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Query: UMLS:C0020500 (hyperoxaluria)
 912 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-two cases of urinary tract calculus disease were investigated for dietary habits, routine chemical and microscopic urinalysis, bacterial culture, quantitative analysis of 24 h urine sample and qualitative analysis of the stones. 54 out of the 56 stones analysed were of mixed type. Magnesium ammonium phosphate was present in 78.2% stones. Dietary habits revealed principal dependence on cereals, lack of animal proteins, consumption of oxalate rich vegetables and widespread consumption of tea. Urinary tract infection was present in 63.7% of the cases. Significant calcium oxalate crystalluria (2+ to 4+) was present in 34.6% of the cases. Hyperoxaluria, hypercalciuria associated with hyperoxaluria-lower excretion of magnesium and citric acid were important urinary risk factors in the local population. These observations strongly suggest the multifactorial etiology of stone disease in this region. Imbalanced nutrition and urinary tract infection were the principal risk factors for urolithiasis in this study.
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PMID:The etiology of urolithiasis in Udaipur (western part of India). 372 15

This study is presented as a debate on nephrolithiasis by a urologist and an internist. The reason is that in 1986 the urologist has become successful at desintegrating almost any stone without open surgery, whereas the internist's approach to the same problem is entirely based upon an understanding of pathophysiological mechanisms. After having reviewed the major risk factors for renal stone disease, i.e. small urine volume, hypercalciuria, hyperoxaluria, hyperuricosuria, very high or very low urine pH and hypocitraturia, the author shows that now it is not only possible to selectively correct each of these disorders, but that in doing so the internist does change the natural history of the disease. For instance, definite remissions have been obtained by advising patients to increase water intake, by administering thiazides to hypercalciurics, pyridoxine to some hyperoxalurics, allopurinol to hyperuricosurics, urease inhibitors to struvite stone formers and citrate to hypocitraturics. Therefore, the author concludes that the role of the urologist and that of the internist are complementary: although the former now desintegrates the stone without open surgery, the latter, who takes care of the same patient next, is now largely able to prevent relapse of nephrolithiasis after determining the cause of the disease.
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PMID:[Renal lithiasis: the internist's viewpoint 1986]. 373 61

The high incidence of renal lithiasis in hyperparathyroidism (55 p. 100) suggests that PTH plays a causal role in stone production. It also motivates a systematic search for primary hyperparathyroidism in all patients with renal stones although it is only found in about 7 p. 100 of cases. PTH acts through the stimulation of 1.25(OH)2 vitamin D production and therefore, the absorption of calcium from the intestine, which in turn increases the filtrable calcium, hence the calciuria. In renal stones, in general, hypercalciuria represents one of the major metabolic disturbances, besides the hyperoxaluria, hyperuricosuria and the reduction of the inhibitors of crystallization. However, hypercalciuria is rarely the indirect result of excess PTH. It is usually caused by increased dietary ingestion of NaCl, meat, calcium and possibly carbohydrates.
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PMID:[Renal lithiasis in idiopathic hypercalciuria and primary hyperparathyroidism]. 376 88

Three cases of mild metabolic hyperoxaluria (with glycollaturia) are described. They showed different types of response to pyridoxine. One responded to low dose, one responded at first to low dose but became resistant, and the third showed temporary response to high dose. One case also had primary hyperparathyroidism and one had medullary sponge kidneys and hypercalciuria. It is important to measure urinary oxalate (and glycollate) in all cases of calcium oxalate urolithiasis.
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PMID:Mild metabolic hyperoxaluria and its response to pyridoxine. 381 Oct 39

We evaluated 113 patients with recurrent or multiple calcium urolithiasis at our outpatient stone clinic between 1980 and 1983. Diagnostic categories included hypercalciuria (36 patients), hyperoxaluria (35 patients), and hyperuricosuria (31 patients). Thiazides and/or allopurinol were administered to the hypercalciurics and hyperuricosurics, respectively for prevention of stone recurrence. Patients followed up for more than one year were 23 (male 16, female 7) in the thiazide group, and 15 (male 12, female 3) in the allopurinol group. The mean treatment interval was 2.49 years in the former, and 2.35 years in the latter. The remission rate (percentage of patients without formation of any new stones) was 82.6% in the thiazide group, and 73.3% in the allopurinol group. The group stone formation rate was reduced from 0.85 to 0.35/pt-yr in the thiazide group, and from 0.74 to 0.27/pt-yr in the allopurinol group. Efficacy of these two drugs for the prevention of calcium stone recurrence was observed in this selective therapy, but a careful double blind study should be carried out to draw a definite conclusion.
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PMID:[Experimental and clinical studies on calcium lithiasis. II. Prevention of recurrent calcium stones with thiazides and allopurinol]. 381 44

Urinary excretions of calcium, oxalate and uric acid were estimated in 160 stone-formers (male 118, female 42) and 257 healthy controls (male 207, female 50). Stone-formers were divided into two groups according to their stone analysis: calcium containing stone-formers and non-calcium stone-formers. Calcium stone-formers were divided again into those who had a single stone episode and multiple or recurrent stone episodes. Urinary calcium and oxalate showed significant increases in calcium stone-formers, while urinary uric acid increased only in male calcium stone-formers. Recurrent calcium stone-formers demonstrated significant high levels of urinary calcium excretion especially in males, whereas no difference of urinary oxalate excretion between recurrent and single stone-formers. The frequency distributions on the excretion of three subjects were estimated respectively in patients with calcium stone and in controls. Relative risks, risk curves and stone probabilities were proposed and compared. The higher excretion values of urinary calcium and oxalate closely related to higher risks of forming calcium stones. On the other hand, urinary uric acid did not have such a relation to calcium stone formation. We defined the states which urinary excretions exceeded 95% upper confidence limits of normal controls as hyperexcretions. Hypercalciuria was more than 200 mg/day in male and female, hyperoxaluria was 50 mg/day in male and 45 mg/day in female and hyperuricosuria was 850 mg/day in male and 650 mg/day in female according to our definition. Among male calcium stone-formers, hypercalciuria was found in 45.3%, hyperoxaluria in 26.4% and hyperuricosuria in 15.1%. While in female calcium stone-formers, hypercalciuria in 23.7%, hyperoxaluria in 26.3% and hyperuricosuria in 13.2%. Of the male calcium stone-formers 57.5% showed either or both hypercalciuria and hyperoxaluria, and recurrent stone-formers also demonstrated a higher incidence among them. Excretion products of urinary calcium and oxalate were calculated and compared in each group. Calcium stone-formers showed significant high values especially in male recurrent stone-formers. The estimation by combining some risk factors will provide more useful means of assessing severity of urinary calculous diseases and therapeutic effects of their various treatments.
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PMID:[Studies of urinary risk factors in urolithiasis]. 399 84

As calcium oxalate stones are the most important component in urolithiasis, an experimental model has to be designed to clarify the pathogenesis and aid in their prevention. Hyperoxaluria as well as hypercalciuria were produced in rats by administering ethylene glycol (0.5%, in drinking water administered ad libitum) and 1-alpha (OH) D3 (0.5 micrograms/rat given every other day), respectively, for three to four weeks. Neither drug alone produced stones efficiently as did the combination regimen of these two compounds. The occurrence of stones was 77.3%, and with only a moderate degree of renal functional impairment. Biochemical and histological data were obtained using this model.
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PMID:[Experimental and clinical studies on calcium urolithiasis: (I) Animal model for calcium oxalate urolithiasis using ethylene glycol and 1-alpha (OH) D3]. 403 34

The state of saturation of urine with calcium salts has been estimated by means of a computer model system whose accuracy has been improved by the use of stability constants of 31 complexes which were re-determined at 37 degrees C and at the actual ionic strength of urine. The experimental determination of the concentration solubility products of calcium oxalate monohydrate (CaOx) and of calcium hydrogen phosphate dihydrate (bsh) allows an expression of the saturation degree as free concentration product ratio beta CaOx and beta bsh. Morning urine samples from 50 healthy controls and 50 idiopathic calcium stone-formers and 24 h urines from 40 normal subjects and 192 stone-formers, taking normal diet were investigated by this technique. From our results urine supersaturation with calcium oxalate salts seems to play an important role in calcium stone disease. Hypercalciuria and hyperoxaluria seem to be the main pathological features in this regard. The data concerning beta bsh values have not confirmed previous reports in which this parameter was found to be increased in stone-formers.
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PMID:Urine saturation with calcium salts in normal subjects and idiopathic calcium stone-formers estimated by an improved computer model system. 404 6

Using the ambulatory protocol previously described, 241 patients with nephrolithiasis were evaluated. They could be categorized into 10 groups from the results obtained. Absorptive hypercalciuria type I (87 per cent male) comprised 24.5 per cent and was characterized by normocalcemia, normal fasting urinary calcium (less than 0.11 mg/100 ml glomerular filtration), an exaggerated urinary calcium following an oral calcium load (greater than 0.20 mg/mg creatinine), normal urinary cyclic adenosine monophosphate (AMP) (less than 5.4 nmol/100 ml glomerular filtration) and serum parathyroid hormone (PTH), and hypercalciuria (greater than 200 mg/day during a calcium- and sodium-restricted diet). Absorptive hypercalciuria type II (50 per cent male) accounted for 29.8 per cent; its biochemical features were the same as those for absorptive hypercalciuria type I, except for normocalciuria during a restricted diet and low urine volume (1.42 +/- 0.55 SD liter/day). Renal hypercalciuria (56 per cent male), disclosed in 8.3 per cent, was represented by normocalcemia and high values for fasting urinary calcium (0.160 +/- 0.054 mg/100 ml glomerular filtration), urinary cyclic AMP (6.80 +/- 2.10 nmol/100 ml glomerular filtration) and serum PTH. Primary hyperparathyroidism (57 per cent female), accounted for 5.8 per cent, typically included hypercalcemia, hypophosphatemia, hypercalciuria and high urinary cyclic AMP. Hyperuricosuric calcium urolithiasis (100 per cent male) comprised 8.7 per cent, and was characterized by hyperuricosuria (776 +/- 164 mg/day) and urinary pH exceeding pK for uric acid (5.91 +/- 0.33). In enteric hyperoxaluria (60 per cent female), encountered in 2.1 per cent of cases, urinary oxalate was increased (6.29 +/- 13.2 mg/day). Noncalcium-containing stones were found in 2.1 per cent of the patients with uric acid lithiasis (100 per cent male) and in another 2.1 per cent of the patients with infection lithiasis (60 per cent female). These conditions were typified by low urinary pH (5.29 +/- 0.12) and high urinary pH (6.69 +/- 1.16), respectively. Renal tubular acidosis was found in one patient (male, 0.4 per cent). In 10.8 per cent of the patients (81 per cent male), no metabolic abnormality could be found, although urine volume was low (1.41 +/- 0.51 liter/day). Hypercalciuria could not be differentiated between absorptive hypercalciuria and renal hypercalciuria in 5.4 per cent of the patients. Thus, this ambulatory protocol disclosed a physiologic disturbance in nearly 90 per cent of the cases and provided a definitive diagnosis in 95 per cent of the patients.
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PMID:Ambulatory evaluation of nephrolithiasis. Classification, clinical presentation and diagnostic criteria. 624 14

On the basis of routine clinical and laboratory investigations, one or more probable or possible causes of stone formation were established in 27% of upper urinary tract and 98% of bladder stone patients. In the upper urinary tract, causes were usually found for triple phosphate and pure calcium phosphate stones and rarely for pure calcium oxalate stones. Except for cystine stones and largely for triple phosphate stones there was no definite correlation between the composition of stone and causes. Uric acid and urate stones were often not associated with obvious causes, but their demonstration should lead to further investigations. In a small group of recurrent calcium stone formers examined for hypercalciuria, hyperoxaluria, hyperuricosuria, and renal tubular acidosis, positive findings were noted for 65%, but there was no consistent correlation between these findings and the types of stone. Stone analysis is most useful in so far as it identifies or excludes triple phosphate, cystine, and uric acid/urate stones. This may be done by simple chemical analysis. Certain rare components may, however, be overlooked, as will details of stone structure, unless crystallographic methods are employed.
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PMID:Correlation between causes and composition of urinary stones. 634 79


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