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PubMed1985

Immunochemical studies of serum, urine and calculus proteins in urolithiasis.

Total serum protein levels in 70 patients with urolithiasis were not significantly different from those in 20 control subjects, although certain variations were detected in individual protein patterns. In contrast, total urinary protein was significantly higher in patients with urolithiasis. 4-6 different components, i.e., albumin, alpha 1-acidic glycoprotein, alpha 1-antitrypsin, Gc-globulin, fibrinogen and immunoglobulin G, were found in the matrices of calculi and in urine, suggesting that proteinuria may play a role in the formation of stones in patients with urolithiasis.

Blood Proteins↗
PubMed1979

Urolithiasis and hyperoxaluria in chronic inflammatory bowel disease.

The incidence of urolithiasis was registered in 87 patients with chronic inflammatory bowel disease and compared with that of renal oxalate excretion. All patients were studied while on a standardized diet with fixed amounts of fat, calcium, and oxalate. Pyelography had been performed in all. Nine, or 35%, of 26 hyperoxaluric patients had urolithiasis, compared with 14, or 23%, of 61 patients were normal renal oxalate excretion, the difference being statistically insignificant. No significant difference in urinary oxalate or urinary calcium in stone-formers as compared with non-stone-formers could be demonstrated. Oxalate was a more frequent component of calculi in patients with normal renal oxalate excretion than in patients with hyperoxalura. Thus, we were unable to demonstrate an increased incidence of urolithiasis in patients with hyperoxaluria compared with a control group with normal renal oxalate excretion. Our results cast doubt on the concept that enteric hyperoxaluria per se is the cause of stone diathesis in chronic inflammatory bowel disease.

Adult↗
PubMed1984

Evaluation of a calculolytic diet in female dogs with induced struvite urolithiasis.

The calculolytic effect of a diet designed to reduce the urine concentration of urea, P, and Mg was evaluated in female Beagles with induced urease-positive urinary tract infections and struvite urolithiasis and in female Beagles with induced sterile struvite urolithiasis. The reduced-protein calculolytic diet induced urolith dissolution in 5 of 6 infected dogs with struvite urolithiasis in 2 to 5 months (means = 14.4 weeks). At the end of 6 months, uroliths in comparable control dogs fed a maintenance diet were 5 times larger and 14 times heavier than at the beginning of the study. The calculolytic diet induced urolith dissolution in 6 of 6 noninfected dogs with struvite uroliths in 2 to 4 weeks (means = 3.3 weeks). Four uroliths in noninfected dogs fed the maintenance diet dissolved over a period of 2 to 5 months (means = 14 weeks). Urolith dissolution in dogs fed the calculolytic diet was associated with diet-induced diuresis, reduction in urine pH, reduction in urine concentration of urea ammonia, P, and Mg, and increase in urine titratable acidity. Consumption of the calculolytic diet was also associated with significant (P = less than 0.01) reduction in the serum concentration of urea and albumin and a significant (P = less than 0.01) increase in serum hepatic alkaline phosphatase activity. Concomitant occurrence of hydropic degeneration of hepatocytes indicated that these biochemical and morphologic changes were associated with dietary protein restriction.

Animals↗
PubMed1978

[Statistical observation of urolithiasis at the Hokkaido University Hospital (1959-1975) (author's transl)].

In recent 17 years from 1959 to 1975, 32296 patients were visited to the Urological department of Hokkaido university hospital. 1192 patients (male 818, female 374) were diagnosed as urolithiasis in this period. The incidence was 3.7%. Among them, 1324 urinary calculi were seen. In detail, renal stone 509 (38.4%), ureteral stone 717 (54.2%), bladder stone 84 (6.4%), urethral stone 14 (1.1%). The tendency of upper urinary stone-wave was increasing gradually. Especially after 1965, it was increasing sharply. The tendency of lower's was stable. There was 15 urolithiasis in childhood in this duration. Most of them were upper urinary stone. 9 patients were under 5 years of age. The cause of urolithiasis was found in 9.5%. The upper urinary stone was found only 4.7% but, 57% was found in lower urinary stone. In this report, statistical studies of this work was compared and discussed with already published data in 1961 of our department.

Adolescent↗
PubMed1995

Economic impact of urolithiasis in the United States.

PURPOSE: We determined the economic costs to individuals in 1993 for the evaluation and treatment of upper urinary tract calculi. MATERIALS AND METHODS: Hospital discharge statistics, prevalence data for urolithiasis and the relative frequency of surgical treatments from Civilian Health and Medical Program of the Uniformed Services claims data were assessed. RESULTS: The total charges for evaluation, hospitalization and treatment were estimated to be $1.23 billion per year. Professional charges for those who were hospitalized were estimated to be $183 million. Outpatient evaluation of urolithiasis was expected to cost $278 million. Indirect costs for lost wages were estimated to be $139 million. CONCLUSIONS: The total annual cost for urolithiasis in the United States is estimated to be $1.83 billion.

Cost of Illness↗
PubMed1995

[The characteristics or urolithiasis in flight personnel and the treatment results using a method of extracorporeal shockwave lithotripsy on the Russian lithotripter Urat-P2].

Urolithiasis occurs more frequently in the pilots than in the ground-service personnel. To decrease a damaging effect of the focused shock waves on the renal tissue while using remote lithotripsy technique, a new domestic-certified lithotriptor "URAT-P2" which shows a significantly low energy of shock wave with sufficient effectiveness of crushing the renal stones, is devised. Urolithiasis in the pilots is apparent at the early stages of its development and its complicated forms are less common than in the subjects of other professions. The stones are predominantly located in the renal calyces (73,3% of cases), in the left kidney and urethra in 63,3% of cases and there were urate stones in 40% of cases. The clinical use of the URAT-P2 complex in 30 pilots indicated that it holds advantages over the production domestic-certified lithotriptor. The stones are crushed in all the patients but the complications associated with a negative effect of the focused shock waves on the renal tissue are absent. The use of the new lithotriptor for treating urolithiasis in the pilots will allow one to improve the treatment response and to maintain professional worthiness of the pilots for a long time.

Adult↗
PubMed1995

[Clinical kidney function studies in sheep. III. Pathologic function changes in nephropathies of sheep and in urolithiasis of rams and billy goats].

Examination of renal function have been carried out in sheep with acute prerenal (n = 6), renal (n = 15) or postrenal failure (n = 3), pyelocystitis (n = 4), and in cases of urolithiasis in rams (n = 16) and billy goats (n = 11) respectively. The calculation of parameters was done on the basis of the estimated weight dependent endogenous creatinine excretion. A control group of 56 healthy non pregnant or early pregnant (< 120th day of pregnancy) ewes have been used. The renal creatinine clearance was reduced and the absolute as well as the fractional renal water excretion was enhanced in all groups of sick animals. An elevated fractional excretion of sodium and phosphate could be seen as well. Functional disturbances could be observed in urolithiasis in like manner as in acute renal failure. There was proteinuria, glucosuria, excessive potassium excretion and often decreased plasma concentration of potassium in both syndromes. A hyperkalemia occurred only in the final state of urolithiasis. No clinical outcome of chronic nephropathies could be seen. Mortality of the described acute nephropathies was about 76%. The results of examination were suitable to control the course and restitution of renal function. They were not helpful for differential diagnosis and prognosis of acute renal failure.

Animals↗
PubMedDate not supplied

[The place of supravesical endourology in the modern combined treatment of urolithiasis].

Equally with increasing role of extracorporeal impulse lithotripsy (EIL) as the most progressive method of uroliths elimination, there is a growing usage of x-ray endoscopy which raises EIL efficacy, helps to prevent its complications and side effects, serves a good adjuvant and preventive tool. A nonrandomized [correction of randomized] trial of 2000 consecutive sessions of EIL in 1311 patients with various forms of urolithiasis provided evidence for detailing indications for such methods of supravesical endourology as catheterization and stenting of the upper urinary tracts, transcutaneous puncture nephrostomy, percutaneous and transurethral roentgenoendoscopic surgery of nephroliths and ureteroliths. Combined application of EIL and supravesical endourological techniques allows elimination of the stones without surgical interventions in complicated urolithiasis in patients with stag-horn calculi, multiple and large ones, with calculi of anomalous and floating kidney, etc. The need in x-ray endoscopy is also dictated by EIL contraindications and high efficacy of the x-ray endoscopy operations. The experience gained in the Research Urological Institute as regards surgical, endoscopic and EIL treatments of urolithiasis provided the material for design of algorithms to be adopted in the choice of therapeutic policy in ureteroliths and coral renal calculi.

Adolescent↗
PubMed1994

[Current approach to solving the problem of urolithiasis].

The article analyses experience in the management of about 1,500 patients with urolithiasis who underwent in- and out-patient treatment at the Urological Clinic of the Moscow Regional Scientific Research Clinical Institute in 1990-1993. Indications were determined for applying lithotripsy in patients with stones in anomalous kidneys, in cases of a solitary kidney, and children with urolithiasis. The tactics of management of large kidney stones is described. The use of endoscopic methods of treatment (percutaneous and transurethral) is evaluated. Modern methods of urolithiasis treatment were applied instead of an open operation in 90% of patients.

Adolescent↗
PubMedDate not supplied

[The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis].

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.

Anti-Bacterial Agents↗
PubMed1994

[Urolithiasis in male sheep and goats. Clinical picture, therapeutic possibilities and prognostic evaluation].

A report is given about the course of urolithiasis in 34 rams and 18 castrated billy-goats. Different therapeutic procedures of this disease are discussed. Concrements in the processus urethrae (n = 27) were removed by amputation of this organ. In animals with a further proximal situated urethral obstruction an ischiourethrostomy was done (n = 7). 21 animals were healed and 9 animals were sent home in an improved condition, but with urine leaking from an artificial opening. Complications as: hyperdistended and ruptured bladder (n = 9) or hydronephrosis caused by severe urine pressure were mostly seen when the diagnosis urolithiasis had been urine pressure were mostly seen when the diagnosis urolithiasis had been confirmed too late, or when the animals had been treated for several days only with analgetics or spasmolytics. Urine cellulitis of the ventral abdomen (n = 11) had not always a bad prognosis. 7 of 11 cases were healed.

Amputation, Surgical↗
PubMed1993

[Examination of the risk factors for infectious urolithiasis formation in patients receiving urinary diversion or urinary reconstruction using intestine--comparison of reservoir and ileal conduit].

Urinary risk factors and preventive factors for infectious calcium (Ca) urolithiasis formation, such as citrate, oxalate, Ca, phosphate, magnesium, and uric acid were examined more than 2 months after performing a urinary reservoir in 12 patients (R group) and ileal conduit in 10 patients (C group). There was no difference in the positive rate of risk factors between the two groups and also no difference in the positive rate of more than two risk factors between the two groups. Although four patients with more than two risk factors in the R group suffered from reservoir stones all of which included Ca-urolithiasis, none in the C group did. In the R group, the incidence of stone formation in patients with 2 or more risk factors was significantly higher than those in patients with 1 or no risk factor. In conclusion, the urinary reservoir operation should not be carried out in patients with more than two risk factors for urolithiasis formation, and urinary risk factors should be examined before reservoir operation.

Adult↗
PubMed1977

Canine urolithiasis: retrospective analysis of 438 cases.

In a retrospective analysis of 438 cases of canine urolithiasis, a total of 561 urolithic episodes were found to have occurred in a 6 1/2-year period. The hospital incidence of urolithiasis during that period, defined as the proportion of dogs hospitalized with urolithiasis to the total number of dogs hospitalized, was 2.8%. The major chemical component of the calculus in 307 dogs was phosphate; in 95 dogs, cystine; in 21 dogs, urate; in 12 dogs, oxalate; and in 3 dogs, carbonate. The Miniature Schnauzer, Dachsund, Dalmatian, Pug, Bulldog, Welsh Corgi, Beagle, and Bassett Hound were breeds that had a significantly higher (P less than 0.05) incidence of calculi than did breeds of other dogs hospitalized. Predisposition for calculi, by sex, was not found. Most dogs with calculi were between 3 and 7 years old. Most calculi were radiopaque and were located in the bladder or in the bladder and urethra. Specimens for bacteriologic culture were obtained by catheterization or by swabbing of tissue at the surgical site. Of 259 specimens obtained, 181 were culture-positive. The most common organisms isolated were Staphylococcus spp, Escherichia coli, Proteus spp, Streptococcus spp, and Klebsiella spp. Most of the bacteria were sensitive to gentamicin, chloramphenicol, nitrofurantoin, cephalothin, and methanamine mandelate.

Age Factors↗
PubMedDate not supplied

[The treatment procedure in patients with a combination of kidney tumor and urolithiasis].

Renal carcinoma and urolithiasis combine rather rarely. Postnephrectomy patients often consult the urologist when the condition is serious because of complications resultant from uroliths in the contralateral kedney. In view of solitary kidney, progressive chronic pyelonephritis, associated chronic renal failure surgical treatment of the condition becomes risky and necessitates individual approach to choice of therapeutic policy and definition of indications to urolithiasis treatment in patients after nephrectomy for renal carcinoma. This includes the decision whether to perform nephrolithiasis before or after nephrectomy and whether to attempt any surgery in the absence of urolithiasis clinical symptoms.

Adult↗
PubMed1997

[Cause of hematuria in children with special consideration of urolithiasis. Personal observations].

Microscopic hematuria was diagnosed in case of 102 children out of 2505 hospitalised in Provincial Special Hospital at Children's Ward, which is of all treated children. The most numerous age group were school children. The most common reason of microscopic hematuria was infection of urinary system which was found in case of 34 children (33%). Isolated microscopic hematuria was infection of urinary system which was found in case of 34 children (33%). Isolated microscopic hematuria was diagnosed in 39 cases (38%) and in 23 cases out of these, which is more than a half (59%), the threat of urolithiasis was recognised. The percentage of cases with the threat of urolithiasis with reference to the number of all children with microscopic hematuria was 23. This would suggest the necessity of examining patients in the direction of hypercrystalluria with microscopic hematuria, especially the isolated one. Increased excretion of uric acid was discovered in 52% cases, which is much more common than the increased excretion of calcium, stated in 35% cases of urolithiasis threat. In case of 13% of those children increased excretion of both above mentioned elements was discovered. In case of 16 children (15%) out of 102 children with microscopic hematuria, no final diagnosis was made and microscopic hematuria was supposed to be idiopathic.

Adolescent↗
PubMedDate not supplied

[Early diagnosis of urolithiasis, assessment of its activity and composition of lithogenic urine salts (Litos system)].

Until recently, the diagnosis of urolithiasis has been made by its complication--an apparent calculus in the kidney. We have discovered the phenomenon of pathological crystallization of urinary lithogenetic salts. Now, basing on this phenomenon we are able to make a diagnosis of urolithiasis at its preclinical stage, i.e. before the appearance of renal calculus, to control the course of urolith formation and to find out composition of the stone. We propose a complex of original techniques (Litos system) which provides pathogenetic diagnosis of urolithiasis.

Apatites↗
PubMed1998

Urolithiasis in dogs. I: Mineral prevalence and interrelations of mineral composition, age, and sex.

OBJECTIVE: To compile and statistically analyze selected data from a large number of canine urinary calculi. SAMPLE POPULATION: 11,000 specimens: 5,781 from female dogs, 5,215 from male dogs, and 4 from dogs of unrecorded sex. PROCEDURE: Records were used to compile information from all canine calculi analyzed between July 1981 and January 1994. Interrelations of mineral composition, location of specimens within the urinary tract, age and sex of affected dogs, and number of previous episodes of urolithiasis were determined. RESULTS: Approximately 70% of the specimens were from a first episode of urolithiasis. Calculi were located in the urinary bladder of 93.1% of females and 79.0% of males, and in the upper urinary tract of 4% of females and 2% of males. Calculi were found in multiple sites in 23.1% of males and 5.2% of females. Significantly higher proportions of struvite, apatite, and urate were found in uroliths from females; oxalate, cystine, silica, and brushite were significantly more prevalent in males. Sixty-one percent of specimens from males and 29% from females were composed of a single mineral substance. The most common mineral combination of 2 or more minerals included struvite and apatite. An additional 67 specimens from male dogs and 49 from female dogs contained other mineral combinations. In 48% of specimens from males and nearly 62% of specimens from females, the minerals formed several distinct layers of differing composition. CONCLUSIONS: Male and female dogs from urinary calculi composed of 1 or more of several distinct minerals. Prevalence of canine uroliths differs between ages and between the sexes. Many specimens contain complex layering of minerals; most specimens were found in the urinary bladder. CLINICAL RELEVANCE: Sex and age of dogs, mineral types of likely calculi in males versus females, and their anatomic location are important considerations for clinicians when evaluating risk in dogs with urolithiasis.

Age Distribution↗
PubMed2006

Acute renal failure due to bilateral xanthine urolithiasis in a boy with Lesch-Nyhan syndrome.

Lesch-Nyhan syndrome is a very rare X-linked recessive disorder caused by mutation in the gene encoding enzyme hypoxanthine-guanine phosphoribosyltransferase (HPRT). A complete deficiency of HPRT leads to severe purine overproduction and to uric acid renal lithiasis as a consequence. This may be effectively prevented by administration of allopurinol; however, its overdosage may result in xanthinuria and xanthine urolithiasis. We report on a 9-year-old boy with Lesch-Nyhan syndrome who developed acute renal failure due to bilateral staghorn xanthine urolithiasis resulting from long-term treatment with excessive doses of allopurinol. To the best of our knowledge, the presented case is the first one in the literature.

Acute Kidney Injury↗