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Kidney Stones and Fruit Flies

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by

Leon Frajmund

on 31 July 2013

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Transcript of Kidney Stones and Fruit Flies

Fruit Flies and Kidney Stones
By
Leon Frajmund
Tiffany Ocran
Humans
Kidney Stones
Aka Renal Lithiasis
Aka Nephrolithiasis
Overview
Literally: stones in kidneys (renal calculi)
Solid concretion made of dietary minerals in urine
Usually leave body in urine
If >3 mm, can block ureter
Result is pain. Lots of it
Caused mainly by diet
Men at higher risk (80% of cases are males)
Various types of stones
Renal colic
Excruciating pain groin/inner thigh
Sudden urges to urinate
Restlessness
Blood and/or pus in urine
Sweating
Nausea
Vomiting
Painful urination
Low fluid intake (water)
High intake of:
Animal protein
Sodium
Refined sugars
Fructose/high fructose corn syrup
Foods with high oxalate content
Grapefuit/apple juice
Soft drinks
Calcium containing stones
(generally calcium oxalate)
Struvite stones
i.e. ammonium magnesium phosphate
Uric Acid stones
Most common type (80% of US cases)
Commonly resemble envelopes or dumbbells
Increased oxalate/calcium diet
Increased susceptibility to this type
10%-15% of cases
aka "infection stones", urease stones, triple-phosphate stones
Caused by urea-splitting bacteria
Prone to urinary tract infection = prone to Struvite kidney stones
Can grow rapidly to large scale
Can form Calyceal Staghorn stones (antler-shaped stones)
These require invasive surgery
Common Urea-Splitting Bacteria
Proteus mirabilis
Proteus vulgaris
Morganella morganii
5%-10% of cases
Metabolic illnesses (obesity) increase likelihood
Pleomorphic crystals (takes at least 2 distinct forms)
Usually diamond-shaped, but rods/squares also occur
Caused by overly acidic urine/excessive uric acid in urine and/or serum
Formation/Prevention
How does it form?
Normal urine has crystallization-promoters and crystallization-inhibitors
Balance between these prevent kidney stones
When urine becomes supersaturated, balance is broken
Supersaturation happens because of
Abnormally high crystallization-promoter concentration
Abnormally low crystallization-inhibitor concentration
Low urine volume
Any combination thereof
Once supersaturated:
Seed crystal can form through nucleation (aggregation onto one specific area)
Nucleation onto a solid surface (wall of kidney) is easier/expends less energy than free-floating nucleation
Seed crystal keeps growing until it exits the body/is removed
Dietary measures
Keep well hydrated (water/citrate-rich drinks) (e.g. lemonade, orange juice)
Limit
Vitamin C intake to < 15 gm/day
Sodium intake to < 35 gm/day
Calcium intake to 15-19 gm/day
Animal protein intake < 6.0-8.1 oz/day
Consumption of soft drinks
Supplements
Diuretics
Allopurinol
Sodium Bicarbonate
Acetazolamide (Diamox) (drug)
Treatment
Natural expulsion
98% of small stones are expelled unaided
Takes about 4 weeks since first symptoms
Painkillers can be used to aid with pain
Expulsion Therapy
Undertook in the occurrence of larger stones
Doctor prescribes drugs which accelerate/encourage natural expulsion
Procardia, Tamsulosin
Stronger painkillers may be used
Non-invasive surgery
Invasive surgery
Regular surgery
Type most people are familiar with
Extracorporeal Shock Wave Lithotripsy
ESWL
Carried out when stone is near renal pelvis
Fragments stone in many smaller, easier-to-handle stones
HOW?
Rapid pulses of high-intensity ultrasonic energy, that's how

"Side effects may occur"
Use may cause
Bruising of area of application (common)
Rupturing of blood vessels in kidney (common)
Internal bleeding
Subcapsular hematomas
Acute renal failure
Also...
Often requires multiple treatments
Effectiveness highly dependent on:
Size of stone
Composition of stone
Location of stone
Kidney Stones
Fruit Flies
Why use fruit flies for kidney stone research?
General Research pros:
Short, fast life cycle
Ease of reproduction
Small
Affordable and Abundant
Shares most of human DNA
Easy to feed
Kidney Stones Research pros:
Unlike most animals, unbothered by stones (ethical)
Kidney tubule is transparent and easy to access
Calculi form rapidly
Rosy fruit flies can reproduce xanthuria, a rare human disease
Current research
Researchers:
Mayo Clinic, Rochester, Minnesota
&
University of Glasgow
Lead:
Dr.Michael F. Romero, Mayo
Julian Dow, PhD, Glasgow
Others:
Erik Ritman, M.D. Ph.D
Jim Thompson, Ph.D
Taku Hirata, Ph.D
Daniel P. Bondeson, undergraduate researcher
Goals
Study the formation of kidney stones in fruit flies, and how different compounds affect them, in search of potential drug candidates for prevention and/or cure
Dr. Michael F. Romero
Professor Julian A. Dow
Bibliography
Melissa , H.. N.p.. Web. 18 Jul 2013. <http://www.bbc.co.uk/news/science-environment-17398951>.
"Who Knew? Fruit Flies Get Kidney Stones Too, May Hold Key to Treatment for Humans." Mayo Clinic -. N.p., n.d. Web. 18 July 2013.
"University News." University of Glasgow ::. N.p., n.d. Web. 18 July 2013.
"Renal Fellow Network: Fruit Flies and Kidney Stones." Renal Fellow Network: Fruit Flies and Kidney Stones. N.p., n.d. Web. 18 July 2013.
"Kidney Stone." Wikipedia. Wikimedia Foundation, 17 July 2013. Web. 18 July 2013.
Tarkan, Laurie. "A Rise in Kidney Stones Is Seen in U.S. Children."Http://www.nytimes.com/. New York Times, 27 Oct. 2008. Web. 18 July 2013.
US News. U.S.News & World Report, n.d. Web. 18 July 2013.
"National Kidney and Urologic DiseasesInformation Clearinghouse (NKUDIC)." Kidney Diseases Statistics for the United States. N.p., n.d. Web. 18 July 2013.
Final words
While kidney stones rarely cause long term damage, they are unbelievably unpleasant
Peak periods: men 40-70 y.o., women 50's
However, stones are beginning to show up on children as young as 5 or 6
Yearly 3.3 million Americans seek medical treatment, accumulating for a total of about $5.3 billion per year
With the fruit fly kidney stone research, scientists hope to find a way to decrease both these statistics, through developing new drugs, treatments and/or prevention methods
Full transcript