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PubMed1980

The use of SEM in the study of oxalate induced experimental nephrolithiasis.

The formation of calcium oxalate crystals in rat kidneys was induced by intraperitoneal challenge with sodium oxalate. The structure of these crystals and the effect of their formation on the architecture of the tubular epithelium was studied by SEM. From the results we conclude that the crystals were formed intraluminally in the renal tubules. During the growth of the microliths they were closely adherent to the luminal surface of the tubular epithelial cells. Two types of the crystals were identified. Calcium oxalate monohydrate crystals consisted of plate-like crystallites and were more common. Dihydrate crystals on the other hand were tetragonal dipyramids and were less common. Elemental analysis of the crystal surface revealed them to be closely similar to the crystals present in calcium oxalate stones. The renal tubules were morphologically altered. Their epithelial cells underwent focal necrosis. There was a focal loss of the microvillous brush border of the proximal tubules. The epithelial cells formed large blebs which protruded into the tubular lumen. Sometimes the tubular lumen was completely occluded by the crystals. Crystals were often covered with cellular debris. It is suggested that the cellular debris derived from from necrotic cells become incorporated into the calculi. A similar process may be involved in the formation of mucoproteinaceus matrix of the human renal stones.

Animals↗
PubMed1980

Triamterene nephrolithiasis.

We identified triamterence in 181 renal calculi (o.4% of 50.000 calculi submitted for analysis). Triamterene formed the nucleus of the stone or was deposited with calcium oxalate or uric acid. One third of these stones were mainly or entirely triamterene, though a similar proportion had only minor amounts. A recommended dose of triamterene-hydrochlorothiazide sufficed to produce triamterene deposition in renal calculi. We estimate the annual incidence of the complication to be one per 1,500 users of triamterene-hydrochlorothiazide. Triamterene lithiasis develops particularly in persons who have had a renal stone, and they should not receive this drug.

Calcium Oxalate↗
PubMed1980

[Results of partial kidney resection in nephrolithiasis].

In order to establish the actual recidivation rate, the patients with partial resections of the kidneys of the years 1965 to 1978 were examined. Of 120 patients treated 106 could be examined for the second time, at a mean time of secondary examination of 6.5 years. 24.5% of the patients had a recidivation at the time of the examination. The annual recidivation rate was calculated depending on the examination. It increases with the duration of the time of the after-examination. The comparison with the recidivation number after pyelolithotomy (26.7%) does not show an evident effect of the partial resection of the kidney on the frequency of recidivations. In the judgment, however, the selection of these patients for this operation technique is to be taken into consideration. The use of the coagulum pyelolithotomy has led to a more stringent indication for the partial resection of the kidney.

Adolescent↗