Urolithiasis Through the Ages: Data on More Than 200,000 Urinary Stone Analyses

Knoll, Thomas; Schubert, Anne B.; Fahlenkamp, D.; Leusmann, D. B.; Wendt‐Nordahl, Gunnar; Schubert, G.

doi:10.1016/j.juro.2010.11.073

Cited by 222 publications

(196 citation statements)

References 29 publications

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“…In our study, renal stones were more common in younger individuals. Renal stones are also most often observed in younger non-PHPT individuals (4, 37), although some report differently (1). Hence, our finding could just be explained by an increased risk of renal stones with young age in the general population.…”

Section: Discussionmentioning

confidence: 60%

“…Primary hyperparathyroidism (PHPT) is a common disease with a population prevalence traditionally estimated to be 0.1-0.4% (1,2,3), previously estimated to be 0.1-0.4% (2,4) and recently up to 0.7% (5,6). The diagnostic incidence has increased considerably after the introduction of multichannel biochemistry.…”

Section: Introductionmentioning

confidence: 99%

“…In the bones, the PTH elevates plasma calcium by promoting osteoclastic bone resorption (9,11) and possibly also by enhancing the active transport of calcium over the bone-extracellular fluid barrier mediated by osteocytes and lining cells (12). PTH also increases the renal production of calcitriol (1,25(OH) 2 D) by activating the enzyme 25OHD-1a-hydroxylase (13,22). Finally, calcitriol stimulates the intestinal calcium absorption (14) and to some extent promotes the renal TRCa% (15).…”

Section: Introductionmentioning

confidence: 99%

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Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables

Starup-Linde

Waldhauer

Rolighed

et al. 2012

European Journal of Endocrinology

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Objective: To study the prevalence of renal stones and nephrocalcinosis in patients with primary hyperparathyroidism (PHPT) and to appraise biochemical variables as risk factors for developing renal calcifications. Design: Cross-sectional. Materials and methods: All patients (nZ177) undergoing diagnostic evaluation and surgery for PHPT at Aarhus University Hospital between 2007 and 2009. All patients underwent routine spiral CT scans of the abdomen to determine the presence or absence of renal calcifications. Results: A total of 45 patients (25.4%, 95% confidence intervals: 19.0-31.4%) had renal stones (15.3%) and/or renal calcifications (10.2%) on the CT scans. Compared with those without calcification (nZ132), the group with calcification had a significantly lower plasma creatinine level (67.0G25.1 vs 74.6G17.5 mmol/l, 2PZ0.03). Moreover, CaE was higher in PHPT patients with renal calcification than in PHPT patients without (0.91G0.28 vs 0.74G0.40 mmol/mmol, 2PZ0.02). The other measured or derived biochemical variables were similar in the two groups. No biochemical variable was predictive for renal calcifications in a multiple regression analysis. Conclusion: We found a high prevalence of renal calcifications among PHPT patients but no deterioration of renal function. The occurrence of calcifications was related to low plasma creatinine and a high urine calcium/creatinine ratio. However, biochemical markers in general were poor predictors for the risk of renal stones or nephrocalcinosis indicating that routine image diagnostics may be needed for the identification of these complications in order to establish indication for surgery and ensure proper treatment.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables

Starup-Linde

Waldhauer

Rolighed

et al. 2012

European Journal of Endocrinology

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“…Other investigators have noted similar increases in uric acid stone disease in the elderly population with rates ranging from 11% to 31.5%. 9,10,[15][16][17] Conversely, in our study calcium phosphate stone disease was more common in the younger age groups. However, when brushite stones were specifically examined they were more likely to present in older individuals.…”

Section: Discussionmentioning

confidence: 75%

2243 Effect of Age on the Clinical Presentation of Incident Symptomatic Urolithiasis in the General Population

Krambeck

Lieske

et al. 2012

Journal of Urology

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Purpose-We characterized variation in the clinical presentation between older and younger first time symptomatic stone formers in the general population.Materials and Methods-We studied a random sample of Olmsted County, Minnesota residents with their first diagnostic code for urolithiasis between 1984 and 2003. Chart validated symptomatic stone formers had a confirmed stone by imaging or stone passage. Clinical presentation characteristics were compared between age groups.Results-Among the 3,473 charts reviewed there were 1,590 validated incident symptomatic stone formers (mean age 43 years, range 18 to 96). Older individuals were more likely to present with atypical or no pain, fever, diarrhea, pyuria, urinary tract infections and bacteremia (p <0.001). Stone size and location did not differ by patient age. Calcium phosphate stone disease was associated with younger age, while uric acid stone and atypical stone composition was associated with older age (p <0.001). Older individuals were less likely to pass the stone spontaneously and were more likely to require surgical intervention (p <0.001). Surgical intervention was required in 516 (32.5%) individuals. Younger individuals were more likely to undergo ureteroscopy while older individuals were more likely to undergo shock wave lithotripsy, temporizing stent placement and percutaneous nephrolithotomy.Conclusions-The detection of stone disease in older individuals can be challenging due to atypical pain or absence of pain, as well as the presence of other comorbid conditions such as urinary tract infections and diarrhea. A higher index of suspicion for urolithiasis may be needed in the elderly for a more timely diagnosis and intervention to prevent morbidity. Keywords urolithiasis; age factors; epidemiology; urinary tract infections Urolithiasis is a common disorder affecting all age groups. Studies from the United States and other countries indicate that the incidence of upper tract stone disease has increased steadily during the last 5 decades. [1][2][3][4][5] With improvements in medical care and overall life expectancy, stone disease could become more common in the geriatric population. However, little is known about the effect of age on urolithiasis and existing data on geriatric stone disease are inconsistent. Payne et al found that urinary stone disease was more likely to Population based studies confirm an increase in urinary stone disease in the elderly. The NHANES II (National Health and Nutrition Examination Survey) showed increasing rates of stone disease in men up to age 65 years and in women to age 70 years. 11 A population based epidemiological study focusing on Olmsted County, Minnesota found that incident stone disease peaked for men age 60 to 69 years, and 2 peaks were noted for women at ages 30 to 39 and 60 to 69 years. 1 Finally, another study focusing on Wisconsin residents showed an increase in stone incidence in the age 60 to 64 and age 80 to 84 cohorts. 5 Given this evidence that stone disease has a significant impact on the agin...

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“…Male-to-female ratio varies from 3.13:1 (in Germany) to 1.15:1 (in Iran) [126,150]. In Thailand, we found a much lower of maleto-female ratio at 1.1-1.2:1 implying that Thai men and women have a comparable chance to develop urinary stones [146,151].…”

Section: Urolithiasismentioning

confidence: 90%

Oxidative Stress in Urolithiasis

Boonla¹

2018

Reactive Oxygen Species (ROS) in Living Cells

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Oxygen is absolutely essential for the survival of our life. However, metabolic consumption of oxygen inevitably yields reactive oxygen species (ROS). Imbalance of ROS production and antioxidant capacity causes oxidative stress that potentially damages biomolecules leading to cell injury and death. In fact, ROS have two-faceted functions. Under physiologic condition, ROS function as signaling molecules and participate in maintaining redox balance. In pathology, ROS induce oxidative stress that critically involves in the development of several diseases including urolithiasis (UL). UL or urinary stone disease is a common urologic condition in all countries with progressively increasing prevalence. Most of UL are multifactorial with polygenic susceptibility and highly recurrent nature. Formation of urinary stones is driven by supersaturation of urinary lithogenic ions, and calcium oxalate (CaOx) is the most prevalent stone type. Oxidative stress clearly plays an active role in UL development. In vitro, lithogenic crystals induce ROS generation in renal tubular cells leading to oxidative stress, cell injury and release of inflammatory mediators. In nephrolithic rats, oxidative stress and CaOx deposit are gradually increased in the rats' kidneys. Intervention with antioxidants efficiently reduces oxidative damage and crystal deposits. Human studies show that patients with UL have increased oxidative stress and renal tubular injury relative to the non-stone-forming individuals. Increased oxidative lesions and inflammation are observed in the stone-containing kidneys of the patients. Furthermore, renal fibrosis mediated through tubular epithelial-mesenchymal transition is observed in kidneys of stone patients. Increased renal fibrosis is significantly associated with decreased kidney function. From therapeutic point of view, nutraceutical regimens that are able to reduce oxidative stress may be clinically useful alternatives for preventing stone formation and recurrence. This chapter has an intention to provide a basic knowledge of ROS generation and oxidative stress and up-to-date research findings of oxidative stress in UL based on the published articles as well as the author's studies.

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Urolithiasis Through the Ages: Data on More Than 200,000 Urinary Stone Analyses

Cited by 222 publications

References 29 publications

Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables

Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables

2243 Effect of Age on the Clinical Presentation of Incident Symptomatic Urolithiasis in the General Population

Oxidative Stress in Urolithiasis

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