Factors associated with complications after percutaneous nephrolithotomy: an analysis of 1,066 cases

SUMMARY OBJECTIVE: The aim of this study was to identify predictive factors for complications after percutaneous nephrolithotomy. METHODS: We prospectively analyzed patients who underwent percutaneous nephrolithotomy from June 2011 to October 2018. The association of preoperative and intraoperative factors with the presence of complications was assessed using univariate and multivariate analyses. The significance level was set at p<0.05. RESULTS: A total of 1,066 surgeries were evaluated, and the overall complication rate was 14.9%. In all, 105 (9.8%) surgeries were performed in the prone position, and 961 (90.2%) were performed in the supine position. Univariate analysis demonstrated that surgical position, upper pole puncture, surgical time, number of tracts, and Guys Stone Score were associated with complications. In multivariate analyses, prone position (odds ratio [OR] 2.10; p=0.003), surgical time ≥90 min (OR 1.76; p=0.014), upper pole puncture (OR 2.48; p<0.001), and Guys Stone Score 3 or 4 (OR 1.90; p=0.033) were independent predictive factors for complications after percutaneous nephrolithotomy. CONCLUSION: Performing percutaneous nephrolithotomy in the supine position, in under 90 min, and avoiding upper pole punctures may reduce complications during the treatment of large kidney stones.

A single-center study of the clinical characteristics of stone cultures and preoperative urine cultures of patients with kidney stones / 现代泌尿外科杂志

【Objective】 To analyze the clinical characteristics of stone culture and preoperative urine culture of patients with renal calculi in Songjiang area of Shanghai and the relationship with postoperative infection. 【Methods】 The clinical data of 213 patients with kidney stones treated at our hospital during Jan.2020 and Jun.2022 were retrospectively analyzed. All patients underwent preoperative clean midcourse urine culture, drug sensitivity test and stone culture. The gender difference between male and female patients and the difference in postoperative infection between stone/bacterial culture positive and negative patients were analyzed. 【Results】 Among the 213 patients, 47(22.1%) had positive urine culture, and the most common bacterium was Escherichia coli (20 strains, 42.6%). The proportion of Escherichia coli was significantly higher in female patients than in male patients [12 strains (48.0%) vs.8 strains (36.4%), P<0.05], while the proportion of Klebsiella pneumoniae was significantly higher in male patients than in female patients [5 strains (22.7%) vs. 3 strains (12.0%), P<0.05]. Drug sensitivity results showed the main Gram-negative bacteria were highly resistant to ampicillin/sulbactam, cefazolin and cefuroxime, but sensitive to imipenem, kanamycin and piperacillin/tazobactam. The main Gram-positive bacteria were highly resistant to clindamycin, erythromycin and levofloxacin, but sensitive to vancomycin, teicoplanin and linezolid. Stone culture was positive in 31 cases (14.6%), and the most common bacterium was Proteus mirabilis (9 strains, 29.0%). However, there was no significant difference in the main bacterial spectrum between male and female patients. The positive rate of urine culture/stone culture in patients with postoperative fever/urosepsis was significantly higher than that in patients with negative urine culture/stone culture (P<0.05). 【Conclusion】 Escherichia coli is the main urinary spectrum of patients with kidney stones in Songjiang area, which is greatly different from the stone culture results. In clinical practice, etiological detection and antibiotics are necessary to reduce the occurrence of postoperative infection.

Descripción de las características sociodemográficas y clínicas de pacientes con litiasis renal

Contexto: los cálculos renales son cúmulos o depósitos de minerales que se forman en los cálices, la pelvis renal o el tracto urinario. Objetivo: describir las características sociodemográficas y clínicas de una muestra de pacientes con litiasis renal, mayores de 18 años. Metodología: estudio observacional descriptivo de pacientes atendidos en una consulta ambulatoria de Nefrología en Manizales en el periodo 2010-2020, donde se contaba con estudios en sangre, orina de 24 horas y estudio fisicoquímico del cálculo, además de datos sociodemográficos y clínicos relacionados. Se fragmentaron en grupos, de acuerdo con los hallazgos encontrados en los cálculos disponibles, dividiéndose en oxalato de calcio en su totalidad, calcio mixto con otro compuesto y el último grupo de cálculo no calcio. Resultados: se identificaron 54 pacientes con nefrolitiasis, de los cuales 14 de ellos fueron excluidos. Finalmente, 40 pacientes cumplieron con los criterios de inclusión. La mediana de edad fue 52,5 años, predominio del sexo masculino (55 %), donde se encontró en 20,5 % hiperuricemia, hipercalcemia en 17,6 %, hiperfosfatemia en 5 % e hipercaliemia en 7,5 %. En orina se encontró: hipocitraturia en el 71,1 %, seguido de hipercalciuria (12,5 %), hiperuricosuria (10 %) e hiperoxaluria (5 %). En 17 de los pacientes (42,5 %) se logró el estudio de la composición fisicoquímica del cálculo, en ellos la variedad de calcio mixto fue la más frecuente (55,5 %). Conclusiones: este estudio describe las características de pacientes con cálculos renales, mostrando que la mayoría tiene alteraciones metabólicas asociadas a nefrolitiasis, siendo la hipocitraturia el hallazgo más frecuente y que la mayoría de los cálculos tiene calcio en su composición.

Background: Kidney stones are accumulations or mineral deposits that form in the calyces, renal pelvis, or urinary tract. Purpose: To describe the sociodemographic and clinical characteristics of a sample of patients with kidney stones over 18 years of age. Methodology: Descriptive observational study. Patients treated in an outpatient nephrology and urology consultation in Manizales during the years 2010 to 2020, in which there were studies in blood, 24-hour urine, and a physicochemical study of the stone, as well as related sociodemographic and clinical data. They were divided into groups, according to the findings found in the available stones, dividing into calcium oxalate in its entirety, calcium mixed with another compound and the last group of non-calcium stone. Results: 54 patients with nephrolithiasis were identified, 14 of them were excluded. Finally, 40 patients met the inclusion criteria. Median age was 52.5 years, male predominance (55%), hyperuricemia was found in 20.5%, hypercalcemia in 17.6%, hyperphosphatemia in 5% and hyperkalemia in 7.5%. In urine, hypocitraturia was found in 71.1%, followed by hypercalciuria (12.5%), hyperuricosuria (10%), and hyperoxaluria (5%). In 17 patients (42.5%) there was a result of the physicochemical composition of the stone, in them the mixed calcium variety was the most frequent (55.5%). Conclusions: This study describes the characteristics of patients with kidney stones, showing that the majority have metabolic alterations associated with nephrolithiasis, hypocitraturia being the most frequent finding, and that most stones have calcium in their composition.

Thiazide and thiazide-like diuretics in nephrolithiasis / Diuréticos tiazídicos e tiazídicos-like na nefrolitíase

Abstract Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.

Resumo Diuréticos tiazídicos e tiazídicos-like são amplamente usados para o tratamento da hipercalciúria em pacientes com formação de cálculos. Embora os efeitos dos diferentes tiazídicos devam ser relativamente semelhantes em termos de prevenção da recorrência do cálculo, sua potência e efeitos colaterais podem ser diferentes. No entanto, há poucos dados sobre os efeitos metabólicos e ósseos desses agentes em pacientes com nefrolitíase recorrente com hipercalciúria. O objetivo deste artigo de atualização foi comparar nossa experiência quanto ao uso de tiazídicos e tiazídicos-like com a publicada na literatura atual, no que diz respeito às suas propriedades anticalciúricas e consequente redução da formação de cálculos recorrentes. Discutimos também seu impacto na massa óssea e potenciais efeitos colaterais.

The Influence of Hydronephrosis with Different Degrees on Urodynamics of Renal Pelvis: A Model Study / 医用生物力学

Objective To study urodynamic changes of urine at different degrees of hydronephrosis based on computational fluid dynamics (CFD) method, so as evaluate the influence of hydronephrosis degree on kidneys’ ability to discharge stones. Methods Twelve models, including the branched pelvis Model A (normal hydronephrosis A1, mild hydronephrosis A2, medium hydronephrosis A3, severe hydronephrosis A4 models), mature ampullary pelvis Model B (normal hydronephrosis B1, mild hydronephrosis B2, medium hydronephrosis B3, severe hydronephrosis B4 models), and embryo pot abdominal pelvis Model C (normal hydronephrosis C1, mild hydronephrosis C2, medium hydronephrosis C3, severe hydronephrosis C4 models) were established. The urine flow velocity and velocity vector at the neck of the kidney, the outlet of the renal pelvis were calculated by CFD method. Results As the degree of hydronephrosis increased, the flow velocity of urine at the neck of the kidney and the outlet of the renal pelvis decreased. The urinary shearing force of the stones and the kidney’s ability to discharge stones gradually decreased, whereas the circulatory stagnation zone and the velocity boundary layer in kidney aggregate system gradually increased. Conclusions Hydronephrosis can cause changes in urodynamics of the urine. Therefore, the effect of hydronephrosis with different degrees on the patient’s ability to discharge stones after surgery should be fully considered， so as to choose an appropriate treatment method for kidney stones in clinic.

Litiasis renal en Costa Rica: bioquímica y epidemiología / Nephrolithiasis in Costa Rica: Biochemistry and Epidemiology

Resumen Objetivo: La litiasis renal es la tercera enfermedad urológica más común, siendo una causa considerable de morbilidad por la sintomatología que presenta. Aunque es conocida en otros países, incluyendo Latinoamérica, en el nuestro no disponemos de informes sobre la situación, razón por la cual este estudio pretende establecer la composición bioquímica diferencial de los cálculos renales más frecuentes, para así distinguir epidemiológicamente si existen variables entre las edades y sexo. Métodos: Se encontraron 291 casos de pacientes cuyas muestras fueron referidas al centro en el periodo de 1 octubre de 2015 al 30 de septiembre de 2017. Se realizaron descripciones de las variables clínico-biológicas, y comparaciones estadísticas entre la composición bioquímica de los cálculos renales y edades descritas, para encontrar diferencias entre sexos. Resultados: Hay una mayor prevalencia de litiasis renal en hombres (62 %), en comparación con las mujeres (38 %). La mediana de presentación de la litiasis renal fue de 45 años. Se presentó en la quinta década de edad en hombres y en la cuarta década de edad en mujeres. Los compuestos oxalato de calcio, carbonato de apatita, ácido úrico y estruvita fueron los más prevalentes en litiasis renal. Conclusión: La situación de la litiasis renal en Costa Rica fue similar a la descrita en otros países. Se observa un mayor rango etario en la distribución de la enfermedad en ambos sexos. La enfermedad en el país representa un problema multifactorial en el cual las comorbilidades y los factores dietarios propician la litiasis renal.

Summary Aim: Kidney stones are the third most common urological disease, after urinary infection and prostatic disease. It is a considerable cause of morbility due to the symptoms it presents, causing many consults to the health system. This disease is well known in other countries, including Latinoamerica, but in our country there is no information available about our statistics. This study pretends to stablish the frequency of differential and biochemical composition of kidney stones in our population and distinguish differences between age and gender. Methods: 291 cases whose kidney stones samples were referred to our center in the period from October first, 2015 to September 30th, 2017. Description of the clinical and biological variables was made, and statistical comparisons were made in terms of biochemical composition, gender and age to find differences. Results: There was a higher prevalence of kidney stones in men (62%) compared to women (38%). The median age of presentation of the disease was 45 years. It occurs in the fifth decade of life in 80 Acta méd costarric Vol 62 (2), abril-junio 2020men and the forth decade in women. The compounds calcium oxalate, apatite carbonate, uric acidand struvite were the most prevalent among the patients. Conclusion: The situation of renal lithiasis in Costa Rica is similar to that described in other countries. A greater age range was observed in the distribution of the disease in both sexes. The disease in the country represents a multifactorial problem in which comorbidities and dietary factors favor renal lithiasis.

Tubeless PCNL in Macrotract for Multiple and Staghorn Calculus with More Than One Tract- A Single Centre Experience and Literature Review..

Percutaneous nephrolithotomy (PCNL) has gradually become a preferred method of treatment modality for kidney stones in adults as well as in paediatric patients. The primary objective of this study was to evaluate the outcomes and complications in patients having multiple and staghorn calculi and of different sizes, who underwent tubeless PCNL at a single, tertiary care hospital.METHODSA retrospective study was conducted at IGIMS, Patna from January 2017 to February 2018. Patients who underwent conventional PCNL with one or two access for single, multiple or staghorn calculus without nephrostomy tube were included in the study. Patients having solitary kidney with stones are excluded from this study. The primary outcomes of the study were haemoglobin, pain score, and duration of hospital stay.RESULTSA total of 96 patients underwent conventional PCNL with a mean age of 34 years and male:female ratio of 1.3:1. Majority of the patients had a single stone (n=54) followed by 28 patients with multiple stones. Medical comorbidities including hypertension, diabetes mellitus and chronic obstructive pulmonary disease were observed in patients of single (n=8), multiple (n=3) and staghorn (n=2) groups, respectively. Postoperative complications such as haematuria and pleural effusion were developed by the patients. Seventy-six patients were treated with single-tract and 20 by double tract PCNL.CONCLUSIONSPCNL is safe and efficient with limited post-operative complications. The number of residual stones were nil in single stone group while in multiple and staghorn groups insignificant number of renal stones was seen.

Balloon dilatation combined with pneumatic and ultrasound lithotripsy in the treatment of unilateral renal stones by percutaneous nephrolithotomy / 上海交通大学学报（医学版）

Objective: To investigate the application effect of balloon dilatation and percutaneous nephrolithotomy (PCNL) combined with pneumatic and ultrasound lithotripsy on the clinical treatment of unilateral kidney stones. Methods: Ninety-four patients with unilateral kidney stones who accepted PCNL in the Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from June 2017 to July 2019, were retrospectively analyzed and divided into group A and group B. Among them, 68 patients (group A) were subjected to balloon dilatation combined with pneumatic and ultrasound lithotripsy, while 26 patients (group B) underwent fascia dilatation combined with holmium laser lithotripsy. The clinical effects of two kinds of lithotripsy on the treatment of unilateral kidney stones were compared. Results: The operation time was shorter in group A than that in group B [(107.82±10.87) min vs (115.41±10.68) min, P=0.003]. The increase rate of postoperative white blood cell (WBC) was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). The fever ( ≥ 38.5 ℃ ) rate was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). There were no significant differences in hemoglobin reduction, WBC count, hospital stay, stone-free rate, blood transfusion rate and perforation rate of collection system between the two groups (all P>0.05). Conclusion: Balloon dilatation combined with pneumatic and ultrasound lithotripsy in treatment of unilateral renal stones by PCNL can shorten the operation time, and reduce the increase rate of postoperative WBC and fever rate, which is worthy of being promoted in the clinical treatment of patients with unilateral kidney stones.

Anatomical etiology and clinical significance of three-dimensional digital measurement of kidney stones / 中国组织工程研究

BACKGROUND: There are many causes of kidney stones, but there is no clear answer to whether kidney anatomy and morphology studies affect the generation of stones. OBJECTIVE: To reconstruct a three-dimensional model of the kidney and to measure and analyze anatomical data related to the etiology of kidney stones. METHODS: Thirty patients with kidney stones treated at Liangxiang Hospital in Fangshan District, Beijing from December 2017 to February 2019 were randomly selected as the study group, and the control group was 30 normal people who underwent physical examination during the same period. After collecting renal CT scan data from two groups of patients, the three-dimensional model of the kidney was reconstructed by image segmentation and fusion using Mimics 16.0. The length and width of the kidney, the length and width of the renal sinus, diameter of the junction between the renal pelvis and ureter, the distance from the upper edge of the kidney to the longitudinal line of the spinous process, the distance from the lower edge of the kidney to the longitudinal line of the spinous process, and the distance from the hilum to the longitudinal line of the spinous process. Multi-parameter Logistic regression analysis was performed on kidney anatomy parameters of patients with kidney stones. RESULTS AND CONCLUSION: There were no significant differences in the three-dimensional digital measurement results between patients with kidney stones and healthy people in the following aspects: the length and width of the kidney, length and width of the renal sinus, diameter of the junction between the renal pelvis and ureter, distance from the upper edge of the kidney to the longitudinal line of the spinous process, distance from the lower edge of the kidney to the longitudinal line of the spinous process, and distance from the hilum to the longitudinal line of the spinous process (P > 0.05). Multi-parameter Logistic regression analysis results of the kidney of patients with kidney stones indicated that there was no significant correlation among the length and width of the kidney, length and width of the renal sinus, diameter of the junction between the renal pelvis and ureter, distance from the upper edge of the kidney to the longitudinal line of the spinous process, distance from the lower edge of the kidney to the longitudinal line of the spinous process, and distance from the hilum to the longitudinal line of the spinous process (P > 0.05). These findings reveal that the difference in kidney morphology has nothing to do with the formation of stones.

Research advance in Randall plaque of kindey stone / 中南大学学报(医学版)

Urinary calculi are characterized by high incidence and recurrence rate, which is a challenge in urology. The theory of Randall plaque is widely recognized by scholars. The mechanism of Randall plaque formation includes vascular calcification, osteogenic transformation and so on. However, it still lacks a unified theory for the Randall plaque formation. As an important type of non-coding RNA, long non-coding RNA (lncRNA) is closely related to the occurrence and progress of many diseases. The difference in lncRNA expression between the renal papillary tissues of non-calculous patients and the renal papillary tissues of Randall plaque in renal calculous patients suggests that lncRNA may be involved in the formation of Randall plaque. Pseudoxanthoma elasticum is a rare autosomal recessive hereditary disease, caused by a mutation in the ABCC6 gene. Patients with pseudoxanthoma elasticum have a high prevalence of calculi, and plaque formation is observed in the patient's kidney, which may suggest that mutation in the ABCC6 gene might be involved in the formation of Randall plaque.

Long-term analysis of safety and efficacy of standard percutaneous nephrolithotomy in patients with solitary kidneys / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the long-term efficacy and safety of ultrasound-guided percutaneous nephrolithotomy (PCNL) in the treatment of patients with solitary kidney stones.@*METHODS@#The clinical data of 22 patients with solitary kidney stones treated with PCNL in Peking University People's Hospital from September 2008 to June 2014, with the follow-up data of more than 5 years were analyzed retrospectively. Perioperative indicators, postoperative stone free rate (SFR) and incidence of complications were recorded. Ultrasonography was used to evaluate the long-term stones recurrence rate. Serum creatinine and estimated glomerular filtration rate (eGFR) were used to assess the long-term renal function.@*RESULTS@#In this group of 22 patients, the average age was (50.3±11.8) years, with 10 cases of anatomic solitary kidneys, 12 functional solitary kidneys, and the median stone diameter was 1.65 (1.1-3.9) cm. All the patients had multiple stones, including 7 cases of staghorn stones. The median pre-operative serum creatinine was 104.5 (60.0-460.0) μmol/L, and the mean eGFR was (60.3±29.4) mL/min, showing no statistically significant difference compared with that before surgery. The mean operative time was (88.2±42.0) min, and there were 11 cases of single-channel and double-channel PCNL. The median serum creatinine on the first day after surgery was 102.0 (63.0-364.0) μmol/L, and the mean eGFR was (58.0±25.1) mL/min. The mean postoperative hospital stay was (8.7±5.2) days. In this group, 5 patients (22.7%) presented short-term complications, among which 4 patients presented postoperative infection and massive hemorrhage at the same time, which improved after conservative treatment, and 1 patient presented pleural injury and improved after closed thoracic drainage. Two patients (9.1%) developed long-term complications, and ureteral stricture occurred 3 months after operation, which improved after balloon dilatation. The median follow-up time was 6.2 (4.7-11.1) years. The median serum creatinine at the last follow-up was 104.0 (72.4-377.0) μmol/L, and the mean eGFR was (60.1±23.7) mL/min, showing no statistically significant difference compared with that before surgery. Renal function decreased in 6 patients (27.3%). Initial and final SFR were 72.7% and 100%, respectively. During the 6.2-year follow-up, 9 patients (40.9%) experienced recurrence of kidney stone. After stone recurrence, 13 lithotomy surgeries were performed, and the SFR by the latest follow-up was 63.6%.@*CONCLUSION@#This study had the longest follow-up time for patients with solitary kidney stones after PCNL reported at home and abroad. Ultrasound-guided standard PCNL was safe and effective in the treatment of solitary kidney stones. Long-term follow-up results showed that the recurrence rate of kidney stones was still high, but the long-term renal function was stable after operation, and some patients showed mild renal function decline.

Effective Treatment for Kidney Stone with Local Plants from Aadilabad Telangana State, India

Aim: We aim to treat the poor and downtrodden tribal people of Adilabad district of Telangana State, South India, who are suffering from kidney stones, with locally available plants and with any side effects also without financial burden on them. Design of the study: Identifying the infected people with kidney stones based on the lab reports, explaining about our treatment, educating them, counseling them, treatment and precautionary measures. Place and Duration of Study: Adilabad district, Telangana State, South India. Duration of study is for two years that is 2018 to 2019. Methodology: We have identified around 24 patients (male and female) suffering from kidney stone ailment, but we have presented only six patients details in table form. Treatment is with locally available plants for two days, the results were very much success. Results: After our treatment the kidney stones, though they are large in size they dissolved and were passed through the urinary tract. Conclusions: Our treatment is pure with plants without any side effects and free of cost. The patients were very much satisfied with our treatment.

Factores predictores del estado libre de cálculos en la primera ureteroscopia flexible con litotricia láser / Predictors of stone-free status in the first flexible ureteroscopy with laser lithotripsy

Resumen Introducción: La ureteroscopia flexible con litotricia láser (URSLL) es una modalidad mínimamente invasiva de tratamiento quirúrgico de cálculos renales. La selección inadecuada de pacientes para este procedimiento genera un desbalance de costo-efectividad. Objetivo: Conocer los factores predictores de estado libre de litos en un solo tiempo quirúrgico en pacientes sometidos a URSLL. Método: Cohorte retrospectiva de pacientes sometidos a URSLL. Se realizó un análisis univariado y multivariado (regresión logística) de los predictores de estado libre de cálculos en la primera URSLL, global y categorizado por sexo. Resultados: EL estado libre de cálculos en la primera URSLL fue de 73.62 %. Los predictores de estado libre de cálculos en hombres fueron edad y tamaño, densidad y multiplicidad del cálculo; en las mujeres, el índice de masa corporal y la multiplicidad del cálculo. Conclusiones: Los factores pronósticos de estado libre de cálculos en la primera URSLL son distintos en hombres y mujeres. Las mujeres con obesidad y sobrepeso probablemente tengan cálculos de fácil fragmentación y extracción asociados con ácido úrico.

Abstract Introduction: Flexible ureteroscopy and laser fragmentation (FURSL) is a minimally invasive modality for surgical treatment of renal stones. Inadequate selection of patients for this treatment generates a cost-effectiveness unbalance. Objective: To know the stone-free rate predictors in a single surgical time in patients undergoing FURSL. Method: Retrospective cohort of patients undergoing FURSL. Global and gender-categorized univariate and multivariate (logistic regression) analyses were performed to identify stone-free predictors at first FURSL. Results: Stone-free rate at first FURSL was 73.62%. Predictors in males were patient age and stone size, density and multiplicity; in females, body mass index and multiplicity of stones. Conclusions: Stone-free rate predictors at first FURSL are different in males and females. Women with overweight and obesity probably have easy-to-fragment and easy-to-extract stones associated with uric acid.

Correlation analysis between meteorological conditions and emergency visits for renal calculi and colic / 中国医师进修杂志

Objective To explore the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Methods Retrospective study design was applied to collect the emergency visiting data of acute renal colic attack in zhongnan hospital of Wuhan university from January 1, 2016 to December 31, 2017, as well as the average daily temperature and humidity in wuhan, hubei province during the same period. Pearson correlation analysis and linear regression analysis were used to study the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Results The results of multivariate linear regression analysis showed that the R 2 of daily visits of patients with renal colic and daily meteorological conditions was 0.309 (P < 0.05), and the R 2 of monthly visits of patients and monthly meteorological conditions was 0.642 (P<0.05). Conclusions Both temperature and humidity are correlated with the number of emergency visits of acute attack patients with renal calculi and colic.

Litiasis urinaria y su relación con el consumo de aguas duras en la comuna de Maipú / Urinary lithiasis and its relation to the consumption of hard water in the Maipu Borough

INTRODUCCIÓN: La litiasis urinaria es una patología frecuente, que afecta principalmente a adultos en edad productiva, y que en el último tiempo ha presentado un aumento en la incidencia global. Cerca del 80 % de los cálculos se componen mayoritariamente de calcio. Existe controversia en la literatura sobre el rol que podría tener el consumo de aguas con altos índices de dureza y el riesgo de padecer litiasis. El objetivo de este estudio es identificar una posible asociación entre dureza de agua para consumos e incidencia de litiasis urinaria en la poblacion de Maipú. MATERIALES Y METODOS: Se incluyen en el estudio todos los pacientes atendidos por urólogos en forma ambulatoria electiva en el Hospital El Carmen de Maipú, por diagnóstico de litiasis urinaria, en los años 2015 y 2016, que residen en la comuna. Se georreferenciaron de acuerdo a sus direcciones en los distintos sectores de distribución de agua potable.Se realizó análisis fisicoquímico de muestras de agua extraídas de cada sector para determinar su dureza. Se estudiaron a través del índice de correlación de Pearson las posibles asociaciones entre dureza del agua e incidencia de litiasis. RESULTADOS: La dureza promedio del agua de Maipú es de 484 mg/L de CaCO3, valor que se encuentra por sobre el promedio regional y nacional. La incidencia anual de litiasis en la poblacion estudiada fue de 4,4 casos/10.000 habitantes, valor similar al promedio nacional. El índice de correlación de Pearson entre dureza de agua e incidencia anual fue de -0,51. CONCLUSIONES: No fue posible establecer una relación causal entre dureza de agua e incidencia de litiasis en la población estudiada. Se sugiere avanzar en esta misma línea con estudios futuros de casos y controles.AU

INTRODUCTION: Urinary lithiasis is a frequent pathology, which mainly affects adults in a productive age, and which-in recent times- has increased in terms of global incidence. About 80 % of the stones are composed mainly of calcium.There is controversy in literature addressing the possible relation amongst water consumption with high hardnessindexes and the risk of lithiasis. The objective of this study is to identify a possible association between water hardnessfor consumption and urinary lithiasis incidence in the Maipu population. MATERIALS AND METHODS: All patients assisted by urologists on an elective ambulatory basis, at the El Carmen Hospital in Maipú, diagnosed with urinary lithiasis, in the years 2015 and 2016, and who reside in the Borough have been included in the study. They were georeferenced according to their address in the different drinking water distribution areas. Physiochemical analysis of water samples extracted from each sector was carried out to determine its hardness. The possible associations between hardness of water and incidence of lithiasis were studied through the Pearson correlation index. RESULTS: The average water hardness in Maipu is 484 mg / L of CaCO3, a value that is above the regional and national average. The annual incidence of lithiasis in the studied population was 4.4 cases / 10,000 inhabitants, a value that is similar to the national average. The Pearson correlation index between water hardness and annual incidence was -0.51. CONCLUSIONS: It was not possible to establish a causal relation between water hardness and incidence of lithiasis in the studied population. It is suggested to advance in this same line with future case and control studies.

Effect of Fructus Mume Extract on Repair of Renal Injury Induced by Nanobacteria in Rats and Its Relationship with Antagonistic Stone Formation / 中国医科大学学报

Objective To observe the early effect of Fructus mume extract on KIM-1 and OPN levels in rats with kidney stone formation induced by nanobacteria and to investigate the therapeutic significance of F.mume extract on early kidney stone formation.Methods Nanobacteria were separated and cultured from human upper urinary calculi.The study group appropriately included 54 healthy male SD rats.The renal calculus model was constructed by tail vein injection of nanobacteria.A kidney stone model was created with an F.mume extract intervention,and rats were killed at different stages of the intervention.Real-time polymerase chain reaction was used to detect the KIM-1 mRNA expression in rat renal tissue,and the KIM-1 concentration in urine was detected by using enzyme-linked immunosorbent assay.We detected kidney tissue stone crystals and OPN expression by using hematoxylin-eosin staining and immunohistochemistry.Results Renal tubules of the experimental model were significantly expanded,that is,the formation of renal tubular stones.The early KIM-1 and OPN expression levels were increased.The above-mentioned changes positively correlated with the injection time of the nanobacteria,and F.mume extract antagonized the changes.Conclusion F.mume extract may be useful for the repair of renal injury to reduce kidney stone formation,which may be related to the gene regulation of KIM-1 and OPN.

Effects of Tamm-Horsfall protein on kidney stone formation / 医学研究生学报

Objective Tamm-Horsfall protein (THP) may play a role in kidney stone formation.The article aimed to conduct a preliminary study on the role of THP in kidney stone formation by investigating the changes of THP in rat urine, pathological changes of renal tissue and the formation of calcium salt crystals after establishing CNPs rat model of kidney stones.Methods Stone samples of 40 patients from February to June 2015 in our department were collected to establish the model of CNPs-induced kidney stone in rats and prepare CNPs suspension.48 SD rats were randomly divided into experimental group (group A) and blank control group (group B).Group A were injected with CNPs and the same amount of sterile saline injection in the group B.The urine of rats was collected after injection at 3h, 6h, 12h, 24h, 1w, 2w, 4w and 8w.ELISA were applied to detect THP levels in the urine.Then the rats were killed to take the kidney tissue.HE staining was used to investigate the pathological changes of the cells and evaluate the formation of the calcium salt crystals.Results THP levels in group A at 24h, 1w, 2w, 4w and 8w ([166.03±3.02], [173.50±1.78], [174.55±2.05], [176.54±2.45], [177.11±1.76]pg/mL) were significantly higher than that at 3h(165.89±2.23pg/mL)(P<0.05), which was the same case in comparison with those of group B ([157.65±2.22], [156.54±1.43], [159.45±3.21], [158.63±2.98], [157.33±2.05]pg/mL).Compared with the calcium salt crystal score at 6h (1 point), the scores at 3,6,12,24h (average score 2 points) increased.At 2w the score increased significantly to 3 points and reached the top score(6.7points) at 8w, which was of significant difference.The score of calcium salt crystals was in positive correlation with THP content (r=0.843,P<0.05).Conclusion THP in urine may contribute to the aggregation of calcium salt crystals and the formation of kidney stones.

Effect of Yiqihuoxue Paishiyin combined with levofloxacin on renal calculus and inflammatory state / 中国生化药物杂志

Objective To study the effect of Yiqihuoxue Paishiyin combined with levofloxacin on renal calculus and inflammatory state. Methods 76 patients with kidney stones in our hospital from February 2015 to September 2016 were selected as the study object,and they were divided into control group 38 cases and observation group 38 cases by the method of random number table,then the control group were treated with levofloxacin, the observation group were treated with supplementing qi,promoting blood circulation and removing stones combined with levofloxacin,then the clinical effective rates,serum fever and pain related inflammatory factors before and after the treatment of two groups were analyzed .Results The total effective rates of observation group with different stone diameters and stone locations were all higher than those of control group,the serum fever and pain related inflammatory factors at different time after the treatment were all lower than those of control group , the differences were all significant ( P <0.05 ) . Conclusion Yiqihuoxue Paishiyin combined with levofloxacin treatment of kidney stones in patients with significant effect , can effectively control the body's inflammatory state, improve the level of inflammatory factors.

Expression of matrix Gla protein and bone morphogenetic protein 2 in renal papillary tissues in patients with calcium oxalate kidney stones / 中南大学学报(医学版)

Objective:To compare expression levels of matrix Gla protein (MGP) and bone morphogenetic protein 2 (BMP-2) in Randall's plaque of renal papillary tissues in patients with calcium oxalate kidney stones and the underlying mechanism for stone formation.Methods:A total of 30 samples of Randall's plaque in renal papillary tissues from patients with calcium oxalate kidney stones were collected from the Department of Urology of Xiangya Hospital of Central South University from April,2015 to December,2015 and served as an experimental group.Ten samples of renal papillary tissues in patients undergone renal tumor nephrectomy were collected from the same hospital and served as a control group.The expressions of MGP and BMP-2 mRNA and protein were detected by quantitative real-time PCR and Western blot.Meanwhile,immunohistochemical technique was used to observe the expressions of MGP and BMP-2 in different parts of renal papillary tissues in the 2 groups.Results:1) The mRNA expression levels of MGP in the experimental group and the control group were 0.760±0.804 and 1.365±0.348,respectively,with significant difference between them (P＜0.05).Them RNA levels of BMP-2 in the experimental group and the control group were 2.500±0.725 and 1.485±0.870,respectively,with significant difference between them (P＜0.05).The expression levels of MGP protein in the experimental group and the control group were 0.130±0.424 and 0.202±0.704,respectively,with no significant difference between them (P＞0.05).The expression levels of BMP-2 protein in the experimental group and the control group were 0.885±0.220 and 0.682±0.272,respectively,with significant difference between them (P＜0.05).T-he immunohistochemistry showed that the protein expression of MGP in the experimental group was lower than that in the control group,while the protein expression of BMP-2 in the experimental group was higher than that in the control group (both P＜0.05).Conclusion:The BMP-2 expression is increased while MGP expression is decreased in renal papillary tissues in patients with calcium oxalate kidney stones,and the formation of calcium oxalate kidney stone might be a kind ofosteogenetic reaction or ectopic calcification.

Clinical effects of different position of percutaneous nephrolithotomy in solitary renal calculi / 局解手术学杂志

Objective To study the effect and safety of modified Valdivia position and prone position in percutaneous nephrolithotomy(PCNL) on renal calculi.Methods The clinical data of 94 patients with solitary renal calculi admitted in our hospital from September 2015 to November 2016 were enrolled to this study,who were divided into control group and study group by surgery methods and body position,47 cases in each group.The control group received PCNL with prone position,and the study group were treated by PCNL with modified Valdivia position.The operative condition,postoperative condition,stone clearance rate and incidence of adverse reactions between the two groups between two groups were compared,and the levels of diastolic blood pressure(DBP),systolic blood pressure(SBP) and heart rate(HR) between the two groups were observed.Results After position placement,DBP and SBP level decreased in both groups,the level of DBP and SBP in study group were lower than the control group,the difference was significant(P0.05).The operative time,intraoperative blood loss,hospitalization time,reoperation rate and blood transfusion rate in the study group were lower than those in control group,the differences were significant(P0.05).Conclusion PCNL with modified Valdivia position has high safety and significant effect on patients with kidney stones,which can effectively remove stones,reduce operation time.