[Investigations of the causes of urolithiasis. 3. Nutriological studies in the patients with urolithiasis--relationship of food to excretions in the urine (author's transl)].
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Adult↗
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Results for “Urolithiasis”
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Diagnosis of pediatric urolithiasis: role of ultrasound and computerized tomography.
PURPOSE: Pediatric urolithiasis is believed to be uncommon, and may present without the classic symptoms of renal colic. The objectives of this study were to describe the presenting features and radiographic evaluation of pediatric urolithiasis, and to determine the accuracy of ultrasound and unenhanced computerized tomography (CT) in detecting urolithiasis. MATERIALS AND METHODS: We retrospectively reviewed the charts of children 0 to 18 years old with urolithiasis. Data collected included age, sex, race, presenting symptoms, radiographic studies performed during initial evaluation, calculus location and family history of urolithiasis. RESULTS: A total of 75 patients had complete data for analysis. Of these patients 54 (72%) had urolithiasis symptoms (flank pain, gross hematuria or both). Patients with urolithiasis symptoms were older at diagnosis (median age 11.9 years vs 1.0 years, p <0.001) and were more likely to have a family history of urolithiasis (54% vs 14%, p = 0.002). The 39 CTs performed were accurate in detecting calculi in children with urolithiasis symptoms (96% to 100%) and in those without symptoms (100%). The 36 ultrasounds performed had more variable accuracy in children with urolithiasis symptoms (33% to 100%) vs those without symptoms (89%). Ultrasound failed to detect urolithiasis in 41% of the patients with urolithiasis symptoms, compared to 5% with CT. CT was also highly accurate regardless of calculus location (89% to 100%), whereas ultrasound was again more variable (kidney 90%, kidney and ureter 75%, ureter alone 38%). CONCLUSIONS: Ultrasound failed to detect calculi in 41% of the children with urolithiasis symptoms, whereas CT was highly accurate in all situations. Unenhanced CT should be performed in all children with persistent urolithiasis symptoms and nondiagnostic ultrasound.
Adolescent↗
Prevalence and risk factors for urolithiasis in primary gout: is a reappraisal needed?
OBJECTIVE: To assess the prevalence and risk factors for urolithiasis in primary gout. METHODS: One hundred forty patients with primary gout were studied. Urolithiasis was defined as a history of urolithiasis, or nephrolithiasis detected via ultrasonography in patients with no previous record of urolithiasis. Patient age, duration of gout, presence of tophi, obesity, alcoholism, high blood pressure, diabetes, hyperlipidemia, family history of urolithiasis, daily urine output, uricemia, urine pH, FeNa, FeUrate, urine pH/FeUrate index, and daily urine excretion of urate, sodium, calcium and potassium were compared between lithiasic and non-lithiasic subjects. RESULTS: Fifty-five (39%; 95% CI 31-47) patients had urolithiasis, of which 37 (26%) were diagnosed by clinical history and 18 (13%) by ultrasonography. Patients with a silent kidney stone diagnosed by ultrasound tended to have shorter evolution of gout. Aside from urinary H+ ion concentration (lithiasic subjects 5.17 +/- 3.9 microM/l; non-lithiasic subjects 3.80 +/- 3.01 microM/l; p = 0.02), no difference was found between lithiasic and non-lithiasic subjects for the other variables studied. CONCLUSION: Ultrasonography increased the probability of diagnosing urolithiasis by 50%, meaning the prevalence of urolithiasis in gout is likely higher than previously reported. A higher urinary H+ ion concentration was the only variable associated with urolithiasis. Due to advances in diagnosis of gout and urolithiasis, as well as biochemical assays, the prevalence and risk factors for urolithiasis in gout require reassessment.
Adult↗
Analysis of osteopontin DNA in patients with urolithiasis.
We previously reported the importance of osteopontin (OPN) in the formation of urinary calculus. Since OPN protein is present in normal kidneys, we investigated the difference in OPN at the DNA level between normal subjects and urolithiasis patients. There has not been any genetic investigation of OPN in familial urolithiasis previously reported worldwide. To confirm hereditary predisposing factors for urolithiasis, changes in OPN DNA within a family were investigated in relation to the presence or absence of urinary calculus. Leukocyte OPN DNA from two normal subjects and five patients with urinary calculus was investigated by SSCP analysis: OPN DNA nucleotide sequence was determined, based on the result of SSCP analysis. As a result, a mutation of GCC to GCT, encoding amino acid position 250 (Ala-250) was found. To confirm the frequency of mutation at this site, OPN DNA was extracted from peripheral blood in 36 normal subjects (Con group), 25 patients with familial urolithiasis (FSF), and 40 patients with recurrent urinary calculus and who had had two or more previous episodes (RSF). The degree of mutation at Ala-250 was then examined by restriction fragment length polymorphism (RFLP) method. As described above, the nucleotide codon encoding the amino acid sequence position 250, Ala-250, was GCC in two normal subjects. This is the original codon. In five patients with urolithiasis it was GCT, showing a substitution of C with T. On examining the frequency of this mutation, the ratio of normal homozygous GCC was 11/36 in the Con group, 1/25 in FSF and 1/40 in RSF. The ratio of heterozygous GCC/GCT was 16/36 in the Con group, 15/25 in FSF and 26/40 in RSF, and the ratio of homozygous GCT was 9/36 in the Con group, 9/25 in FSF and 13/40 in RSF. Furthermore, the gene frequency of the normal codon GCC was 0.528 in the Con group, 0.3 in FSF and 0.35 in RSF, showing a significantly higher incidence in the Con group (P < 0.05). The gene frequency of mutated GCT was 0.472 in Con group, 0.7 in FSF and 0.65 in RSF, showing a significantly higher incidence in urolithiasis patients (P < 0.05). On investigating the inheritance of Ala-250 in five families in which both parent and offspring demonstrated urolithiasis, the nucleotide substitution in Ala-250 in parents with urolithiasis was inherited by their offspring. In all five families the offspring developed urinary calculus. This study showed that there is no difference in OPN structure between the Con group and urolithiasis patients. However, it was predicted that due to the frequency of normally coded GCC being high in the Con group a difference in the amount of OPN might be caused by a difference in transcription velocity between the two groups. Furthermore, it was suggested that examining the inheritance of Ala-250 within a family is a diagnostic method for identifying the predisposing hereditary factors for urolithiasis patients.
Base Sequence↗
Risk relationship between inflammatory bowel disease and urolithiasis: A two-sample Mendelian randomization study.
BACKGROUND: The causal genetic relationship between common parenteral manifestations of inflammatory bowel disease (IBD) and urolithiasis remains unclear because their timing is difficult to determine. This study investigated the causal genetic association between IBD and urolithiasis using Mendelian randomization (MR) based on data from large population-based genome-wide association studies (GWASs). METHODS: A two-sample MR analysis was performed to assess the potential relationship between IBD and urolithiasis. Specific single nucleotide polymorphism data were obtained from GWASs, including IBD (n = 59957) and its main subtypes, Crohn's disease (CD) (n = 40266) and ulcerative colitis (UC) (n = 45975). Summarized data on urolithiasis (n = 218792) were obtained from different GWAS studies. A random-effects model was analyzed using inverse-variance weighting, MR-Egger, and weighted medians. RESULTS: Genetic predisposition to IBD and the risk of urolithiasis were significantly associated [odds ratio (OR), 1.04 (95% confidence interval [CI], 1.00-.08), P = 0.01]. Consistently, the weighted median method yielded similar results [OR, 1.06 (95% CI, 1.00-1.12), P = 0.02]. The MR-Egger method also demonstrated comparable findings [OR, 1.02 (95% CI, 0.96-1.08), P = 0.45]. Both funnel plots and MR-Egger intercepts indicated no directional pleiotropic effects between IBD and urolithiasis. CD was strongly associated with it in its subtype analysis [OR, 1.04 (95% CI, 1.01-1.07), P = 0.01], and UC was also causally associated with urolithiasis, although the association was not significant [OR, 0.99 (95% CI, 0.95-1.03), P = 0.71]. CONCLUSION: A unidirectional positive causal correlation was identified between IBD and urolithiasis, with varying degrees of association observed among the different subtypes of IBD. Recognizing the increased incidence of urolithiasis in patients with IBD is crucial in clinical practice. Early detection and surveillance of IBD, improved patient awareness, adoption of preventive strategies, and promotion of collaborative efforts among healthcare providers regarding treatment methodologies are vital for improving patient outcomes.
Humans↗
Urolithiasis in pregnancy: Current diagnosis, treatment, and pregnancy complications.
UNLABELLED: Urolithiasis complicates up to one in every 200 pregnancies; consequently, the practicing obstetrician should be aware of the symptoms of urolithiasis, the diagnostic procedures available for its diagnosis, and their associated risks. These include ultrasound, urography, and magnetic resonance imaging. Diagnosis of urolithiasis during pregnancy can be a challenge as a result of the normal physiological changes of pregnancy. Conservative management is the first-line treatment for noncomplicated urolithiasis in pregnancy. If spontaneous passage of the stone does not occur or if complications develop, urologic consultation should be obtained. Several obstetric complications have been associated with urolithiasis, including preterm labor and preterm premature rupture of membranes, although the reported rates of these complications in association with urolithiasis vary widely and overlap normal background rates. Given that urolithiasis will be encountered by most obstetricians, and that obstetricians are often on the front line of management for this condition, an appreciation of current diagnostic modalities, treatment protocols, and associated potential obstetric complications is warranted. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to recall that urolithiasis is common in pregnancy, state that there are a variety of diagnostic procedures, summarize that conservative treatment is usually successful, and explain that complications of pregnancy usually occur when there is failure of conservative treatment.
Diagnosis, Differential↗
[Urinary citrate excretion in children with calcium urolithiasis].
UNLABELLED: Citrate is thought to be one of the most important inhibitor of calcium salts crystallization in the urine. Therefore, an assessment of urinary citrate excretion is an integral element of metabolic evaluation in urolithiasis. The reported incidence of urolithiasis associated with hypocitraturia varies from 10% to 63%. The purpose of the study was to assess urinary citrate excretion in children with calcium urolithiasis living in region of Lublin. The study comprised 60 children (34 boys and 26 girls) aged 4.3-18 years. In 36 of them, calcium oxalate urolithiasis was diagnosed by spectrophotometry. In the remaining children, an assessment of stone composition was impossible. However, in all children, stones were radiopaque. Hypercalciuria (HC) and mild hyperoxaluria (HOx) were diagnosed in 23 and 16 children, respectively. In the remaining 21 children urolihiasis was classified as idiopathic. The controls were 35 healthy age- and gender-matched children. Urinary citrate excretions were assessed by enzymatic method in 24-hour urine specimens and expressed as citrate/creatinine ratios (Cit/Cr). Decreased Cit/Cr were observed in 9 (15%) children with calcium urolithiasis. However, there was no significant difference between the mean Cit/ Cr in children with calcium urolithiasis and controls (410 +/- 207 mg/g vs 385 +/- 144 mg/g). There was also no significant difference between the mean Cit/ Cr in children with HC and controls. Similarly, the mean Cit/Cr did not differ significantly between children with HOx and controls. However, the lowest mean Cit/Cr was revealed in children with HOx (306 +/- 161 mg/g). CONCLUSIONS: In most children with calcium urolithiasis urinary citrate excretion was normal. However, in some children with urolithiasis, detection of hypocitraturia allows to explain pathogenesis of stone formation and to carry on a causative prophylaxis.
Adolescent↗
Prevalence of urolithiasis in rural Thebes, Greece.
INTRODUCTION: Worldwide, urolithiasis is the third most common urological disease affecting both males and females. Both genetic and environmental factors contribute to stone formation. The recurrence rate is approximately 50%, rising to 70% within 10 years and this condition represents a significant healthcare cost burden. An unusually frequent history of urolithiasis has been observed among patients from the rural area of Thebes, Viotia, Greece. OBJECTIVE: To determine the prevalence of urolithiasis in Thebes. METHODS: A representative sample of persons from the rural area of Thebes was questioned about the occurrence of urinary stones during their lifetime, and acute urolithiasis in 2005. A logistic regression model was used to contrast individuals with lithiasis to those without lithiasis. RESULTS: A total of 422 subjects participated in the study. We found a 15% prevalence of urolithiasis in the rural population of Thebes. The rate was slightly higher in men than in women in almost all age groups questioned, although this was not statistically significant. No case of urolithiasis was found in subjects under the age of 17 years. The prevalence of urolithiasis appeared to increase with age in both men and women. Those drinking bottled water were less likely to have lithiasis. CONCLUSION: The life time prevalence rate of urolithiasis observed in the rural area of Thebes was higher to that reported in other studies performed among males and females in the general population of Europe.
Adult↗
Urolithiasis in pediatric patients with acute lymphoblastic leukemia.
We evaluated the incidence, timing, and consequences of urolithiasis in children with acute lymphoblastic leukemia (ALL). A total of 20 patients with urolithiasis were identified from 2095 patients with ALL treated at St Jude Children's Research Hospital on consecutive protocols between 1968 and 1998. For remission induction therapy, all patients received daily prednisone; continuation chemotherapy regimens differed by protocol with some including pulses of prednisone or dexamethasone and others no glucocorticoid. Patients with urolithiasis were older at diagnosis of ALL than those without urolithiasis (median age, 7.5 vs 5.0 years; P=0.03) and less likely to be black (P=0.03) than white or Hispanic, but sex and treatment era did not differ. Presenting symptoms included abdominal or flank pain, hematuria, and dysuria. All stones analyzed biochemically were calcium stones. The incidence of urolithiasis after completion of therapy was 1.8 per 10 000 person-years. Compared to this baseline rate, the relative risk of urolithiasis was 45 (P<0.01) during induction therapy, 22 (P<0.01) during continuation therapy with glucocorticoids, and 5.1 (P>0.05) during continuation therapy without glucocorticoids. Urolithiasis occurred 4.5 times more often during continuation treatment with glucocorticoids than without (P<0.05). Seven patients (35%) had recurrent urolithiasis. Patients with ALL are at risk of developing calcium renal stones during chemotherapy, especially when a glucocorticoid is included.
Adolescent↗
Indinavir urolithiasis.
Indinavir sulfate is a protease inhibitor that has been found to be extremely effective in increasing CD4+ cell counts and in decreasing HIV-RNA titers in patients with HIV and AIDS. However, patients receiving indinavir also have been noted to have a significant risk for developing urolithiasis. Published reports of indinavir urolithiasis estimate its incidence at between 4 and 13%. Indinavir has a high urinary excretion with poor solubility in a physiologic pH solution. Consequently, patients develop urinary stones that are principally composed of indinavir or of a mixture of indinavir and other substances, such as calcium oxalate. Similar to other forms of urolithiasis, acute flank pain and hematuria are the typical symptoms of indinavir urolithiasis. Indinavir urolithiasis is unique in that computed tomography, which was once thought to be efficacious in identifying all urinary calculi, is not useful in imaging stones that are composed of pure indinavir. Indinavir urolithiasis generally responds to a conservative regimen of hydration, pain control, and the temporary discontinuation of the medication. Only a minority of patients need surgical intervention. Approximately 10% of patients ultimately need to discontinue indinavir therapy altogether. Indinavir is an antiviral agent that has a significant role in the treatment of AIDS. Although urolithiasis is a significant side effect of indinavir use, limiting its clinical application is not the answer. Rather, physicians need to know more about indinavir urolithiasis to help their patients cope with its potential complications.
HIV Protease Inhibitors↗
Ammonium acid urate urolithiasis in Japan.
AIM: Ammonium acid urate (AAU) calculi are a rare urolithiasis in developed countries but are endemic in developing countries. We assessed the features of AAU urolithiasis in Japanese patients. METHODS: We reviewed hospital charts of patients with urolithiasis who were treated with extracorporeal shock wave lithotripsy and endourological procedures at Sagamidai Hospital (Kanagawa, Japan) from January 1992 to December 2001. On the basis of the results of stone analysis with an infrared spectrophotometer, AAU stones were found. RESULTS: Of 8664 urolithiasis that we reviewed, 33 calculi (0.38%) from 29 patients contained AAU crystals. From crystallographic findings, we defined two types of AAU-containing stones: pure and mixed AAU urolithiasis. Pure AAU urolithiasis were seen in 13 stones from 10 patients and mixed AAU in 20 stones from 19 patients. We found significant differences between the groups: the pure AAU group predominantly consisted of young, thin women and the mixed group consisted of middle-aged men. Laboratory findings showed trends of low levels of serum protein, potassium, and urine pH in the pure AAU group. CONCLUSIONS: Because each type of AAU urolithiasis is associated with different patient characteristics and pathophysiological features, it is important to understand the type of AAU urolithiasis in patients with calculi.
Adolescent↗
Multimodal management of urolithiasis in renal transplantation.
OBJECTIVE: To report the largest single series of renal transplant patients (adults and children) with urolithiasis, assess the risk factors associated with urolithiasis in renal transplant recipients, and report the outcome of the multimodal management by endourological and open procedures. PATIENTS AND METHODS: The records of all patients undergoing renal transplantation between 1977 and 2003 were reviewed. In all, 2085 patients had a renal transplant at our centre and 21 (17 adults and four children) developed urinary tract calculi. Their mode of presentation, investigations, treatments, complications and outcomes were recorded. Investigations included one or more of the following; ultrasonography (US), plain abdominal X-ray, intravenous urography, nephrostogram and computed tomography. Management of these calculi involved extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy and in situ lithotripsy, percutaneous nephrolithotomy (PCNL), open pyelolithotomy and open cystolitholapaxy. RESULTS: Thirteen patients had renal calculi, seven had ureteric calculi and one had bladder calculi. The incidence of urolithiasis was 21/2085 (1.01%) in the series. Urolithiasis was incidentally discovered on routine US in six patients, six presented with oliguria or anuria, including one with acute renal failure, four with a painful graft, three with haematuria, one with sepsis secondary to obstruction and infection and in one, urolithiasis was found after failure to remove a stent. Ten patients (63%) had an identifiable metabolic cause for urolithiasis, two by obstruction, two stent-related, one secondary to infection and in six no cause was identifiable. Thirteen required more than one treatment method; 13 (69%) were treated by ESWL, eight of whom required multiple sessions; eight required ureteric stent insertion before a second procedure and four required a nephrostomy tube to relieve obstruction. Two patients had flexible ureteroscopy and stone extraction, three had a PCNL and one had open cystolithotomy. PCNL failed in one patient who subsequently had successful open pyelolithotomy. All patients were rendered stone-free when different treatments were combined. CONCLUSIONS: The incidence of urolithiasis in renal transplant patients is low. There is a high incidence of metabolic causes and therefore renal transplant patients with urolithiasis should undergo comprehensive metabolic screening. Management of these patients requires a multidisciplinary approach by renal physicians, transplant surgeons and urologists.
Adolescent↗
Magnesium status in idiopathic calcium urolithiasis--an orientational study in younger males.
With the aim of revealing a possible magnesium (Mg) deficiency in the aetiology of idiopathic recurrent calcium urolithiasis we studied the Mg content of red blood cells, serum total, protein-bound, ionised and complexed fractions of Mg, and urinary Mg after an overnight fast. The two study groups comprised 12 male recurrent calcium urolithiasis patients and 12 healthy male controls (mean age 31 and 29 years, respectively). In recurrent calcium urolithiasis, serum albumin and Mg of erythrocytes were significantly decreased, as was serum total and protein-bound Mg, whereas serum ultrafiltrable, ionised and complexed Mg were statistically indistinguishable from values in controls. Urinary Mg (per unit creatinine) in recurrent calcium urolithiasis (mean 0.188 vs 0.209 in controls; p = 0.386) was not statistically different, whereas urinary total protein, glucose, and pH were significantly increased. The renal clearances of Mg and glucose were positively correlated (r = 0.56; p < 0.01), with a steeper slope in recurrent calcium urolithiasis than controls. Further fractionation of serum and urinary Mg into ions and complexes in recurrent calcium urolithiasis subjects with identical creatinine clearance revealed no statistical difference between 1) Mg ions and complexes filtered by renal glomeruli; 2) Mg ions and complexes excreted in urine; 3) fractional Mg excretion. Median urine supersaturation with respect to calcium oxalate was insignificantly lower (1.5 vs 2.2), with respect to hydroxyapatite insignificantly higher (3.3 vs 1.8), than in controls. It is concluded that relatively young recurrent calcium urolithiasis patients exhibit a deficiency of Mg in erythrocytes and serum total Mg, but no alteration of renal Mg handling. Thus, in recurrent calcium urolithiasis, a role of Mg deficiency in urine as a factor initiating stone formation may be ruled out, whereas a possible link between cellular Mg deficiency and the impairment of renal tubular functions involved in reabsorption of glucose and proteins, and in urine acidification, deserves further studies.
Adult↗
[Clinico-epidemiologic behavior of urolithiasis in a rural Caribbean region].
OBJECTIVE: The aim of this clinicoepidemiologic study is to determine the frequency, risk factors, morbidity and socioeconomic impact or urolithiasis in the general population of a Caribbean, subtropical rural area. METHODS: A representative sample of 1,504 subjects were randomly selected from the general population of 15,591 inhabitants in the area whose health services were provided by the Policlinico Julio Trujillo using the two-stage and equal probability functions with 95% CI. After informed consent was obtained, a survey was conducted to identify the subjects in the sample that had developed urolithiasis at some time or another. All subjects with a history of urolithiasis were included in a second survey to obtain the data required to complete the study. RESULTS: The prevalence rate was found to be similar to the 2.52% prevalence estimated worldwide. Urolithiasis was more common in the 20-29 years age group for both genders, and prevalent in the caucasians (3.2%) and male gender (3.2%). 36.8% of the subjects that had developed urolithiasis at some time or another had a family history of urolithiasis. Urinary tract infection, arterial hypertension, ischemic heart disease and diabetes mellitus were frequently associated with this condition. The incidence of stone formation was higher for the hottest period. High intake of food rich in oxalic acid, carbohydrates, proteins-purines and dairy products and low intake of fluids were closely linked with lithiasis. 97.2% s had one and 78.3% had more than one episode of nephric colic. 68.4% had one and 61.5% more than one recurrence of urolithiasis. 15.7% required surgery and 42.1% required hospitalization. Only 42.1% of the cases had unspecific medical treatment. No case had specific treatment. CONCLUSIONS: The behavior of urolithiasis in this rural population is the same as that reported in other studies for urban areas. It showed a high frequency, similar risk factors, high morbidity and important socioeconomic impact. Only half of the patients received treatment that is considered to be the least costly.
Adolescent↗
Prevalence of urolithiasis in the autonomous city of Buenos Aires, Argentina.
Urolithiasis is the third most common pathological disease afflicting the urinary tract, and usually occurs between the third and fourth decades of an individual's life. Epidemiological studies about this condition are lacking in our country. In 1998, we performed an epidemiological, cross-sectional study of the prevalence of urolithiasis in a sample of 1,086 subjects, which included men and women of all ages, selected from the general population of the city of Buenos Aires. The method used to gather basic information was an auto administered questionnaire about the present or past history of urolithiasis that was handled at the dwelling by a trained volunteer. We found a 3.96% lifetime prevalence of urolithiasis in the general population of Buenos Aires. The rate was slightly higher in men (4.35%) than in women (3.62%), with a male to female ratio of 1.19:1. No case of urolithiasis was found in subjects under the age of 20. In subjects over 19 years, the prevalence rate of the disease was 5.14%; 5.98% for men (CI 3.41-8.55%) and 4.49% for women (CI 2.61-6.37%). Prevalence increased with age, ranging from 2.75% in the 20-39 age group to 7.79% in those >or=60 years. The life time prevalence rate of urolithiasis observed in Buenos Aires is similar to that reported in a few other studies performed among males and females in the general population of USA and Europe. Prevalence of urolithiasis increases with age both in men and in women.
Adult↗
Vasectomy is associated with an increased risk for urolithiasis.
We evaluated vasectomy as a potential risk factor for urolithiasis. Vasectomy is a common method of contraception among otherwise healthy men. This is also the population at highest risk for urolithiasis. We conducted a case-control study of patients in a large prepaid health maintenance organization. Cases were men experiencing initial episodes of urolithiasis, ascertained by reviewing radiology logs and medical records. The age-matched controls were men with no history of urolithiasis. In logistic regression models, the relative risk of urolithiasis for men with vasectomies compared with men without vasectomies was 1.9 for men younger than 46 years of age (95% confidence interval = 1.2 to 3.1, P = 0.005), and the relative risk was 0.9 (95% confidence interval = 0.5 to 1.5, P > 0.8) for men who were at least 46 years old. The relative risk of urinary calculi was 2.0 (95% confidence interval 1.0 to 4.1, P < 0.05) for men with vasectomies 0 to 4 years before evaluation compared with men without vasectomies, and the excess risk persisted as long as 14 years postvasectomy. Vasectomy was associated with a twofold increased risk for urolithiasis in men younger than 46 years of age. This increased risk may persist for up to 14 years postvasectomy. Given the large number of men who undergo vasectomy worldwide each year, the increased risk for urolithiasis among vasectomized men may result in substantial excess morbidity.
Adult↗
Epidemiologic features of urolithiasis among industrial employees. The Israeli CORDIS Study.
We examined the prevalence of urolithiasis in 5574 men and women employees in 21 industrial plants in Israel who were screened for cardiovascular risk factors between 1985 and 1987 (the CORDIS Study). Among the data gathered were previous physician diagnosis of urolithiasis and ergonomic and demographic data. Urolithiasis was much more frequent in men than in women (age-adjusted prevalence of 4.5% in men and 1.2% in women, P < .0001). Older subjects had higher prevalence than young subjects. There were ethnic differences, and the highest prevalence was in subjects of European origin. Of the occupational factors, only industrial sector was related to prevalence of urolithiasis. Urolithiasis was more frequent among employees in wood industries than in other sectors (P < .05). We concluded that there is an effect of industrial sector on the prevalence of urolithiasis. To determine the cause and magnitude of the association of wood industries with increased prevalence of urolithiasis, ergonomic and chemical factors should be investigated.
Adult↗
Induction of urolithiasis in single comb white Leghorn pullets: effect on glomerular number.
Urolithiasis was induced in an experimental group of Single Comb White Leghorn pullets by feeding them layer ration and exposing them to nephrotrophic Gray strain infectious bronchitis virus (IBV). Gray strain IBV was recovered from kidney and cloacal swabs for up to 26 days after exposure to the virus. Control pullets fed pullet grower ration and not exposed to Gray strain IBV did not develop urolithiasis. The experimental design did not allow differentiation between the roles of layer ration and IBV in triggering urolithiasis. Urolithiasis was associated with asymmetry in left vs. right kidney weight comparisons for individual pullets. Pullets from the urolithiasis group had 43,800 +/- 4,500 glomeruli/gram kidney weight, whereas control pullets had 68,770 +/- 3,500 glomeruli/gram kidney weight. This difference was significant (P less than .01). Total kidney weights did not differ significantly when the experimental and control pullets were compared. Comparisons of glomeruli size distributions indicated that the number of intermediate sized glomeruli (.15 to .22 mm in circumference) was significantly reduced in pullets from the urolithiasis treatment group. These observations indicate that a significant reduction in nephron number can be masked by compensatory hypertrophy of the remaining kidney tissue in pullets with urolithiasis.
Animals↗