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PubMed1975

[The significance of uric acid in calcium oxalate nephrolithiasis].

The findings of serum diagnosis (urea nitrogen, creatinine, uric acid, calcium, phosphorus) in 247 patients with oxalate stone were divided according to sex, and the excretion of uric acid, calcium and phosphorus was estimated. Compared with the control group, the levels of serum uric acid and serum calcium were statistically significantly raised, the mean level not exceeding the normal range. The serum uric acid level was 25% above the normal range in men and 20% above in women, and in the upper range of normal in one third of each, men and women. The excretion of uric acid in women exceeds the normal level in 32% of cases and in 40% of the men, sometimes considerably. The connection between pathological uric acid levels in the serum and urine and the development of oxalate stone, as well as the therapeutic consequences are discussed.

Adult↗
PubMed1993

Renal handling of calcium in hypercalciuric calcium oxalate nephrolithiasis.

In order to gain further insight into the mechanisms of calcium (Ca) homeostasis in hypercalciuria, we studied 32 lithiasic patients who were divided into three groups: normocalciuric patients (NC; n = 11), patients with absorptive hypercalciuria (AH; n = 12) and patients with renal hypercalciuria (RH; n = 9). The patients were investigated on 3 occasions: during a random diet, after a Ca-restricted diet and during a Ca tolerance test. The following determinations were made: Ca intake, Ca tubular reabsorption (Ca TR), plasma 1,25-dihydroxyvitamin D [1,25(OH)2D] and parathyroid hormone (PTH) levels, natriuresis and urinary protein-bound Gla. The latter was measured as a marker of urinary nephrocalcin excretion. Ca TR was decreased in hypercalciuric patients (HC). AH but not RH patients normalized their Ca TR during fasting. Plasma PTH and 1,25(OH)2D levels were similar in all the groups on the 3 occasions. Natriuresis was elevated in RH during the fasting period (p < 0.02 vs. AH). Compared with NC, protein-bound Gla urinary excretion rates (UER) were enhanced in AH after the Ca-restricted period (p < 0.02) and in RH during fasting (p < 0.02). In AH, a strong positive correlation was found between Ca TR and protein-bound Gla UER (r = 0.79, p = 0.002) following a Ca-restricted diet. In the HC group as a whole, fasting protein-bound Gla UER were correlated to plasma 1,25(OH)2D levels (r = 0.68, p < 0.001). In conclusion, the results suggest that PTH directly or indirectly through 1,25(OH)2D increases nephrocalcin synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1994

First morning urine pH in the diagnosis of renal tubular acidosis with nephrolithiasis.

Few reports of patients with renal stones compare fasting first morning urine pH with the lowest urine pH after a single oral dose of 0.1 g/kg ammonium chloride. We studied these values in 110 individuals, including 96 stone formers and 14 non-stone forming controls. We hypothesized that fasting first morning urine pH > or = 6.10 is abnormal. Nine of ten patients who had urine pH > or = 5.25 after NH4Cl, had pH > or = 6.10 for both a single and a second first morning urine, giving a sensitivity of 90%. In contrast, a single fasting first morning urine pH > or = 6.10 was found in 19 of 100 individuals with pH < 5.25 after ammonium chloride. However, only 4 of these 100 individuals had abnormal fasting first morning pH > or = 6.10 on two occasions, giving a specificity of 96% for the two urines. Useful prediction of urine pH > or = 5.25 after ammonium chloride occurs when two fasting first morning urines have pH > or = 6.10.

Acidosis, Renal Tubular↗
PubMedDate not supplied

[Intraoperative echography as a therapeutic aid in the treatment of nephrolithiasis].

Intraoperative ultrasonography was performed in 24 patients with intrarenal pelvis or with recurrent or multiple stones. The stones were located by a 22 or 25 gauge needle, manually introduced under ultrasonography: they were then extracted through a small incision performed along the tract of the exploratory needle. This preliminary experience has shown that the real time B-mode intraoperative ultrasound can provide valuable results in urologic surgery.

Female↗
PubMed1993

Evidence of a link between erythrocyte band 3 phosphorylation and anion transport in patients with 'idiopathic' calcium oxalate nephrolithiasis.

This study was carried out to verify the hypothesis of a link between faster endogenous phosphorylation of band 3 protein, the anion carrier, and anomalous oxalate transmembrane self-exchange found in erythrocyte from calcium oxalate renal stone formers. Agents able to modify 32P-labelling of band 3 protein induced a concurrent modification in oxalate transmembrane flux. Cyclic AMP- and phospholipid-sensitive Ca(2+)-independent protein kinases seem to be critical modulators of band 3 function. These observations demonstrate a close link between the band 3 phosphorylation state and its anion transport function, and provide new insights into the pathogenetic mechanisms of the cellular anomalies observed in calcium-oxalate renal stone disease.

Anion Exchange Protein 1, Erythrocyte↗
PubMed1993

Adenine phosphoribosyltransferase deficiency with renal deposition of 2,8-dihydroxyadenine leading to nephrolithiasis and chronic renal failure.

Homozygous adenine phosphoribosyltransferase deficiency is a genetic defect that is associated with 2,8-dihydroxyadenine urolithiasis. Since the prevalence of the heterozygous state is found in 0.4% to 1.2% of the population, it is surprising that more cases of 2,8-dihydroxyadenine urolithiasis have not been reported. Herein we describe a patient with complete adenine phosphoribosyltransferase deficiency with 2,8-dihydroxyadenine urolithiasis leading to chronic renal failure. Gene sequencing revealed that the patient is a compound heterozygote. One of the mutations (a T insertion between bases 346 and 347) has been encountered before, but the second (a G-to-A substitution at base 1356) has not been previously reported. Possible explanations for the unexpected rarity of 2,8-dihydroxyadenine urolithiasis are discussed.

Adenine↗