Predictive value of kidney stone composition in the detection of metabolic abnormalities

Pak, Charles Y.C.; Poindexter, John R.; Adams‐Huet, Beverley; Pearle, Margaret S.

doi:10.1016/s0002-9343(03)00201-8

Cited by 212 publications

(136 citation statements)

References 21 publications

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“…Studies show that calcium is present in 72% to 88% of pediatric kidney stones (20,22). The same studies show uric acid present in only 2% to 3% of stones in pediatric patients, whereas uric acid is present in 11% of kidney stones in adults (31). Although struvite (ammonium magnesium phosphate) stones previously accounted for a more significant proportion of pediatric stones (17% in one study), improvements in the diagnosis and treatment of urinary tract infections have made this type of stone rare (20,22).…”

Section: Metabolic Factorsmentioning

confidence: 92%

An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

Sas¹

2011

Clinical Journal of the American Society of Nephrology

137

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SummaryNephrolithiasis in children is a painful and costly disease that may also have detrimental long-term effects on kidney function. Recent data provide evidence that the incidence of nephrolithiasis in children is rising. Children who are white, female, and adolescent seem to have the highest risk for forming symptomatic kidney stones. Although the reasons for the rising incidence and demographic discrepancies in pediatric nephrolithiasis are not yet clear, recent investigations into urine chemistry provide clues regarding predisposing metabolic risk factors. As more data emerge regarding epidemiologic and metabolic characteristics of pediatric kidney stone formers, we hope to gain a better understanding of the causes of kidney stone disease and, ultimately, provide better strategies for stone prevention in children.

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Section: Metabolic Factorsmentioning

confidence: 92%

An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

Sas¹

2011

Clinical Journal of the American Society of Nephrology

137

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“…The drugs most frequently associated with this presentation are acetazolamide when given orally to treat glaucoma and topiramate, which is in common use today for seizure disorders and migraines (7). Calcium oxalate stones are more frequent than calcium phosphate stones in primary hyperparathyroidism, but some studies suggest an increased prevalence of calcium phosphate as at least a component of stones in this setting (8). As in this case, I usually check PTH levels in patients with calcium phosphate stones but only in calcium oxalate stone formers with high or high normal serum calcium concentration.…”

Section: Defective Renal Tubular Acidificationmentioning

confidence: 99%

A Woman with Recurrent Calcium Phosphate Kidney Stones

Goldfarb

2012

Clinical Journal of the American Society of Nephrology

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SummaryKidney stones composed predominantly (50% or more) of calcium phosphate constitute up to 10% of all stones and 15%-20% of calcium stones, 80% of which are composed of calcium oxalate. Calcium phosphate is a minor component of up to 30% of calcium oxalate stones as well. The cause of calcium phosphate stones is often obscure but most often related to a high urine pH. Some patients with calcium phosphate stones may have incomplete renal tubular acidosis. Others have distal renal tubular acidosis characterized by hyperchloremic acidosis, hypocitraturia, and high urine pH. The use of carbonic anhydrase inhibitors such as acetazolamide, topiramate, and zonisamide leads to a similar picture. Treatment options to specifically prevent calcium phosphate stone recurrence have not been tested in clinical trials. Increases in urine volume and restriction of sodium intake to limit calcium excretion are important. Citrate supplementation is probably effective, although the concomitant increase in urine pH may increase calcium phosphate supersaturation and partially offset the inhibition of crystallization resulting from the increased urine citrate excretion and the alkali-associated reduction in urine calcium excretion. Thiazides lower urine calcium excretion and may help ensure the safety of citrate supplementation.

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“…This pathological change is essential for forming kidney stones in humans. In addition, to confirm whether the deposits contained CaOx, the major constituents of most human urinary stones, 24 we performed Pizzolato staining on kidney tissue sections from control and mIL-20R1a transgenic mice. The results revealed that the basophilic granular material in dilated cortical tubules in kidneys of transgenic mice was composed of CaOx-containing protein (data not shown).…”

Section: Resultsmentioning

confidence: 99%

“…24 The mechanism of CaOx stone formation is complex and many factors are involved. The intratubular growth, aggregation and retention of crystals are considered essential for the development of kidney stones.…”

Section: Introductionmentioning

confidence: 99%

Mouse interleukin-20 receptor 1a targets renal epithelial cells and is associated with renal calcium deposition

Wei

Chang

2008

Genes Immun

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We previously identified a novel transcript, mouse (m)IL-20R1a, generated by alternative splicing of the mIL-20R1 gene and studied its possible in vitro functions. However, the function of mIL-20R1a in vivo is unknown. Overexpression of mIL-20R1a in transgenic FvB/N mice resulted in the pathological change of excess calcium deposited in the kidneys. The interplay between renal epithelial cells and calcium oxalate (CaOx) was important in the crystallization involved in the formation of renal stones (nephrolithiasis). Thus, we investigated and compared the responses of mouse renal proximal (TKPTS) and collecting (M-1) tubule cell lines to CaOx with or without mIL-20R1a. The renal epithelial cell lines exposed to CaOx in the presence of mIL20R1a showed significantly increased lactate dehydrogenase release; loss of cell viability through apoptosis; increased CaOx internalization; higher tumor necrosis factor (TNF)-a, MCP-1 and RANTES expression; and higher reactive oxygen species production. Interleukin-6, TNF-a and MCP-1 were also upregulated in the kidneys of mIL-20R1a transgenic mice. These effects of mIL-20R1a on CaOx-exposed renal epithelial cells showed that mIL-20R1a functioned as an aggravating factor in promoting calcium deposition in kidney of mice.

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Predictive value of kidney stone composition in the detection of metabolic abnormalities

Cited by 212 publications

References 21 publications

An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

A Woman with Recurrent Calcium Phosphate Kidney Stones

Mouse interleukin-20 receptor 1a targets renal epithelial cells and is associated with renal calcium deposition

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