Search Results (240)

Kidney stone disease is a common urinary system disorder with a continuously rising global incidence, posing a major public health challenge. As a classic traditional Chinese medicine for the treatment of kidney stones, Lysimachia christinae Hance (LCH) has not yet been fully elucidated in terms of its pharmacological mechanism. In this study, a rat model of calcium oxalate kidney stones and a calcium oxalate monohydrate (COM)-induced injury model of human renal tubular epithelial (HK-2) cells were established. Combined with transcriptomic analysis and experimental verification, the therapeutic effect and underlying molecular mechanism of LCH against kidney stones were systematically explored. Results demonstrated that LCH extract significantly reduced serum levels of blood urea nitrogen (BUN) and creatinine (Cr), as well as renal tissue levels of kidney injury molecule-1 (KIM-1) and cystatin-C (Cys-C) in rats with calcium oxalate crystal-induced renal injury, and diminished calcium oxalate crystal deposition and adhesion in rat renal tissues as well as HK-2 cells, thus exerting a robust renoprotective effect. Mechanistically, transcriptome sequencing indicated that the anti-nephrolithiasis effect of LCH was closely related to the inhibition of oxidative stress and ferroptosis. LCH extract reversed CaOx crystal-induced upregulation of NADPH oxidase 2 (NOX2) and downregulation of superoxide dismutase 2 (SOD2), reduced intracellular oxygen species (ROS) levels, downregulated the expression of transferrin receptor 1 (TFR1) and acyl-CoA synthetase long-chain family member 4 (ACSL4) while upregulating that of ferritin heavy chain 1 (FTH1), solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4), and diminished intracellular iron accumulation, thereby effectively ameliorating crystal-mediated renal injury. The present study demonstrates that the therapeutic effect of LCH on kidney stones is closely related to the regulation of the NOX2/ROS signaling axis and ferroptosis, providing novel theoretical evidence for its clinical application. Full article

Objectives: To develop and rigorously evaluate a Hybrid Multi-Path Attention Convolutional Neural Network (HMPA-CNN) for the classification of kidney diseases across heterogeneous institutional datasets and imaging modalities. Materials and Methods: The proposed HMPA-CNN employs dual parallel pathways to disentangle spatial (3 × 3 convolutions) and textural (5 × 5 convolutions) representations, followed by attention-based feature recalibration and gated fusion. Performance was assessed on five geographically distinct datasets comprising 29,148 CT and MRI images collected from Turkey, Bangladesh, Jordan, Iraq, and publicly available international sources. The evaluation framework included three-class tumor discrimination, four-class renal pathology classification, six-class tumor subtyping, binary kidney stone detection, and chronic kidney disease (CKD) assessment under cross-modality conditions. Results: The model achieved 99.76% overall accuracy on the KidneyNeXt three-class dataset, 99.96% on the four-class multi-institutional CT dataset, and 99.74% on the independent Jordan cohort under a four-class configuration. In the more granular six-class tumor subtyping task, overall accuracy was 96.36%. The same architecture achieved 93.85% overall accuracy on the MRI-based CKD classification task, suggesting that the framework can be adapted to a different imaging modality. Across most classification tasks, specificity exceeded 99%, with benign–malignant misclassification remaining below 2%. Performance declined to 91.96% for kidney stone detection, reflecting the intrinsic difficulty of small-object localization in axial CT images. Conclusions: The dual-path architecture consistently preserved high discriminative performance across institutions, diagnostic granularities, and imaging modalities. Its stable specificity and low benign–malignant confusion suggest potential utility as a supportive tool within renal imaging workflows, particularly for screening and structured diagnostic assistance. Clinically, benign–malignant misclassification is the most critical error, as it may delay oncologic evaluation or lead to unnecessary follow-up. Therefore, the model should be used as a decision-support tool rather than an autonomous diagnostic system. Further prospective validation is required to determine its impact in routine clinical practice. Full article

Background/Objectives: Recently, a 6.3 Fr single-use flexible ureteroscope (f-URS) was introduced to the market. The purpose of this pilot study is to present our experience with it during Endoscopic Combined Intrarenal Surgery (ECIRS) and to compare its performance with the conventional 7.5 Fr scope. Methods: For percutaneous access, renal puncture was performed in a nonpapillary approach. Regarding retrograde access, for the first group, a 7.5 Fr single-use f-URS was used, while for the second group, a 6.3 Fr single-use f-URS was utilized. Lithotripsy was primarily performed in an antegrade manner, using the Lithoclast Trilogy^®. In cases where stones could not be reached with a nephroscope, retrograde lithotripsy was performed with either a Holmium:YAG laser or a Thulium Fiber Laser. Results: In total, 45 patients were included. Of these, 23 patients underwent ECIRS with the 6.3 Fr f-URS and 22 with the 7.5 Fr f-URS. The mean operative time, fluoroscopy time and lasing time were 59.5 ± 5.6 min, 139.7 ± 14.2 s and 18.4 ± 2.7 min in the 6.3 Fr group and 57.1 ± 3.9 min, 133.8 ± 29.7 s and 18.6 ± 1.9 min in the 7.5 Fr group, respectively. Two patients in the 6.3 Fr group and three patients in the 7.5 Fr group experienced Grade II complications. Stone-free rates were 91.3% in the 6.3 Fr group versus 86.4% in the 7.5 Fr group. Conclusions: The use of a 6.3 Fr f-URS during ECIRS is potentially a feasible, safe and efficient approach. Both the 6.3 Fr and 7.5 Fr scopes were associated with comparable outcomes during ECIRS. Additional studies are needed so as to draw safer conclusions. Full article

Therapeutic interventions within the urinary system are often limited by the complex and tortuous anatomy of the renal pelvis and ureters, restricting access to deep regions and increasing the risk of mucosal trauma. In this study, we present a multifunctional, magnetically controlled ferrofluid droplet robotic platform engineered for high deformability and precision navigation. A custom electromagnetic actuation system was developed and optimized via COMSOL Multiphysics (version 6.3, COMSOL Inc., Stockholm, Sweden) simulations to generate programmable magnetic fields. Experimental validation in both simplified environments and anatomically realistic 3D-printed urinary tract models demonstrated the droplets’ capacity for controlled locomotion, reversible deformation, and traversing constrictions significantly smaller than their resting diameter. The droplets’ locomotion and extreme deformability are governed by the dynamic balance between the applied magnetic gradient forces, the restoring interfacial tension of the ferrofluid, and the fluidic viscous drag. Quantitatively, the droplets achieved robust translational velocities up to 260 mm/s under single-coil actuation (51 mT, 20 Hz) and 108 mm/s under a more stable dual-coil configuration (51 mT, 8.3 Hz). Furthermore, two clinically relevant functionalities were successfully executed: rapid vibration-induced release of encapsulated dye for targeted drug delivery, and the precise mechanical capture and transport of artificial kidney stones. These results establish a highly versatile platform for minimally invasive urological procedures, highlighting the immense potential of soft magnetic microrobotics for integrated therapeutic applications. Full article

Background and Clinical Significance: Over recent decades, percutaneous nephrolithotomy (PCNL) has emerged as a primary treatment, firmly establishing itself as the cornerstone approach for managing large kidney stones. Postoperative bleeding commonly stems from an arteriovenous fistula (AVF), a connection between a damaged artery with high flow and a damaged vein with low flow, or from a pseudoaneurysm (PA), which involves arterial blood leaking into the tissue, causing a localized hematoma. The preferred technique for addressing such vascular complications is selective trans-arterial angioembolization, widely regarded as the gold standard. Case Presentation: In this article, we present the case of a 42-year-old woman who experienced delayed bleeding eight years after PCNL and a previous angioembolization. The patient presented with macroscopic hematuria, and further investigations, including cystoscopy, contrast-enhanced abdominal-pelvic CT, and angiography, were performed. To stop the bleeding, we identified and performed selective angioembolization (SAE) of a small arterial branch arising from an inferior branch of the right renal artery. Conclusions: To the best of our knowledge, this is the initial documented instance of delayed bleeding manifesting eight years post-PCNL and angioembolization. This occurrence is exceptionally rare, given that the patient exhibited no urological signs or symptoms over the intervening years, and no predictive or risk factors were identified. Full article

Background/Objectives: To evaluate whether adjunctive silodosin improves the stone-free rate (SFR) and clinical outcomes of extracorporeal shock wave lithotripsy (ESWL) for renal calculi. Methods: In this prospective randomised controlled trial, 100 adults with solitary radiopaque non-lower pole renal stones measuring 5–20 mm underwent single-session ESWL and were randomised (1:1) to receive either silodosin 8 mg once daily plus standard care or standard care alone for up to 12 weeks. Participants were followed up for three months. The primary outcome was SFR at three months on follow-up imaging. The secondary outcomes included time to stone clearance, renal colic episodes, analgesic requirement and adverse events. Results: At three months, the SFR was higher in the silodosin group than in the control group (68.0% vs. 50.0%; RR 1.36, 95% CI 0.97–1.90), but this difference did not reach statistical significance (p = 0.067). In a prespecified exploratory subgroup analysis, patients with stones measuring 10–20 mm showed a higher SFR with silodosin than controls (61.8% vs. 34.4%; p = 0.026), whereas no benefit was observed for stones measuring 5–9 mm (p = 0.803). Time-to-clearance analysis using Kaplan–Meier methods suggested earlier confirmed stone clearance in the silodosin group (hazard ratio 1.58, 95% CI 1.02–2.45; log-rank p = 0.036). Silodosin was also associated with fewer renal colic episodes and lower analgesic requirements. No serious drug-related adverse events were observed. Conclusions: This randomised controlled trial did not meet its primary endpoint because adjunctive silodosin did not significantly improve the overall SFR after ESWL. However, a possible benefit was observed in patients with renal stones measuring 10–20 mm, together with improved pain-related outcomes. These findings suggest that silodosin may have a role in selected patients, but the subgroup effects should be considered hypothesis-generating rather than definitive. Full article

Introduction: The ureteral access sheath (UAS) is commonly used in retrograde intrarenal surgery (RIRS) to improve vision, lower intrarenal pressure (IRP), and facilitate access. However, concerns regarding ureteral injury remain. We conducted this study to evaluate the surgical efficacy and safety of a selective omission strategy for UAS use during RIRS in patients with small renal stones (<10 mm) or in cases where UAS placement is technically difficult. Materials and Methods: This retrospective study included consecutive patients who underwent single-surgeon RIRS at Changhua Christian Hospital between October 2020 and April 2023 for renal or upper ureteral stones. Sheathless RIRS was performed in patients with stones < 10 mm, or in whom insertion of a 10/12 Fr UAS was unsuccessful despite successful advancement of an 8 Fr semirigid ureteroscope, and when the surgeon estimated the procedure could be completed within 2 h. All procedures used a holmium laser with a 9 Fr or 7.5 Fr flexible ureteroscope. No patients were pre-stented, and all received postoperative double-J stenting. Results: Among 55 patients, 18 (32.7%) underwent sheathless RIRS and 37 (67.3%) underwent UAS-assisted RIRS. Stone size was significantly smaller in the sheathless group (12 mm vs. 17 mm, p = 0.001). The 3-month stone-free rate (SFR) was 66.7% in the sheathless group and 62.2% in the UAS group (p = 0.745). Operative time was similar between groups (77 vs. 85 min, p = 0.154), with no statistically significant differences in postoperative pain or length of hospital stay. In the UAS-assisted group, six patients developed febrile urinary tract infection, of whom two progressed to sepsis; all recovered after antibiotic therapy. No fever or sepsis occurred in the sheathless group. On multivariable analysis, lower calyceal stone location was independently associated with SFR, whereas UAS use was not. Conclusions: In a selected cohort (stones < 10 mm or difficult UAS insertion with an expected operative time < 2 h), sheathless RIRS was feasible and showed no statistically significant differences in SFR or perioperative outcomes compared with UAS-assisted RIRS. However, due to selection bias, stone-size imbalance, and limited statistical power, these findings should not be interpreted as procedural equivalence and require confirmation in adequately powered studies with stratified/adjusted analyses. Full article

Background and Objectives: Ureteral access sheaths (UASs) are widely used in retrograde intrarenal surgery (RIRS) to facilitate irrigation and instrument access. Recently, flexible and navigable suction UASs (FANS-UASs) have been developed to enhance visibility and stone fragment evacuation; however, their comparative effectiveness remains uncertain. This study aimed to evaluate the clinical outcomes of FANS-UAS versus conventional UAS during RIRS for renal stones. Materials and Methods: A systematic review and meta-analysis were performed following PRISMA guidelines. PubMed, Embase, and the Cochrane Library were searched through May 2025 for comparative studies of FANS-UAS and conventional UAS. Study quality was assessed using the Scottish Intercollegiate Guidelines Network checklist. Primary outcomes included stone-free rate (SFR), operative time, complications, and hospital stay. Subgroup analyses were conducted according to stone size (≤2 cm vs. >2 cm). Results: Nine studies involving 1791 patients were included. FANS-UAS demonstrated a significantly higher SFR (OR = 5.99, 95% CI: 2.86–12.51; I² = 86.7%) and fewer complications (OR = 0.33, 95% CI: 0.23–0.45; I² = 0%). Operative time and hospital stay did not differ significantly between groups. Subgroup analysis showed no significant SFR difference for stones ≤2 cm, whereas for stones >2 cm, FANS-UAS tended to yield higher SFR—though based on limited evidence. Conclusions: FANS-UASs appear to improve stone clearance and reduce perioperative complications in RIRS without increasing operative burden. While further high-quality randomized trials are needed, current evidence supports the growing adoption of FANS-UAS in endourological practice. Full article

Objective: The optimal surgical approach for 1.0–2.0 cm renal stones in solitary kidney patients remains controversial. This retrospective study compared mini-percutaneous nephrolithotomy (mPCNL) and flexible ureteroscopy (f-URS) outcomes in this vulnerable population. Methods: Between June 2018 and April 2024, 50 patients with solitary kidneys and 1.0–2.0 cm renal stones underwent either mPCNL (n = 26) or f-URS (n = 24). Outcomes included 3-month stone-free rate (SFR), complications (Clavien–Dindo classification), and renal function (serum creatinine, eGFR by CKD-EPI equation) at the baseline, 72 h, and 1 month. Results: Stone-free rates were comparable (mPCNL 96.2% vs. f-URS 91.7%, p = 0.157). The f-URS group demonstrated significantly less hemoglobin decline (2.2 ± 0.9 vs. 5.7 ± 2.4 g/dL, p < 0.001) and shorter hospitalization (4.1 ± 1.1 vs. 7.8 ± 1.6 days, p < 0.001). All Grade II complications (8.3%, requiring transfusion) occurred in the mPCNL group. At 1 month, serum creatinine decreased more with f-URS (15.4 ± 7.96 vs. 8.7 ± 4.23 μmol/L, p < 0.001), with greater eGFR improvement (16.7 ± 4.7 vs. 15.4 ± 5.2 mL/min/1.73 m², p = 0.023). Conclusions: In this retrospective cohort, f-URS achieved comparable stone clearance to mPCNL alongside a superior early safety profile and better short-term renal functional preservation. These preliminary findings suggest that f-URS represents a viable nephron-sparing option for this high-risk population. However, these results are considered hypothesis-generating, and further prospective, long-term studies are required to evaluate the durability of these functional benefits. Full article

Background and Objectives: Because of its consistently high stone-free rates (SFRs), percutaneous nephrolithotomy (PCNL) continues to be the first-line treatment for renal stones larger than 20 mm. Standard 24 to 30 Fr access tracts, however, are linked to access-related morbidity, such as bleeding, pain, and extended hospital stays. These restrictions have led to progressive tract miniaturization and the development of mini-PCNL, ultra-mini PCNL, and micro-PCN techniques. Materials and Methods: We performed a narrative review of studies published through January 2026 using PubMed and Google Scholar. Search terms included percutaneous nephrolithotomy, mini-PCNL, ultra-mini PCNL, micro-PCNL, and vacuum-assisted PCNL. Original studies, systematic reviews, and meta-analyses reporting clinical outcomes, complications, and advancements were selected, whereas conference abstracts, non-English papers, and articles without accessible full text were excluded. Results: Across randomized trials, miniaturized PCNL generally preserves efficacy when patients are selected appropriately. Across randomized trials and meta-analyses, miniaturized PCNL achieved stone-free rates comparable to standard PCNL (typically ~80–90% for stones ≤20 mm and similar rates in selected stones >2 cm), while demonstrating lower hemoglobin decrease (mean difference approximately −0.6 to −1.0 g/dL), reduced transfusion rates, and shorter hospital stays, at the cost of longer operative time (mean difference ~8–12 min). On the other hand, operative time may increase, and smaller working channels can make visualization and fragment evacuation more demanding as stone burden rises. Raised intrarenal pressure is a recurring safety issue because it may increase infectious risk unless drainage is actively managed. Recent innovations aim to address these limitations, including vacuum-assisted access sheaths, pressure-controlled irrigation, improved laser and lithotripsy platforms, image-fusion guidance, navigation systems, and robotic assistance. Conclusions: PCNL now spans a spectrum of tract sizes rather than a single standard approach. When chosen appropriately and performed with attention to pressure control and fragment evacuation, miniaturized PCNL can reduce morbidity without sacrificing stone clearance. Future advancements in percutaneous stone surgery are more likely to rely on integrated technological solutions that improve accuracy, safety, and repeatability than on additional tract size reduction. Full article

Background/Objectives: Primary aldosteronism (PA), the leading cause of secondary hypertension, results from autonomous aldosterone hypersecretion. It is characterized by increased extracellular volume, elevated cardiac output, and greater arterial stiffness compared with essential hypertension, reflecting aldosterone-mediated hemodynamic dysregulation. The prevalence and morbidity of PA are increasingly acknowledged; however, PA continues to be underdiagnosed because of limited screening and diagnostic complexity. Methods: A narrative review was conducted using PubMed (2015–2025), with terms targeting PA epidemiology, excluding treatment-focused studies. From 971 articles, 133 relevant studies (original research studies, reviews, meta-analyses) were included, addressing prevalence, risk factors, comorbidities, genetics, and diagnostic issues. Results: PA prevalence in hypertensive populations is 5–10%, rising to 17.8% in young-onset and 20–30% in resistant hypertension. Screening indications include resistant/severe hypertension, hypokalemia, adrenal incidentaloma, young-onset disease, obstructive sleep apnea (59.8% comorbidity in hypertensive PA), and familial history, while a link may exist with papillary thyroid cancer. The aldosterone–renin ratio (ARR) is the primary screening tool, limited by assay variability and confounders (e.g., sodium intake). Confirmatory testing (such as with the saline infusion test) is often challenging to perform in routine practice. Adrenal venous sampling (AVS) is useful for subtyping unilateral (aldosterone-producing adenoma; APA; ~35–50%) vs. bilateral (idiopathic hyperaldosteronism; IHA) disease, despite technical challenges. Somatic mutations (e.g., KCNJ5, more frequent in Asians) and rare familial forms drive PA. Complications include cardiovascular events (Major Adverse Cardiovascular Events; MACE: 13.6% at 5.8 years), stroke, renal impairment (decreased eGFR, proteinuria), metabolic disorders (diabetes, obesity), and novel associations (vertebral fractures, renal stones, normal-tension glaucoma). Psychiatric comorbidities (depression/anxiety in 30–70% of patients) have been associated with central mineralocorticoid receptor effects, with sleep disturbances being prominent in females. Subclinical PA predicts hypertension and arterial stiffness. Conclusion: Improved screening protocols, standardized ARR cutoffs, and advanced imaging and genetic analyses are needed to enhance PA detection. Future research should validate cost-effective screening and clarify psychiatric-metabolic links for optimized management. Full article

Despite the known association between calcium and magnesium in drinking water and stone risk, the difference in stone prevention of purified water remineralized with varying calcium-to-magnesium ratios (Ca:Mg) remains unclear. Objectives: This study investigates the impact of different Ca:Mg in the remineralization of purified water on calcium oxalate crystallization and renal injury. Methods: Sixty male Sprague-Dawley rats were induced calcium oxalate crystals by a sodium oxalate diet and divided into six groups, where they drank purified water with or without remineralized varying Ca:Mg (0.5, 3.4, 10, 20, 100). Serum and urine biomarkers of renal function, renal injury, mineral metabolism, bone metabolism, and urine calcium oxalate crystals were detected. Kidneys were isolated for pathological examination. Results: Findings showed that remineralization by 0.5 and 3.4 Ca:Mg significantly reduced urinary calcium oxalate crystallization, renal injury, and improved renal function, while extreme ratios (Ca:Mg over 10) showed no benefits. Conclusions: These results elucidate the pathophysiological effects of Ca:Mg in drinking water on renal health, particularly emphasizing the protective role of the 0.5 and 3.4 in inhibiting calcium oxalate crystallization and mitigating renal injury. It provides a quantifiable reference for purified water remineralization aimed at stone prevention. Full article

Background and Objectives: The use of fluoroscopy during retrograde intrarenal surgery (RIRS) results in cumulative ionizing radiation exposure to both the patient and the surgical team. We aimed to evaluate the efficacy and safety of fluoroscopy-free (FF) RIRS performed by experienced surgeons in the management of renal stones < 2 cm. Materials and Methods: A total of 255 patients who underwent RIRS for renal stones < 2 cm between 2023 and 2025 were retrospectively analyzed. Patients were randomly assigned to the groups. Fluoroscopy was used (FU) during RIRS in 123 patients, whereas fluoroscopy was not used during RIRS in 132 patients. All procedures were performed by a single experienced surgeon. For patients in both groups, the following variables were retrospectively reviewed: demographic characteristics, stone characteristics, localization, and diameter, operative time, fluoroscopy time and dose, postoperative complications, length of hospital stay, and stone-free rates (SFR). Results: The operative time was 34.7 ± 8.7 min in the FF group and 42.0 ± 12.9 min in the FU group, being significantly shorter in the FF group (p < 0.001). No fluoroscopy was used in the FF group, whereas in the FU group the fluoroscopy time and dose were recorded as 7.75 ± 3.6 s and 1.31 ± 0.61 mGy, respectively. There were no significant differences between the groups in terms of length of hospital stay or SFR. No intraoperative complications were observed in either group. Postoperative complications occurred in 29 (21.9%) patients in the FF group and 42 (34.1%) patients in the FU group; the difference between groups was statistically significant (p = 0.030). Conclusions: In appropriately selected patients with renal stones < 2 cm, fluoroscopy-free RIRS performed by experienced surgeons can be applied effectively and safely, with shorter operative times and lower complication rates. Full article

Background: The global incidence of urolithiasis is increasing, with a growing proportion of cases occurring in elderly patients. Flexible ureteroscopy (fURS) is an established minimally invasive treatment for renal stones; however, concerns persist regarding its safety and effectiveness in older populations with higher comorbidity burdens. This scoping review aims to evaluate the current evidence on the safety and efficacy of fURS in elderly patients, with a specific focus on perioperative complications, postoperative recovery, and long-term outcomes. Methods: A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A systematic literature search of PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from database inception to 26 November 2025. Observational and experimental studies evaluating outcomes of fURS in elderly patients were included. Data were synthesized descriptively. Results: Fourteen studies met the inclusion criteria, comprising predominantly retrospective cohort analyses and large registry-based studies. Definitions of elderly patients varied across studies (≥65 to ≥80 years). Elderly patients consistently exhibited higher comorbidity burdens and ASA scores than younger cohorts. Intraoperative complications were uncommon (<5%) and largely independent of age. Overall postoperative complication rates ranged from 12% to 18%, with the majority being low grade (Clavien–Dindo I–II). Major complications (Clavien–Dindo ≥III) were rare, generally occurring in fewer than 5% of cases. Stone-free rates were comparable between elderly and non-elderly patients. Long-term outcomes, including renal function preservation, stone-event-free survival, and late complications, were favorable and not significantly influenced by age. Conclusions: Current evidence indicates that fURS is a safe and effective treatment option for renal stone disease in elderly patients. Chronological age alone should not be considered a contraindication to ureteroscopic stone surgery. Careful patient selection, perioperative optimization, and procedural efficiency remain critical determinants of outcomes. Full article

Objective: The formation of calcium oxalate (CaOx) kidney stones is accompanied by the pyroptosis of renal epithelial cells. The risk of kidney stone formation can possibly be reduced through pyroptosis inhibition. Methods: Pyroptosis of HK-2 cells induced by 3 µm CaOx monohydrate (COM-3 µm) was inhibited by Pelvetia siliquosa polysaccharides before and after sulfation (PSP0 and PSP3, with −OSO₃− contents of 1.04% and 36.12%, respectively). The inhibitory efficiency and mechanism of PSP0 and PSP3 were evaluated via caspase-1/PI double staining and Western blot detection of pathway proteins in pyroptosis cells. The potential anti-stone effect of polysaccharides was evaluated through measurement of the extent of crystal adhesion on the cell surface. Results: The proportion of pyroptosis cells induced by COM-3 µm reached 17.87%. After protection by PSP0 and PSP3, the percentage of pyroptosis cells was reduced to 12.7% and 6.35%. The levels of NLRP3, ASC, gasdermin D, IL-1β, and IL-18 related to pyroptosis were downregulated. In addition, the activation of the NF-κB pathway was considerably inhibited. During inhibition of pyroptosis, reactive oxygen species and lactate dehydrogenase levels were decreased, the integrity of zonula occludens-1 protein was restored, and the expressions of CaOx-specific adhesion proteins (ANXA3 and CD44) were substantially decreased. As a result, the adhesion of COM crystals on the cell surface was reduced. PSP3 exhibited a higher protection energy efficiency than PSP0. Conclusions: PSP0 and PSP3 inhibited the pyroptosis of HK-2 cells through the NLRP3/ASC/caspase-1/IL-1β pathway, which caused the inhibition of cell inflammation and injury, reduced the expressions of adhesion proteins, and reduced the risk of CaOx crystal adhesion and stone formation. The biological activity of PSP0 and PSP3 after sulfation modification increased. Full article