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Andrew D. Rule - One of the best experts on this subject based on the ideXlab platform.
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Determining the true burden of Kidney Stone disease
Nature reviews. Nephrology, 2020Co-Authors: Charat Thongprayoon, Amy E. Krambeck, Andrew D. RuleAbstract:The incidence and prevalence of Kidney Stones have increased over the past four decades. However, the diagnosis of 'Kidney Stone' can range from an incidental asymptomatic finding of limited clinical significance to multiple painful episodes of ureteral obstruction with eventual Kidney failure. Some general strategies may be useful to prevent the recurrence of Kidney Stones. In particular, greater attention to Kidney Stone classification, approaches to assessing the risk of recurrence and individualized prevention strategies may improve the clinical care of Stone formers. Although there have been some advances in approaches to predicting the recurrence of Kidney Stones, notable challenges remain. Studies of Kidney Stone prevalence, incidence and recurrence have reported inconsistent findings, in part because of the lack of a standardized Stone classification system. A Kidney Stone classification system based on practical and clinically useful measures of Stone disease may help to improve both the study and clinical care of Stone formers. Any future Kidney Stone classification system should be aimed at distinguishing asymptomatic from symptomatic Stones, clinically diagnosed symptomatic Stone episodes from self-reported symptomatic Stone episodes, symptomatic Stone episodes that are confirmed from those that are suspected, symptomatic recurrence from radiographic recurrence (that is, with radiographic evidence of a new Stone, Stone growth or Stone disappearance from presumed passage) and determine Stone composition based on mutually exclusive categories.
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predictors of symptomatic Kidney Stone recurrence after the first and subsequent episodes
Mayo Clinic proceedings, 2019Co-Authors: Lisa E Vaughan, Felicity Enders, John C Lieske, Vernon M Pais, Marcelino E Rivera, Ramila A Mehta, Terri J Vrtiska, Andrew D. RuleAbstract:Abstract Objective To predict symptomatic recurrence among community Stone formers with one or more previous Stone episodes. Patients and Methods A random sample of incident symptomatic Kidney Stone formers in Olmsted County, Minnesota, was followed for all symptomatic Stone episodes resulting in clinical care from January 1, 1984, through January 31, 2017. Clinical and radiographic characteristics at each Stone episode predictive of subsequent episodes were identified. Results There were 3364 incident Kidney Stone formers with 4951 episodes. The Stone recurrence rates per 100 person-years were 3.4 (95% CI, 3.2-3.7) after the first episode, 7.1 (95% CI, 6.4-7.9) after the second episode, 12.1 (95% CI, 10.3-13.9) after the third episode, and 17.6 (95% CI, 15.1-20.0) after the fourth or higher episode (P Conclusion The revised Recurrence Of Kidney Stone tool predicts the risk of symptomatic recurrence by using readily available clinical characteristics of Stone formers.
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Stone composition among first time symptomatic Kidney Stone formers in the community
Mayo Clinic proceedings, 2015Co-Authors: Prince Singh, Amy E. Krambeck, Lisa E Vaughan, Felicity Enders, John C Lieske, Eric J Bergstralh, John J Knoedler, Andrew D. RuleAbstract:Abstract Objective To determine the variation in Kidney Stone composition and its association with risk factors and recurrence among first-time Stone formers in the general population. Patients and Methods Medical records were manually reviewed and validated for symptomatic Kidney Stone episodes among Olmsted County, Minnesota, residents from January 1, 1984, through December 31, 2012. Clinical and laboratory characteristics and the risk of symptomatic recurrence were compared between Stone compositions. Results There were 2961 validated first-time symptomatic Kidney Stone formers. Stone composition analysis was obtained in 1508 (51%) at the first episode. Stone formers were divided into the following mutually exclusive groups: any brushite (0.9%), any struvite (0.9%), any uric acid (4.8%), and majority calcium oxalate (76%) or majority hydroxyapatite (18%). Stone composition varied with clinical characteristics. A multivariable model had a 69% probability of correctly estimating Stone composition but assuming calcium oxalate monohydrate Stone was correct 65% of the time. Symptomatic recurrence at 10 years was approximately 50% for brushite, struvite, and uric acid but approximately 30% for calcium oxalate and hydroxyapatite Stones ( P P for trend=.10). However, among calcium oxalate Stones, 10-year recurrence rate ranged from 38% for 100% calcium oxalate dihydrate to 26% for 100% calcium oxalate monohydrate ( P for trend=.007). Conclusion Calcium Stones are more common (93.5% of Stone formers) than has been previously reported. Although clinical and laboratory factors associate with the Stone composition, they are of limited utility for estimating Stone composition. Rarer Stone compositions are more likely to recur.
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Chronic Kidney Disease in Kidney Stone Formers
Clinical journal of the American Society of Nephrology : CJASN, 2011Co-Authors: Andrew D. Rule, Amy E. Krambeck, John C LieskeAbstract:Recent population studies have found symptomatic Kidney Stone formers to be at increased risk for chronic Kidney disease (CKD). Although Kidney Stones are not commonly identified as the primary cause of ESRD, they still may be important contributing factors. Paradoxically, CKD can be protective against forming Kidney Stones because of the substantial reduction in urine calcium excretion. Among Stone formers, those with rare hereditary diseases (cystinuria, primary hyperoxaluria, Dent disease, and 2,8 dihydroxyadenine Stones), recurrent urinary tract infections, struvite Stones, hypertension, and diabetes seem to be at highest risk for CKD. The primary mechanism for CKD from Kidney Stones is usually attributed to an obstructive uropathy or pyelonephritis, but crystal plugs at the ducts of Bellini and parenchymal injury from shockwave lithotripsy may also contribute. The historical shift to less invasive surgical management of Kidney Stones has likely had a beneficial impact on the risk for CKD. Among potential Kidney donors, past symptomatic Kidney Stones but not radiographic Stones found on computed tomography scans were associated with albuminuria. Kidney Stones detected by ultrasound screening have also been associated with CKD in the general population. Further studies that better classify CKD, better characterize Stone formers, more thoroughly address potential confounding by comorbidities, and have active instead of passive follow-up to avoid detection bias are needed.
Susan L. Furth - One of the best experts on this subject based on the ideXlab platform.
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ecological momentary assessment of factors associated with water intake among adolescents with Kidney Stone disease
The Journal of Urology, 2019Co-Authors: Gregory E. Tasian, Susan L. Furth, Michelle E Ross, Lihai Song, Steven Warner, Janet Audrainmcgovern, Douglas J Wiebe, Brittney Henderson, Anisha I PatelAbstract:Purpose:Maintaining high water intake decreases Kidney Stone recurrence but is difficult to do. Strategies to reduce Stone recurrence among adolescents are lacking. We conducted an ecological momentary assessment study to identify factors associated with water intake in adolescents with nephrolithiasis.Materials and Methods:The study population consisted of 15 female and 10 male patients 12 to 18 years old with at least 1 prior Kidney Stone. For 7 days participants used “smart” bottles to self-monitor water intake and received questionnaires randomly 4 times daily, which were completed in real time on mobile devices. The questionnaires ascertained awareness of water intake volume, awareness of water intake goals, perceived need to drink, access to water, alternative beverage consumption and attitudes toward bathrooms. Linear mixed effects models were fit to estimate the association between momentary responses and daily water intake.Results:During 175 person-days 595 assessments (85%) were completed. Media...
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assessment of the combination of temperature and relative humidity on Kidney Stone presentations
Environmental Research, 2018Co-Authors: Michelle E Ross, David S. Goldfarb, Susan L. Furth, Ana M Vicedocabrera, Robert E Kopp, Lihai Song, Jose Pulido, Steven Warner, Gregory E. TasianAbstract:Temperature and relative humidity have opposing effects on evaporative water loss, the likely mediator of the temperature-dependence of nephrolithiasis. However, prior studies considered only dry-bulb temperatures when estimating the temperature-dependence of nephrolithiasis. We used distributed lag non-linear models and repeated 10-fold cross-validation to determine the daily temperature metric and corresponding adjustment for relative humidity that most accurately predicted Kidney Stone presentations during hot and cold periods in South Carolina from 1997 to 2015. We examined three metrics for wet-bulb temperatures and heat index, both of which measure the combination of temperature and humidity, and for dry-bulb temperatures: (1) daytime mean temperature; (2) 24-h mean temperature; and (3) most extreme 24-h temperature. For models using dry-bulb temperatures, we considered four treatments of relative humidity. Among 188,531 patients who presented with Kidney Stones, 24-h wet bulb temperature best predicted Kidney Stone presentation during summer. Mean cross-validated residuals were generally lower in summer for wet-bulb temperatures and heat index than the corresponding dry-bulb temperature metric, regardless of type of adjustment for relative humidity. Those dry-bulb models that additionally adjusted for relative humidity had higher mean residuals than other temperature metrics. The relative risk of Kidney Stone presentations at the 99th percentile of each temperature metric compared to the respective median temperature in summer months differed by temperature metric and relative humidity adjustment, and ranged from an excess risk of 8-14%. All metrics performed similarly in winter. The combination of temperature and relative humidity determine the risk of Kidney Stone presentations, particularly during periods of high heat and humidity. These results suggest that metrics that measure moist heat stress should be used to estimate the temperature-dependence of Kidney Stone presentations, but that the particular metric is relatively unimportant.
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Kidney Stone Recurrence among Children and Adolescents.
The Journal of urology, 2016Co-Authors: Gregory E. Tasian, Abdo Kabarriti, Angela Kalmus, Susan L. FurthAbstract:Purpose: Kidney Stone disease has become increasingly common during childhood and adolescence. However, the rate of symptomatic Kidney Stone recurrence for pediatric patients is uncertain. We sought to determine the recurrence rate of symptomatic Kidney Stones in a cohort of children with incident symptomatic nephrolithiasis.Materials and Methods: We performed a retrospective cohort study of patients 3 to 18 years old without anatomical abnormalities or genetic causes of nephrolithiasis who presented with a first symptomatic Kidney Stone between 2008 and 2014. We determined recurrence rates of symptomatic nephrolithiasis, defined as a new Kidney Stone on ultrasound and/or computerized tomogram associated with pain and/or vomiting. We also estimated associations between completing 24-hour urinalysis and symptomatic Kidney Stone recurrence using Kaplan-Meier curves and multivariable Cox regression models.Results: A total of 285 children with a median age of 14.8 years (IQR 11.3–16.6) at nephrolithiasis diag...
Gregory E. Tasian - One of the best experts on this subject based on the ideXlab platform.
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ecological momentary assessment of factors associated with water intake among adolescents with Kidney Stone disease
The Journal of Urology, 2019Co-Authors: Gregory E. Tasian, Susan L. Furth, Michelle E Ross, Lihai Song, Steven Warner, Janet Audrainmcgovern, Douglas J Wiebe, Brittney Henderson, Anisha I PatelAbstract:Purpose:Maintaining high water intake decreases Kidney Stone recurrence but is difficult to do. Strategies to reduce Stone recurrence among adolescents are lacking. We conducted an ecological momentary assessment study to identify factors associated with water intake in adolescents with nephrolithiasis.Materials and Methods:The study population consisted of 15 female and 10 male patients 12 to 18 years old with at least 1 prior Kidney Stone. For 7 days participants used “smart” bottles to self-monitor water intake and received questionnaires randomly 4 times daily, which were completed in real time on mobile devices. The questionnaires ascertained awareness of water intake volume, awareness of water intake goals, perceived need to drink, access to water, alternative beverage consumption and attitudes toward bathrooms. Linear mixed effects models were fit to estimate the association between momentary responses and daily water intake.Results:During 175 person-days 595 assessments (85%) were completed. Media...
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assessment of the combination of temperature and relative humidity on Kidney Stone presentations
Environmental Research, 2018Co-Authors: Michelle E Ross, David S. Goldfarb, Susan L. Furth, Ana M Vicedocabrera, Robert E Kopp, Lihai Song, Jose Pulido, Steven Warner, Gregory E. TasianAbstract:Temperature and relative humidity have opposing effects on evaporative water loss, the likely mediator of the temperature-dependence of nephrolithiasis. However, prior studies considered only dry-bulb temperatures when estimating the temperature-dependence of nephrolithiasis. We used distributed lag non-linear models and repeated 10-fold cross-validation to determine the daily temperature metric and corresponding adjustment for relative humidity that most accurately predicted Kidney Stone presentations during hot and cold periods in South Carolina from 1997 to 2015. We examined three metrics for wet-bulb temperatures and heat index, both of which measure the combination of temperature and humidity, and for dry-bulb temperatures: (1) daytime mean temperature; (2) 24-h mean temperature; and (3) most extreme 24-h temperature. For models using dry-bulb temperatures, we considered four treatments of relative humidity. Among 188,531 patients who presented with Kidney Stones, 24-h wet bulb temperature best predicted Kidney Stone presentation during summer. Mean cross-validated residuals were generally lower in summer for wet-bulb temperatures and heat index than the corresponding dry-bulb temperature metric, regardless of type of adjustment for relative humidity. Those dry-bulb models that additionally adjusted for relative humidity had higher mean residuals than other temperature metrics. The relative risk of Kidney Stone presentations at the 99th percentile of each temperature metric compared to the respective median temperature in summer months differed by temperature metric and relative humidity adjustment, and ranged from an excess risk of 8-14%. All metrics performed similarly in winter. The combination of temperature and relative humidity determine the risk of Kidney Stone presentations, particularly during periods of high heat and humidity. These results suggest that metrics that measure moist heat stress should be used to estimate the temperature-dependence of Kidney Stone presentations, but that the particular metric is relatively unimportant.
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Kidney Stone Recurrence among Children and Adolescents.
The Journal of urology, 2016Co-Authors: Gregory E. Tasian, Abdo Kabarriti, Angela Kalmus, Susan L. FurthAbstract:Purpose: Kidney Stone disease has become increasingly common during childhood and adolescence. However, the rate of symptomatic Kidney Stone recurrence for pediatric patients is uncertain. We sought to determine the recurrence rate of symptomatic Kidney Stones in a cohort of children with incident symptomatic nephrolithiasis.Materials and Methods: We performed a retrospective cohort study of patients 3 to 18 years old without anatomical abnormalities or genetic causes of nephrolithiasis who presented with a first symptomatic Kidney Stone between 2008 and 2014. We determined recurrence rates of symptomatic nephrolithiasis, defined as a new Kidney Stone on ultrasound and/or computerized tomogram associated with pain and/or vomiting. We also estimated associations between completing 24-hour urinalysis and symptomatic Kidney Stone recurrence using Kaplan-Meier curves and multivariable Cox regression models.Results: A total of 285 children with a median age of 14.8 years (IQR 11.3–16.6) at nephrolithiasis diag...
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daily mean temperature and clinical Kidney Stone presentation in five u s metropolitan areas a time series analysis
Environmental Health Perspectives, 2014Co-Authors: Gregory E. Tasian, Jose Pulido, Antonio Gasparrini, Christopher S Saigal, Benjamin P Horton, Richard J Landis, Rodger Madison, Ron KerenAbstract:Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and Kidney Stone presentation is unknown.Objectives: Our objective was ...
Michel Daudon - One of the best experts on this subject based on the ideXlab platform.
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Synergistic role of calcium and vitamin D in a murine model of Kidney Stone disease
2016Co-Authors: Emmanuel Letavernier, Cécile Verrier, Florent Goussard, Léa Huguet, Jean-philippe Haymann, Laurent Baud, Dominique Bazin, Michel DaudonAbstract:The role of vitamin D in Kidney Stone formation remains controversial. We analyzed whether long-term exposure of rats to vitamin D supplementation, with or without calcium-rich diet, would promote Kidney Stone formation or Kidney tissue calcifications. Four groups of rats received vitamin D alone (100,000 UI/Kg every 3 weeks), a calcium-enriched diet alone (calcium gluconate 2g/l in drinking water), both vitamin D supplementation and calcium rich diet, or a standard diet (controls) during 6 months. Serum and urine parameters and crystalluria have been monitored during 6 months
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Calcium and vitamin D have a synergistic role in a rat model of Kidney Stone disease
Kidney International, 2016Co-Authors: Emmanuel Letavernier, Cécile Verrier, Florent Goussard, Léa Huguet, Jean-philippe Haymann, Laurent Baud, Dominique Bazin, Joëlle Perez, Michel DaudonAbstract:Vitamin D supplementation in humans should be accompanied by calcium administration to avoid bone demineralization through vitamin D receptor signaling. Here we analyzed whether long-term exposure of rats to vitamin D supplementation, with or without a calcium-rich diet, would promote Kidney Stone formation. Four groups of rats received vitamin D alone (100,000 UI/kg/3 weeks), a calcium-enriched diet alone, both vitamin D supplementation and calcium-enriched diet, or a standard diet (controls) for 6 months. Serum and urine parameters and crystalluria were monitored. Kidney Stones were assessed by 3-dimensional micro-computed tomography, infrared spectroscopy, von Kossa/Yasue staining, and field emission scanning electron microscopy. Although serum calcium levels were similar in the 4 groups, rats receiving vitamin D had a progressive increase in urinary calcium excretion over time, especially those receiving both calcium and vitamin D. However, oral calcium supplementation alone did not increase urinary calcium excretion. At 6 months, rats exposed to both calcium and vitamin D, but not rats exposed to calcium or vitamin D alone, developed significant apatite Kidney calcifications (mean volume, 0.121 mm3). Thus, coadministration of vitamin D and increased calcium intake had a synergistic role in tubular calcifications or Kidney Stone formation in this rat model. Hence, one should be cautious about the cumulative risk of Kidney Stone formation in humans when exposed to both vitamin D supplementation and high calcium intake.
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Stones: Tolvaptan might prevent Kidney Stone formation.
Nature reviews. Urology, 2016Co-Authors: Emmanuel Letavernier, Michel DaudonAbstract:Tolvaptan, an arginine vasopressin receptor antagonist, decreases urinary supersaturation in Kidney Stone formers by considerably increasing diuresis, suggesting that this drug might be an effective therapy for reducing the risk of developing Kidney Stones in these patients.
John C Lieske - One of the best experts on this subject based on the ideXlab platform.
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predictors of symptomatic Kidney Stone recurrence after the first and subsequent episodes
Mayo Clinic proceedings, 2019Co-Authors: Lisa E Vaughan, Felicity Enders, John C Lieske, Vernon M Pais, Marcelino E Rivera, Ramila A Mehta, Terri J Vrtiska, Andrew D. RuleAbstract:Abstract Objective To predict symptomatic recurrence among community Stone formers with one or more previous Stone episodes. Patients and Methods A random sample of incident symptomatic Kidney Stone formers in Olmsted County, Minnesota, was followed for all symptomatic Stone episodes resulting in clinical care from January 1, 1984, through January 31, 2017. Clinical and radiographic characteristics at each Stone episode predictive of subsequent episodes were identified. Results There were 3364 incident Kidney Stone formers with 4951 episodes. The Stone recurrence rates per 100 person-years were 3.4 (95% CI, 3.2-3.7) after the first episode, 7.1 (95% CI, 6.4-7.9) after the second episode, 12.1 (95% CI, 10.3-13.9) after the third episode, and 17.6 (95% CI, 15.1-20.0) after the fourth or higher episode (P Conclusion The revised Recurrence Of Kidney Stone tool predicts the risk of symptomatic recurrence by using readily available clinical characteristics of Stone formers.
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Stone composition among first time symptomatic Kidney Stone formers in the community
Mayo Clinic proceedings, 2015Co-Authors: Prince Singh, Amy E. Krambeck, Lisa E Vaughan, Felicity Enders, John C Lieske, Eric J Bergstralh, John J Knoedler, Andrew D. RuleAbstract:Abstract Objective To determine the variation in Kidney Stone composition and its association with risk factors and recurrence among first-time Stone formers in the general population. Patients and Methods Medical records were manually reviewed and validated for symptomatic Kidney Stone episodes among Olmsted County, Minnesota, residents from January 1, 1984, through December 31, 2012. Clinical and laboratory characteristics and the risk of symptomatic recurrence were compared between Stone compositions. Results There were 2961 validated first-time symptomatic Kidney Stone formers. Stone composition analysis was obtained in 1508 (51%) at the first episode. Stone formers were divided into the following mutually exclusive groups: any brushite (0.9%), any struvite (0.9%), any uric acid (4.8%), and majority calcium oxalate (76%) or majority hydroxyapatite (18%). Stone composition varied with clinical characteristics. A multivariable model had a 69% probability of correctly estimating Stone composition but assuming calcium oxalate monohydrate Stone was correct 65% of the time. Symptomatic recurrence at 10 years was approximately 50% for brushite, struvite, and uric acid but approximately 30% for calcium oxalate and hydroxyapatite Stones ( P P for trend=.10). However, among calcium oxalate Stones, 10-year recurrence rate ranged from 38% for 100% calcium oxalate dihydrate to 26% for 100% calcium oxalate monohydrate ( P for trend=.007). Conclusion Calcium Stones are more common (93.5% of Stone formers) than has been previously reported. Although clinical and laboratory factors associate with the Stone composition, they are of limited utility for estimating Stone composition. Rarer Stone compositions are more likely to recur.
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Chronic Kidney Disease in Kidney Stone Formers
Clinical journal of the American Society of Nephrology : CJASN, 2011Co-Authors: Andrew D. Rule, Amy E. Krambeck, John C LieskeAbstract:Recent population studies have found symptomatic Kidney Stone formers to be at increased risk for chronic Kidney disease (CKD). Although Kidney Stones are not commonly identified as the primary cause of ESRD, they still may be important contributing factors. Paradoxically, CKD can be protective against forming Kidney Stones because of the substantial reduction in urine calcium excretion. Among Stone formers, those with rare hereditary diseases (cystinuria, primary hyperoxaluria, Dent disease, and 2,8 dihydroxyadenine Stones), recurrent urinary tract infections, struvite Stones, hypertension, and diabetes seem to be at highest risk for CKD. The primary mechanism for CKD from Kidney Stones is usually attributed to an obstructive uropathy or pyelonephritis, but crystal plugs at the ducts of Bellini and parenchymal injury from shockwave lithotripsy may also contribute. The historical shift to less invasive surgical management of Kidney Stones has likely had a beneficial impact on the risk for CKD. Among potential Kidney donors, past symptomatic Kidney Stones but not radiographic Stones found on computed tomography scans were associated with albuminuria. Kidney Stones detected by ultrasound screening have also been associated with CKD in the general population. Further studies that better classify CKD, better characterize Stone formers, more thoroughly address potential confounding by comorbidities, and have active instead of passive follow-up to avoid detection bias are needed.
