Recent advances in understanding and managing urolithiasis

Strohmaier, Walter

doi:10.12688/f1000research.9570.1

Cited by 7 publications

(6 citation statements)

References 51 publications

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“…During the last few years, there has been significant progress in both understanding and management of urolithiasis. The importance of urine biochemistry was questioned by several investigators years ago, however, the decisive role of cellular process (induced by oxidative stress) and the renal papilla has only recently been generally accepted as the most important step in stone formation [1]. Urolithiasis is characterized by the formation and retention of solid crystals within the urinary tract.…”

Section: Introductionmentioning

confidence: 99%

“…Kidney stones are mostly composed of calcium oxalate, which predominantly generates free radicals that are toxic to renal tubular cells [2]. For calcium oxalate urolithiasis, the formation of papillary calcifications plays a key role and is of prognostic relevance [1]. Urolithiasis places a significant economic burden on the healthcare system, especially in industrialized countries where, owing to changes in lifestyle and diet, the incidence of stone disease has steadily increased over the last several decades; unfortunately, it will probably continue to increase for a number of reasons, one of which is global warming [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Chronomics of Circulating Plasma Lipid Peroxides and Antioxidant Enzymes in Renal Stone Formers

Kushwaha

Gupta

Sharma³

et al. 2017

Ind J Clin Biochem

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The chronome of lipid peroxidation and antioxidant defense mechanisms may relate to the efficacy and management of time qualified preventive therapeutic and dietary interventions. One hundred renal stone patients, 20-60 years of age, and 50 clinically healthy volunteers, 21-45 years, were synchronized for 1 week with diurnal activity from 06:00 to 22:00 and nocturnal rest. All subjects took their usual meals three times daily (breakfast around 08:30, lunch around 13:00, and dinner around 20:30) with usual fluid intake. Drugs known to affect free radical system were not taken. Blood samples were collected at 6-h intervals for 24-h under standardized, presumably 24-h synchronized conditions. Determinations included plasma lipid peroxides, in terms of malondialdehyde (MDA) and blood superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and catalase (CAT) activities. A marked circadian variation was demonstrated for each studied variable by populationmean cosinor in renal stone patients and healthy participants (p \ 0.001). By comparison to healthy subjects, parameter tests indicate that the stone formers had a higher MESOR of MDA, but a lower MESOR of SOD, GPx, GR and CAT. Furthermore, the patients also differed from the healthy controls in terms of their circadian amplitude and acrophase (tested jointly) of all variables (p \ 0.001). Mapping the broader time structure with multifrequency circadian characteristics of oxidants and anti-oxidants is needed for exploring their role as marker in the treatment and management of urolithiasis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronomics of Circulating Plasma Lipid Peroxides and Antioxidant Enzymes in Renal Stone Formers

Kushwaha

Gupta

Sharma³

et al. 2017

Ind J Clin Biochem

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“…Stone location, stone burden, and any accompanied urinary tract obstructive signs provide crucial information in the management of urolithiasis, especially in patients that require surgical intervention. Small (<3 cm) and simple caliceal and pelvic stones may be treated with ESWL or flexible ureteroscopy; 9 larger and complex kidney stones are treated with PCNL. Proximal ureteral calculi can be treated with ESWL, flexible ureteroscopy, or PCNL.…”

Section: Radiological Evaluation Of Urolithiasismentioning

confidence: 99%

Medical evaluation and pharmacotherapeutical strategies in management of urolithiasis

Haleem

Mamuchashvili

et al. 2021

Therapeutic Advances in Urology

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Treatment of urolithiasis depends on several important factors which include stone location, size, composition, and patient symptoms. Although significant advancements have been made in the surgical management of urolithiasis in the last decade, pharmacotherapy which can prevent the formation of new stones and decrease the recurrence of urolithiasis has not experienced the same level of success. Currently, urolithiasis is regarded as a complicated syndrome that is determined by numerous factors, and any treatment plan for urolithiasis should be individualized while considering any potential damage arising from stone-forming factors. This review introduces the most popular methods currently used to evaluate urolithiasis and the pharmacotherapy of urolithiasis based on patient-specific factors.

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“…1,2 The incidence of renal stones is increasing off late, mainly due to changes in lifestyle and diet combined with environmental factors, with urolithiasis being more prevalent in warm regions. 3 Before the development of endourologic techniques, open surgery was the treatment of choice for renal stones. 4 To evaluate the role of double J stent versus no stent in patients of renal and upper ureteric calculus undergoing extracorporeal shock wave lithotripsy Endourologic techniques for the treatment of urolithiasis were introduced around 40 years ago, and since their advent, they have become an important modality for the treatment of renal and ureteric stones, largely because of higher stone free rates combined with lower complication rate.…”

Section: Introductionmentioning

confidence: 99%

To evaluate the role of double J stent versus no stent in patients of renal and upper ureteric calculus undergoing extracorporeal shock wave lithotripsy

2022

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Background: Extracorporeal shock wave lithotripsy (ESWL) was first introduced by Chaussy in 1980 for the treatment of urolithiasis, which has revolutionized the treatment of urinary stones. Renal colic, urinary tract obstruction, uremia, and renal failure can occur because of the stone fragments obstructing the ureter during the post-ESWL period. The role of double-J (DJ) stents in ESWL is controversial. Aims and Objectives: The aim of the study was to evaluate the role of DJ stent in patients with renal and upper ureteric calculus undergoing extracorporeal shockwave lithotripsy. Materials and Methods: Two hundred patients with solitary calculus 5 mm–2 cm in size, amenable to ESWL, located in renal pelvis, upper or middle calyx, upper ureter visiting Lok Nayak Hospital, New Delhi from December 2015 to April 2019 were studied and randomized into two groups: Test group (non-stented, 100 patients) and control group (Stented, 100 patients). Both groups underwent ESWL and subsequently compared for the following parameters: Stone clearance, post lithotripsy pain and analgesic dose requirement, number of ESWL sittings and shockwaves required, steinstrasse, urinary tract infection (UTI), and hematuria. Patients were followed up for 3 months after stone clearance to look for any recurrence. Results: There was a significant difference (P<0.05) in the two groups with smaller number of ESWL sittings and number of shockwaves required, low frequency of colicky pain episodes and mean pain score, less analgesic dose requirement, lower incidence of hematuria, and UTI in non-DJ stent group. The overall stone clearance was higher in the non-DJ stent group (96.4%) as compared to the DJ stent group (89.3%). The incidence of steinstrasse was higher in the DJ stent group (10.7%) as compared to none in the non-DJ stent group. Conclusions: There is no additional benefit of DJ stent on stone clearance, rather stenting further increases the morbidity due to associated complications. DJ stenting should not be performed in patients undergoing ESWL for renal and upper ureteric calculus up to 2 cm size.

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Recent advances in understanding and managing urolithiasis

Cited by 7 publications

References 51 publications

Chronomics of Circulating Plasma Lipid Peroxides and Antioxidant Enzymes in Renal Stone Formers

Chronomics of Circulating Plasma Lipid Peroxides and Antioxidant Enzymes in Renal Stone Formers

Medical evaluation and pharmacotherapeutical strategies in management of urolithiasis

To evaluate the role of double J stent versus no stent in patients of renal and upper ureteric calculus undergoing extracorporeal shock wave lithotripsy

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