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Iranian Journal of Kidney Diseases Mar 2016The incidence of urolithiasis has increased in both the developed and the developing countries during the past decades. Economically, the increase of urolithiasis... (Review)
Review
INTRODUCTION
The incidence of urolithiasis has increased in both the developed and the developing countries during the past decades. Economically, the increase of urolithiasis contributes to the rise of the healthcare burden everywhere. Moreover, this increase has been associated with a change in the epidemiology of urolithiasis in terms of age and sex distribution, and also the location and type of calculi.
MATERIALS AND METHODS
We searched the MEDLINE for relevant literature dating back to 1980. This review compared the trends in epidemiological factors affecting urolithiasis in the developed and the developing countries during the past decades.
RESULTS
People in the developing countries are more likely to contract kidney calculi at a younger age than in the developed countries. Although calculus disease is still more prevalent in men than in women, the latter are increasingly affected in both worlds. Uric acid calculi are more prevalent in the developing than in industrialized countries. There is a progressive increase in the frequency of calcium oxalate and calcium phosphate calculi in the developing countries where these used to be less frequent.
CONCLUSIONS
The incidence and prevalence of urinary calculi is increasing globally. Many factors including aging of the population, changes in diet, global warming, and employment of more accurate diagnostic tools seem to be involved in this increase. An increasing affluence and adaptation of Western diet habits in many developing countries seem likely to contribute to the changes.
Topics: Age Distribution; Calcium Oxalate; Calcium Phosphates; Developed Countries; Developing Countries; Diet; Female; Global Warming; Humans; Incidence; Male; Risk Factors; Sex Distribution; Struvite; Uric Acid; Urinary Calculi
PubMed: 26921745
DOI: No ID Found -
International Journal of Surgery... Dec 2016The etiology of stone disease remains unknown despite the major technological advances in the treatment of urinary calculi. Clinically, urologists have relied on 24-h... (Review)
Review
The etiology of stone disease remains unknown despite the major technological advances in the treatment of urinary calculi. Clinically, urologists have relied on 24-h urine collections for the last 30-40 years to help direct medical therapy in hopes of reducing stone recurrence; yet little progress has been made in preventing stone disease. As such, there is an urgent need to develop reliable animal models to study the pathogenesis of stone formation and to assess novel interventions. A variety of vertebrate and invertebrate models have been used to help understand stone pathogenesis. Genetic knockout and exogenous induction models are described. Surrogates for an endpoint of stone formation have been urinary crystals on histologic examination and/or urinalyses. Other models are able to actually develop true stones. It is through these animal models that real breakthroughs in the management of urinary stone disease will become a reality.
Topics: Animals; Disease Models, Animal; Humans; Urinary Calculi
PubMed: 27840313
DOI: 10.1016/j.ijsu.2016.11.018 -
Nature Reviews. Urology Oct 2015Urolithiasis affects around 10% of the US population with an increasing rate of prevalence, recurrence and penetrance. The causes for the formation of most urinary... (Review)
Review
Urolithiasis affects around 10% of the US population with an increasing rate of prevalence, recurrence and penetrance. The causes for the formation of most urinary calculi remain poorly understood, but obtaining the chemical composition of these stones might help identify key aspects of this process and new targets for treatment. The majority of urinary stones are composed of calcium that is complexed in a crystalline matrix with organic and inorganic components. Surprisingly, mitigation of urolithiasis risk by altering calcium homeostasis has not been very effective. Thus, studies to identify other therapeutic stone-specific targets, using proteomics, metabolomics and microscopy techniques, have been conducted, revealing a high level of complexity. The data suggest that numerous metals other than calcium and many nonmetals are present within calculi at measurable levels and several have distinct distribution patterns. Manipulation of the levels of some of these elemental components of calcium-based stones has resulted in clinically beneficial changes in stone chemistry and rate of stone formation. The elementome--the full spectrum of elemental content--of calcium-based urinary calculi is emerging as a new concept in stone research that continues to provide important insights for improved understanding and prevention of urinary stone disease.
Topics: Calcium; Humans; Urinary Calculi; Urolithiasis
PubMed: 26334088
DOI: 10.1038/nrurol.2015.208 -
International Journal of Surgery... Dec 2016The devastating contamination of milk formula with Melamine, which caused havoc in China, happened almost eight years ago. Although most patients with... (Review)
Review
The devastating contamination of milk formula with Melamine, which caused havoc in China, happened almost eight years ago. Although most patients with melamine-associated urinary stone were given conservative medical treatment, the impact was not completely eliminated. Extensive studies are needed to assess chronic effects in the affected population. In this review, we describe the pathogenesis, pathology, clinical manifestations, management and epidemiology; and the need for longer term follow-up of melamine-associated urinary stones.
Topics: Animals; Child, Preschool; China; Female; Food Contamination; Foodborne Diseases; Humans; Infant; Infant, Newborn; Male; Milk; Triazines; Urinary Calculi
PubMed: 27845270
DOI: 10.1016/j.ijsu.2016.11.012 -
Urology Nov 2015
Topics: Diagnostic Imaging; Emergency Service, Hospital; Female; Guideline Adherence; Humans; Male; Quality of Health Care; Urinary Calculi
PubMed: 26590037
DOI: 10.1016/j.urology.2015.07.045 -
Clinical Journal of the American... Jul 2016Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic,... (Review)
Review
Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment.
Topics: Diet; Environmental Exposure; Humans; Population Health; Prevalence; Primary Prevention; Secondary Prevention; Urinary Calculi
PubMed: 26964844
DOI: 10.2215/CJN.13251215 -
Current Opinion in Urology Jan 2019To summarize recommendations of the guidelines of the American Urological Association and European Association of Urology, and our opinion on which urinary tract stone... (Review)
Review
PURPOSE OF REVIEW
To summarize recommendations of the guidelines of the American Urological Association and European Association of Urology, and our opinion on which urinary tract stone disease patients should be metabolically evaluated at which moment and how often.
RECENT FINDINGS
A standard metabolic evaluation should be performed in all stone formers to prevent recurrent disease. This includes a medical and lifestyle history, physical examination, basic urine and blood analysis, radiological examination and stone analysis. The latter should already be performed during surgery, especially when only a couple of fragments are sent for analysis. Supplementary, performing a 24-h urine analysis should be supported in all patients to understand the lithogenic process that will guide the according follow-up. When risk factors are found, an extended individualized metabolic evaluation should be performed to exclude underlying metabolic diseases and to start stone-specific recurrence prevention.
SUMMARY
Urologists should be trained in perioperative stone characterization, because it contains information of urinary environment at the times of stone formation and growth. The extensiveness and frequency of metabolic work-up and follow-up of stone formers should be tailored to the type of stone, severity of the disease, patient's comorbidities and medications.
Topics: Humans; Recurrence; Risk Factors; Urinalysis; Urinary Calculi
PubMed: 30325869
DOI: 10.1097/MOU.0000000000000562 -
European Review For Medical and... 2016Urinary stones have been recognized as a human disease since dawn of history and treatment of this condition is reported by Egyptian medical writings. Also, pears have a... (Review)
Review
Urinary stones have been recognized as a human disease since dawn of history and treatment of this condition is reported by Egyptian medical writings. Also, pears have a very long history, being one of the earliest cultivated fruit trees and also known for medicinal use. Urinary tract stone formation represents a common condition and also a significant burden for health care service, due also to possible frequent relapses. Furthermore, urinary stones have been reported to have relationship with different metabolic derangements, and appropriate diet could contribute to avoid or reduce urinary stone formation. Citrate is an inhibitor of crystal growth in the urinary system, and hypocitraturia represents a main therapeutical target in stone formers. Pears contain a significant amount of malic acid, a precursor of citrate, and have antioxidant activity as well. A diet supplemented with pears, and associated with low consumption of meat and salt could impact positively cardiometabolic risk and urinary tract stone formation. However, very few studies evaluated the impact of pears utilization on health, and none on urinary tract stone formation in particular. High content in malate could warrant protection against stone formation, avoiding patients at high risk to be compelled to assume a considerable and expensive amount of pills.
Topics: Citrates; Dietary Supplements; Egypt; Fruit; Humans; Kidney Calculi; Phytotherapy; Pyrus; Recurrence; Urinary Calculi; Weapons
PubMed: 26914114
DOI: No ID Found -
Current Opinion in Urology Mar 2020Burst wave lithotripsy and ultrasonic propulsion of kidney stones are novel, noninvasive emerging technologies to separately or synergistically fragment and reposition... (Review)
Review
PURPOSE OF REVIEW
Burst wave lithotripsy and ultrasonic propulsion of kidney stones are novel, noninvasive emerging technologies to separately or synergistically fragment and reposition stones in an office setting. The purpose of this review is to discuss the latest refinements in technology, to update on testing of safety and efficacy, and to review future applications.
RECENT FINDINGS
Burst wave lithotripsy produced consistent, small passable fragments through transcutaneous applications in a porcine model, while producing minimal injury and clinical trials are now underway. A more efficient ultrasonic propulsion design that can also deliver burst wave lithotripsy effectively repositioned 95% of stones in 18 human participants (18 of 19 kidneys) and clinical trials continue. Acoustic tractor beam technology is an emerging technology with promising clinical applications through the manipulation of macroscopic objects.
SUMMARY
The goal of the reviewed work is an office-based system to image, fragment, and reposition urinary stones to facilitate their natural passage. The review highlights progress in establishing safety, effectiveness, and clinical benefit of these new technologies. The work is also anticipating challenges in clinical trials and developing the next generation of technology to improve on the technology as it is being commercialized today.
Topics: Acoustics; Animals; Disease Models, Animal; Humans; Kidney Calculi; Lithotripsy; Lithotripsy, Laser; Swine; Ultrasonic Therapy; Ultrasonography; Ureteroscopy; Urinary Calculi
PubMed: 31905177
DOI: 10.1097/MOU.0000000000000727 -
California Medicine Feb 1966The possibility of upper urinary tract calculus disease is at least as great in pregnant as in nonpregnant women, and such disease if present carries greater risks...
The possibility of upper urinary tract calculus disease is at least as great in pregnant as in nonpregnant women, and such disease if present carries greater risks during pregnancy. The well-being and even the life of both mother and fetus may depend on prompt diagnosis, the right kind of management and effective treatment. With adequate precaution, such essential procedures as urography and emergency surgical intervention can be carried out during pregnancy at little greater hazard than ordinarily attends them.
Topics: Female; Humans; Pregnancy; Pregnancy Complications; Urinary Calculi; Urography
PubMed: 5909865
DOI: No ID Found