ABSTRACT
Purpose: The aim is to study the diversity in the composition of kidney stones and its association with the basic biochemical metabolic panel in patients with kidney stone disease (KSD). Methods: A cross-sectional prospective study enrolling consecutive patients with KSD attending a tertiary care hospital in Mangalore (India) was undertaken. Mineral compositions of kidney stones were analyzed using attenuated total reflection-Fourier transform infrared spectroscopy. Kidney stones were classified into different groups according to the composition. Metabolic status was assessed to analyze possible association with the kidney stone. Results: A total of 369 patients (male 305 and female 64) in the age group of 43.05 ± 14.3 years were included in the study and showed a high diversity of kidney stone types with >50% with mixed compositions. A significant association was found between pure stone type and gender as well with age group (P < 0.001). Serum calcium levels in the calcium oxalate stone formers were significantly higher (P < 0.001) than others. Similarly, uric acid stone formers showed higher random blood sugar, blood urea, uric acid, and serum creatinine levels (P < 0.001). Urine pH was also found to be a contributing factor for the stone formation (P < 0.001). Stone recurrence did not differ significantly concerning stone composition as well as metabolic status. Conclusion: The study reports a high diversity of the kidney stone types among patients. This finding highlights the increased cases of mixed stones that may be because of various lifestyle factors resulting in altered metabolic status. This finding warrants mechanistic studies to understand the etiology of stone formation. This will enable to develop novel noninvasive interventional strategies and proper preventive strategies to reduce the risk of KSDs.
ABSTRACT
Nutrition has been widely recognized to have certain levels of influence on the risk of kidney stone formation. Thus, this case-control study was conducted to determine the association of dietary intake and lifestyles factors with kidney stone disease. Sociodemographic data, dietary intake, supplements intake, smoking and alcohol habit, medical history, physical activity and anthropometric data were obtained using interviewer-administered pre-tested questionnaires among 81 patients who had been diagnosed with kidney stone disease and 81 patients without kidney stone disease at Universiti Kebangsaan Malaysia Medical Centre. The results indicated that body mass index and hip circumference were higher among cases as compared to controls in both men and women (p < 0.05). Energy, macronutrients and micronutrients intake were higher for case subjects compared to control subjects for all significant parameters (p < 0.05). Results showed positive association of kidney stone with consumption of nuts (≥1 time/week) for men and women while consumption of eggs (1-3 times/month) and beans (1-6 times/week) showed positive association for women. Analysis of multivariate found the risk factor among women was diabetes mellitus [Adjusted OR = 27.6 (95% CI = 1.43-53.3)] (p < 0.05). Whilst, plain water intake of at least 6 glasses [Adjusted OR = 0.001 (95% CI = 0.000-0.08)] (p < 0.05) and 8 glasses per day [Adjusted OR = 0.001 (95% CI = 0.000-0.02)] (p < 0.05) reduced the risk among women. The risk factors for men were smoking habits [Adjusted OR = 16.2 (95% CI = 1.29-203)] (p < 0.05), consumption of carbonated drink 1-3 times per month [Adjusted OR = 6.25 (95% CI = 1.04-40.7)] (p < 0.05) and 1-6 times per week [Adjusted OR = 12.5 (95% CI = 1.41-111)] (p < 0.05). Unhealthy dietary and lifestyles factors increased the risk of kidney stone disease and various risk factors were found for different sexes.
Subject(s)
Kidney CalculiABSTRACT
The surgical management of kidney-stone disease has undergone dramatic changes over the past 20 years. The introduction and development of percutaneous renal surgery, extracorporeal shock-wave lithotripsy, ureteroscopy, and technical advances in the available modalities for intracorporeal lithotripsy have led to a revolution in the surgicalmanagement of kidney-stone disease. The indications for open kidney-stone surgery have been narrowed significantly, and for the most part open surgery has become a second or third line treatment option. In this article, the authors attempt to better define acceptable indications for open kidney-stone surgery, to review commonly accepted advantages of open stone procedures and to establish expected results and outcomes following open surgery for kidney-stone disease