Untargeted lipidomics based on UPLC-QTOF-MS/MS and structural characterization reveals dramatic compositional changes in serum and renal lipids in mice with glyoxylate-induced nephrolithiasis.

Context: Pediatric nephrolithiasis is a noticeable cause of morbidity among children. Although, nephrolithiasis is a common disease in adults, its incidence has had a rising trend in children. Objectives: Here in, we reviewed the current state regarding evaluation and management of children with nephrolithiasis in the last decade. Data Sources: The current literature regarding incidence and trend, along with diagnostic evaluation and management of children aged less than 18 years old with nephrolithiasis was searched on MEDLINE and Google scholar from January 2005 to March 2016. Study Selection and Data Extraction: The search terms included, “kidney stone OR nephrolithiasis OR urolithiasis and Pediatric OR children”. English language and human studies were included. Expert opinions, editorials and case reports were excluded. Consequently, the authors independently reviewed the abstracts and the papers, which matched the inclusion criteria. Results: From a total of 1050 studies identified through the database search, 71 articles were selected for the review. According to the results of this review, pediatric nephrolithiasis has an increasing rate worldwide. Recent studies in this regard indicated that the number of girls with nephrolithiasis has increased. The change of life style, diet, obesity and metabolic syndrome and popular imaging study along with referral of the patients to pediatric centers could be contributed to this trend. Conclusions: Evaluation of patients, particularly young children, includes metabolic assessment. Stone analysis and 24-urine collection analysis are very helpful for determining underlying diseases. Medical as well as surgical approaches are used to prevent kidney injuries.

http://jpr.mazums.ac.ir/files/site1/user_files_d553bd/sosha1965-A-10-30-57-984602a.pdf

Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

Idiopathic osteoporosis and nephrolithiasis are formidable health problems showing a progressive increase in their incidence and prevalence in the last decades. These temporal trends were observed in both pediatric and adult populations worldwide. Epidemiological and experimental studies indicate that both disorders show several common pathogenic environmental and genetic factors. In this review, we analyzed the clinical characteristics common to the two disorders and the state-of-the-art knowledge regarding the genetic predisposition and the environmental factors recognized as triggers in adult and pediatric ages. As a result of this work, we propose to consider idiopathic nephrolithiasis and osteoporosis as two possible expressions of a unique clinical syndrome. Accordingly, the clinical approach to both disorders should be modified in order to program an efficient primary and secondary prevention strategy.

https://www.mdpi.com/1422-0067/21/21/8183/pdf

Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin?

Kidney Stones as an Underrecognized Clinical Sign in Pediatric Cushing Disease

Background Nephrolithiasis is a systemic metabolic disease with a high prevalence worldwide and is closely related to lipid-mediated oxidative stress and inflammation. Orthosiphon stamineus Benth. (OS) is a traditional medicinal herb mainly containing flavonoids, caffeic acid derivatives, and terpenoids, which has the effect of treating urinary stones. However, the active ingredients of OS for the treatment of kidney stones and their regulatory mechanisms remain unknown. As a powerful antioxidant, flavonoids from herbs can mitigate calcium oxalate stone formation by scavenging radical. Thus, this work focused on EtOAc extract of OS (EEOS, mainly flavonoids) and aimed to reveal the potential intrinsic mechanism of EEOS in the treatment of kidney stones disease. Methods Firstly, 75% ethanol extract of OS was further extracted with EtOAc to obtain EtOAc extract containing 88.82% flavonoids. Secondly, the extract was subjected to component analysis and used in animal experiments. Then, an untargeted lipidomics based on ultrahigh performance liquid chromatography coupled with TripleTOF 5600 mass spectrometer (UPLC-QTOF-MS) was performed to test the lipid changes of kidneys in the control group, model group and EEOS treatment groups. Finally, multivariate statistical analysis was used to identify differences between the lipid profiles of mice in the model group and the EEOS group. Results Fifty-one lipid metabolites were significantly different between the mice in the model group and the EEOS intervention group, including glycerophosphocholines, glycerophosphoethanolamines, glycerophosphoinositols, and glycerophosphoglycerols. And the composition of glycerophospholipids-esterified ω-3 polyunsaturated fatty acids and glycerophospholipid subclasses in the kidneys of the EEOS group significantly changed compared to model group. Conclusions The EEOS can inhibit the stones formation by improving oxidative stress and inflammation mediated by glycerophospholipid metabolism. This study reveals the potential mechanism of EEOS for kidney stones treatment at the lipid molecule level, providing a new direction for further study of the efficacy of OS.

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Lipidomics Reveals the Therapeutic Effects of EtOAc Extract of Orthosiphon stamineus Benth. on Nephrolithiasis.

Aim

There is conflicting evidence about the role of obesity in paediatric nephrolithiasis. This Polish study explored the influence of nutritional status and lipid disturbances on urinary lithogenic factors and the risk of kidney stone formation in children and adolescents from three to 18 years of age.



Methods

We carried out serum lipid profile evaluations and 24-h urine chemistry analyses on 493 overweight/obese paediatric participants (mean age 13 years) without nephrolithiasis and 492 healthy normal weight sex and age-matched controls.



Results

A third (33%) of the study group had blood lipid disturbances, with more acidic urine, lower urinary citrate excretion and a higher fraction of ionised calcium and higher Bonn Risk Index than the controls. The participants' body mass index standard deviation score (BMI Z-score) was positively correlated with urinary oxalate and uric acid and negatively correlated with citrate excretion. Total cholesterol, low-density lipoprotein cholesterol and triglycerides correlated negatively with citraturia, while high-density lipoprotein cholesterol correlated positively.



Conclusion

The main factor that predisposed overweight and obese children to kidney stones was hypocitraturia. Urinary citrate excretion was related to both BMI Z-scores and all lipid fraction abnormalities. However, hypercholesterolaemia and particularly low-density lipoprotein hypercholesterolaemia seemed to play a major role.

M Baran

Papers

Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones.