Volume 21, Number 4Review ArticlesImpact of Demographic Factors and Systemic Disease on Urinary Stone Risk Parameters Amongst Stone FormersOriginal ResearchRobert OsterOmotola AshorobiDustin WhitakerCarter BoydBarbara GowerWilliam PooreKyle WoodDean G AssimosThis article examines via multivariate analysis the associations between demographic factors and systemic diseases on stone risk parameters in a stone-forming population. A retrospective chart review of adult stone formers who completed 24-hour urine collections from April 2004 through August 2015 was performed. Data was collected on age, sex, race, body mass index (BMI), and diagnoses of diabetes and hypertension. CT imaging and renal/abdominal ultrasonography (within ±6 mo) were reviewed for diagnosis of fatty liver disease. Statistical analysis included Pearson and Spearman correlation analysis, and linear and logistic regression analyses, both univariate and multivariate. Five hundred eighty-nine patients were included. Numerous urinary parameters were significant in association with demographic factors or systemic diseases in a multivariate analysis. Older age was associated with decreased calcium (Ca) excretion (P = 0.0214), supersaturation of calcium oxalate (SSCaOx; P = 0.0262), supersaturation of calcium phosphate (SSCaP; P < 0.0001), and urinary pH (P = 0.0201). Men excreted more Ca (P = 0.0015) and oxalate (Ox; P = 0.0010), had lower urine pH (P = 0.0269), and higher supersaturation of uric acid (SSUA; P < 0.0001) than women. Blacks had lower urine volume (P = 0.0023), less Ca excretion (P = 0.0142), less Ox excretion (P = 0.0074), and higher SSUA (P = 0.0049). Diabetes was associated with more Ox excretion (P < 0.0001), lower SSCaP (P = 0.0068), and lower urinary pH (P = 0.0153). There were positive correlations between BMI and Ca excretion (P = 0.0386), BMI and Ox excretion (P = 0.0177), and BMI and SSUA (P = 0.0045). These results demonstrate that demographic factors and systemic disease are independently associated with numerous risk factors for kidney stones. The mechanisms responsible for these associations and disparities (racial differences) need to be further elucidated. [Rev Urol. 2019;21(4):158–165] © 2020 MedReviews®, LLCObesityKidney stonesDiabetesSystemic diseaseFatty Liver
Volume 22, Number 1Review ArticlesObesity and Kidney Stone ProceduresManagement ReviewCarter J BoydNikhi P SinghDean G AssimosWilliam PooreKyle WoodObesity is a chronic disease that has increased in prevalence in the United States and is a risk factor for the development of nephrolithiasis. As with other medical conditions, obesity should be considered when optimizing surgical management and choosing kidney stone procedures for patients. In this review, we outline the various procedures available for treating stone disease and discuss any discrepancies in outcomes or complications for the obese cohort. [Rev Urol. 2020;22(1):24–29] © 2020 MedReviews®, LLCPercutaneous nephrolithotomyShockwave lithotripsyObesityUreterorenoscopyRobotic surgeryKidney stonesLaparoscopyOpen surgery
Volume 22, Number 1Review ArticlesObesity and Its Impact on Kidney Stone FormationDisease State ReviewBarbara GowerNikhi P SinghCarter J BoydWilliam PooreKyle WoodDean G AssimosThe prevalence of obesity is rising and places this cohort at risk for developing kidney stones. Some of the pathophysiologic responses that link obesity and kidney stone formation have been identified. Herein, we review the involved mechanisms driving this relationship and the impact of various weight loss strategies on kidney stone risk. [Rev Urol. 2020;22(1):17–23] © 2020 MedReviews®, LLCObesityKidney stonesDiabetesMetabolic syndromeHypertensionWeight managementObese animal models