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At least 955 records · Page 53Linked to original sources
PubMed1977

Treated and untreated recurrent calcium nephrolithiasis in patients with idiopathic hypercalciuria, hyperuricosuria, or no metabolic disorder.

Two hundred two recurrent calcium oxalate stone-forming patients with idiopathic hypercalciuria or hyperuricosuria, or both, were treated for an average of 2.91 years (1 to 7 years) with thiazide or allopurinol, or both. The frequency of new stone formation was drastically reduced. During the treatment period of 625 patient years, 220.0 new stones should have occurred, whereas 22 were actually formed (chi-square=178, P less than 0.001). Thirty-four patients without discernible metabolic disturbances and treated only with increased fluid intake and dietary advice formed 29 new stones compared to a predicted 33.2 stones (87.3%). Thirty similar patients treated with thiazide and allopurinol formed six stones compared to a predicted 31.8, P less than 0.001. Chronic reversal of idiopathic hypercalciuria and hyperuricosuria with thiazide and allopurinol is an effective way to prevent recurrent calcium oxalate stones. Conservative measures are only of marginal effectiveness in treating metabolically normal stone forming patients; however, thiazide and allopurinol appear to decrease new stone formation.

Allopurinol↗
PubMed1999

[Aqueous diuresis and prophylaxis of recurrent nephrolithiasis].

Crystal precipitation in urine results from factors such as ionic strength, pH, soluble complexes formation, formation site and retention of initial solid particle. Among the most frequent causes are poor diuresis and changes in urine pH, their influence being quantified in different ways. Effects of water diuresis such as prophylaxis for urinary calculi are due to the intrinsic properties of the water contained in the urine, solid particles dragging, action on urine infection and changes in urine pH. Urinary flow has an influence on pH, so that its decrease coincides with concentrate urine and low pH, whereas its increase involves the presence of dilute urine and high pH. The purpose of this study is to understand the relationship between increased urine volume due to greater water intake and changes in urine pH, as well as the physiological intervening mechanisms.

Diuresis↗
PubMed2000

[Etiology of nephrolithiasis in children: own observation].

Recurrent formation of renal calculi may be prevented by selective medical therapy designed to correct underlying metabolic disturbances in urine biochemistry. The aim of the study was to estimate potential risk factors of urolithiasis in 102 children before ESWL treatment. Metabolic disturbances followed by anatomical malformations of urinary tract, recurrent urinary tract infections caused by urease-induced microorganisms are the most frequent risk factors. In single cases possible risk factors were: immobilization and chronic corticosteroid therapy.

Child↗
PubMedDate not supplied

Epidemiology of nephrolithiasis.

The overall probability of forming stones differs in various parts of the world: 1-5% in Asia, 5-9% in Europe, 13% in North America, 20% in Saudi Arabia. The composition of stones and their location in the urinary tract, bladder or kidneys may also significantly differ in different countries. Moreover, in the same region, the clinical and metabolic patterns of stone disease can change over time. We examined some epidemiological evidence about the main risk factors for stone formation, both individual and environmental. A slightly higher rate of renal stone disease emerged in males than in females, and in white Caucasians than in Blacks. Stones in the upper urinary tract appear to be related to the life-style, being more frequent among affluent people, living in developed countries, with high animal protein consumption. Bladder stones are nowadays mainly seen in the Third World, on account of very poor socio-economic conditions. A high frequency of stone formation among hypertensive patients has been reported, and among those with high body mass as well. There is no evidence of any rise in the risk of stone formation in relation to dietary calcium intake or tap water hardness.

Age Distribution↗
PubMed2000

Nephrolithiasis: a consequence of renal epithelial cell exposure to oxalate and calcium oxalate crystals.

PURPOSE: Formation of calcium oxalate (CaOx) kidney stones was investigated using three approaches. MATERIALS AND METHODS: Pathogenesis of crystalluria and crystal deposition in the kidneys was examined in vivo by inducing hyperoxaluria in rats. Cultures of LLC-PK1 and MDCK cells were exposed to oxalate (Ox) and CaOx crystals to examine the effect on cells in various sections of the renal tubules. The nucleation potential of various substrates was examined by incubating them in metastable solutions of CaOx. RESULTS: Calcium oxalate crystals and nonphysiologic levels of Ox were injurious to renal epithelial cells. To combat these nephrotoxins, renal epithelial cells produce a variety of macromolecules such as bikunin and osteopontin, which are modulators of crystallization and may also be involved in crystal attachment to the cells. Sustained hyperoxaluria in association with CaOx crystals induced apoptosis as well as necrosis. Cellular degradation products induced heterogeneous nucleation of crystals at lower and physiologic levels of oxalate. They also promoted aggregation. CONCLUSIONS: Crystals begin to form in earlier segments of the nephron with a chance to grow and be retained in the collecting ducts after aggregation with other large crystals. Crystal deposits in the collecting ducts near the papillary surface, when exposed to the renal pelvic urine, become nidi for the development of kidney stones.

Animals↗
PubMed2000

[Psoas abscess caused by nephrolithiasis with perirenal abscess complicated with pleural effusion].

Left pleural effusion was found in a 60-year-old woman in whom chest radiography performed during a physical check up revealed no abnormality. Abdominal CT scanning revealed an abscess in the left psoas muscle. The psoas abscess was eliminated temporarily by drainage under ultrasonographic guidance and by the administration of antibiotics, but recurred one month later. A stag-horn renal stone considered to have caused the psoas abscess by formation of a perirenal abscess was eliminated by left nephrectomy. It is suggested tentatively that the psoas abscess might have been the cause of the pleural effusion.

Abscess↗
PubMedDate not supplied

[Laboratory methods of predicting primary and recurrent nephrolithiasis].

Concentrations of Na, K, Ca ions, oxalic and uric acids, total Ca, P as well as urease activity, the ability to form crystals, speed of crystallization, crystal chemical composition, pH stability were evaluated in the urine from 40 urolithiasis patients and 40 patients with recurrent nephroliths. It was found that fast or moderate crystallization, high urease activity and ability to form crystals, unstable urine pH indicate a high risk of both primary and recurrent nephrolith formation.

Calcium↗