Urolithiasis最新文献_第2页

Toward reliable preoperative prediction of urinary stone composition: critical considerations for imaging and clinical data integration. 迈向可靠的术前预测尿路结石组成：影像学和临床资料整合的关键考虑因素。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-23 DOI: 10.1007/s00240-025-01844-8

Qiming Wu, Zilin Gong, Chen Liu

引用次数: 0

Commentary on "validation of the STONE and new STONE score for ureteral stones in elderly patients: a retrospective cohort study". 对“老年患者输尿管结石的STONE和新STONE评分的验证：一项回顾性队列研究”的评论。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-18 DOI: 10.1007/s00240-025-01851-9

Huacai Zhu, Ciyi Guan, Zhanping Xu

引用次数: 0

Development and validation of an explainable machine learning model for predicting sepsis risk following flexible ureteroscopic lithotripsy. 开发和验证可解释的机器学习模型，用于预测输尿管镜碎石术后败血症风险。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-18 DOI: 10.1007/s00240-025-01856-4

Ruichen Li, Biao Zhang, Liying Zeng, Jiayan Mo, Jinyuan Zhang, Sheng Bi

{"title":"Development and validation of an explainable machine learning model for predicting sepsis risk following flexible ureteroscopic lithotripsy.","authors":"Ruichen Li, Biao Zhang, Liying Zeng, Jiayan Mo, Jinyuan Zhang, Sheng Bi","doi":"10.1007/s00240-025-01856-4","DOIUrl":"10.1007/s00240-025-01856-4","url":null,"abstract":"Sepsis is a severe complication of flexible ureteroscopic lithotripsy (fURL), a widely used treatment for kidney stones. This study aimed to develop and validate a predictive model based on machine learning (ML) for assessing the risk of sepsis following fURL while enhancing its interpretability through Shapley Additive Explanations (SHAP). This retrospective study in China was conducted to develop and validate a prediction model for sepsis following fURL. The derivation cohort comprised 1,386 patients treated between 2019 and July 2024 divided into training and internal validation subsets. External validation was performed on a cohort of 604 patients treated between 2019 and 2023 at a collaborating center. Sepsis was diagnosed according to Sepsis-3.0 consensus guidelines. Fifteen machine learning algorithms were employed to construct predictive models, and their performance was meticulously evaluated using metrics such as the area under the receiver operating characteristic curve (AUC). To enhance model interpretability, the Shapley Additive Explanations (SHAP) method was applied to assess and rank the importance of individual features. The Extra Trees (ET) model incorporating eight key features demonstrated the best discriminative ability, with an AUC of 0.90. It accurately predicted sepsis in both internal (AUC = 0.87) and external validation (AUC = 0.81). In this study, we developed an Extra Trees (ET) machine learning model to predict sepsis risk following fURL, which demonstrated high accuracy in predicting sepsis in both the internal and external validation cohorts. This model, equipped with SHAP-driven interpretability and deployed as an accessible web application, has the potential to serve as a clinical tool for patient risk stratification following fURL.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"179"},"PeriodicalIF":2.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: "timing of nephrostomy tube removal and its association with stone-related morbidity following endoscopic management of obstructive urolithiasis: a retrospective cohort study". 评论：“内镜治疗梗阻性尿石症后肾造口管拔除时机及其与结石相关发病率的关系：一项回顾性队列研究”。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-18 DOI: 10.1007/s00240-025-01852-8

Yunus Colakoglu

引用次数: 0

Association between biological aging acceleration and kidney stone in Chinese adults: exploring the role of insulin resistance. 中国成人生物衰老加速与肾结石的关系：胰岛素抵抗的作用

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-18 DOI: 10.1007/s00240-025-01857-3

Zijian Zhou, Zixuan Gong, Guoliang Lu, Baoxing Huang, Dawei Wang

{"title":"Association between biological aging acceleration and kidney stone in Chinese adults: exploring the role of insulin resistance.","authors":"Zijian Zhou, Zixuan Gong, Guoliang Lu, Baoxing Huang, Dawei Wang","doi":"10.1007/s00240-025-01857-3","DOIUrl":"10.1007/s00240-025-01857-3","url":null,"abstract":"Advanced biological aging is linked to a higher risk of adverse health outcomes; however, its association with kidney stone (KS) remains unclear. This cross-sectional study investigated the relationship between biological aging acceleration (BAA) and KS, along with the potential mediating role of insulin resistance, in 18,868 Chinese adults aged 20-80 years undergoing health examinations at Ruijin Hospital between 2020 and 2024. Biological age was assessed using the Klemera-Doubal method biological age (KDM-BA) and Phenotypic age(PhenoAge) algorithms, with BAA calculated via residual analysis relative to the chronological age. Insulin resistance(IR) was evaluated using surrogate indices including the triglyceride glucose index (TyG), TyG-body mass index (TyG-BMI), and metabolic score for insulin resistance (METS-IR). The overall prevalence of KS was 5.25%. After full covariate adjustment, participants in the highest quintile of KDM-BA acceleration had a 1.34-fold higher risk of KS than those in the lowest quintile (95% confidence interval [CI]: 1.05-1.70). Similarly, those in the highest PhenoAge acceleration quintile exhibited a 1.39-fold increase in KS risk (95% CI: 1.10-1.76). KDM-BA and PhenoAge acceleration increased by 12% (odds ratio[OR]: 1.12, 95% CI: 1.04-1.20) and 9% (OR: 1.09, 95% CI: 1.03-1.16) per standard deviation, respectively, in correlation with higher KS risk. Restricted cubic spline analysis confirmed dose-response relationships for both KDM-BA (P-overall=0.002) and PhenoAge acceleration (P-overall=0.007) with KS. Mediation analysis indicated that IR accounted for 7-13% of these associations. These results imply that an increased risk of KS is linked to accelerated biological ageing, with IR playing a role in this association in Chinese adults. Metabolic and aging monitoring should be enhanced in patients with KS.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"178"},"PeriodicalIF":2.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Paradigm shift in kidney stone research: moving beyond metabolism toward the gut-immune-kidney axis. 肾结石研究的范式转变：从新陈代谢转向肠道-免疫-肾脏轴。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-13 DOI: 10.1007/s00240-025-01850-w

Songhe Chen, Pingbo Bao

引用次数: 0

Scanning electron microscopy and energy dispersive spectroscopy of Randall's plaque stones: an unexpected finding of monosodium urate crystals. 兰德尔氏斑块结石的扫描电子显微镜和能量色散光谱：尿酸钠晶体的意外发现。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-13 DOI: 10.1007/s00240-025-01842-w

Victor Hugo Canela, Antonia Costa-Bauzá, Felix Grases, Tarek M El-Achkar, James E Lingeman, James C Williams

{"title":"Scanning electron microscopy and energy dispersive spectroscopy of Randall's plaque stones: an unexpected finding of monosodium urate crystals.","authors":"Victor Hugo Canela, Antonia Costa-Bauzá, Felix Grases, Tarek M El-Achkar, James E Lingeman, James C Williams","doi":"10.1007/s00240-025-01842-w","DOIUrl":"10.1007/s00240-025-01842-w","url":null,"abstract":"Randall's plaques (RP) are located at the papillary tip, originating in the basement membranes of the thin loops of Henle, vasa recta and collecting ducts, and are associated with kidney stone retention. Disruption of the papillary epithelial layer exposes interstitial RP to calyceal urine, enabling calcium oxalate monohydrate (COM) overgrowth and papillary RP stone formation. This study aimed to analyze the surface and internal structures of RP stones using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Stones were collected from patients during percutaneous nephrolithotomy, ureteroscopy or both. Eighteen stones from nine patients were examined by stereoscopic microscopy, micro computed tomography (micro CT), SEM and EDS. Seven RP stones were sectioned for internal structure analysis. SEM revealed mineralized tubules potentially originating from thin loops, collecting ducts, ducts of Bellini, or vasa recta. These were frequently covered by collagen fibrils, and some were filled with dense or particulate mineral. Calcium phosphate (CaP) apatite was observed in various crystallized phases within RP regions. In three of the seven sectioned RP stones, monosodium urate monohydrate crystals were intercalated with RP, confirmed by EDS. Our multimodal imaging approach provides new insights into RP composition. This study suggests that sodium urate may precede RP formation in a subset of cases, potentially due to early, unexpected urinary pH shifts. Further studies are needed to validate this hypothesis and advance our understanding of RP stone pathophysiology, informing better diagnostic and therapeutic strategies for kidney stone disease.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"175"},"PeriodicalIF":2.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing AI-enabled LLMs in urolithiasis and urology: from ChatGPT through deepseek to fusion and collaboration LLMs. 增强人工智能支持的尿石症和泌尿外科法学硕士：从ChatGPT到deepseek到融合和协作法学硕士。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-11 DOI: 10.1007/s00240-025-01833-x

Yuxuan Song, Yang Liu, Yun Peng, Jiyao Deng, Caipeng Qin, Tao Xu

引用次数: 0

Do elevated intrarenal pressures during mini percutaneous nephrolithotomy increase postoperative pain?? 经皮肾镜取石术中肾内压升高会增加术后疼痛吗？

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-11 DOI: 10.1007/s00240-025-01849-3

Ziv Savin, Kavita Gupta, Christopher Connors, Yuval Elkun, Eve Frangopoulos, Raymond Khargi, Vinay Durbhakula, Blair Gallante, William M Atallah, Mantu Gupta

{"title":"Do elevated intrarenal pressures during mini percutaneous nephrolithotomy increase postoperative pain??","authors":"Ziv Savin, Kavita Gupta, Christopher Connors, Yuval Elkun, Eve Frangopoulos, Raymond Khargi, Vinay Durbhakula, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1007/s00240-025-01849-3","DOIUrl":"https://doi.org/10.1007/s00240-025-01849-3","url":null,"abstract":"Introduction: High intrarenal pressures (IRP) during mini-PCNL have been postulated to result in increased postoperative pain but no studies have evaluated this to our knowledge. We sought to determine if there is a correlation between IRP and immediate postoperative pain when using different tract sizes.Methods: Patients were enrolled and assigned for standard (s-PCNL, 24fr), suctioning-mini (sm-PCNL, 16fr) and non-suctioning-mini (nsm-PCNL, 17.5fr) PCNLs. IRP was measured continuously with a novel technique of real-time monitoring using a 0.014 single-use pressure-sensing COMET™ guidewire. Postoperative pain was documented at the PACU using the VAS pain score. Correlation tests were used to evaluate the association between maximal IRP or tract size and postoperative pain.Results: The study cohort consisted of 30 patients with 10 patients in each group. The median age was 59 and the median stone volume was 438 mm3. None of the patients were pre-stented. Baseline characteristics were comparable across the groups. The median average IRP of the entire cohort was 7 mmHg (IQR 5-11), and the median maximal pressure was 50 mmHg (IQR 30-66). There were no IRP differences between the groups (p = 0.67 for average; p = 0.35 for maximal). Average and maximal VAS pain scores were not different between the tract size groups (p = 0.09 and p = 0.17, respectively), and no significant association was found between maximal IRP and pain scores.Conclusion: The IRP range during PCNL is relatively low, regardless of the tract size. There was no association between the level of maximal IRP and postoperative pain. Our findings provide new in-vivo evidence challenging the commonly cited 30 mmHg IRP threshold and support its reevaluation, given the lack of strong clinical validation.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"174"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence. 冷却诱导的尿刷石结晶作为钙性肾结石复发的预测风险标志物。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-06 DOI: 10.1007/s00240-025-01820-2

Yutaro Tanaka, Ichiro Tsujino, Hiroshi Y Yoshikawa, Kazufumi Takano, Atsushi Okada, Kenjiro Kohri, Takahiro Yasui, Masashi Yoshimura, Yusuke Mori, Mihoko Maruyama

{"title":"Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence.","authors":"Yutaro Tanaka, Ichiro Tsujino, Hiroshi Y Yoshikawa, Kazufumi Takano, Atsushi Okada, Kenjiro Kohri, Takahiro Yasui, Masashi Yoshimura, Yusuke Mori, Mihoko Maruyama","doi":"10.1007/s00240-025-01820-2","DOIUrl":"10.1007/s00240-025-01820-2","url":null,"abstract":"Kidney stones have a high recurrence rate-10% within 5 years and 50% within 10. Crystalluria reflects the urinary physicochemical environment and may serve as a recurrence marker, but key crystals like brushite are rarely detected under ambient conditions. This study aimed to identify novel recurrence markers by inducing crystallization through urine cooling and analyzing crystal composition. The analyzed urine samples from 164 stone formers, including first-time stone formers (FSF, n = 77) and recurrent stone formers (RSF, n = 87). The RSF group was further stratified into low-risk (n = 43) and high-risk (n = 44) groups based on recurrence intervals. A 24-hour urine test assessed mineral composition and supersaturation indices. Urine samples were then cooled to induce crystallization; precipitated crystals were analyzed using microscopy and Raman spectroscopy. The presence, size, and quantity of brushite crystals were compared among the groups. Before cooling, crystals were detected in only 10.9% of samples, whereas after cooling, crystallization occurred in 76.2%, revealing six crystal types, including calcium oxalate dihydrate (COD) and brushite. COD prevalence did not differ significantly among the groups, whereas brushite crystals were significantly more frequent in the high-risk RSF (47.7%) than in low-risk RSF (16.3%) and FSF (16.9%) (p = 0.002) groups. Additionally, the high-risk RSF group had greater quantity and larger size of brushite crystals than did other groups. Cooling-induced brushite crystallization is a promising risk marker for early stone recurrence, with higher crystal quantity and larger size strongly associated with high-risk patients. This method might enhance predictive accuracy beyond traditional 24-hour urine tests, providing a simple, cost-effective tool for recurrence prevention.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"172"},"PeriodicalIF":2.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0