Urolithiasis最新文献

{"title":"Prediction of postoperative SIRS risk factors in MetS patients undergoing PCNL.","authors":"Song Wei, Shu-Hao Li, Bo-Ran Lv, Bai-Yu Liu, Hua Wang, Cheng Hu","doi":"10.1007/s00240-025-01806-0","DOIUrl":"10.1007/s00240-025-01806-0","url":null,"abstract":"<p><p>This study aimed to identify preoperative risk factors for systemic inflammatory response syndrome (SIRS) in patients with metabolic syndrome (MetS) undergoing percutaneous nephrolithotomy (PCNL) and to develop a predictive nomogram for individualized risk stratification. A retrospective analysis was conducted on 245 MetS patients who underwent PCNL between January 2021 and December 2024, among whom 27.8% developed postoperative SIRS. Patients were randomly assigned to training and validation cohorts in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was initially applied to select candidate predictors, followed by univariate and multivariate logistic regression analyses to identify independent risk factors. A nomogram was subsequently constructed based on the significant variables and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Multivariate analysis identified five independent predictors of postoperative SIRS: higher standard deviation of stone density, reduced renal parenchymal thickness, increased lateral and posterior perirenal fat thicknesses, and the presence of staghorn calculi (P < 0.05). The nomogram demonstrated good discriminative ability, with an area under the ROC curve (AUC) of 0.888 (95% CI: 0.834-0.942) in the training cohort and 0.882 (95% CI: 0.802-0.962) in the validation cohort. The calibration curve and the Hosmer-Lemeshow test (P = 0.1485) indicated good model calibration and fit. DCA further confirmed the clinical utility of the model. This nomogram offers a reliable preoperative tool for SIRS risk stratification in MetS patients undergoing PCNL, aiding early intervention and personalized perioperative management.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"135"},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567892","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":"Gut microbiota-derived indole-3-acetic acid ameliorates calcium oxalate renal stone formation via AHR/NF‑κB axis.","authors":"Junfeng Jing, Xu Yan, Lang Wang, Yanbin Zhang, Wei Qi, Junhua Xi, Zongyao Hao","doi":"10.1007/s00240-025-01779-0","DOIUrl":"10.1007/s00240-025-01779-0","url":null,"abstract":"<p><p>The exact mechanism of calcium oxalate stone (CaOx) formation is not fully understood. Evidence suggests that disruptions in the gut microbiota and its metabolites influence kidney stone formation. We conducted microbiome-metabolome analysis to pinpoint microbial metabolites linked to kidney stones in both patient and healthy control groups. We explored the impact of these kidney stone-related microbial metabolites on CaOx-induced stones, along with their underlying mechanisms of action. We exposed NRK-52E cells to CaOx crystals that had been pretreated with indole-3-acetic acid. Rats, induced to develop CaOx stones via ethylene glycol and ammonium chloride administration, were also treated with IAA. Our investigations encompassed assessments of Ca²⁺ levels, reactive oxygen species levels, markers of oxidative stress, apoptosis levels, inflammation levels, and gene expression within AHR/NF‑κB pathway, both in cellular and tissue samples.Indole-3-acetic acid showed significantly reduction in patients with renal stones. The administration of IAA has been found to alleviate the deposition and adhesion of calcium oxide stones in the kidneys. Furthermore, IAA demonstrates beneficial effects on kidney damage and inflammation. IAA efficiently reduces intracellular levels of ROS, osteopontin, and CD44 in NRK-52E cells exposed to CaOx as well as in a rat model of stone formation. Mechanistically, IAA inhibits the activation of the NF-κB signaling pathway through the elevation of AHR in kidney stones. Our research has uncovered a novel connection between gut microbiota-derived tryptophan metabolites and kidney stones. The microbial metabolite IAA/AHR/NF-κB pathway may be a promising target for kidney stone treatment.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"134"},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545046","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":"In-vitro and In-silico evaluation of the inhibitory effects of Persea americana leaf extract against calcium oxalate stones.","authors":"Emel Akyol, Merve Danisman, Mualla Oner","doi":"10.1007/s00240-025-01791-4","DOIUrl":"10.1007/s00240-025-01791-4","url":null,"abstract":"<p><p>This study investigated the effects of Persea americana extract (PAE) as a potential inhibitor of calcium oxalate monohydrate growth using both in-vitro and in-silico methods with spontaneous crystallization to evaluate its effectiveness in preventing kidney stones. X-ray diffraction was used to characterize the morphology of calcium oxalate (CaOx) crystals, while scanning electron microscopy (SEM) was used to determine their particle size and crystal formation patterns. SwissADME (Absorption, Distribution, Metabolism, Excretion) computational analysis predicted the biological activity of the extract. The experimental results show that the inhibition of crystal growth increases with the amount of PAE in solution, and crystal growth was almost completely inhibited for 450 min at a concentration of 100 mL of PAE. The in vitro results also revealed that Persea americana leaf promoted the formation of calcium oxalate dihydrate (COD) crystals rather than monohydrate crystals. These findings on PAE's inhibitory effect on calcium oxalate crystallization suggest that natural additives could be valuable in treating kidney stone disease.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"133"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529673","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":"Does suction in Mini PCNL mitigate rise in intrarenal pressure? A prospective randomised study.","authors":"Madhu Sudan Agrawal, Naveen Kumar, Dilip Mishra, Anurag Yadav, Laxmi Kant Sharma, Gaurav Sharma, Sachin Patel, Diptiranjan Bai","doi":"10.1007/s00240-025-01804-2","DOIUrl":"10.1007/s00240-025-01804-2","url":null,"abstract":"<p><p>The rise in intra-renal pressure during Mini PCNL (percutaneous nephrolithotripsy) potentially leads to pyelovenous backflow and infectious complications. This prospective randomized study compares intra-renal pressure (IRP) in patients undergoing Mini PCNL (mPCNL) procedure with and without suction for renal stones. Suction mPCNL is expected to lower IRP by continuously aspirating irrigation fluid and stone fragments, thereby enhancing procedural safety. A total of 100 patients with kidney stones measuring 1-4 cm were randomized into two groups: Mini PCNL with suction (n = 50) and Mini PCNL without suction (n = 50). IRP was measured using a pressure transducer connected to a ureteral catheter. Key outcome measures included intra-renal pressure, stone-free rate, operative time, and complication rates. The suction mPCNL group demonstrated a significantly lower IRP (16.92 ± 2.93 mmHg) compared to the non-suction group (19.48 ± 4.77 mmHg, p = 0.002). The suction group also experienced shorter mean operative times (35.98 ± 14.10 min vs. 47.12 ± 15.36 min, p = 0.001) and lithotripsy times (19.50 ± 11.70 min vs. 26.24 ± 10.49 min, p = 0.003). The stone-free rate was higher in the suction group though this difference was not statistically significant. Likewise, the complication rates, including postoperative infection rates (fever and urosepsis) showed a downward trend in the suction group, however the difference was not statistically significant (p > 0.05). Suction mPCNL effectively reduces IRP, shortens operative time, maintains a comparable stone-free rate, making it a safer and more efficient alternative to traditional mPCNL. This study highlights the potential advantages of integrating suction mechanisms to control IRP and improve patient outcomes in PCNL procedures.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"132"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529671","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":"Reno-protection by Didymocarpus pedicellata against oxalate-induced damage: mechanistic insights into mitigation of oxidative stress induced signaling pathways in renal cell line and rat model.","authors":"Anubha Singh, Kshama Kumari, Simran Tandon, Tanzeer Kaur, Chanderdeep Tandon","doi":"10.1007/s00240-025-01794-1","DOIUrl":"https://doi.org/10.1007/s00240-025-01794-1","url":null,"abstract":"<p><p>Oxidative stress is a key driver of inflammatory injury which predisposes renal cells to nephrolithiatic damage. Recurrent stone formation is associated with cellular dysfunction, oxidative stress, inflammation and renal epithelial cell death. Didymocarpus pedicellata is an important medicinal herb in the ayurvedic system for the treatment of renal afflictions. The phytochemicals present in medicinal plants like D. pedicellata show potential in mitigating these series of cellular responses. Bioactivity guided fractionation, crystallization assays, phytochemical screening and GCMS analysis were performed to assess secondary metabolites present in D. pedicellata. The cytoprotective potential of the extract was evaluated by assessing cell viability, reactive oxygen species (ROS) generation, analyzing cell death, and gene expression changes to determine the extent of damage caused by oxalate exposure. The crystal-cell interface, adhesion dynamics, and morphological alterations were characterized using histological analysis via hematoxylin and eosin staining and ultrastructural examination by scanning electron microscopy. Hyperoxaluric rat model was generated by treating the rats with ethylene glycol and ammonium chloride to induce nephrocalcinosis and the effects of treatment with D. pedicellata were evaluated using renal physiology biomarkers, microscopic analysis of urine and histological studies for crystal deposition and kidney tissue injury. Gene expression analysis of p38 Mitogen-activated protein kinase and Osteopontin was done to assess the expression levels due to hyperoxaluria and treatment with D. pedicellata extract. D. pedicellata extract showed cytoprotective potential through in vitro and in vivo studies. Antilithiatic efficacy was evaluated through crystallization assays which led to metabolic profiling through GCMS analysis exhibiting a wide range of secondary metabolites with antioxidant and anti-inflammatory properties. Our study demonstrated that oxalate injured NRK52-E renal epithelial cells when cotreated with ethanolic extract of D. pedicellata led to an overall increase in cell viability, reduced production of intracellular reactive oxygen species (ROS) which lowered oxidative damage in the cells and decreased apoptosis. Staining the tissues with H&E and SEM imaging revealed modulation of crystal structure and enhanced adhesion to renal epithelial cells. Further evaluation of calcium oxalate deposition in rat model revealed that D. pedicellata alleviated crystal deposition and kidney tissue injury as evaluated by urine analysis and histological studies and decreased expression of inflammatory markers p38MAPK and Osteopontin. This study demonstrates that D. pedicellata exerts cytoprotective effect against calcium oxalate induced nephrocalcinosis by reducing the production of reactive species, oxidative stress, lowering inflammation and apoptosis finally reducing renal injury.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"131"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529674","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":"Commentary on \"the impact of video-animated information on anxiety, satisfaction, and pain perception in patients undergoing ESWL: a randomized controlled study\".","authors":"Rui Ye, Ding-Ming Song, Yi-Bo He","doi":"10.1007/s00240-025-01805-1","DOIUrl":"https://doi.org/10.1007/s00240-025-01805-1","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"130"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529670","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":"Intelligent pressure-controlled retrograde intrarenal surgery versus microchannel percutaneous nephrolithotomy to treat 2-3 cm renal calculi.","authors":"Zhongsheng Yang, Qiliang Zhai, Junjing Wu, Leming Song, Yongming Huang, Ting Sun","doi":"10.1007/s00240-025-01799-w","DOIUrl":"10.1007/s00240-025-01799-w","url":null,"abstract":"<p><p>We performed a comparative analysis of intelligent pressure-controlled ureteroscopic lithotripsy (IRIRS) and intelligent pressure-controlled microchannel percutaneous nephrolithotomy (IMPCNL) to treat 2-3 cm renal calculi. Patients (n = 140) with 2-3 cm renal calculi were randomly divided into the IRIRS and IMPCNL groups (n = 70/group). Surgical time, length of hospital stays, stone clearance rate, decrease in hemoglobin level, postoperative pain score, and incidence of complications were compared between groups. The IRIRS group had significantly longer operative durations than the IMPCNL group (average: 58.3 ± 7.4 vs. 52.5 ± 6.8 min). Stone clearance rates at 4 weeks postoperatively were 90.0% and 92.8% in the IRIRS and IMPCNL groups, respectively (P > 0.05). The IRIRS group had shorter hospital stays than the IMPCNL group (1.9 ± 0.3 vs. 3.2 ± 0.4 days). Intraoperative hemoglobin levels decreased more in the IMPCNL (1.03 ± 0.12 g/dL) than in the IRIRS (0.25 ± 0.06 g/dL, P < 0.001) group. Two and one cases in the IRIRS and IMPCNL group, respectively, experienced postoperative fever. The overall complication incidence did not significantly differ (12.9% IRIRS and 15.7% IMPCNL; P > 0.05). IRIRS and IMPCNL are safe, effective interventions for 2-3 cm renal calculi. Given its minimally invasive nature and positive operative safety outcomes, IRIRS has promising future applications.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"129"},"PeriodicalIF":2.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529672","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":"Comment on \"perioperative changes of blood routine in daytime transurethral ureteroscopic laser lithotripsy and construction of a risk prediction model for delayed discharge\".","authors":"Çağatay Özsoy","doi":"10.1007/s00240-025-01803-3","DOIUrl":"https://doi.org/10.1007/s00240-025-01803-3","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"128"},"PeriodicalIF":2.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529669","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":"Evaluating shear wave elastography as a predictor of extracorporeal shock wave lithotripsy outcomes in children.","authors":"Mehmet Demir, İsmail Yağmur, Osman Dere, İbrahim Halil Albayrak, Abdulhakim Şengel","doi":"10.1007/s00240-025-01796-z","DOIUrl":"10.1007/s00240-025-01796-z","url":null,"abstract":"<p><p>The aim of this study was to demonstrate the utility of Shear Wave Elastography (SWE) in predicting the success of extracorporeal shock wave lithotripsy (ESWL) in pediatric patients. A total of 102 patients < 18 years of age with a diagnosis of kidney stones underwent ESWL between May 2021 and December 2023. SWE measurements of the stones were performed in all patients prior to ESWL. The subjects were divided into two groups: those who responded to ESWL and those who did not. Age, gender, stone location, stone size, body mass index (BMI), Hounsfield Unit (HU), and stone SWE values were compared between the groups. Among the 102 patients included in the study, 78 exhibited a positive response to ESWL. In the responder group, the SWE, HU, and stone size values were significantly lower than the non-responder group (p < 0.05). SWE exhibited significant efficacy in discriminating between responders and non-responders [area under the curve (AUC): 0.979 & p = 0.000]. A SWE cutoff value of 13.70 kPa was identified for patient differentiation [AUC:0.929 & p = 0.000]. SWE appears to be an effective method for predicting the success of ESWL in pediatric patients and may serve as an alternative parameter to HU for pre-treatment evaluation.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"126"},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486063","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":"Correction: Disruptions in Tiopronin therapy: impacts on clinical outcomes of pediatric cystinuria patients during the COVID-19 pandemic.","authors":"Hülya Gözde Önal, Hülya Nalçacioğlu, Demet Tekcan Karali, Meltem Necibe Ceyhan Bilgici, Ozlem Aydog, Ozan Özkaya, Ender Özden, Saban Sarikaya","doi":"10.1007/s00240-025-01802-4","DOIUrl":"10.1007/s00240-025-01802-4","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"127"},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486062","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}