SEARCH · PubMed Health

Results for “Nephrolithiasis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources

PubMed1999

Nephrolithiasis on indinavir.

(1) Nephrolithiasis is found in 4-13% of patients treated with indinavir, an HIV protease inhibitor. Most of these stones are composed of indinavir. (2) Outcome is often favourable, with simple passage of the stone, but endoscopic or surgical treatment is sometimes required. (3) Crystalluria seems to be more frequent, but is often asymptomatic. (4) Prevention is based on fluid intake of at least 1.5 litres a day. Indinavir withdrawal may be necessary.

HIV Protease Inhibitors↗

PubMed1999

Hyperoxaluria in idiopathic calcium nephrolithiasis--what are the limits?

OBJECTIVE: The object of this study was to investigate the role for measurement of 24-h renal oxalate excretion in the evaluation of idiopathic calcium stone formers. MATERIALS AND METHODS: Renal excretion rates of oxalate and creatinine were measured in 24-h urines in 46 consecutive male recurrent idiopathic calcium stone formers and 61 healthy males. Furthermore, day-to-day variation in renal oxalate excretion in 10 male recurrent stone formers and 10 healthy males were evaluated by measuring 24-h oxalate excretion on 5 different days in each individual. Concentrations of oxalate in urine were measured using an enzymatic method without ascorbate interference. RESULTS: The cumulative frequency distribution curves of 24-h renal oxalate excretion rates of stone formers and controls were congruent, and there were no statistically significant differences in oxalate excretion rates between stone formers and controls. Mean 24-h oxalate excretion (95%-confidence intervals) was 0.22 (0.18-0.25) mmol and 0.21 (0.18-0.24) mmol in stone formers and controls, respectively (p = 0.9). The day-to-day variation study did not reveal any differences in renal oxalate excretion pattern between stone formers and controls, and the presence of intermittent hyperoxaluria could not be confirmed. The oxalate excretion rates were generally low. CONCLUSION: In our region, there appear to be no differences in 24-h renal excretion rates of oxalate between male recurrent idiopathic calcium stone formers and healthy males, and the syndrome of mild hyperoxaluric calcium nephrolithiasis could not be identified in our population of idiopathic stone formers. Hence, a limit of abnormal oxalate excretion that distinguishes an idiopathic stone former from a non-stone former could not be defined in our population. Therefore, the value of routine measurement of urinary oxalate in idiopathic urolithiasis is difficult to accept, and cannot be recommended.

Case-Control Studies↗

PubMed2000

[The prospects of improving efficacy in the treatment of nephrolithiasis].

In 83.7% of patients with nephrolithiasis the morpho-functional disorders of urinary ways were disclosed. The complex of pathogenetically substantiated treatment of such patients was proposed. Together with performing of sparing removing of calculi the operative correction of hemo- and urodynamics with disorders local homeostasis restoration is performed using application of specific inhibitors of urolithogenesis, basing on hyperbaric oxygenation.

Humans↗

PubMed2000

[Nephrolithiasis: a new approach to the old disease].

The epidemiology and metabolic causes of the nephrolithiasis may be different. The author discusses, in a very selective way, major advances in the understanding of this disease.

Humans↗

PubMed2000

[Importance of dietary sodium in the hypercalciuria syndrome and nephrolithiasis].

The studies involved 20 children with idiopathic hypercalciuria (IH). An influence of urinary sodium excretion, and reflection of its intake, on urinary calcium excretion has been assessed. Children who were normocalciuric had significancy lower values of urine sodium excretion when compared with those with persisting hypercalciuria. The main factor responsible for hypercalciuria in children seemed to be urine sodium excretion. As urine sodium excretion reflects its intake, reduction dietary salt, rather than calcium intake, may be useful in the management of children with hypercalciuria and nephrolithiasis.

Calcium↗

PubMed2000

[Changes of kidney parenchyma in children with nephrolithiasis after ESWL treatment in ultrasonography, power Doppler and thermovision monitoring].

The authors discuss the results ultrasonographic (USG), power Doppler (PD) and thermovision (TV) examination in monitoring changes of kidney parenchyma in 30 children with nephrolithiasis after ESWL treatment. To monitor possible effect of shock wave on the kidney parenchyma the USG, PD and TV examination were done before ESWL treatment as well as, 48 hours and 3 months following the treatment. Parts of kidney parenchyma localized on the way of shock wave to the stone were analysed. Echogenicity of kidney parenchyma was analysed by comparison of echo amplitude in subsequent USG examinations. Parenchymal blood flow by computer analyse was estimated. In TV examination the temperature distribution in the place of skin kidney projection was estimated. Changes in echogenicity of kidney parenchyma and impaired kidney parenchymal blood flow 48 hours after ESWL were found. In TV examination 48 hours after ESWL transient reduction in skin temperature was observed in the place of shock wave transmission. In 3 months after ESWL disturbances in the kidney parenchyma in USG, PD and TV were not observed.

Adolescent↗

PubMedDate not supplied

[Nephrolithiasis].

The development of efficacious techniques for stone elimination, and in particular of extracorporeal lithotripsy, slackened, in the last two decades, the pharmacological research on nephrolithiasis, with the result that the currently available efficacious drugs are very few. Instead, the recent elucidation of some relevant etiopathogenetic aspects, with special reference to the quantitative and qualitative changes of specific urinary inhibitors of crystallization, could open new therapeutic avenues for many lithiasic forms, now considered idiopathic.

Calcium↗

PubMed2001

A case report of primary hyperparathyroidism with severe bony involvement and nephrolithiasis.

INTRODUCTION: Although the majority of patients with primary hyperparathyroidism have a relatively asymptomatic benign disorder, there are patients who have a more aggressive disorder. CLINICAL PICTURE: We report a case of primary hyperparathyroidism presenting during pregnancy complicated by antepartum haemorrhage and severe prematurity. The diagnosis was made postpartum, when her problems rapidly progressed to result in severe neuromuscular weakness, bilateral pathological hip fractures as well as nephrolithiasis. TREATMENT: Surgical parathyroidectomy was performed. The underlying lesion was a large solitary parathyroid adenoma with cystic elements. CONCLUSION: Primary hyperparathyroidism is not an innocuous disease and can result in severe morbidity if left untreated.

Adenoma↗

PubMed2000

[Oxidation-reduction processes in patients with recurring nephrolithiasis complicated with chronic pyelonephritis and urostasis during combined treatment].

Results of study into the condition of reduction-oxidation processes, in particular of those associated with generation of the superoxide radical, are submitted together with those of determination of levels of inorganic phosphate which is known to be an important indicator of the tissue bioenergy potential, in 112 patients presenting with a recurring form of nephrolithiasis exposed to a multiple-modality treatment that included conventional antiinflammatory and antibacterial therapy plus "open" and endourological operations on kidneys and ureters. The multiple-modality treatment of the main group patients was supplemented with phlogenzyme, a drug of II generation systemic enzymotherapy. An enhanced generation of superoxide radical was recordable having developed in the wake of a steady increase in the activity of xanthinoxidase. The authors have come to the conclusion that the conducted therapeutic intervention, especially as part of systemic enzyme therapy, results in decline of activity of the xanthine oxidation processes and brings about a change in the blood:urine inorganic phosphate concentrations ratio.

Chronic Disease↗

PubMed1991

Seasonal variations in urinary risk factors among patients with nephrolithiasis.

Twenty-four hour urine specimens from 5,677 stone-forming patients throughout the United States were analyzed for seasonal variations in urinary risk factors for nephrolithiasis. Determinations were performed for urine volume, pH, calcium, oxalate, phosphorus, sodium, magnesium, citrate, sulfate, uric acid, and the relative supersaturation (RS) of calcium oxalate, brushite, monosodium urate, and uric acid. Criteria for significant seasonal variation included a significant difference in monthly means of risk factors, seasonal grouping of the data by the Student-Newman-Keuls multiple range test, consistent year-to-year trends and a physiologically significant range. Minimum urine volume of 1.54 +/- 0.70 SD L/day occurred in October while a maximum urine volume of 1.76 +/- 0.78 SD L/day was observed during February. Minimum urine pH of 5.94 +/- 0.64 SD was observed during July and August while a maximum pH of 6.18 +/- 0.61 SD was observed during February. Daily urinary excretion of sodium was lowest during August, 158 +/- 74 SD mEq/day and highest during February 177 +/- 70 SD mEq/day. The RS of brushite and uric acid were found to display significant pH-dependent seasonal variation with a maximum RS of uric acid 2.26 +/- 1.98 SD in June and a low of 1.48 +/- 1.30 SD in February. Maximum RS of brushite 2.75 +/- 2.58 was observed during February. Minimum RS of brushite 1.93 +/- 1.70 SD was observed in June. Phosphorus excretion displayed seasonal variation about a spring-fall axis with a maximum value 1042 +/- 373 SD mg/day in April and a minimum value of 895 +/- 289 SD mg/day. Urine volume, sodium, and pH were significantly lower during the summer (June, July, August) than in the winter (December, January, February). The RS of uric acid was higher, but that of brushite and monosodium urate was lower in the summer than in the winter. The seasonal changes observed in urine volume, pH, sodium, and the RS of brushite and uric acid are consistent with summertime sweating and increased physical activity. Seasonal variations in phosphorus excretion are probably dietary in origin. The summertime was characterized by an increased propensity for the crystallization of uric acid but not of calcium oxalate or calcium phosphate.

Calcium↗

PubMed2001

[Nephrolithiasis in a HIV infected patient treated with indinavir].

Protease inhibitors together with reverse transcriptase inhibitors are used in antiretroviral treatment. Indinavir, precipitating in renal tubules, quite often can cause nephrolithiasis. The case of a HIV infected patient with renal colic probably caused by indinavir, diagnostic and therapeutic options in such cases are described in the paper.

Adult↗

PubMedDate not supplied

[Immunologic assessment of the risk of developing infectious-inflammatory complications after percutaneous operations for nephrolithiasis].

A retrospective comparison of the evidence obtained at preoperative examination of 68 patients with urolithiasis operated with the use of percutaneous technologies has demonstrated that the risk of postoperative infectious-inflammatory complications depends much on the immune status of the patient. Patients with initially different states of phagocytic immunity and antibody production had different courses of the postoperative period. An algorithm of immunological prediction of an acute pyelonephritis attack after percutaneous operations for nephrolithiasis is proposed.

Adolescent↗

PubMed2002

Changes in the oxidant-antioxidant balance in the kidney of rats with nephrolithiasis induced by ethylene glycol.

PURPOSE: We investigated the possible mechanism of increased free radicals, the role of antioxidant enzymes and their correlation with renal tubular damage in the kidney after feeding 0.75% ethylene glycol to male Wistar rats. MATERIALS AND METHODS: Rats were divided into 7 experimental groups according to the duration of ethylene glycol feeding (1, 3, 5, 7, 9, 21 or 42 days) and into age matched control groups. Chemiluminescence levels were examined in blood samples (renal artery and vein) and in the kidney. The activities of oxidase and antioxidant enzymes were measured in kidney homogenates. The nitroblue tetrazolium perfusion method and immunohistochemical stains with ED1 and CD45 were performed. Urinary levels of alpha and mu-glutathione S-transferase (GST) were also measured and expressed in gm. urinary creatinine. RESULTS: Chemiluminescence levels of renal venous blood samples were elevated on days 1, 3 and 7 (p <0.05), and those of the kidney were elevated only on days 3 and 42 (p <0.05) compared with controls. The infiltration of CD45 positive cells in the kidney increased on day 7 and a further increase in these positive cells was noted on day 21. Fused ED1 positive cells surrounding the calcium oxalate crystals and adjacent to the nitroblue tetrazolium positive area were found on day 42. Xanthine oxidase activity showed no significant change, whereas nicotinamide adenine dinucleotide dependent oxidase activity was higher on day 5 and nicotinamide adenine dinucleotide phosphate dependent activity was elevated in all experimental groups (p <0.05). The activities of catalase and manganese superoxide dismutase were elevated in the early stage. On day 42 almost all antioxidant enzyme activities were attenuated (p <0.05) except that of catalase. The urinary levels of alpha-GST were elevated from day 7 until day 42, whereas levels of mu-GST were elevated from day 3 until day 42 except day 5. CONCLUSIONS: The possible mechanism that causes free radical elevation in the kidney may be different in the course of nephrolithiasis after ethylene glycol treatment. Initially the systemic circulation may bring the toxic substance into the kidney and cause it to produce free radicals. In the late stage gradually infiltrating leukocytes and decreased antioxidant enzyme activities may cause the kidney to remain under excessive oxidative stress.

Animals↗

PubMed2002

Inbreeding and nephrolithiasis in Croatian island isolates.

The aim of this study was to investigate a recessive genetic component in susceptibility to nephrolithiasis (NL) by comparing its prevalence in highly inbred, moderately inbred and non-inbred villages of three Croatian islands: Brac, Hvar and Korcula. The average inbreeding coefficient of each village population (F) was estimated in a random sample of 20-30% adults from 14 villages using Wright's path method (based on genealogical information), isonymy data and average deviation from Hardy-Weinberg expectations for MN, Ss and Kk serogenetic polymorphisms. The six villages with the greatest genealogical F value (0.025-0.049; current total population N=1,401), the four with intermediate value (0.012-0.015; N=998) and the four with the smallest value (0.002-0.008; N=1,500) were chosen for this study. Medical records of entire populations were reviewed and the diagnosis of NL was established according to unified criteria, based on the information from the specialists in general hospitals and on the agreement in diagnosis between the investigators and local general practitioners. The variance in environmental and socio-cultural factors between villages was shown to be minimal. Prevalence of NL in each village was standardised by sex and age to the total population of all 14 villages. The standardized prevalence of NL was 1.5% in the group of villages with low F, 2.3% in the group with moderate F (p<0.10), and 5.4% in the group with high F (p<0.001). The correlation factor between F values by villages and the standardized prevalence of NL was 0.45 (p<0.05). The study showed that a large number of predominantly recessive genetic factors might mediate the susceptibility to formation of renal stones in humans.

Consanguinity↗

PubMedDate not supplied

[Citrate therapy in treating urate nephrolithiasis].

Citrate therapy was tried in 483 patients with urate nephrolithiasis. A good response was obtained both in monotherapy or in combination of urates with invasive or remote treatment. The authors advocate the drug blemaren (ESPARMA, Germany) as most beneficial among citrate drugs.

Citrates↗

PubMedDate not supplied

[LithoRisk: A software for calculating and visualising nephrolithiasis risk profiles].

BACKGROUND: The pathogenesis of nephrolithiasis, based on the anomalies of the urinary environment, demands metabolic and physicochemical assessment for the medical management of patients. Standard metabolic protocols include the measurement of pertinent urine chemistry values and the calculation of the extent of saturation in stone-forming salts. However, patients are often given fragmentary and hard-to-consult reports and so this weakens the strength of the therapeutic recommendations. This paper introduces LithoRisk, a dedicated software which graphically represents risk profiles of stone formation, including the extent of saturation. METHODS: LithoRisk uses the results of 24-h urine chemistry values widely available in hospital laboratories, i.e., sodium, potassium, calcium, magnesium, ammonia, phosphate, sulphate, citrate, oxalate, chloride, pH and urine volume. Uric acid and cystine are optional. The relative supersaturation (beta), estimated according to our own ab initio calculation, is given in a scale whereby beta=1 is saturation, beta < 1 under - and beta > 1 oversaturation. LithoRisk is available as a CD-ROM and can be loaded on Windows 95/98/Millenium/XP. Colour or laser printers are suitable for printed records. RESULTS: LithoRisk is easily loaded on any PC by following video instructions. Once the loading of the program is completed a grey icon LithoRisk appears on the Desktop. The program can be opened by clicking twice on the icon. The patients data page first appears on the screen and is followed by the evaluation page for the input of variables. This generates the graph representing the diagnostic lithorisk profile, which is drawn as a line connecting different values, according to a specific scale and related to an arbitrary normal point. Normal values are shown as green lines, whereas abnormal ones are red. The beta values for calcium oxalate and phosphate, uric acid and cystine are instantaneously calculated and reported on the graph. CONCLUSIONS: LithoRisk produces a complete, unique and easy to understand report that includes all relevant parameters, it therefore expresses the overall risk of stone formation. It requires the results of chemistry tests done on the same 24-h urine collection, and carried out using suitable preservatives. If the tests for unusual parameters, i.e. sulphate and ammonia, are unavailable, one can use default values with minimal alterations on beta calculation. In spite of being arbitrary, the normal thresholds values are based on widely accepted literature data. The risk profile recognises the most relevant abnormalities and enables the establishment of individual targets aimed at reducing the propensity towards stone formation.

Humans↗

PubMed2003

[Etiopathogenesis and clinical aspects of nephrolithiasis--at present].

This paper deals of kidney stones, hard concretions that grow within the urinary tract, 71.5% of which have calcium contents. A high rate of recurrences underscores the importance of medical prevention with a variety of conservative (increased fluid intake and dietary modifications) and drug therapy (potassium citrate, potassium magnesium citrate, thiazides, allopurinol). In single stone formers and mild recurrent diseases, the conservative therapy may alone be effective and should be maintained in more severe recurrent disease, together with drug treatment. In particular, in idiopathic calcium oxalate nephrolithiasis, the importance of sodium restriction in the diet, that should reduce calcium excretion, has been recently shown, limiting the old assumption of the value of dietary calcium restriction; in fact normal or higher calcium intake, binding oxalate in the intestinal tract, seems to confer protection against stone formation. The urologic approach to urolithiasis has changed with the introduction of extracorporeal shock wave lithotripsy (ESWL), a technique that allows a relatively noninvasive removal of stones. Nevertheless ESWL does not change the propensity of recurrence of stone formers, and the importance of medical prevention remains paramount in the management of renal stone disease.

Humans↗

PubMed2003

Use of drotrecorgin alfa--recombinant activated human protein C in treatment of septic shock in the course of therapy for nephrolithiasis.

BACKGROUND: Septic shock is the most dangerous complication of nephrolithiasis management utilizing percutaneous methods. CASE REPORT: The patient, D.M., aged 60 was subjected to scheduled percutaneous nephrolithotomy due to coral calculosis of the pyelocalyceal system. As pyuria was noted intraoperatively, nephrostomy was left after the procedure. Over ten hours after the surgery the patient developed the symptoms of severe septic shock with progressive respiratory distress, renal failure, intravascular coagulation syndrome and impaired consciousness. Nephrectomy was performed, antibiotic treatment and high doses of norepinephrine instituted. Hemodynamic stabilization was obtained, without, however, marked improvement of the patient's condition. Because of persistent coagulation disorders and multiorgan dysfunction, recombinant activated protein C preparation--drotrecorgin alfa (Xigris Eli Lilly) was added to the therapeutic regimen. From the second day of infusion, systematic improvement of the coagulation system parameters was observed, making it possible to reduce the doses of catecholamines, oxygen concentration in the gas mixture used for ventilation, as well as stabilization of the function of the preserved kidney. The patient was weaned off the respirator on the 8th day of treatment and on the 13th day referred to the Urology Department, from which she was soon discharged home. CONCLUSIONS: 1. Surgical resection of the infection source and cause of the septic shock is the prerequisite for successful pharmacological treatment. 2. Administration of rh-APC to a patient meeting the PROWESS criteria may be an effective and safe method of treatment in the complex management of septic shock.

Disseminated Intravascular Coagulation↗