Kidney stone disease affects 12% of the global population with a prevalence that continues to increase. It is recurrent in up to 50% of patients within 5 years and is associated with major health concerns including coronary artery disease and chronic kidney disease. Thus, kidney stones pose a substantial health and economic burden. However, despite kidney stone disease being one of the oldest known and most common diseases worldwide, our understanding of the mechanisms underlying stone formation is lacking. Moreover, recent data have raised questions about the efficacy of currently used therapeutic options for calcium oxalate stones, which account for 75% of all kidney stones. Development of new therapeutics for the successful prevention and management of this disease will require improved understanding of the causes of kidney stones. Recent advancements have shed light on the nuanced contribution of diet, environment and genetics as well as the more fundamental roles of calcium oxalate crystallization, Randall’s plaque formation, inflammation and even a possible contribution of the recently discovered urinary microbiome. This review provides a comprehensive overview of our current understanding of kidney stone pathogenesis and identifies new frontiers and remaining gaps in our knowledge of this disease.

Background: Urinary tract infections (UTIs) are among the most prevalent bacterial infections. With many patients turning to the Internet as a health resource, this study seeks to understand public engagement with online resources concerning recurrent UTIs (rUTIs), assess their reliability, and identify common questions/concerns about rUTIs. Methods: Social media analysis tool BuzzSumo was used to calculate online engagement (likes, shares, comments, views) with information on rUTIs. The reliability of highly engaged articles was evaluated using the DISCERN questionnaire. Highly engaged categories were entered as keywords in Google Trends to quantify search interest. To categorize patient-specific concerns, a database containing anonymously collected patient questions about rUTIs was created. Results: BuzzSumo revealed four search categories: general information, treatment, causes, and herbal remedies. DISCERN scores indicated moderate reliability overall; however, the “herbal remedies” category demonstrated poor reliability despite high engagement. Google Trends analysis highlighted “causes” and “treatment” searches as highest in relative interest. The 10 most popular categories of concern were antibiotics, microbiome, vaccines, prevention, pelvic pain, sex, testing, symptoms, diet/lifestyle, and hormones. Conclusions: People living with rUTIs demonstrate key concerns and often seek information online, yet articles with high engagement often contain unreliable information. Healthcare professionals may consider counteracting misinformation by providing evidence-based information online about rUTIs.

Background: With the rise in availability of herbal supplements, there has been a similarly expanding landscape of online information about these supplements. Aims/Objectives: This study identifies commonly used herbal supplements, their ingredients, oxalate content, and the reliability of their online information. Methods/Methodology: A survey was administered to members of a nephrolithiasis Facebook group on their use of herbal supplements. The top 10 bestselling herbal supplements on Amazon and their common ingredients were identified. Consumer interest and online engagement with these ingredients were analyzed using Google Trends and BuzzSumo. The reliability of the top 10 articles for each ingredient was rated using the DISCERN questionnaire. Oxalate content was quantified by ion chromatography coupled with mass spectrometry. Results/Findings: The most common ingredients in supplements were black pepper, ginger, apple cider vinegar, and turmeric. Google Trends identified apple cider vinegar, ginger, and turmeric as search terms of high interest. BuzzSumo revealed the highest article engagement and video views for apple cider vinegar. For all ingredients, average DISCERN scores for the most popular articles were in the “poor reliability” category. Turmeric-containing and standalone turmeric formulations were found to have the highest oxalate levels, with ranges of 2.69–54.8 mg/g and 15–19.5 mg/g, respectively. Conclusions: High consumer interest in herbal supplements combined with unreliable online information highlights the need for high-quality, evidence-based information. With popular herbal supplements containing varying amounts of oxalate, it may be useful for those providing care for kidney stone formers to familiarize themselves with popular herbal products and their lithogenic potential.

Introduction: Patterns of dietary intake are known risk factors for both kidney stone formation and recurrence. ^1,2 Dietary recommendations such as the Dietary Approaches To Stop Hypertension (DASH) diet can reduce risk, ^3,4 but patients may lack knowledge or a practical understanding on implementing these diet patterns. Virtual teaching kitchens have proven effective in improving dietary practices in other populations, but have not been applied to patients with kidney stones. ^5,6 This study assessed the effectiveness of virtual teaching kitchen sessions in enhancing dietary confidence and practices for kidney stone prevention. Methods: Eligible adults, aged 18 years and older, with a history of recurrent kidney stones were recruited to participate in one of two virtual teaching kitchen sessions. Pre-intervention surveys were administered to participants assessing individual cooking habits and dietary confidence. Post-intervention surveys assessed changes in cooking attitudes, dietary confidence, and program satisfaction. Results: Forty-six participants completed both pre- and post-intervention surveys. Results showed significant improvements in enjoyment of trying new recipes, reduced frustration with cooking, and perceptions of home-cooked meals as both affordable and healthy. Participants also reported finding cooking less tiring and increased confidence in adopting key dietary practices, including reducing added sugar intake, choosing lean proteins, using spices instead of salt, consuming more fruits and vegetables, and controlling portion sizes (all p<0.05). Conclusions: The virtual teaching kitchen intervention significantly improved participants’ confidence and attitudes toward adopting dietary practices essential for kidney stone prevention, highlighting its promise as an educational tool for patients.

Background: Urinary tract infections (UTIs) are among the most prevalent infections. Dietary supplements with herbal ingredients have gained popularity as alternative or adjunctive therapies. However, the quality of online information regarding these supplements remains uncertain. Materials and Methods: Amazon’s Best-Sellers Rank was used to identify the most purchased UTI dietary supplements. After selecting the 5 most common ingredients from these supplements, their Google search interest was assessed on Google Trends. The quality of YouTube videos regarding the use of the selected ingredients for UTI prevention was evaluated using DISCERN and mDISCERN questionnaires, JAMA benchmark criteria, and Global Quality Score (GQS). Results: Cranberry, D-mannose, probiotics, hibiscus, and Uva ursi were the most popular ingredients on Amazon that were selected for further analysis. Cranberry, D-mannose, and probiotics all had considerable search interest on Google Trends. While videos on the use of these ingredients for UTIs demonstrated high view counts, average quality measures across all 4 criteria were low. Conclusions: YouTube videos on UTI supplements are widely accessed but often unreliable. Our study suggests that the availability and online visibility of evidence-based educational resources may help support informed decision-making among individuals seeking nonantibiotic approaches to UTI prevention.