Kidney stones are collections of microcrystals formed inside the kidneys, which affect 6% to 12% of the population worldwide, with an increasing recurrence (50%-72%) after the first episode. The most abundant type is calcium oxalate (66%), described as monohydrated (COM) and dihydrated (COD). An issue in their chemistry is the transformation process of the metastable specie (COD) into the stable one, which is chemically, and in appearance, monohydrated. Since the origin of these species is different, it is important to differentiate between the transformation stage (and what stabilize COD) to understand the physiopathology and prevent the patients' recurrence. This work focuses on the organic matter distribution along these nephroliths by synchrotron radiation-based infrared microspectroscopy. Differences in the asymmetric stretching of the aliphatic hydrocarbons suggest that lipids may participate in the stabilization of COD and as inhibitors of COM formation/development; however, the presence of proteins in the nucleus could indicate a promoting role.
INTRodUCTIoN: We assessed the effectiveness of the joint use of a pH meter in combination with dietary supplements in restoring the urinary pH balance of patients with medical history of uric acid or calcium phosphate/calcium oxalate stones in real-world practice. MeTHodS: An interventional, prospective, and open-label study was performed. At baseline visit, patients were assigned to a group according to the type of previous calculus and urinary pH: the alkalinizer group (uric acid stones and/or pH < 5.5) and acidifier group (calcium oxalate stones and/or pH > 6.2) received dietary supplement to increase or decrease, respectively, urinary pH. Patients were examined at baseline and after treatment for 30, 60, and 90 days. Urinary pH, type of therapy, compliance, and self-reported renal colic events were recorded at each visit. ReSULTS: The study included 143 patients, 45.5% in the alkalinizer group and 54.5% in the acidifier group, and the mean age was 53.60 years. Both nutraceuticals were significantly effective in normalizing urinary pH (P < 0.00001) at all follow-up visits compared with baseline, with a maximum percentage of patients who achieved nonlithogenic pH (54.9%) at day 60 (P < 0.00001). Analysis of the effect of treatment compliance at 60 days indicated that 71.8% of compliant and 45.9% of noncompliant patients achieved nonlithogenic pH (odds ratio [OR]: 3.03, 95% confidence interval [CI]: 1.29-6.66). A Cox-regression model indicated that nonlithogenic pH at 90 days (hazard ratio [HR]: 0.428, 95% CI: 0.193-0.947) and compliance at 60 days (HR: 0.428, 95% CI: 0.189-0.972) were independently associated with colic complaints-free survival. CoNCLUSIoNS: In patients with medical history of renal lithiasis, monitoring of pH in combination with dietary supplements may be useful in maintaining nonlithogenic pH values, yielding very high ratios of success, especially in compliant patients. Besides this main outcome, a reduction in self-reported colic complaints associated with pH balance was also observed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.