative stone practices.

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“…A stepwise discriminant analysis for assessment of the contribution of different variables revealed the change in urine volume as an independent risk factor for stone recurrence. Hosking et al (1983) reviewed the clinical courses of 108 patients with idiopathic calcium stone disease on a conservative management program of increased fluid intake and elimination of dietary excesses alone and with a mean total follow-up of 76.073.7 months (Hosking et al, 1983, CE III). There was no evidence of stone growth or new stone formation (metabolic inactivity) in 58.3% of the patients after a mean follow-up of 62.6 months.…”

Section: Preventive Effects Of Fluid Intakementioning

confidence: 99%

Fluid intake and epidemiology of urolithiasis

Siener

Hesse

2003

Eur J Clin Nutr

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A low urine volume is an important risk factor in urinary stone formation. The present article summarizes available data from epidemiological and clinical studies to elucidate the impact of fluid intake and urine volume on the risk of urinary stone formation and the prevention of stone recurrence. A review of the literature shows that an increased urine volume achieved by a high fluid intake exerts an efficacious preventive effect on the onset and recurrence of urinary stones. A high water intake and urine dilution results in a marked reduction in saturation of lithogenous salts. The type of fluids should be carefully selected to achieve the appropriate change of urine composition depending on stone composition. A sufficient intake of fluid is one of the most important preventive measures for stone recurrence.

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The Stone Clinic Effect in Patients With Idiopathic Calcium Urolithiasis

Cited by 205 publications

References 21 publications

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Heritability of Urinary Traits That Contribute to Nephrolithiasis

Compliance of the recurrent renal stone former with current best practice guidelines

Fluid intake and epidemiology of urolithiasis

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