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Query: UMLS:C0020438 (hypercalciuria)
 2,502 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 91 staghorn calculi are reviewed. Possible aetiological factors are analysed. A high incidence of hypercalciuria was found, and the significance of this is discussed. The rates of complete stone clearance after conservative surgery are considered for different types of staghorn calculus and it is felt that local circulatory arrest with kidney cooling may be of value in removing stones due to Proteus. The place of elective nephrectomy in the management of staghorn calculi is discussed. Nephrectomy may be the treatment of choice in the management of large, unilateral stones in older patients.
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PMID:Staghorn calculi of the kidneys. A. Clinical review. 100 82

The authors studied the features of urolithiasis in three different geographical regions: Moscow, the Kirghiz SSR, and Berlin from the findings of examination of the composition and structure of uroliths removed by operation or passed spontaneously, (602 concrements from Moscow, 10,000 from Berlin, and 127 from Kirghizia). X-ray diffraction measurement, infrared spectrophotometry, and polarizing microscopy were conducted to analyze the composition and structure of the stones. Complex biochemical examination was carried out in patients from Moscow and Kirghizia. According to the results of the study, the following features of urolithiasis are common in the studied regions: (1) prevalence of oxalate lithiasis on the whole, which points to the principal role of metabolic factors in lithogenesis; (2) approximately similar amounts of apatite carbonate crystals in the uroliths; (3) certain similarity in composition of concrements from Berlin and Kirghizia. The most essential differences are: (1) the frequency of renal oxalate stones is highest in Berlin and lowest in Moscow. The prevalent types of calcium oxalate stones are: whewellite of concentric structure (linked with hyperuricemia) in Kirghizia; whewellite of small randomly orientated crystals (linked with hypercalciuria) and stones with signs of transformation of weddellite to whewellite in Moscow; (2) lesser distribution of phosphate lithiasis in Berlin than in Kirghizia and particularly in Moscow. Prevalence of struvite crystals in stones from Moscow, the formation of which is linked with the vital activity of Proteus and E. coli; (3) higher distribution of urate lithiasis in Moscow and particularly in Kirghizia where significant metabolic risk factors of lithogenesis were revealed.
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PMID:[The characteristics of the chemical composition and structure of urinary stones and their prevalence in the cities of Moscow, Berlin and of the Kirghiz SSR]. 214 36

The authors report 17 personal cases of lithiasis of the upper urinary tract discovered in the course of pregnancy. They discuss the diagnostic and therapeutic problems, taking into account the double risk of mother and foetus. The essential diagnostic sign is renal colic, with or without fever. Spontaneous excretion of these calculi is possible, but in 8 of the 17 cases, a ureteric catheter had to be passed or an operation was required. Neither the delivery nor the health of the infants delivered seemed to be harmed by this renal calculi disease. The authors recall that the most common cause of non-obstetrical abdominal pain in the course of pregnancy is in fact urinary calculi. The incidence is about 1 cases of lithiasis per 1,000 pregnancies. It appear that a physiological hyperparathyroidism of pregnancy is responsible for a hypercalciuria which could be a factor favouring the development of lithiasis during pregnancy. The important point is to know how to distinguish those forms of pyelonephritis of pregnancy which are due to a stone obstructing the upper urinary tract, as any purulent retention in the upper tract can lead to a pyonephrosis, a bacteraemia or even a septicaemia. The presence of the foetus makes interpretation of a plain abdominal film difficult. In any case, its indication is questionable, whenever the urine is septic, particularly with Proteus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lithiasis of the upper urinary tract and pregnancy]. 663 Oct 37

The analysed material includes 100 children with urolithiasis treated in the Pediatric Clinic of the National Research Institute of Mother and Child in Warsaw between 1976 and 1978. Patients' age was from 3 months to 18 years. The analysed group included 51 boys and 49 girls. Urinary tract infection was found in 54 cases, i.e. 57,4% of the analysed material. The most common bacterial strains were those producing urease. They were detected in 48 children i.e. 88,9% of cases with urinary tract infection. Mostly these were bacteria of Proteus group--sporadically Pseudomonas aeruginosa and Staphylococcus albus. In the analysed patients urinary tract obstruction was observed in 36 children, i.e. 36% of cases. In 77% of the analysed material, localization of concrements was in upper urinary tract in 19% in the ureters and in 4% in the lover urinary tract. While in adult patients the most common compound of urinary stones was calcium oxalate, in children the most common stone compounds were phosphates (found in 38 cases i.e. 58,4% of the analysed material). The second frequent compound was oxalate found in 20 cases (30,7%). Less frequent compounds were uric acid and cystine. Performed study allowed to establish the cause of urolithiasis in 93 out of 100 examined children. Metabolic reasons of urolithiasis were found in 26 cases, i.e. 26% of the analysed material. They were as follows: idiopathic hypercalciuria--12 cases, uric acid urolithiasis--8 cases, primary hyperoxaluria--3 cases, cystinuria--2 cases, and incomplete acidosis of distal renal tubuli--1 case. Urolithiasis of probably metabolic origin was detected in 13 children (13%). Other reasons of urolithiasis in children were: infection (31%), idiopathic urolithiasis (17%) and others (6%). In 7 cases the reason of urolithiasis was not established.
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PMID:[Metabolic etiology of urinary calculi in children]. 717 91

A study of 100 cases of nephrolithiasis between 3 to 15 years of age is reported. Seventy four cases were more than 10 years old. The common presenting symptoms included abdominal pain (69%), burning micturition (23%), gross hematuria (4%) and unexplained pyrexia (6%). Associated urinary tract malformations were found in 16 cases. Twenty four had struvite calculi. Urinary infection with Proteus mirabilis was found in 23 children and idiopathic hypercalciuria in 31 cases. Following surgical removal, either percutaneously or by open surgery, 8 patients had residual calculi and in 6 cases recurrence occurred.
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PMID:Nephrolithiasis in children. 807 21

The present series comprises 2086 consecutive patients who were studied in a stone clinic during a period of 15 years. Each patient was subjected to a comprehensive protocol including a fully biochemical investigation. Calcium stones were by far the commonest accounting for 61% of cases; infection, uric acid/calcium oxalate and cystine stones accounted respectively for 24%, 8%, 5% and 2%. Nephrolithiasis was more prevalent in males with the male to female ratio 1:0.76, on the other hand infection stones were more frequent in females with the male to female ratio 1:1.6. The peak age incidence of renal calcium stones occurred in the third to fifth decades, although about 3.4% reported onset of disease in the first and second decades of life. The onset of cystine stones was always in the first and second decades, while uric acid stones affected older patients. Renal stones were recurrent in about 50% of cases. In a retrospective analysis it was found the interval to first recurrence to be less than 5 years in about half patients. The cystine and uric acid groups had the highest rate of recurrence. In patients with calcium stones a definite metabolic or mechanical cause for their stones was found respectively in 8.2% and 10.1%. Particularly primary hyperparathyroidism was revealed in 2.8%. A metabolic defect could be found in 54% of the patients with idiopathic calcium stones. In these patients with idiopathic calcium stones the prevalence rate of hypercalciuria was 33%. In patients with uric acid stones and with mixed uric acid/calcium oxalate stones a definite metabolic cause for their stones was found respectively in 9.5% and 4.1% whereas an underlying disease of the urinary tract was diagnosed respectively in 8.5% and 6.2%. In patients with struvite stones the incidence of persistent infection was 46% (Proteus 18%). In this group the presence of an underlying disease of the urinary tract was diagnosed in 18.8% whereas a definite metabolic disease was demonstrated in 8.5%, a urinary risk factor for metabolic stone disease in 42% and a previous episode of metabolic stone disease in 33%.
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PMID:Clinical observations on 2086 patients with upper urinary tract stone. 893 17

Although urolithiasis is common in spinal cord injury patients, it is presumed that the predisposing factors for urinary stones in spinal cord injury patients are immobilization-induced hypercalciuria in the initial period after spinal injury and, in later stages, urine infection by urease-producing micro-organisms, e.g., Proteus sp., which cause struvite stones. We describe a patient who sustained C-7 complete tetraplegia in a road traffic accident in 1970, when he was 16 years old. Left ureterolithotomy was performed in 1971 followed by left nephrectomy in 1972. Probably due to adhesions, this patient developed volvulus of the intestine in 1974. As he had complete tetraplegia, he did not feel pain in the abdomen and there was a delay in the diagnosis of volvulus, which led to ischemia of a large segment of the small bowel. All but 1 ft of jejunum and 1 ft of ileum were resected leaving the large bowel intact. In 1998, suprapubic cystostomy was performed. In 2004, this patient developed calculus in the solitary right kidney. Complete stone clearance was achieved by extracorporeal shock wave lithotripsy. Stone analysis: calcium oxalate 60% and calcium phosphate 40%. Metabolic evaluation revealed hyperoxaluria, hypocitraturia, and hypomagnesiuria. Since this patient had hyperoxaluria, the stool was tested for Oxalobacter formigenes, a specific oxalate-degrading, anerobic bacterium inhabiting the gastrointestinal tracts of humans; absence of this bacterium appears to be a risk factor for development of hyperoxaluria and, subsequently, calcium oxalate kidney stone disease. DNA from the stool was extracted using the QIAamp DNA stool Mini Kit (Qiagen, Chatsworth, CA). The genomic DNA was amplified by polymerase chain reaction using specific primers for oxc gene (developed by Sidhu and associates). The stool sample tested negative for O. formigenes. The patient was prescribed potassium citrate mixture; he was advised to avoid oxalate-rich food, maintain recommended levels of calcium in his diet, and take live bio-yogurt. Two months later, 24-h urinary oxalate decreased from 0.618 to 0.411 mmol/day; 24-h urine citrate increased from 0.58 to 1.10 mmol/day. Six months later, an oxalate absorption test was performed. The patient swallowed a capsule, soluble in gastric juice, containing 50 mg (0.37 mmol) sodium [13C2]oxalate corresponding to 33.8 mg of [13C2]oxalic acid. The amount of labeled oxalate, excreted in urine, was measured by a gas chromatographic-mass spectrometric assay. Oxalate absorption, expressed as the percentage of the labeled dose recovered in the 24-h urine after dosing, was 8.3% (reference range: 2.3-17.5%). In addition to other conventional measures, oral administration of O. formigenes or lactic acid bacteria mixture to promote bacterial degradation of oxalate in the gut, and thus combat hyperoxaluria, may play a role in prevention of calcium oxalate kidney stones.
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PMID:Hyperoxaluria, hypocitraturia, hypomagnesiuria, and lack of intestinal colonization by Oxalobacter formigenes in a cervical spinal cord injury patient with suprapubic cystostomy, short bowel, and nephrolithiasis. 1761 9