Urolithiasis最新文献

{"title":"Commentary on \"ureteral access sheath or percutaneous nephrostomy during flexible ureteroscopy: which is better?\"","authors":"Hao Xu, Shuangying Zhang, Yuxuan Song","doi":"10.1007/s00240-025-01722-3","DOIUrl":"https://doi.org/10.1007/s00240-025-01722-3","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"49"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597976","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}

{"title":"Preoperative classification of urinary stones based on community detection.","authors":"Danhui Mao, Hao Liu, Qianshan Wang, Mingyan Ma, Mohan Zhang, Juanjuan Zhao, Xin Wang","doi":"10.1007/s00240-025-01711-6","DOIUrl":"10.1007/s00240-025-01711-6","url":null,"abstract":"<p><p>In the treatment of urinary stones, surgical intervention is crucial. Urinary stones composition and type directly affect surgical planning. However, research on preoperative stone composition analysis is limited. This paper aimed to predict urinary stones types preoperatively using clinical data. Data from 1020 patients, including stone composition, clinical biochemical indicators, and demographic information, were collected. A stone composition graph network was constructed using cosine similarity, with stone composition as nodes and biochemical/demographic data as node features. The Louvain community detection algorithm was utilized to divide the network into distinct communities for the classification of stone types, with the effectiveness of the partitioning evaluated by the Modularity score. Stone types were classified, and their distribution across genders and age groups was described. Clinical feature averages were calculated for each community, and patients were assigned to the most similar community. Six machine learning algorithms (RandomForest, GradientBoosting, SVM, KNN, Logistic Regression, XGBoost) were trained to predict stone types. Model performance was evaluated, and the importance of clinical features for prediction was ranked. Six stone types were identified (Modularity = 0.828), namely common COM (Class I), COM with minor AU (Class II), COM with high UA (Class III), COM containing MAP (Class IV), high CAP-MAP (Class V), and high COM-CAP containing DCPD (Class VI). Among males, Class III and Class I were most prevalent; among females, Class V and Class III were most prevalent (χ² = 95.066, P < 0.001). Patients with Class IV stones were significantly older than those with Class I stones (P = 0.038). GradientBoosting showed the best prediction performance, with an Accuracy of 0.837, Precision of 0.840, Recall of 0.8366, F1 Score of 0.8368, and ROC-AUC area of 0.941. Significant clinical features for prediction included urine specific gravity, white blood cells, pH, and crystals. This paper first analyzed stone categories using a community detection algorithm and then predicted types using machine learning, providing a reference for preoperative surgical planning in urinary stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"48"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574289","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}

{"title":"OxDc-A0: an oral gastro-tolerant oxalate decarboxylase for treating secondary hyperoxaluria.","authors":"Hai-Feng Liu, Chun-Yan Li, Yan-Hong Liu, Qi Yao, Qing-Shan Li, Long-Jiang Yu","doi":"10.1007/s00240-025-01698-0","DOIUrl":"10.1007/s00240-025-01698-0","url":null,"abstract":"<p><p>Secondary hyperoxaluria is an acquired oxalate metabolic disorder characterized by increased urinary oxalate excretion. Reducing exogenous oxalate absorption through enzyme therapy represents a promising therapeutic strategy. However, the extremely acidic pH and protease-rich environment of the upper gastrointestinal tract pose major obstacles for the oral administration of protein therapeutics. OxDc-A0, a novel gastro-tolerant recombinant oxalate decarboxylase, can degrade oxalate in the stomach, thereby limiting the oxalate pool in the gastrointestinal tract and reducing oxalate absorption and urinary excretion. This study aimed to investigate the pharmacodynamics, pharmacokinetics, and safety profile of OxDc-A0 to assess its drug likeliness. The pharmacodynamics were evaluated in vitro and in hyperoxaluria beagle dog model induced by a high-oxalate diet. OxDc-A0 exhibited excellent gastric tolerance and significant efficacy in reducing urinary oxalate excretion in the dog model with hyperoxaluria. The safety of OxDc-A0 was evaluated in Sprague-Dawley rats, beagle dogs, and golden hamsters according to the guidelines for preclinical safety studies. No adverse effects were observed on the central nervous, cardiovascular, or respiratory system in rats or dogs treated orally with OxDc-A0 up to 37,500 U/kg. Pharmacokinetic studies showed that OxDc-A0 is non-systemically absorbed and is mainly distributed in the gastrointestinal tract. Toxicological studies showed that OxDc-A0 has excellent tolerance, with a NOAEL of 37,500 U/kg/day in both rats and dogs. The maximum tolerated dose was ≥ 105,000 U/kg in rats and ≥ 87,000 U/kg in dogs. Overall, OxDc-A0 shows great potential as a new drug candidate for treating secondary hyperoxaluria.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"47"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568128","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}

{"title":"Is there a safe no radiation option for endoscopic kidney stone treatment in children? multicenter results of modified retrograde intrarenal surgery without fluoroscopy in pediatric patients.","authors":"Tunc Ozan, Ahmet Karakeci, Kemal Yilmaz, Necip Pirincci, Fatih Osmanlioglu, Ercan Yuvanc, Erdal Yilmaz, Irfan Orhan","doi":"10.1007/s00240-025-01719-y","DOIUrl":"10.1007/s00240-025-01719-y","url":null,"abstract":"<p><p>The practice of fluoroscopy during pediatric endoscopic kidney stone procedures requires attention because of radiation concerns that demand new treatment methods. This study aimed to present the multicentric results of single guide wire flexible ureterorenoscopy (URS) and retrograde intrarenal surgery (RIRS) procedures without fluoroscopy and an ureteral access sheath (UAS) in treating kidney stones in pediatric patients. Moreover, we aim to evaluate the efficacy and safety of this procedure to ascertain the feasibility of this radiation-free therapeutic intervention for treating kidney stones in children. A retrospective analysis was done on the data of 105 pediatric patients who underwent retrograde intrarenal surgery (RIRS) treatment in two tertiary healthcare centers without fluoroscopy and UAS between May 2014 and May 2024. Of these 105 patients evaluated, 74 (70.5%) were male and 31 (29.5%) were female. The patients had a mean age of 71 ± 4 (ranging from 6 to 204) months. The mean size of stones was 9.3 ± 5 (ranging from 6 to 20) mm, and the average operation time was 51 (ranging from 31 to 98) minutes. Additionally, in 24 (22.8%) patients, the flexible URS could not proceed through the ureteral orifice. Thus, a double J stent was inserted, and the surgical procedure was repeated one month later without any complications. However, 2 (1.9%) of the patients experienced postoperative fever, and 6 (5.7%) patients had minor complications related to haematuria. Stone-free status was observed in 87 out of 105 patients (82.9%). Despite using a single guide wire without fluoroscopy and UAS in treating kidney stones in pediatric patients, the RIRS procedure is technically effective and safe. It may be considered a viable non-surgical procedure that is effective in safeguarding pediatric patients from the harmful effects of radiation, rendering it a promising alternative for pediatric urolithiasis management.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"46"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558018","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}

{"title":"Recommendations for optimizing Urolithiasis treatment protocols: insights into MPCNL and FURL efficacy and safety.","authors":"Biao Jiang, Jiansheng Xiao","doi":"10.1007/s00240-025-01718-z","DOIUrl":"https://doi.org/10.1007/s00240-025-01718-z","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"45"},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543343","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}

{"title":"Inhibition of NLRP3 alleviates calcium oxalate crystal-induced renal fibrosis and crystal adhesion.","authors":"Yuexian Xu, Guoxiang Li, Wanqing Liu, Defeng Ge, Zongyao Hao, Wei Wang","doi":"10.1007/s00240-025-01716-1","DOIUrl":"10.1007/s00240-025-01716-1","url":null,"abstract":"<p><p>Kidney stones are gaining attention as one of the most common urological diseases. In this study, we first constructed a mouse model of calcium oxalate (CaOx) crystal deposition by intraperitoneal injection of glyoxalate (Gly) and found that the levels of NLRP3, CASP1 and ASC, which constitute the NLRP3 inflammasome, as well as the level of its downstream product, IL-1β, were elevated in the kidneys of the model group of mice, as determined by RNA-seq. We then examined NLRP3 expression via immunohistochemistry, immunofluorescence, qPCR, and Western blotting in human samples, calcium oxalate monohydrate (COM)-stimulated HK2 cells, and a model of calcium oxalate crystal deposition via intraperitoneal injection. We then constructed systemic NLRP3 knockout mice and found via RNA-seq that CaOx crystal-induced renal fibrosis and crystal adhesion may be attenuated after the knockout of NLRP3. We further substantiated these findings by knocking down NLRP3 both in vitro and in NLRP3-knockout mice. Consistently, we observed more pronounced calcium oxalate crystal-induced renal fibrosis and enhanced crystal adhesion upon overexpression of NLRP3 in vitro and in vivo. Ultimately, we utilized the NLRP3 inhibitor MCC950 to support the potential of NLRP3 as a therapeutic target. Our research revealed that NLRP3 plays a pivotal role in kidney stone formation by mitigating renal fibrosis and reducing crystal adhesion induced by CaOx crystals.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"44"},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543132","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}

{"title":"Environmental determinants in the development of kidney stone.","authors":"Caitao Dong, Yijun Yang, Bobo Cheng, Sixing Yang, Yanxin Wang","doi":"10.1007/s00240-025-01717-0","DOIUrl":"10.1007/s00240-025-01717-0","url":null,"abstract":"<p><p>The increase with years of kidney stone prevalence has become a serious public health problem worldwide. The geographical distribution pattern of kidney stone (known as \"stone belt\") clearly indicates the critical role of environmental exposure in its formation, which has long been an underestimated risk factor in studying the development of kidney stone. Based on our previous studies and bibliometric analysis, we discerned four environmental determinants and elaborated their impacts on human internal exposure related to kidney stone formation. The importance of climatic factor lies in that the relatively high temperature and low humidity environment may contribute greater prevalence of kidney stone, since it promotes elevating the concentration of relatively insoluble stone-forming salts. Geological factors including water quality, hydrogeology, and soil environment is involved in kidney stone formation via the food chain. Additionally, air pollution and heavy metal pollutants also act as potential risk factors by directly or indirectly affecting the normal renal function and urinary metabolism. This review thus provides insights into the specific mechanisms affecting metabolic changes in the human body which result in kidney stone formation under environmental exposure, and shed light on the pathogenesis of nephrolithiasis from an interdisciplinary perspective.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"43"},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542871","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}

{"title":"Characterizing stone ablation with the thulium fiber laser: a single-pulse comparison of different pulse durations.","authors":"Ron Marom, Leilane Glienke, John W Robinson, Timothy L Hall, William W Roberts, Khurshid R Ghani","doi":"10.1007/s00240-025-01714-3","DOIUrl":"10.1007/s00240-025-01714-3","url":null,"abstract":"<p><p>Stone ablation using the thulium fiber laser (TFL) at different pulse duration/peak power or laser fiber-to-stone distances requires further research to understand effective and safe settings. In this study we characterized the vapor bubble anatomy and stone crater morphology at various settings and standoff distances. Optical profiles of 1 J short pulse (SP), 1 J long pulse (LP), 3 J SP, and 2.4 J LP of a TFL system (Fiberdust, Quanta) were assessed. We used high-speed imaging and segmentation to quantify the vapor bubble. Using Begostones, stone craters from a single pulse at each setting were compared at 0, 0.5, 1, 2 and 3 mm standoff distances. The temporal optical profile of TFL is rectangular in shape with a peak power of ~ 180W (LP) and ~ 470W (SP). Increasing the pulse energy did not increase the peak power. LP generated a channel-like bubble while SP formed multiple generations of a spherical bubble. Ablation volume with SP was greater than LP for all distances (p < 0.001) with up to 350% increased crater volume at contact. Ablation reduced as distance increased with both modes. There was no ablation at > 1 mm distance with LP. For SP, increasing the pulse energy had minimal impact on crater depth. The SP creates a bubble geometry that tends to collapse more quickly in comparison to LP. Peak power of TFL is a function of pulse duration, not pulse energy. LP results in weak ablation. When using SP, increasing the pulse energy increased ablation volume by increasing crater area rather than depth.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"42"},"PeriodicalIF":2.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537749","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}

{"title":"Ultrasound versus fluoroscopy-guided extracorporeal shockwave lithotripsy in renal calculi: a systematic review and meta-analysis.","authors":"Mohammed Ramadhan, Arthur Braga, Mohammad Alzaid, Tarek Benzouak, Fadl Hamouche, Ahmad Almarzouq","doi":"10.1007/s00240-025-01696-2","DOIUrl":"10.1007/s00240-025-01696-2","url":null,"abstract":"<p><p>Extracorporeal shockwave lithotripsy (ESWL) is one of the first-line treatments in the management of renal stones and is usually performed using fluoroscopic (FS) guidance. Ultrasonography (US) is a potential alternative with minimal radiation exposure. The primary aim of this study was to compare the stone free rate (SFR) between US and FS guided ESWL. The secondary outcomes were overall complications, re-intervention rate, hematuria, UTI, pain occurrence and number of shocks required. A prospectively registered systematic review and meta-analysis (CRD42024511335) according to PRISMA guidelines, was conducted. MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, were searched up to February 15, 2024. Snowballing techniques and Google Scholar were used for external gray literature. Adult and pediatric subgroups were pooled and individually analyzed. Twelve studies were identified with 2673 patients. Ultrasonography yielded a significantly favorable SFR (OR 1.43;95%CI [1.06-1.94]; P = 0.02). This difference was found only in the adult subgroup. No differences were found between modalities, nor within any subgroup in terms of secondary outcomes. In this meta-analysis, US-ESWL demonstrated a higher SFR compared to standard FS-ESWL However, this finding was shown only in adult patients, and although there was no difference in pediatric patients, the minimized radiation exposure remains an attractive attribute in US-ESWL.These results should be interpreted cautiously, due to a limited number of RCTs and heterogeneity between studies. More research is needed especially in pediatric populations, to further elucidate the role of US in ESWL.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"41"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504041","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}

{"title":"An examination of the quality of kidney stone information on YouTube and TikTok.","authors":"Zuzanna Augustyn, Helen L Richards, Alice McGrath, Yvonne Swanton, Derek B Hennessey","doi":"10.1007/s00240-025-01713-4","DOIUrl":"10.1007/s00240-025-01713-4","url":null,"abstract":"<p><p>Social media is increasingly consulted by patients for health-related information. The quality of this information is unknown and unregulated. This study aimed to investigate the quality of kidney stones information on two popular video platforms, YouTube and TikTok, and examine factors related to its quality. A search using keywords of \"kidney stones\" alongside \"information, prevention, treatment\" was used across YouTube and TikTok. The top 50 videos on each platform were rated by 4 independent reviewers on: general information, epidemiology, symptoms/presentation, treatment, and prevention. The American Urological Association's kidney stone curriculum was utilised as the benchmark for quality. The total number of views across the 100 videos was over 46 million. Overall, 91% of videos were educational in terms of genre. Misinformation was present in 34% of TikTok and 2% of YouTube videos. YouTube received significantly higher quality ratings across all parameters bar prevention (z's>-4.79 p's < 0.001); however, less than 50% of YouTube videos were rated as good quality. There was no association between quality and the number of likes or views across platforms (p's > 0.3). The quality of information presented across platforms was very variable with over half of videos considered poor quality. Given the high usage of social media as a source of health information it is important that healthcare providers and the general public are aware of the limits of information available on both platforms and continued efforts are made to develop high quality videos suitable for patient consumption.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"40"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493809","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}