Urolithiasis最新文献_第3页

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

Comment on "Unraveling the role of gut microbiota on the formation of nephrolithiasis: insights from integrated analysis of GWAS, single-cell transcriptomics, bulk RNA sequencing and network pharmacology". 对“揭示肠道微生物群在肾结石形成中的作用：来自GWAS、单细胞转录组学、大量RNA测序和网络药理学综合分析的见解”的评论。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-06 DOI: 10.1007/s00240-025-01839-5

Xinxian Cai, Xinran Shi, Zhe-Zhong Zhang

引用次数: 0

Author's reply to comment on "residual fragments after percutaneous nephrolithotomy: is it mandatory to treat them all? 作者回复“经皮肾镜取石术后残留碎片：是否必须全部治疗？”

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-04 DOI: 10.1007/s00240-025-01847-5

Elisa De Lorenzis, Federica Passarelli, Andrea Li Puma, Emanuele Montanari, Giancarlo Albo, Luca Boeri

引用次数: 0

High-power Ho:YAG lithotripsy increases subclinical renal stress: a prospective randomized KIM-1 study. 高倍率Ho:YAG碎石增加亚临床肾应激：一项前瞻性随机KIM-1研究。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-09-02 DOI: 10.1007/s00240-025-01816-y

Haider Nihad Izaddin Alalam, Furkan Güldibi, Mehmet Giray Sönmez, Cemile Topçu, Selçuk Güven, Mehmet Balasar

{"title":"High-power Ho:YAG lithotripsy increases subclinical renal stress: a prospective randomized KIM-1 study.","authors":"Haider Nihad Izaddin Alalam, Furkan Güldibi, Mehmet Giray Sönmez, Cemile Topçu, Selçuk Güven, Mehmet Balasar","doi":"10.1007/s00240-025-01816-y","DOIUrl":"10.1007/s00240-025-01816-y","url":null,"abstract":"This study aimed to compare the safety profile of high-power (HPL) and low-power (LPL) Holmium:YAG lasers in retrograde intrarenal surgery (RIRS), using urinary Kidney Injury Molecule-1 (KIM-1) as an early biomarker for acute kidney injury (AKI). Sixty patients with renal stones (1.5-2.5 cm) were prospectively randomized into HPL and LPL groups. Urinary KIM-1 and KIM-1/creatinine ratios were measured preoperatively and at 4 and 24 h postoperatively. Intraoperative parameters, stone-free rates (SFR), complications, and renal function (eGFR, serum creatinine) were also assessed. Intrarenal temperatures were recorded before and after lithotripsy. Operative time, SFR, complication rates, and renal function parameters were similar between groups (p > 0.05). However, KIM-1 levels were significantly higher in the HPL group at 24 h postoperatively (278.8 ± 239.6 pg/mL vs. 170.3 ± 172.9 pg/mL, p = 0.003), and the KIM-1/creatinine ratio was also elevated (5.5 ± 4.5 vs. 3.1 ± 2.0, p = 0.035). No significant differences were observed in postoperative serum creatinine or eGFR. Intraoperative renal temperatures increased slightly in the HPL group, but the difference was not statistically significant. While high-power laser lithotripsy does not adversely affect global renal function, it is associated with elevated levels of renal injury biomarkers, suggesting greater subclinical renal stress.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"169"},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970774","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

Validation of the STONE and new STONE score for ureteral stones in elderly patients: a retrospective cohort study. 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。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-08-31 DOI: 10.1007/s00240-025-01843-9

İbrahim Altundağ, Mehmet Taylan Koçer

{"title":"Validation of the STONE and new STONE score for ureteral stones in elderly patients: a retrospective cohort study.","authors":"İbrahim Altundağ, Mehmet Taylan Koçer","doi":"10.1007/s00240-025-01843-9","DOIUrl":"https://doi.org/10.1007/s00240-025-01843-9","url":null,"abstract":"Ureteral stones are a common cause of emergency department visits. However, their presentation in older adults may be atypical. As the global population ages, effective and low-risk diagnostic strategies are increasingly vital to improve patient outcomes, reduce radiation exposure, and lower healthcare costs. This retrospective cohort study conducted between January 2020 and December 2024. We aimed to assess the diagnostic performance of the STONE and New STONE scores in detecting ureteral stones among patients aged 60 and older presenting with flank pain. A total of 161 patients who underwent abdominal computed tomography (CT) were included, with ureteral stones detected in 48.4%. Patients with stones had significantly higher STONE (8.7 ± 2.0 vs. 6.1 ± 1.9) and New STONE scores (5.0 ± 1.9 vs. 2.7 ± 1.6) compared to patients without stone (p < 0.001 for both). The STONE score showed an AUC of 0.830 and the New STONE score 0.829. A cut-off STONE score > 5 yielded 97.4% sensitivity, while a cut-off > 9 provided 88.0% specificity. For the New STONE score, a cut-off > 3 offered 89.7% sensitivity, and a cut-off > 6 showed 97.6% specificity. Both scores demonstrated reliable diagnostic accuracy in elderly patients. The STONE score favored sensitivity, while the New STONE score favored specificity. Our findings suggest that these scoring systems may support imaging decision-making and contribute to reducing unnecessary CT exposure and healthcare costs in older adults with suspected ureteral stones.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"167"},"PeriodicalIF":2.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970813","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

The association between frailty index and all-cause mortality in US individuals with kidney stones: mediation by systemic immune-inflammation (SII) index. 美国肾结石患者虚弱指数与全因死亡率之间的关系：由全身免疫炎症（SII）指数介导。

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-08-31 DOI: 10.1007/s00240-025-01837-7

Shuangning Liu, Yu Dai, YanHu Meng, Jie Zhang, Xiaoke Sun, Yatao Jia

{"title":"The association between frailty index and all-cause mortality in US individuals with kidney stones: mediation by systemic immune-inflammation (SII) index.","authors":"Shuangning Liu, Yu Dai, YanHu Meng, Jie Zhang, Xiaoke Sun, Yatao Jia","doi":"10.1007/s00240-025-01837-7","DOIUrl":"10.1007/s00240-025-01837-7","url":null,"abstract":"The relationship between the frailty index (FI) and all-cause mortality in patients with kidney stones remains unclear, and whether this relationship is mediated by the systemic Immune-Inflammation index (SII). This cohort study analyzed data from the National Health and Nutrition Examination Survey (NHANES) in the United States, spanning 2007 to 2018. Utilizing Kaplan-Meier survival curves, Cox regression analysis, restricted cubic splines (RCS), and mediation analysis, the research investigated the relationships between FI, SII, and all-cause mortality in individuals with kidney stones. During a median follow-up of 6.3 years (16695 person-years) ,356 total deaths were recorded. A cohort of 2,620 U.S. participants was enrolled from NHANES 2007-2018. Frail individuals demonstrated significantly higher all-cause mortality compared to non-frail counterparts (HR = 1.78, 95% CI: 1.56-2.02, P < 0 0.001). Among patients with kidney stones, the FI showed a positive correlation with the SII (β = 38.18, 95% CI: 10.38-65.99, P < 0.01). The SII indirectly influenced the FI and all-cause mortality in these patients, accounting for 5.6% of the mediating effect. Among U.S. adults with kidney stones, the FI is linked to a higher risk of all-cause mortality, with SII potentially serving as a biological mechanism.","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"166"},"PeriodicalIF":2.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970832","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

Beyond single-center promise: can machine learning models for urinary stone composition deliver broad clinical utility? 超越单一中心的承诺：泌尿结石成分的机器学习模型能带来广泛的临床应用吗？

IF 2.2 2区医学

Urolithiasis Pub Date : 2025-08-31 DOI: 10.1007/s00240-025-01845-7

Yuqing You, Jinyan Guo, Weifeng Yao

引用次数: 0