Kidney Stones PowerPoint Presentation – PPT & pdf file

In this PowerPoint presentation, we discuss kidney stones and their types, and we cover different aspects of this metabolic disorder. We try to clarify some common questions in the Renal stone, such as:

What are the different types of kidney stones and their prevalences?
How do vitamin C and D supplements impact the risk of developing kidney stones?
How do dietary and behavioral interventions play a role in preventing kidney stones?
Kidney stones are a common health issue with a high prevalence and recurrence rate. They are typically diagnosed through symptoms like renal colic, pain, hematuria, vomiting, or fever. The economic burden of kidney stones is substantial, with annual medical costs exceeding $2 billion in the U.S.

The document outlines various factors influencing Renal stone formation, including dietary habits and the consumption of certain beverages. It highlights an increased risk associated with drinks like juice, punch, and sugary sodas, while beverages like wine, beer, tea, and coffee may reduce the risk.

The COVID-19 pandemic has seen a rise in cases, partly due to increased vitamin C and D supplement intake. Vitamin C, metabolized into oxalate, can contribute to stone formation, while vitamin D, which regulates calcium-phosphorus balance and immune function, may increase calcium excretion in urine.

Preventive measures include dietary changes, such as limiting high-oxalate foods and adjusting urinary pH. Specific strategies vary by stone type, with calcium-rich foods recommended for calcium stone prevention and sodium bicarbonate or potassium citrate for uric acid and cystine stones. Struvite stone prevention requires complete stone removal to eliminate infection reservoirs.

Treatment options for kidney stones include shockwave lithotripsy and the use of calcium channel blockers. The document concludes with references to scientific literature for further reading on kidney stone management.
Reference:
https://sciencecodons.com/2868-kidney-stones/

1. Kidney stones 1

2. 2 Page number 3 7 17 28 31 Titles Kidney stones and types Prevalence Prevention Treatment References

3. Kidney stones & types Kidney stones(calculi) are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae .They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. (Saeed R. Khan et all , 2016) 3

4. Figure 1.1 Normal anatomy of Kidney without stone (https://diagnosisbook.com/human-anatomy/kidney-anatomical-and-functional/amp) 4

5. Diagnosis Patients with urinary stones generally present with the typical reno-ureteral colic and less frequently with loin pain ;associated manifestations could be gross hematuria ,vomiting and sometimes fever. However, patients can also be asymptomatic. (Saeed R. Khan et all , 2016) 5

6. Figure 1.2 Kidney stone(Calculi) types and their specifications (https://ebrary.net/27232/health/kidney_stones) 6

7. Prevalence Stone formation is highly prevalent ,with rates up of to 14.8% and increasing ,and a recurrence rate up of to 50% with the first 5 years of initial stone episode . (Saeed R. Khan et all , 2016) 7

8. Table 2.1 kidney stones distribution and structure 8 structure percentage Stone type CaC 2 O 4 or Ca 3 (PO 4 ) 2 80 Calcium oxalate mixed with calcium phosphate NH 4 MgPO 4 . 6H 2 O 10 Struvite 9 Uric acid 1 Cystine

9. Figure 2.1 the medical costs associated with kidney stones exceed $2 billion annually, and there are additional costs because of missed work ( Margaret s. pearle et all ,2005) (Christopher s. saigal et all ,2005 ). (https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/treatment) 9

10. Chart 2.1 (Pietro Manuel Ferraro et all ,2013) 10 The risk of developing kidney stones in participants using these beverages one or more meal per day Juice Punch(Alcoholic or Non-alcoholic) Non-cola sugar sweetened soda Sugar sweetened soda(cola) 12% 18% 22% 23%

11. Chart 2.2 ( Pietro Manuel Ferraro et all ,2013) 11 The decreased risk of developing kidney stones in participants using these beverages one or meal per day White Wine Red Wine Beer Tea Decaffeinated Coffee Coffee 33% 31% 41% 11% 16% 26%

12. Kidney stones prevalence in COVID-19 pandemic First ,vitamin C is used for its antioxidative properties and functioning of immune system. Oxalate is an end product of the metabolism of vitamin C . The increase in the ingestion of ascorbic acid leads to excessive formation of oxalate.(Aya Karam et all , 2021) 12

13. Figure 2.2 Vitamin C methabolism (https://www.researchgate.net/figure/tamin-C-metabolism-Ascorbic-acid-participates-both-in-acid-base-ascorbic_fig1_301583749) 13

14. Kidney stones prevalence in COVID-19 pandemic Vitamin D regulates the calcium-phosphorus hemostasis and is also required for the immune system function .Calcitriol decreases the parathyroid hormone (PTH) synthesis ,subsequently increasing the excretion of calcium into urine.(Aya Karam et all , 2021) 14

15. Figure 2.3 Vitamin D absorption from sunlight (https://medium.com/@rachou_28925/vitamin-d-the-crucial-sunshine-vitamin-e732ae758358) 15

16. Urolithiasis and vitamin C & D Therefore ,supplementation with vitamin C and D ,although maybe beneficial for the management of COVID-19 ,is not without risk .These molecules should be used with caution ,particularly in prior stone formers.( Aya Karam et all , 2021) 16

17. Prevention In the majority of patients with idiopathic stone disease ,behavioral and nutritional interventions are potentially helpful and should be the first step of stone prevention. (Saeed R. Khan et all , 2016) 17

18. Figure 3.2 Kidney stones preventive diet (https://www.vectorstock.com/royalty-free-vector/high-calcium-and-vitamins-foods-vector-6917082) 18

19. Oxalate absorption Low oxalate diets are difficult to attain because of presence of oxalate in many common foods. Only foods with very high oxalate content should be limited or avoided. (Saeed R. Khan et all , 2016 ) 19

20. Figure 3.3 Calcium rich foods for calcium stones prevention (https://www.organicfacts.net/15-calcium-rich-foods.html) 20

21. Figure 3.4 Thiazides function on nephrons (https://tmedweb.tulane.edu/pharmwiki/doku.php/thiazides) 21

22. Uric acid stones prevention To prevent frequently occurring uric acid stones ,uric acid supersaturation in the urine must be decreased .This can be achieved by increasing urinary volume (>21 per day) ,increasing urinary pH to approximately 7.0 ,decreasing uricosuria and administering sodium bicarbonate or potassium citrate. (Saeed R. Khan et all , 2016) 22

23. Figure 3.5 Sodium bicarbonate (https://athleticsillustrated.com/wp-content/uploads/2020/07/Soda.jpg) 23

24. Cystine stones prevention The preventive strategy involves increasing water intake to >31 per day and the administration of sodium bicarbonate or potassium citrate to raise urinary pH and increase the solubility of cystine. The target pH is 7.0 to 8.0.(Saeed R. Khan et all , 2016) 24

25. Figure 3.6 Cystinuria (https://en.wikipedia.org/wiki/Cystinuria) 25

26. Struvite stones prevention Complete removal of struvite stones is a prerequisite for successful recurrence prevention .Indeed ,it is almost impossible to cure infection in the presence of the stone because it represents a microorganism reservoir.(Saeed R. Khan et all , 2016) 26

27. Figure 3.7 Coffee and tea are sources of caffeine ,which has been reported to increase diuresis moderately together with the excretion of magnesium and potassium as well as calcium and sodium. (https://ak.picdn.net/shutterstock/videos/17073175/thumb/1.jpg) 27

28. Treatment (https://advancedurology.com/advanced-blogging/what-is-a-swollen-kidney-a-guide-to-bilateral-hydronephrosis/) 28

29. Video 4.1 Shockwave lithotripsy (https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lithotripsy) 29

30. Figure 4.1 Calcium channel blockers function (https://www.nature.com/articles/hr2016183) 30

31. References 1) Soda and Other Beverages and the Risk of Kidney Stones , Pietro Manuel Ferraro, Eric N. Taylor, Giovanni Gambaro, Gary C.  Curhan , CJASN Aug 2013, 8 (8) 1389-1395;  DOI:  10.2215/CJN.11661112 2) Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, Traxer O, Tiselius HG. Kidney stones. Nature reviews Disease primers. 2016 Feb 25;2(1):1-23. 3) Aya Karam, Georges Mjaess , Hadi Younes, Fouad Aoun, Increase in urolithiasis prevalence due to vitamins C and D supplementation during the COVID-19 pandemic,  Journal of Public Health , 2021;, fdab328 31

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