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Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts' experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to comprehensively investigate the relationship between blood volatile organic compounds (VOCs) and kidney stone prevalence for U.S. adults. Methods: In this cross-sectional study, 10,052 participants from the 2007–2020 National Health and Nutrition Examination Survey (NHANES) were included. Multivariate logistic regression model was employed to investigate the association between 9 blood VOCs and kidney stones. We explored the dose–response relationship between blood VOCs and kidney stones using restricted cubic spline (RCS) analysis. Additionally, weighted quantile sum (WQS) regression model was performed to assess the overall association of 9 blood VOCs with kidney stones. Finally, subgroup analyses were conducted to identify the findings in different populations at high prevalence. Results: Logistic regression analysis and dose–response risk curves revealed that blood benzene (aOR = 1.308, 95% CI: 1.118–1.530, P = 0.001), blood ethylbenzene (aOR = 1.280, 95% CI: 1.054–1.554, P = 0.013), blood m-/p-xylene (aOR = 1.187, 95% CI: 1.008–1.398, P = 0.040), blood 2,5-dimethylfuran (aOR = 1.319, 95% CI: 1.135–1.533, P < 0.001) and blood furan (aOR = 1.698, 95% CI: 1.305–2.209, P < 0.001) were positively associated with the prevalence of kidney stones. WQS regression analysis revealed that exposure to mixed blood VOCs was positively correlated with kidney stone prevalence (OR = 1.34, 95% CI: 1.14–1.57), with furans carrying the greatest weight. Subgroup analyses suggested that kidney stones were more susceptible to the effects of blood VOCs in young and middle-aged, female, overweight and obese, non-hypertensive, and non-diabetic populations. Conclusions: In this study, the results indicated that high VOC exposure was positively and independently associated with kidney stones in U.S. adults. This finding highlighted the need for public health strategies to reduce VOC exposure and its role in kidney stone prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: Structured Problem Solving (SPS) is a patient-centered approach to promoting behavior change that relies on productive collaboration between coaches and participants and reinforces participant autonomy. We aimed to describe the design, implementation, and assessment of SPS in the multicenter Prevention of Urinary Stones with Hydration (PUSH) randomized trial. Methods: In the PUSH trial, individuals with a history of urinary stone disease and low urine output were randomized to control versus a multicomponent intervention including SPS that was designed to promote fluid consumption and thereby prevent recurrent stones. We provide details specifically about training and fidelity assessment of the SPS coaches. We report on implementation experiences related to SPS during the initial conduct of the trial. Results: With training and fidelity assessment, coaches in the PUSH trial applied SPS to help participants overcome barriers to fluid consumption. In some cases, coaches faced implementation barriers such as variable participant engagement that required tailoring their work with specific participants. The coaches also faced challenges including balancing rapport with problem solving, and role clarity for the coaches. Conclusions: We adapted SPS to the setting of kidney stone prevention and overcame challenges in implementation, such as variable patient engagement. Tools from the PUSH trial may be useful to apply to other health behavior change settings in nephrology and other areas of clinical care. Trial registration: ClinicalTrials.gov Identifier NCT03244189. [ABSTRACT FROM AUTHOR]

Background: For renal stones > 20 mm, percutaneous nephrolithotomy (PNL) offers the best stone clearance rates with acceptable complication rates. This study aimed to compare the efficiency of high-power holmium YAG laser and ballistic lithotripsy during mini-PNL. Methods: Data from 880 patients who underwent mini-PNL for renal stones was investigated retrospectively. The study utilized propensity score matching to create two groups: laser lithotripsy (n = 440) and ballistic lithotripsy (n = 440). The groups were matched based on stone size, Guy's stone score, and stone density. The main objectives of the study were to assess the stone-free rate (SFR), duration of surgery, and complication rates. Results: The average age of the population was 51.4 ± 7.1 years, with a mean stone size of 28.6 ± 8.3 mm and a mean stone density of 1205 ± 159 HU. There were no significant differences between the groups. The SFRs of the laser lithotripsy and ballistic lithotripsy were 92.5% and 90.2%, respectively (p = 0.23). The laser lithotripsy group had a notably shorter surgery time (40.1 ± 6.3 min) compared to the ballistic lithotripsy group (55.6 ± 9.9 min) (p = 0.03). Complication rates were similar (p = 0.67). Conclusions: Our study shows that a high-power holmium YAG laser provides quicker operation time compared to ballistic lithotripsy. However, ballistic lithotripsy is still an effective and safe option for stone fragmentation during mini-PNL. In places where a high-power holmium YAG laser is not available, ballistic lithotripters are still a safe, effective, and affordable option for mini-PNL. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between C-reactive protein (CRP) and the risk of developing kidney stones is unclear, and we aimed to assess the association between CRP and kidney stones in US adults. Methods: We used data from NHANES 2007–2010, and we excluded participants who were under 18 years of age and lacked data on CRP and kidney stones. Finally, we included a total of 11,033 participants and performed weighted multivariate regression analysis and subgroup analysis to assess the independent relationship between CRP and kidney stones. Results: The mean prevalence of kidney stones among the participants was 9.8%. Notably, as CRP levels increased, the prevalence of kidney stones exhibited a corresponding rise across quartiles (Kidney stones: Quartile 1: 7.59%; Quartile 2: 8.77%; Quartile 3: 9.64%; Quartile 4: 10.89%). CRP was positively associated with the risk of kidney stones (Model 1: OR = 1.09, 95% CI: 1.01–1.18, p = 0.03; Model 2: OR = 1.09, 95% CI: 1.00–1.18, p = 0.03, Model 3: OR = 1.14, 95%CI: 1.02–1.26, p = 0.04). Participants in the highest CRP quartile experienced a 69% increased risk of kidney stones compared to those in the lowest quartile (OR = 1.64, 95% CI: 1.04–2.59, p = 0.03). Notably, interaction tests revealed that gender, BMI, diabetes, hypertension, CKD and smoking or alcohol consumption status did not significantly influence the association between CRP and kidney stones. Conclusions: Our findings reveal a significant association between higher CRP levels and an increased risk of kidney stones. In clinical practice, heightened awareness of CRP as a potential biomarker could aid in risk assessment and management strategies for kidney stone patients. [ABSTRACT FROM AUTHOR]

Background: Laser lithotripsy using a thulium fiber laser (TFL) has become an effective treatment option for small renal stones with low complication rates. TFL has a higher absorption coefficient, smaller fibers, and better pulse rate capability. Methods: We conducted a systematic review and meta-analysis to evaluate the published evidence regarding TFL's lithotripsy performance in retrograde intrarenal surgery (RIRS), for which we primarily assessed the outcomes of stone-free rate, operation time, and complications. We searched different databases from inception to April 2023. We assessed the methodological quality and risk of bias using the Cochrane Risk of Bias tool for randomized trials and the ROBINS-I tool for non-randomized studies. We used a random-effects model for meta-analysis and assessed heterogeneity using the I2 statistic. Results: Twelve published studies evaluated the efficacy of RIRS using a TFL for treating renal and ureteral stones. The meta-analysis revealed a predicted stone-free rate of 89.37% (95% CI: 83.93% to 93.12%), indicating that, on average, approximately 89.37% of patients achieved a stone-free state after treatment. The substantial heterogeneity among the studies was evident, as shown by a Q-value of 33.1174 and a p-value of 0.0003. The I2 value of 69.80% (95% CI: 25.91% to 92.02%) highlighted the proportion of variability attributed to genuine heterogeneity across the studies. Moreover, the H2 value 3.31 (95% CI: 1.35 to 12.53) indicated significant heterogeneity beyond random chance. The estimated overall effect size (logit-transformed) of 2.1289 was highly statistically significant (z = 8.7648, p < 0.0001) with a confidence interval of 1.6528 to 2.6049. The reported complications varied across studies, encompassing Clavien grade I–II complications in most cases, with a subset experiencing more severe Clavien grade III–V complications. Additionally, other studies noted a range of complications, such as haematuria, fever, transient creatinine elevation, and postoperative issues like bleeding, pain, and sepsis. Conclusion: This meta-analysis suggests that RIRS using TFL is an effective and safe treatment option for renal and ureteral stones, with high stone-free and low complication rates. The included studies exhibited a low risk of bias and were of high quality. However, more extensive randomized controlled trials with extended follow-up periods are needed to investigate this technique's efficacy and safety. [ABSTRACT FROM AUTHOR]

Background: Kidney stone disease (KSD) is a common condition that affects 10% population in the United States (US). The relationship between thiamine and riboflavin intake and KSD has not been well-studied. We aimed to investigate the prevalence of KSD and the association between dietary thiamine and riboflavin intake with KSD in the US population. Methods: This large-scale, cross-sectional study included subjects from the National Health and Nutrition Examination Survey (NHANES) 2007–2018. KSD and dietary intake were collected from questionnaires and 24-hour recall interviews. Logistic regression and sensitivity analyses were performed to investigate the association. Results: This study included 26,786 adult participants with a mean age of 50.12 ± 17.61 years old. The prevalence of KSD was 9.62%. After adjusting for all potential covariates, we found that higher riboflavin intake was negatively related to KSD compared with dietary intake of riboflavin < 2 mg/day in the fully-adjusted model (OR = 0.541, 95% CI = 0.368 to 0.795, P = 0.002). After stratifying by gender and age, we found that the impact of riboflavin on KSD still existed in all age subgroups (P < 0.05) but only in males (P = 0.001). No such associations were found between dietary intake of thiamine and KSD in any of the subgroups. Conclusions: Our study suggested that a high intake of riboflavin is independently inversely associated with kidney stones, especially in male population. No association was found between dietary intake of thiamine and KSD. Further studies are needed to confirm our results and explore the causal relationships. [ABSTRACT FROM AUTHOR]

Background: Urolithiasis with high prevalence and recurrence rate, has impacts on kidney injury in patients, becomes a socioeconomic and healthcare problem in worldwide. However, the biology of kidney with crystal formation and proximal tubular injury remains essentially unclear. The present study aims to evaluate the cell biology and immune-communications in urolithiasis mediated kidney injury, to provide new insights in the kidney stone treatment and prevention. Results: We identified 3 distinct injured-proximal tubular cell types based on the differentially expression injury markers (Havcr1 and lcn2) and functional solute carriers (slc34a3, slc22a8, slc38a3 and slc7a13), and characterized 4 main immune cell types in kidney and one undefined cell population, where F13a1+/high/CD163+/high monocyte & macrophage and Sirpa/Fcgr1a/Fcgr2a+/high granulocyte were the most enriched. We performed intercellular crosstalk analysis based on the snRNA-seq data and explored the potential immunomodulation of calculi stone formation, and founded that the interaction between ligand Gas6 and its receptors (Gas6-Axl, Gas6-Mertk) was specifically observed in the injured-PT1 cells, but not injured-PT2 and -PT3 cells. The interaction of Ptn-Plxnb2 was only observed between the injured-PT3 cells and its receptor enriched cells. Conclusions: Present study comprehensively characterized the gene expression profile in the calculi rat kidney at single nucleus level, identified novel marker genes for all cell types of rat kidney, and determined 3 distinct sub-population of injured-PT clusters, as well as intercellular communication between injured-PTs and immune cells. Our collection of data provides a reliable resource and reference for studies on renal cell biology and kidney disease. [ABSTRACT FROM AUTHOR]

Background: Kidney stone disease (KSD) is commonly accompanied with renal fibrosis, characterized by accumulation and reorganization of extracellular matrix (ECM). During fibrogenesis, resident renal fibroblasts are activated to become myofibroblasts that actively produce ECM. However, such fibroblast–myofibroblast differentiation in KSD remained unclear. Our present study thus examined effects of secreted products (secretome) derived from proximal (HK-2) vs. distal (MDCK) renal tubular cells exposed to calcium oxalate monohydrate (COM) crystals on activation of renal fibroblasts (BHK-21). Methods: HK-2 and MDCK cells were treated with 100 µg/ml COM crystals under serum-free condition for 16 h. In parallel, the cells maintained in serum-free medium without COM treatment served as the control. Secretome derived from culture supernatant of each sample was mixed (1:1) with fresh serum-free medium and then used for BHK-21 culture for another 24 h. Results: Analyses revealed that COM-treated-HK-2 secretome significantly induced proliferation, caused morphological changes, increased spindle index, and upregulated fibroblast-activation markers (F-actin, α-SMA and fibronectin) in BHK-21 cells. However, COM-treated-MDCK secretome had no significant effects on these BHK-21 parameters. Moreover, level of transforming growth factor-β1 (TGF-β1), a profibrotic factor, significantly increased in the COM-treated-HK-2 secretome but not in the COM-treated-MDCK secretome. Conclusions: These data indicate, for the first time, that proximal and distal tubular epithelial cells exposed to COM crystals send different messages to resident renal fibroblasts. Only the secretome derived from proximal tubular cells, not that from the distal cells, induces renal fibroblast activation after their exposure to COM crystals. Such differential effects are partly due to TGF-β1 secretion, which is induced by COM crystals only in proximal tubular cells. [ABSTRACT FROM AUTHOR]

Backgrounds: Kidney stone also known as urolithiasis or nephrolithiasis, is one of the oldest diseases known to medicine, however, the gene expression changes and related kidney injury remains unclear. Methods: A calculi rat model was developed via ethylene glycol– and ammonium chloride–induction. Integrated proteomic and transcriptomic analysis was performed to characterize the distinct gene expression profiles in the kidney of calculi rat. Differential expressed genes (DEGs) were sub-clustered into distinct groups according to the consistency of transcriptome and proteome. Gene Ontology and KEGG pathway enrichment was performed to analyze the functions of each sub-group of DEGs. Immunohistochemistry was performed to validated the expression of identified proteins. Results: Five thousand eight hundred ninety-seven genes were quantified at both transcriptome and proteome levels, and six distinct gene clusters were identified, of which 14 genes were consistently dysregulated. Functional enrichment analysis showed that the calculi rat kidney was increased expression of injured & apoptotic markers and immune-molecules, and decreased expression of solute carriers & transporters and many metabolic related factors. Conclusions: The present proteotranscriptomic study provided a data resource and new insights for better understanding of the pathogenesis of nephrolithiasis, will hopefully facilitate the future development of new strategies for the recurrence prevention and treatment in patients with kidney stone disease. [ABSTRACT FROM AUTHOR]

Background: Kidney stone is the major cause of morbidity, and its prevalence is increasing in the world. This study aimed to assess the prevalence and risk factors of kidney stone in the adult population of southern Iran based on the data of the Kharameh Cohort Study. Methods: This cross-sectional study was conducted on 10,663 individuals aged 40–70 years old, using the baseline data of Kharamah cohort study, which started in 2014. Among all participants, 2251 individuals had a history of kidney stone. The participants' demographic characteristics, behavioral habits, and the history of underlying diseases were investigated. The crude and Age Standardized Prevalence Rate of kidney stones was calculated. Also, logistic regression was used to identify the predictors of kidney stone. To check the goodness of fit index of the model, we used the Hosmer–Lemeshow test. All analyses were performed in STATA software. Results: The prevalence of kidney stone was estimated 21.11%. Also, the Age Standardized Prevalence Rate in men and women was calculated 24.3% and 18.7%, respectively. The mean age of the participants was 52.15 years. Higher prevalence of kidney stone was seen in women aged 40–50 years (40.47%, p = 0.0001) and moderate level of social economic status (31.47%, p = 0.03), men with overweight (44.69%, p < 0.0001) and those in a very high level of social economic status (35.75%, p = 0.001). The results of multiple logistic regression showed that the chance of having kidney stone was 1.17 times higher in diabetic individuals, 1.43 times higher in hypertensive individuals, 2.21 times higher in individuals with fatty liver, and 1.35 times higher in individuals with overweight. The level of socio economic status, male sex, and age were the other factors related to kidney stone. Conclusion: In this study, underlying diseases such as fatty liver, diabetes, and hypertension as well as age, male sex, overweight, and high social economic status were identified as important risk factors for kidney stone. Therefore, identifying individuals at risk of kidney stone and providing the necessary training can greatly help to reduce this disease. However, health policymakers should prepare preventive strategies to reduce the occurrence of kidney stone. [ABSTRACT FROM AUTHOR]

Background: In recent years, the safety and effectiveness of one-stage percutaneous nephrolithotomy (PCNL) for the treatment of calculous pyonephrosis have been proven. In order to further reduce postoperative pain and hospital stay, we first proposed and practiced the idea of one-stage tubeless percutaneous nephrolithotomy for calculous pyonephrosis.Methods: A retrospective analysis was performed of case data of 30 patients with asymptomatic calculous pyonephrosis treated in our center with one-stage PCNL from January 2016 to January 2021. Patients were routinely given 20 mg of furosemide and 10 mg of dexamethasone sodium phosphate injection intravenously at the beginning of anesthesia. Among them, 27 patients successfully underwent one-stage tubeless percutaneous nephrolithotomy, while 3 cases were given indwelling nephrostomy tubes because of proposed second-stage surgery or the number of channels was greater than or equal to 3. All patients were operated on by the same surgeon.Results: Preoperatively, 11 of 30 patients (8 men and 22 women) had positive urine bacterial cultures, and all were given appropriate antibiotics based on drug sensitivity tests. All patients completed the surgery successfully. The mean operative time was 66.6 ± 34.7 min, the mean estimated blood loss was 16.67 ± 14.34 mL and the mean postoperative hospital stay was 5.0 ± 3.1 days. The mean postoperative hospital stay was 4.6 ± 2.5 days among the 27 patients with one-stage tubeless percutaneous nephrolithotomy. Of the 3 patients with postoperative fever, 2 had the tubeless technique applied. One patient with 3 channels was given renal artery interventional embolization for control of postoperative bleeding. None of the 30 patients included in the study developed sepsis. The final stone-free rate was 93.3% (28/30) on repeat computed tomography at 1 month postoperatively. The final stone-free rate was 92.6% in the 27 patients undergoing one-stage tubeless percutaneous nephrolithotomy (25/27).Conclusions: One-stage tubeless PCNL is an available and safe option in carefully evaluated and selected calculous pyonephrosis patients. [ABSTRACT FROM AUTHOR]

Background: LncRNA-ATB is a long noncoding RNA (lncRNA) activated by transforming growth factor β (TGF-β) and it has important biological functions in tumours and nontumour diseases. Meanwhile, TGF-β is the most critical regulatory factor in the process of nephrotic fibrosis and calcium oxalate (CaOx) crystal-induced renal injury. The present study aimed to investigate the biological function and mechanism of lncRNA-ATB in CaOx crystal-induced renal injury. Methods: The expression level of lncRNA-ATB was detected by quantitative reverse-transcription polymerase chain reaction (qRT-PCR), the expression levels of epithelial-mesenchymal transition (EMT) markers, TGF-β1 and Kidney Injury Molecule-1 (KIM-1) were detected by qRT-PCR, immunofluorescence staining or western blot analysis, cell proliferation was measured with a CCK-8 kit, cell apoptosis was measured by flow cytometry and TUNEL staining, and cell injury was detected with the Cytotoxicity lactate dehydrogenase (LDH) Assay kit and the expression level of KIM-1. Results: The expression levels of lncRNA-ATB and TGF-β1 were significantly increased in HK-2 cells after coincubation with calcium oxalate monohydrate (COM). COM stimulation caused significant injury in the HK-2 cells, induced cell apoptosis, inhibited cell proliferation, and induced EMT changes. After COM stimulation, the expression levels of the epithelial cell markers E-cadherin and zonula occludens (ZO)-1 in HK-2 cells significantly decreased, whereas the levels of the mesenchymal cell markers N-cadherin, vimentin and α-smooth muscle actin (α-SMA) significantly increased. Interference with lncRNA-ATB expression significantly relieved the COM-induced cell injury, cell apoptosis, proliferation inhibition, and EMT changes. The expression levels of the microRNA-200 (miR-200) family in the HK-2 cells after coincubation with COM were significantly decreased. MiR-200a mimics relieved the COM-induced cell injury, apoptosis, proliferation inhibition, and EMT changes, whereas miR-200a inhibitors abolished the lncRNA-ATB interference-induced relief of the COM-induced cell injury, apoptosis, proliferation inhibition, and EMT. Conclusion: LncRNA-ATB promoted the COM-induced cell injury, cell apoptosis, proliferation inhibition, and EMT to participate in the process of CaOx crystal-induced renal injury by sponging miR-200s. [ABSTRACT FROM AUTHOR]

Background: The prevalence of kidney stones in the world is increasing and environmental factors seem to play a major role in this issue. The aim of the present study was to investigate the prevalence of risk factors of kidney stones in the adult population of Rafsanjan city based on the data of the Rafsanjan Cohort Study (RCS).Methods: In the baseline phase of this study, 10,000 people aged 35 to 70 years are enrolled in the RCS, as one of the prospective epidemiological research studies in Iran. From this population, 9932 participants completed related demographic questionnaires as well as reported a history of diabetes mellitus, kidney stone, and hypertension diseases. The obtained data were analyzed using univariable and multivariable logistics regression.Results: According to the obtained results, 46.54% of the studied population were male and 53.46% were female. The mean age of the participants was 49.94 ± 9.56 years. 2392 people accounting for 24.08% of the population had kidney stones. After adjustment of the variables, six variables of gender, WSI, no consumption of purified water, BMI, and history of hypertension and diabetes were found to be significant related factors of kidney stone disease.Conclusions: Gender, hypertension, obesity, diabetes, and personal habits like alcohol consumption, opium use and, cigarette smoking are effective in the development of kidney stones. So, by identifying the susceptible patients and teaching them, the burden of the disease on society and the individual can be reduced. The results of this study are helpful to health care providers for preventive planning for kidney stone disease. [ABSTRACT FROM AUTHOR]

Background: The dogma that urine is sterile in healthy individuals has been overturned by recent studies applying molecular-based methods. Mounting evidences indicate that dysbiosis of the urinary microbiota is associated with several urological diseases. In this study, we aimed to investigate the urinary microbiome of male patients with calcium-based kidney stones and compare it with those of healthy individuals. Results: The diversity of the urinary microbiota in kidney stone patients was significantly lower than that of healthy controls based on the Shannon and Simpson index (P < 0.001 for both indices). The urinary microbiota structure also significantly differed between kidney stone patients and healthy controls (ANOSIM, R = 0.11, P < 0.001). Differential representation of inflammation associated bacteria (e.g., Acinetobacter) and several enriched functional pathways were identified in the urine of kidney stones patients. Meanwhile, we found the species diversity, overall composition of microbiota and predicted functional pathways were similar between bladder urine and renal pelvis urine in kidney stone patients. Conclusions: A marked dysbiosis of urinary microbiota in male patients with calcium-based kidney stones was observed, which may be helpful to interpret the association between bacteria and calcium-based kidney stones. [ABSTRACT FROM AUTHOR]

Background: To explore long non-coding RNA (lncRNA), mRNA and circular RNA (circRNA) expression profiles and their biological functions in the pathogenesis of kidney stones in ethylene glycol-induced urolithiasis rats. Results: The expression of 1440 lncRNAs, 2455 mRNAs and 145 circRNAs was altered in the kidneys of urolithiasis rats. GO and KEGG biological pathway analysis were performed to predict the functions of differentially expressed lncRNAs, circRNAs and co-expressed potential targeting genes. Co-expression networks of lncRNA-mRNA and circRNA-miRNA were constructed based on correlation analysis between differentially expressed RNAs. mRNAs coexpressed with lncRNAs were involved in many kidney diseases, e.g., Ephb6 was associated with the reabsorption ability of the kidney. Arl5b was associated with the dynamic changes in the podocyte foot process in podocyte injury. miRNAs co-expressed with circRNAs, such as rno-miR-138-5p and rno-miR-672-5p, have been proven to be functional in hypercalciuria urolithiasis. Conclusion: The expression profile provided a systematic perspective on the potential functions of lncRNAs and circRNAs in the pathogenesis of kidney stones. Differentially expressed lncRNAs and circRNAs might serve as treatment targets for kidney stones. [ABSTRACT FROM AUTHOR]

Background: Observational studies have demonstrated an association between nephrolithiasis and hypertension. The aim of this meta-analysis was to summarize all available evidence.Methods: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials databases, and the reference lists of relevant articles were searched to identify observational studies that reported study-specific risk estimates comparing the risk of hypertension in patients with nephrolithiasis. We used a random-effect model to pool the study-specific risk estimates. We also assessed the potential heterogeneity by subgroup analyses, meta-regression analyses, and sensitivity analyses.Results: A total of 7 articles including 9 studies (n = 313,222 participants) were eventually identified in this meta-analysis. In comparison with the patients who did not have nephrolithiasis, nephrolithiasis significantly increased the risk of hypertension (OR, 1.43; 95% CI, 1.30-1.56), with significant heterogeneity between these studies (I 2 = 83.5%, P <0.001). The heterogeneity reduced in subgroups of cohort studies, USA, large sample size trials, men, and adjustment for confounding factors ≥ 5. Sensitivity analysis further demonstrated the results to be robust.Conclusions: Nephrolithiasis is associated with increased risk of hypertension. Future randomized, high-quality clinical trials are encouraged to definitively clarify the relationship between nephrolithiasis and hypertension, which may influence clinical management and primary prevention of hypertension in nephrolithiasis patients. [ABSTRACT FROM AUTHOR]

Background: Computed Tomography (CT) is considered the gold-standard for the pre-operative evaluation of urolithiasis. However, no Hounsfield (HU) variable capable of differentiating stone types has been clearly identified. The aim of this study is to assess the predictive value of HU parameters on CT for determining stone composition and outcomes in percutaneous nephrolithotomy (PCNL).Methods: Seventy seven consecutive cases of PCNL between 2011 and 2016 were divided into 4 groups: 40 (52%) calcium, 26 (34%) uric acid, 5 (6%) struvite and 6 (8%) cystine stones. All images were reviewed by a single urologist using abdomen/bone windows to evaluate: stone volume, core (HUC), periphery HU and their absolute difference. HU density (HUD) was defined as the ratio between mean HU and the stone's largest diameter. ROC curves assessed the predictive power of HU for determining stone composition/stone-free rate (SFR).Results: No differences were found based on the viewing window (abdomen vs bone). Struvite stones had values halfway between hyperdense (calcium) and low-density (cystine/uric acid) calculi for all parameters except HUD, which was the lowest. All HU variables for medium-high density stones were greater than low-density stones (p < 0.001). HUC differentiated the two groups (cut-off 825 HU; specificity 90.6%, sensitivity 88.9%). HUD distinguished calcium from struvite (mean ± SD 51 ± 16 and 28 ± 12 respectively; p = 0.02) with high sensitivity (82.5%) and specificity (80%) at a cut-off of 35 HU/mm. Multivariate analysis revealed HUD ≥ 38.5 HU/mm to be an independent predictor of SFR (OR = 3.1, p = 0.03). No relationship was found between HU values and complication rate.Conclusions: HU parameters help predict stone composition to select patients for oral chemolysis. HUD is an independent predictor of residual fragments after PCNL and may be fundamental to categorize it, driving the imaging choice at follow-up. [ABSTRACT FROM AUTHOR]

Background: Kidney stone matrix protein composition is an important yet poorly understood aspect of nephrolithiasis. We hypothesized that this proteome is considerably more complex than previous reports have indicated and that comprehensive proteomic profiling of the kidney stone matrix may demonstrate relevant constitutive differences between stones. We have analyzed the matrices of two unique human calcium oxalate stones (CaOx-Ia and CaOx-Id) using a simple but effective chaotropic reducing solution for extraction/solubilization combined with label-free quantitative mass spectrometry to generate a comprehensive profile of their proteomes, including physicochemical and bioinformatic analysis.` Results: We identified and quantified 1,059 unique protein database entries in the two human kidney stone samples, revealing a more complex proteome than previously reported. Protein composition reflects a common range of proteins related to immune response, inflammation, injury, and tissue repair, along with a more diverse set of proteins unique to each stone. Conclusion: The use of a simple chaotropic reducing solution and moderate sonication for extraction and solubilization of kidney stone powders combined with label-free quantitative mass spectrometry has yielded the most comprehensive list to date of the proteins that constitute the human kidney stone proteome. [ABSTRACT FROM AUTHOR]

Background: Observational studies have demonstrated an association between nephrolithiasis and hypertension. The aim of this meta-analysis was to summarize all available evidence., Methods: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials databases, and the reference lists of relevant articles were searched to identify observational studies that reported study-specific risk estimates comparing the risk of hypertension in patients with nephrolithiasis. We used a random-effect model to pool the study-specific risk estimates. We also assessed the potential heterogeneity by subgroup analyses, meta-regression analyses, and sensitivity analyses., Results: A total of 7 articles including 9 studies (n = 313,222 participants) were eventually identified in this meta-analysis. In comparison with the patients who did not have nephrolithiasis, nephrolithiasis significantly increased the risk of hypertension (OR, 1.43; 95% CI, 1.30-1.56), with significant heterogeneity between these studies (I 2  = 83.5%, P <0.001). The heterogeneity reduced in subgroups of cohort studies, USA, large sample size trials, men, and adjustment for confounding factors ≥ 5. Sensitivity analysis further demonstrated the results to be robust., Conclusions: Nephrolithiasis is associated with increased risk of hypertension. Future randomized, high-quality clinical trials are encouraged to definitively clarify the relationship between nephrolithiasis and hypertension, which may influence clinical management and primary prevention of hypertension in nephrolithiasis patients.

Background: Many epidemiological studies have conducted to evaluate the association between serum vitamin D levels and the risk of kidney stone. The aim of this study was to summarize the evidence from epidemiological studies between them., Methods: Pertinent studies were identified by a search of PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and China Biology Medical literature up to July 2015. Standardized mean difference (SMD) was conducted to combine the results. Random-effect model was used. Publication bias was estimated using Egger's regression asymmetry test., Results: Seven articles involving 451 kidney stone cases and 482 controls were included in this meta-analysis. Our pooled results suggested that kidney stone patients had a significantly higher serum vitamin D level compared with controls [summary SMD = 0.65, 95 % CI = 0.51, 0.79, I(2) = 97.0 %]. The associations were also significant both in Europe [SMD = 0.35, 95 % CI = 0.17, 0.53] and in Asia [SMD = 1.00, 95 % CI = 0.76, 1.25]. No publication bias was found., Conclusions: Our analysis indicated that serum vitamin D level in kidney stone patients was significantly higher than that in non-kidney stone controls, both in Europe and Asia populations.