Biomedical subjects

P Maikranz

Publications and source records attributed to P Maikranz.

6 recordsLinked to original sources

PubMed1994

Nephrolithiasis in pregnancy.

Although the anatomical and physiological changes of normal pregnancy may predispose to kidney stone formation, it remains an uncommon occurrence. Correct diagnosis is often difficult. Ultrasonography has become the primary radiological diagnostic tool, with a limited excretory urogram only necessary in complicated cases. Nephrolithiasis during pregnancy occurs more frequently during the later stages of gestation, in multiparas, and without a difference in laterality. Conservative management with bed rest, hydration and analgesia can result in spontaneous passage of most stones in gravidas. Past experience of several groups suggests that cystoscopy and/or surgery can usually be done safely when absolutely necessary. Pre-existing stone disease can increase the incidence of maternal urinary tract infections by 10-20%. The most common obstetric complications of stones during gestation is premature labour induced by renal colic. Most drugs normally used to treat stone disease are contraindicated in gestation. Known inhibitors of stone formation are present in gestation and may partially explain why the incidence of stones is not increased in this hypercalciuric state.

Adult↗

PubMed1991

Acute renal failure in pregnancy.

ARF is becoming an increasingly rare complication of pregnancy in industrialized countries because of a decrease in illicit abortions, improved prenatal care, and better management of maternal complications potentially leading to ARF. Early recognition of ARF with prompt therapy of reversible causes and rapid delivery in untreatable cases has led to more favorable outcomes for both gravida and fetus. Clinicians should be alert for entities unique to pregnancy, e.g., concealed uterine hemorrhage in late gestation. Dialysis therapy, if needed, should be started early and performed frequently, with careful attention to avoiding sudden shifts in extracellular volume and hypotension, or bleeding complications.

Acute Kidney Injury↗

PubMed1989

Gestational hypercalciuria causes pathological urine calcium oxalate supersaturations.

Although normal pregnant women are more hypercalciuric than women with calcium oxalate nephrolithiasis (243 +/- 23 mg/day vs. 194 +/- 5 mg/day), pregnancy is not an established stone-forming state and pregnant women do not exhibit pathological crystalluria. One hypothesis to explain their lack of overt stone formation and pathological crystalluria is that pregnancy does not raise urine supersaturation with respect to stone forming salts such as calcium oxalate or calcium monohydrogen phosphate (brushite) to levels as high as in stone forming women. To test this hypothesis, we studied eleven normal women during each trimester of pregnancy, and between six and eight weeks post-partum. During pregnancy, hypercalciuria occurs with unchanged urine volume, citrate and magnesium excretions do not increase proportionally with calcium excretion, and urine pH increases. Supersaturations with respect to calcium oxalate (CaOx) and brushite (Br) are as high as those of women with calcium nephrolithiasis. The lack of pathological crystalluria and stones during pregnancy is not due to a failure of supersaturations to increase; urinary potential for crystallization is as high as in patients with established stone disease.

Adult↗

PubMed1987

Hypertension in pregnancy.

This article reviews the hypertensive complications of pregnancy, focusing on the pathophysiology and management of pre-eclampsia. These are areas where data are sparse and authoritative disagreements loud. We advocate an intermediate approach where treatment regimens aim at a successful conclusion of the pregnancy, without residual pathology in the mother.

Antihypertensive Agents↗

PubMed1987

Nephrolithiasis in pregnancy.

Despite anatomic and physiologic changes that predispose to stone formation, nephrolithiasis in pregnancy remains an uncommon occurrence. Stones occur more frequently in multiparas, during the later stages of gestation, and without a difference in laterality. Correct diagnosis can be confusing. Ultrasound has become a primary diagnostic tool and limited excretory urograms are only recommended for complicated cases. Conservative management can result in spontaneous passage of most stones. When necessary, cystoscopy or surgery can be done safely. Preexisting stone disease is associated with an increased incidence of urinary tract infections in pregnancy. Renal colic often precipitates premature labor. Most drugs used to treat stone disease are contraindicated in gestation. Increased quantities of known inhibitors of stone formation are present in gestation and may explain why the incidence of stones is not increased in this hypercalciuric state.

Colic↗

PubMed1987

Nephrolithiasis and gestation.

Although both anatomical and physiological changes in pregnancy may predispose to kidney stone formation, it still remains an uncommon occurrence. Correct diagnosis is often difficult. Ultrasound has become the primary diagnostic tool, and a limited study excretory urogram is only necessary for complicated cases. Nephrolithiasis during pregnancy occurs more frequently during the later stages of gestation in multiparas, and without a difference in laterality. Conservative management with bed rest, hydration and analgesia can result in spontaneous passage of the majority of stones in gravidas. Past experience indicates that cystoscopy and/or surgery can usually be done safely when absolutely necessary. Pre-existing stone disease can increase the incidence of maternal urinary tract infections by 10-20%. The most common obstetric complication of stones during gestation is the precipitation of premature labour by renal colic. Unfortunately, most drugs used to treat stone disease are contraindicated in gestation. Experimental evidence suggests that known inhibitors of stone formation are present in gestation, and may help to explain why the incidence of stones is not increased in this particularly hypercalciuric state.

Female↗