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Introduction: Kidney stones disease is a medical condition when hard deposites made of various minerals and substances form inside kidneys. It may lead to clinical symptoms as severe pain felt in the belly area or side of the back. Also it can radiate and reach testicles, groin area, labia. Other symptoms may include blood in the urine, abnormal color of urine, fever, nausea, vomiting. Because of growing incidence rate- adequate question is how can we protect ourselves from kidney stones development by changing habits. Aim of study: Fundamental aim of study is to demonstrate how daily, routine habits changes may have a huge impact on kidney stones development risk. State of knowledge: There are a lot of confirmed parameters and factors which can lead to kidney stones devolopment. Factors that increase risk of developing kidney stones include: dehydration, diet (meat intake, fruit/vegetables intake, sodium intake), family or personal history, obesity, digestive diseases and surgery, metabolic disorders, urinary track infections, anatomical abnormalities- obstruction of the kidney, calyceal diverticulum, horseshoe kidney, ureterocele. This group includes many modified factors, so lifetime risk of kidney stones depends also on our habits and way of life. Conclusion: There are many modified factors which may lead to this disease and because of that it is crucial to improve patients and whole society awareness about them. By appropriate daily habits changes we can significantly reduce risk of lifetime kidney stone disease development. It is important to know that concrete reports and analyses were made and they demonstrated scientifically proven correlations.

Urinary tract stones are a common condition that significantly reduces quality of life. A proper diet is an important factor in the prevention and treatment of lithiasis and, for this reason, dietary interventions have become an essential part of treatment. In our review of the literature, we analysed the individual components of diet in terms of the risk of developing urinary tract stones. A number of dietary guidelines have been developed to reduce lithogenic factors in the urine, such as calcium oxalate, calcium phosphate and uric acid. Current guidelines recommend increasing the intake of fluids, increasing the intake of fruit and vegetables, using a balanced calcium supplementation and limiting the supply of sodium and especially animal protein. Based on these recommendations, a vegetarian diet containing dairy products combined with calcium supplementation appears to have the lowest risk of developing urinary stones. However, there are still many uncertainties in this area, and research needs to continue and be expanded to include the influence of diet type on the risk of lithiasis. This will allow us to gain a better understanding of the factors influencing the disease process and to create clear guidelines in the field of urolithiasis in the future.

ABSTRACT Introduction: flexible ureteroscopy is a minimally invasive surgical technique used for the treatment of renal lithiasis. Postoperative urosepsis is a rare but potentially fatal complication. Traditional models used to predict the risk of this condition have limited accuracy, while models based on artificial intelligence are more promising. The objective of this study is to carry out a systematic review regarding the use of artificial intelligence to detect the risk of sepsis in patients with renal lithiasis undergoing flexible ureteroscopy. Methods: the literature review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The keyword search was performed in MEDLINE, Embase, Web of Science and Scopus and resulted in a total of 2,496 articles, of which 2 met the inclusion criteria. Results: both studies used artificial intelligence models to predict the risk of sepsis after flexible uteroscopy. The first had a sample of 114 patients and was based on clinical and laboratory parameters. The second had an initial sample of 132 patients and was based on preoperative computed tomography images. Both obtained good measurements of Area Under the Curve (AUC), sensitivity and specificity, demonstrating good performance. Conclusion: artificial intelligence provides multiple effective strategies for sepsis risk stratification in patients undergoing urological procedures for renal lithiasis, although further studies are needed.

ABSTRACT Introduction: retrograde intrarenal surgery (CRIR) is an evolving tool. Its learning curve is not well established, despite the common use of flexible ureteroscopes today. Our aim is to estimate the number of procedures needed for one to perform RIRS consistently. Material and Methods: a urology resident had his first 80 RIRS for nephrolithiasis analyzed quantitatively and qualitatively. The procedures were divided into 4 groups containing 20 surgeries each (I to IV), according to their order, for comparison. Results: there was no difference in stone sizes between groups. All qualitative variables varied significantly between groups (p

Although urolithiasis is a common disease in the European population, bilateral staghorn stones are a relatively rare variant of nephrolithiasis. It is often associated with a chronic urinary tract infection or a metabolic disorder. The aim of this paper is to show an example of the treatment of bilateral staghorn stones in a patient chronically infected with a resistant strain of Proteus mirabilis. Percutaneous nephrolithotripsy (PCNL) is currently the gold standard of treatment. And this is the way the patient was managed. In the following section, the authors sought to describe new reports on this treatment method and how it could be improved. Conservative treatment does not appear to be a safe alternative. And of the other surgical treatments, PCNL has the greatest benefits. Nearly 68% of patients with bilateral staghorn stones have some underlying metabolic disorder in a small sample of patients. It seems reasonable, therefore, to introduce genetic and metabolic diagnosis in younger patients with the aim of prevention through diet or pharmacotherapy.

To assess the effectiveness of incorporating hygienic-dietary recommendations in laboratory reports in reducing the incidence of renal colic (RC). A study was performed to compare the incidence of RC in two groups of patients who had suffered at least a crystalluria event associated with the risk of urolithiasis. Recommendations were only incorporated in the laboratory reports of one group.

Urolithiasis is not a rare disorder in children. Its etiology, incidence and localization vary by geographic region. It is an increasing problem, especially in developing countries. Metabolic abnormalities have been claimed to play a significant role in the kidney stone disease. Most of the studies confirmed that hypercalciuria, hypocitraturia are the most commonly identified metabolic disorder in children with urolithiasis. It is important to evaluate them to modify and prevent the stone recurrence.

Introduction. Nephrolithiasis consists of the production and retention of calculi in the urinary tract. It is being diagnosed in an increasing number of people of any age, and is one of the most common ailments in the world. Depending on a number of factors, it can be found in 5–20% of the population. Traditional surgeries are being replaced by less invasive methods of treatment. The relation between the endourological removal of calculi from the urinary tract and the assessment of the quality of life of patients who have undergone such procedures is an interesting topic worth analysing. In the 21st century, quality of life became the indicator of the efficacy of many therapies and procedures. It is associated with the quality of treatment, reflecting a better and longer life with the disease. Objective. The objective of this study is to demonstrate the quality of life of the surveyed patients with nephrolithiasis after the endourological removal of calculi from the urinary tract. Materials and methods. The group of surveyed individuals qualified for statistical analysis included 120 people diagnosed with nephrolithiasis. The patients underwent the procedure of the endourological removal of calculi from the urinary tract in 2015 in three hospitals in eastern Poland. Among the respondents, 48% of them underwent extracorporeal shock wave lithotripsy (ESWL), 31% had percutaneous nephrolithotripsy (PCNL), and 21% had uretherorenoscopic lithotripsy (URS). To evaluate the quality of life, a research tool was devised based on an abbreviated version of the Polish adaptation of the WHOQOL – BREF questionnaire. Also, a personal questionnaire prepared by the author was used. Results and conclusions. The analysis of the collected materials demonstrated the impact of the endourological removal of calculi from the urinary tract on the quality of life of the hospitalised patients. Differences were identified in individuals’ general rating of quality of life (57% of respondents were satisfied) and patients’ general satisfaction with their health (47.5% of respondents were satisfied) after the procedure. Significant differences were identified in each of the studied fields: physical, psychological, social and environmental. A statistically significant correlation of p

Kidney stone disease is one of the most common disorders and can be considered a disease systmetic. It occurs in about 5-20 % of all population. Due to the chemical composition of deposits there are several types of kidney stones including calcium oxalate, calcium phosphate, uric acid, magnesium-amonium, phosphate, cysteine. Nephrolithiasis is more common in men than in women. Kidney stones are formed as a result of the crystallization of minerals and their salts. The cause of stone formation in the kidneys also contributes some drugs (such as corticosteroids), hyperparathyroidism, osteoporosis, long-term treatment of peptic ulcer with alkalizing preparations, overdose of vitamin D and improper diet. The most important in treatment of renal colic is relieving pain. Sometimes it is enough to administer analgesics, but sometimes it is necessary to administer strong opioid drugs. Effective medical treatments including thiazide, potassium citrate, acetohydroxamic acid can prevent new stone formation in most patients.

The pathogenesis of urolithiasis in the modern view lies disregulating the pathological process of primary surplus mobilization reactions of protection, which leads to their further transformation in the reaction of damage that is the underlying basis for the formation of vicious circles. 299 patients with nephrolithiasis were examined, 10 patients were in the control group. Found that systemic and renal dysregulation pathological processes of stone the size of stones of 0.6 – 1.0 cm, top, middle cup the upper third of the ureter led to the formation of large and small “vicious circles”. Renal and extrarenal dysregulation pathological processes contributed to the increase in damage to the proximal tubule, since the primary damage to the said nephron. Department is not able to mobilize protective adaptive reactions aimed at increasing the excretion of acids and protein reabsorption, since they require additional energy costs. The use of the drug blemaren in nephrolithiasis reveals protective properties to reduce the manifestations of systemic and renal dysregulation pathological processes and promotes the rupture of formed large and small “vicious circles" with a decrease in proteinuria, the level of tumor necrosis factor-α, improving the transport of sodium ions, fibrinolytic activity of urine and it is advisable to develop guidelines for further use in the clinic of the drug blemaren as a promising method of treatment of urolithiasis.

Introduction: Kidney stone disease (KSD) is a common urological condition that often requires long-term care. Mobile health (mHealth) and eHealth technologies have the potential to enhance chronic disease management and behavioral change. To assess opportunities to apply these tools to improve KSD treatment and prevention, we aimed to assess current evidence on the use, benefits, and limitations of mHealth and eHealth in KSD., Methods: We performed a systematic review of primary research studies of mHealth and eHealth in the evaluation and management of KSD. Two independent researchers screened citations by title and abstract for relevance, then full-text review was performed for descriptive summary of the studies., Results: A total of 37 articles were included for analysis. Primary domains of evidence included: 1) "smart" water bottles and mobile-device apps for tracking fluid consumption, which showed increased intake in most studies; 2) ureteral stent tracking platforms, which improved the rate of long-term retained stents; 3) virtual stone clinics, which have been suggested to increase access, lower costs, and have satisfactory outcomes; 4) smartphone-based endoscopy platforms, which offered cost-effective image quality in resource-limited settings; 5) patient information about KSD online, which was typically characterized as poor quality and/or accuracy, particularly on YouTube. Most studies were proof-of-concept or single-arm intervention designs, with limited assessment of effectiveness or long-term clinical outcomes., Conclusions: Mobile and eHealth technologies have significant real-world applications to KSD prevention, intervention, and patient education. A lack of rigorous effectiveness studies currently limits evidence-based conclusions and incorporation in clinical guidelines., (Copyright © 2023 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Nephrolithiasis is a globally prevalent urologic condition associated with significant morbidity and patient discomfort. Current management of kidney stones includes both surgical and pharmacologic interventions. Though surgery may be necessary under certain circumstances, pharmacologic treatment is a more affordable, readily available, and a less invasive option for patients. A comprehensive scoping review was conducted to summarize the available literature on the pharmacologic strategies for managing the predominant stone types including calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones. Central to these therapeutic approaches is the regulation of factors such as urine pH, stone crystallization, and patient metabolics that precipitate stone development and growth. This review highlights the pharmacological options available for treating each kidney stone type, emphasizing the importance of patient tailored medical management that should be considered by every physician., (Copyright © 2023 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Nephrolithiasis as the most common urological disorder characterized by frequent early relapses, acquires a social character, because these patients are 30 to 45% of all urological patients, while in Europe the disease is diagnosed in 2% of the population. The study included 40 patients with nephrolithiasis, 10 patients constituted the control group. Set the “hidden” damage to the proximal nephron in the presence of renal stones with a size of 0.6-1.0 cm in the upper third of the ureter, the upper and middle sections of the calyx, which is confirmed by the inhibition of enzymatic fibrinolytic activity of urine, the presence of tubular proteinuria in the absence of inhibition of proximal reabsorption of sodium ions. The link “hidden” damage to the proximal tubule of the degree of overload of the proximal nephron is a protein graphics multicorrelation dependence between the protein concentration of urine, standardized excretion protein and excretion, which are becoming more significant disharmony form towards control in the following sequence: the upper third of the ureter, medium cup, top cup.

Se halló cálculos de cistina en la pelvis renal de un ejemplar adulto de Chrysocyon brachyurus (aguará-guazú), cuya muerte había ocurrido en el zoológico de Sáenz Peña (Chaco). El diagnóstico fue realizado por el método colorimétrico del nitroprusiato. La presencia de cristales microscópicos hexagonales en el cálculo pulverizado confirmó la presunción de cistina. La cistinuria es una aminoaciduria hereditaria que a largo plazo produce nefrolitiasis. El aguará-guazú puede padecer esta metabolopatía, por lo que durante su cautiverio la orina de este animal debería ser investigada para detectar la presencia de cristales de cistina; un tratamiento oportuno puede salvarle la vida. En Argentina, el número de C. brachyurus no superaría los 1000 ejemplares, en peligro de extinción.

Introduction: Daily practice requires quick, simple and accessible methods to appropriately assess the urinary excretion of solutes in diagnostic or follow-up evaluations of children with renal lithiasis., Objectives: The objective of this study was to correlate urine elimination of substances related to renal lithiasis that depend on the volume of excreted urine in a unit of time with other parameters that are calculated by measuring the concentration of these substances in blood and urine, such as urinary ratios, fractional excretions and excretion rates., Materials and Methods: The study included 401 healthy children aged 3-14 years (187 boys and 214 girls), mean age 8.78±3.40 years. The analysis was carried out by Pearson's correlation coefficient., Results: There was significant correlation between the elimination of sodium, potassium and chlorine in 24-hour urine sample and the urinary ratios and fractional excretions of these ions. Urinary ratios and rates of excretion of calcium, uric acid, phosphate, magnesium, citrate and oxalate were highly correlated with the determinations of these substances in 24-hour collections., Conclusions: These equations provide relevant information for the study of the etiology of renal lithiasis in children, as well as about compliance to dietary treatment. They also assess the effectiveness of the various treatments used in these patients, without having to resort to 24-hour collections, which pose a considerable challenge in the pediatric age group., (Copyright © 2020 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Nutrition is tightly associated with the risk of stone events. A part from genetic predisposition, a correct and balanced diet might prevent incident kidney stones. Several studies analyzed each dietary component and different diets to better understand their impact on stone recurrence. Fluids: High fluids intake is the most important factor for preventing kidney stones disease and for every 200 mL of water, the risk of stones is reduced by 13%. Soft drinks seems to be associated to a greater risk of stone events, whereas caffeine and citrus fruits juice are not. Calcium: Normally calcium intake with diet does not exceed 1.2 g/day. A balanced consumption of dairy products is capable of reducing oxalate intestinal absorption and urinary excretion compared to low calcium diet, being protective for stone disease. Oxalate: The exact amount of oxalate contained in different foods is difficult to estimate for its variability, even in the same aliment. In addition, the amount of oxalate consumed was shown to be only a minor risk factor for stone disease, whereas its intestinal absorption is strongly influenced by external factors, such as calcium intake. Dietary oxalate restriction is advisable only in patients with known elevated consumption. Sodium: High sodium intake is both associated with hypertension, heart disease and stone risk. Increased sodium consumption is directly associated to hypercalciuria in both calcium stone formers and healthy subjects. Although dietary sodium restriction to recommended values is always desirable in stone formers, it is difficult to achieve for its broad use in food preparation. Proteins: Animal proteins are associated to increased risk for stone formation, whereas vegetable and dairy proteins are not. Increased meat intake was associated to acidic urine pH, negative calcium balance and reduced anti-lithogenic urinary solutes excretion.Fruits and vegetables: Alkalizing foods are one of the most important factors for stone protection. Their consumption increases anti-lithogenic solutes as citrate, potassium and magnesium. A diet rich in fruits and vegetables is strongly recommended for stone formers. Uric acid: Elevated meat consumption is either associated to increased purine metabolism and acid load, favoring uric acid nephrolithiasis by reducing urine pH and increasing urinary excretion of uric acid, especially in patients affected by metabolic syndrome and diabetes.In conclusion, the most effective diet for stone protection is rich in fruits and vegetables, low in animal proteins and salt, with balanced dairy product consumption and obviously, with elevated fluid intake. These characteristics make vegetarian and Mediterranean diets protective and useful for stone formers, whereas western diet is at risk for stone formation.

Patient reported outcome measures (PROMs) are essential to fully understand the impact of diseases and the effectiveness of treatment from a patient's perspective. Generic and disease-specific tools have been used to assess the impact of nephrolithiasis on patients' quality of life (QoL), as well as the impact of various treatment modalities. Additionally, various studies have investigated the factors that might determine the impact of the disease on the patients' QoL. Here were view the available knowledge on this nascent topic and highlight the need for extensive future research in this crucial area.

Objectives: Renal access in percutaneous nephrolithotomy (PCNL) may be obtained via a pre-existing nephrostomy tube (NT) tract; however, emergent NTs are not always ideal for subsequent surgery. We sought to determine the rate of NT tract usability and assess factors related to the usability of emergently placed NTs., Methods: A retrospective review was performed of UC San Diego subjects undergoing percutaneous renal surgery between January 2016 and October 2018. Demographics and peri-operative variables were collected. The primary outcome was the usability of NT tract for dilation and instrumentation. "Usable" indicated a tract in which PCNL could be completed; "unusable" indicated lack of dilation and the requirement of additional tract(s) for PCNL., Results: 35 PCNL cases had previous emergently placed NT which were indwelling at time of percutaneous surgery. 51% of these NT tracts (18/35) were deemed usable and dilated for PCNL. No significant difference was seen between usable and unusable NT groups for number of dilated tracts during PCNL (p=0.13), or either the location of indwelling NT (p=0.96) or renal stones (p=0.95). In the usable NT tract cohort PCNL access was via the lower pole 56% of the time, where as when previous NT tracts were deemed unusable, a separate upper-pole access was obtained intra-operatively 53% of the time (p<0.01)., Conclusions: Pre-existing, emergent NTs served a ssufficient PCNL access tracts in over half of recorded cases. Contrary to recently published reports, the utility of pre-existing NTs appears to vary among health systems. Other variables, including the desired location of PCNL appear to directly influence the like lihood of NT tract usability.

Mesalazine (5-aminosalicylic acid, 5-ASA),is an anti-inflammatory drug well-established as first-line treatment in the management of inflammatory bowel disease. Nephritic colic has been described as an uncommonside effect, but very few mesalazine nephrolithiasis have been published in the literature, probably due to its underdiagnosis for not using appropriate methodology for calculi analysis. We present two cases of lithiasis in patients treated with mesalazine at high dosage, an adverse effect to betaken into account as a drug lithiasis and which is not even mentioned in the patient information leaflet.

Objectives: To evaluate the effectiveness and safety of simultaneous bilateral percutaneous nephrolithotomy performed in patients affected with bilateral renal calculi., Materials and Methods: This is a prospective study from September 2012 to November 2016. Patients diagnosed of bilateral kidney stones with abdominal CT scan were included. Surgical technique prone position, renal puncture guided by fluoroscopy and tract dilation up to 24Ch. We reviewed demographic and stone characteristics, stone free rate, clinical success, complications and follow-up., Results: During the study period, 732 percutaneous nephrolithotomies were performed. Eighteen patients were included (36 renal units, 2.5%), 13 men and 5 women, with a median age of 58 years and an interquartile range (IQR) of 40-66. Median stone burden was 228mm 2 (IQR 134-389); median operative time, 150minutes (IQR 97-180); and median hospital stay, 5 days (IQR 5-15). Stone free rate was 80%. Residual calculi were encountered in 8 renal units (22.2%) and required other complementary techniques for their complete tesolution 4 external shockwave lithotripsies, one open ureterolithotomy, 2 ureteroscopies and one second look. Major complications included 4 cases of severe hemorrhage managed with angiographic embolization. The median follow-up was 36 months (range 26-46)., Conclusions: Simultaneous bilateral percutaneous nephrolithotomy is an effective and safe procedure in patients affected with bilateral renal calculi. It is a surgical challenge that should be performed in selected patients and in centers with experience., (Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

The urolithiasis, with a high incidence nowadays, including formations caused by gallstone of uric acid, has a high correlation to our lifestyles and dietary habits. Through a clinic case, it is intended to review the main nursing actions that may occur with this pathology. To achieve this, the data collected on physical examination and nursing assessment on the model of Virginia Henderson, while the full care plan is developed. The results show the need to establish a standardized healthy education intervention, related to a low-pruine healthy diet for people that suffer this disease. The amount of complications and problems associated with recidivism of hospital accommodation because of the ignorance of gallstone cases increase the risk of reducing the quality of life of the patients., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)

Introduction: The use of flexible ureterorenoscopy for treating kidney stones has increased in recent years, with considerable worldwide variation in the surgical technique and indications., Objectives: To determine the current practice, technique variations, use and indications of flexible ureterorenoscopy for treating kidney stones in Latin American., Methods: We sent (by email and web link) an anonymous questionnaire with 30 questions on flexible ureterorenoscopy for treating kidney stones to Latin American urologists from January 2015 to July 2015. We collected the responses through the Survey Monkey system., Results: A total of 283 urologists in 15 Latin American countries participated (response rate, 10.8%); 254 answered the questionnaire completely; 52.8% were urologists from Mexico and 11% were from Argentina; 11.8% of the responders stated that they performed >100 cases per year; 15.2% considered ureterorenoscopy as the treatment of choice for stones >2cm, and 19.6% performed ureterorenoscopy in single stages for calculi measuring >2.5cm. Some 78.4% use fluoroscopy, 69.1% use a ureteral sheath in all cases, 55.8% place double-J catheters at the end of surgery, 37.3% considered a stone-free state to be 0 fragments, and 41.2% use plain radiography to assess the stone-free condition., Conclusions: Most participating urologists consider flexible ureterorenoscopy as the first-choice treatment for stones <2cm; a small percentage of these urologists perform >100 ureterorenoscopies per year. More than half of the urologists routinely used fluoroscopy and ureteral access sheath; the most common method for determining the stone-free state is plain abdominal radiography., (Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To evaluate an alternative approach to tubeless surgery that allows a second percutaneous procedure using the same nephrostomy tract., Methods: Twenty patients underwent percutaneous nephrolithotomy from September 2012 to May 2013 at our institution. Inclusion criteria were: absence of urinary infection, single puncture and operative time less than 2 h. Following the procedure the initially placed ureteral catheter was exteriorized through the working sheath by tying a non-absorbable suture to its end. On postoperative day 1 all patients were studied with non-enhanced CT or X-ray film. If the patient was rendered stone free, the stent was removed along with the urethro-vesical catheter. If a residual stone was present, we recovered the ureteral catheter and used the same nephrostomy tract for a second endoscopic procedure. Patients were assessed for pain, postoperative complications, length of stay, stone free rate, hematocrit and creatinine variations., Results: Thirteen patients met the inclusion criteria. No major complications related to the stent placement and its exteriorization were seen. Two patients required a second percutaneous procedure successfully achieved recovering the ureteral catheter through the nephrostomy tract., Conclusion: We present a safe and simple modification of tubeless percutaneous nephrolithotomy, with its well-known clinical benefits but maintaining a safe path for an eventual second look procedure if necessary., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)