Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted t...Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy(mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones.展开更多
Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in t...Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes.Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics,metabolism and morphology.In this review we try to provide some quantitative information on urinary supersaturation with respect to stone minerals,especially Ca oxalate(CaO x),on the formation and aggregation of Ca Ox crystals and on crystal retention in the kidney.The paper is centered on idiopathic Ca nephrolithiasis being the most frequent stone disease with only partially known pathogenesis.New aspects of the role of urinary macromolecules in stone formation and of the mechanism of crystal aggregation are provided.展开更多
Nephrolithiasis is increasing in developed and developing countries at an alarming rate. With the global spike in kidney stone diseases, it is crucial to determine what risk factors are influencing the current global ...Nephrolithiasis is increasing in developed and developing countries at an alarming rate. With the global spike in kidney stone diseases, it is crucial to determine what risk factors are influencing the current global landscape for kidney stones. Our aims for this review are: to identity and analyze the four categories of risk factors in contributing to the global scale of stone formation: lifestyle, genetics, diet, and environment; and discuss preventative measures for kidney stone formation. We also performed data search through the published scientific literature, i.e., PubMed~? and found that there is a significant link between lifestyle and obesity with cases of calcium stones. Food and Agriculture Organization of the United Nations and World Health Organization factor indicators for dietary intake and obesity, along with climate data were used to create the projected total risk world map model for nephrolithiasis risk. Complete global analyses of nephrolithiasis deplete of generalizations is nearly insurmountable due to limited sources of medical and demographic information, but we hope this review can provide further elucidation into confounding risk factors and preventative measures for global nephrolithiasis analysis.展开更多
Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurre...Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their effciency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guide-lines are useful in promoting public health and deve-loping nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient’s nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing litho-genic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.展开更多
Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis,but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma,profound ...Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis,but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma,profound tubular damage and interstitial inflammation and fibrosis.Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to endstage renal disease(ESRD).This sequence of events,well recognized in the past in primary and enteric hyperoxalurias,has also been documented in a few cases of dietary hyperoxaluria.Estimates of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide,thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these regions.Studies addressing this question have the potential of improving population health and should be undertaken,alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate,and into the mechanisms of development of oxalate-induced renal parenchymal disease.Novel preventive and therapeutic strategies for treating all types of hyperoxaluria are expected to develop from these studies.展开更多
In human nephrolithiasis, most stones are containing calcium and are located within urinary cavities; they may contain monohydrate calcium oxalate, dihydrate calcium oxalate and/or calcium phosphates in various propor...In human nephrolithiasis, most stones are containing calcium and are located within urinary cavities; they may contain monohydrate calcium oxalate, dihydrate calcium oxalate and/or calcium phosphates in various proportion. Nephrolithiasis may also be associated with nephrocalcinosis, i.e., crystal depositions in tubular lumen and/or interstitium, an entity which suggests specific pathological processes. Several rodents models have been developed in order to study the pathophysiology of intrarenal crystal formation. We review here calcium rodent models classified upon the presence of nephrolithiasis and/or nephrocalcinosis. As rodents are not prone to nephrolithiasis, models require the induction of a long standing hypercalciuria or hyperoxaluria(thus explaining the very few studies reported), conversely to nephrocalcinosis which may occur within hours or days. Whereas a nephrotoxicity leading to tubular injury and regeneration appears as a critical event for crystal retention in nephrocalcinosis models, surprisingly very little is known about the physiopathology of crystal attachment to urothelium in nephrolithiasis. Creating new models of nephrolithiasis especially in different genetic mice strains appears an important challenge in order to unravel the early mechanisms of urinary stone formation in papilla and fornices.展开更多
The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(AN...The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(ANL) is a valid and useful alternative for conventional staghorn calculi excision. Although excellent stone free rates can be achieved with ANL there are some drawbacks that may be of concern. Morbidity related to intraoperative and postoperative complications isone of them. Another, great concern is the possibility of reduction on renal function related to the procedure itself. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. In this review we assess functional results after anatrophic nephrolithotomy.展开更多
Objective To evaluate the effectiveness of shock wave lithortripsy （SWL） for treating patients with calculus after failure of endoscopic lithortripsy. Methods From Feb. 2006 to Mar. 2007, 60 patients presented to ou...Objective To evaluate the effectiveness of shock wave lithortripsy （SWL） for treating patients with calculus after failure of endoscopic lithortripsy. Methods From Feb. 2006 to Mar. 2007, 60 patients presented to our department with the upper urinary tract stones. Thirty-seven patients were renal stones and twentythree were ureteral stones. All patients with average stone burden of 1.5 cm were treated using a Dornier Compact S lithotripter. The total number of shock waves varied from 1 600 to 3 000 and the energy levels ranged from 1 to 6 units. Results For 37 renal stones, the fragmentation was 75. 67% （28cases） after one SWL session, 10.81% （4 cases） after2 SWL sessions, 5. 40% （2 cases） after 3 SWL sessions, and 2. 70% （1 case） after 4 SWL sessions. Two patients （5.40%） failed and changed to open surgery. For23 ureter calculus, the fragmentation was 82.60% （19cases） after one SWL session and l7. 40% （4cases） after 2 SWL sessions. Conclusion SWL is an effective and reliable treatment for patients with calculus after failure of endoscopic lithortripsy. However, it is very important for doctor to choose appropriate therapy. SWL is a remedy.展开更多
文摘Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy(mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones.
文摘Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes.Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics,metabolism and morphology.In this review we try to provide some quantitative information on urinary supersaturation with respect to stone minerals,especially Ca oxalate(CaO x),on the formation and aggregation of Ca Ox crystals and on crystal retention in the kidney.The paper is centered on idiopathic Ca nephrolithiasis being the most frequent stone disease with only partially known pathogenesis.New aspects of the role of urinary macromolecules in stone formation and of the mechanism of crystal aggregation are provided.
基金Supported by National Institute of Diabetes and Digestive and Kidney Diseases,No.DK102043(to Bidhan C Bandyopadhyay)National Institute of Biomedical Imaging and Bioengineering,No.EB021483(to Bidhan C Bandyopadhyay)
文摘Nephrolithiasis is increasing in developed and developing countries at an alarming rate. With the global spike in kidney stone diseases, it is crucial to determine what risk factors are influencing the current global landscape for kidney stones. Our aims for this review are: to identity and analyze the four categories of risk factors in contributing to the global scale of stone formation: lifestyle, genetics, diet, and environment; and discuss preventative measures for kidney stone formation. We also performed data search through the published scientific literature, i.e., PubMed~? and found that there is a significant link between lifestyle and obesity with cases of calcium stones. Food and Agriculture Organization of the United Nations and World Health Organization factor indicators for dietary intake and obesity, along with climate data were used to create the projected total risk world map model for nephrolithiasis risk. Complete global analyses of nephrolithiasis deplete of generalizations is nearly insurmountable due to limited sources of medical and demographic information, but we hope this review can provide further elucidation into confounding risk factors and preventative measures for global nephrolithiasis analysis.
文摘Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their effciency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guide-lines are useful in promoting public health and deve-loping nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient’s nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing litho-genic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.
文摘Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis,but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma,profound tubular damage and interstitial inflammation and fibrosis.Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to endstage renal disease(ESRD).This sequence of events,well recognized in the past in primary and enteric hyperoxalurias,has also been documented in a few cases of dietary hyperoxaluria.Estimates of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide,thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these regions.Studies addressing this question have the potential of improving population health and should be undertaken,alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate,and into the mechanisms of development of oxalate-induced renal parenchymal disease.Novel preventive and therapeutic strategies for treating all types of hyperoxaluria are expected to develop from these studies.
文摘In human nephrolithiasis, most stones are containing calcium and are located within urinary cavities; they may contain monohydrate calcium oxalate, dihydrate calcium oxalate and/or calcium phosphates in various proportion. Nephrolithiasis may also be associated with nephrocalcinosis, i.e., crystal depositions in tubular lumen and/or interstitium, an entity which suggests specific pathological processes. Several rodents models have been developed in order to study the pathophysiology of intrarenal crystal formation. We review here calcium rodent models classified upon the presence of nephrolithiasis and/or nephrocalcinosis. As rodents are not prone to nephrolithiasis, models require the induction of a long standing hypercalciuria or hyperoxaluria(thus explaining the very few studies reported), conversely to nephrocalcinosis which may occur within hours or days. Whereas a nephrotoxicity leading to tubular injury and regeneration appears as a critical event for crystal retention in nephrocalcinosis models, surprisingly very little is known about the physiopathology of crystal attachment to urothelium in nephrolithiasis. Creating new models of nephrolithiasis especially in different genetic mice strains appears an important challenge in order to unravel the early mechanisms of urinary stone formation in papilla and fornices.
文摘The main goals for urinary stone treatment are to preserve renal function, reduce or avoid complications related to calculi, and to render the patient free of calculi as soon as possible. Anatrophic nephrolithotomy(ANL) is a valid and useful alternative for conventional staghorn calculi excision. Although excellent stone free rates can be achieved with ANL there are some drawbacks that may be of concern. Morbidity related to intraoperative and postoperative complications isone of them. Another, great concern is the possibility of reduction on renal function related to the procedure itself. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. In this review we assess functional results after anatrophic nephrolithotomy.
文摘Objective To evaluate the effectiveness of shock wave lithortripsy （SWL） for treating patients with calculus after failure of endoscopic lithortripsy. Methods From Feb. 2006 to Mar. 2007, 60 patients presented to our department with the upper urinary tract stones. Thirty-seven patients were renal stones and twentythree were ureteral stones. All patients with average stone burden of 1.5 cm were treated using a Dornier Compact S lithotripter. The total number of shock waves varied from 1 600 to 3 000 and the energy levels ranged from 1 to 6 units. Results For 37 renal stones, the fragmentation was 75. 67% （28cases） after one SWL session, 10.81% （4 cases） after2 SWL sessions, 5. 40% （2 cases） after 3 SWL sessions, and 2. 70% （1 case） after 4 SWL sessions. Two patients （5.40%） failed and changed to open surgery. For23 ureter calculus, the fragmentation was 82.60% （19cases） after one SWL session and l7. 40% （4cases） after 2 SWL sessions. Conclusion SWL is an effective and reliable treatment for patients with calculus after failure of endoscopic lithortripsy. However, it is very important for doctor to choose appropriate therapy. SWL is a remedy.
