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

The mechanism of stone formation in the urinary tract is reviewed. Diet, urinary tract infection and metabolic disorders account for the different epidemiological patterns of stone formation. The diagnosis and management of renal tract calculi are discussed. Calcium stones are associated with hypercalciuria, urine acidification defects, the use of furosemide in premature babies, hypercalcaemia, hyperoxaluria, hyperuricosuria, an alkaline urine and hypocitraturia. Uric acid stones occur in acid urine, from increased purine synthesis with lympho- or myeloproliferative disorders or from several inborn errors of purine metabolism which can also cause xanthine or dihydroxyadenine stones. Cystinuria, inherited as an autosomal recessive disorder is best treated with a low sodium diet, a fluid intake exceeding 40 ml/kg per day maintaining urine pH between 7.5 and 8 and, if necessary, with oral penicillamine. Oxalate stones occur in relation to diet, bowel disease and primary inherited defects in oxalate metabolism. Urinary tract infection causing struvite and carbonate apatite formation is the commonest cause of stones in Europe.
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PMID:Urolithiasis in children: current medical management. 270 15

Thirty-three children with urinary calculi were studied. In 12, a metabolic cause of calculi was identified (4 hyperoxaluria, 6 hypercalciuria, 2 cystinuria). In 14 children, lithiasis was associated with a urinary tract infection. No identifiable cause could be found in 7 children. A protocol for metabolic evaluation is proposed.
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PMID:[Urinary calculi in children. Etiologic survey]. 276 80

A thorough metabolic evaluation of all staghorn stone patients seems justified, considering the results obtained by the study of 27 such cases. Pak's ambulatory screening test, slightly modified, was used. This allowed the finding of a hypercalciuria in more than 50% of the cases, a hyperuricosuria in 63% of the cases and a hyperoxaluria in one case out of five. A metabolic anomaly was not detected in two patients. Although urinary tract infection, present in 75% of the cases is essential to the genesis of a staghorn stone, the question raises whether metabolic anomalies are not the primary cause of the stone formation.
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PMID:[A study of the causes of staghorn calculi]. 281 90

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

Fifty-five Tunisian children with urinary stones, between the ages of 8 months and 15 years, underwent morphological and infrared spectrophotometric analysis of their stones. This study provides an approach to the aetiological profile of urinary stones in Tunisian children. The nucleus of the stones was composed of acidic ammonium urate in 48% of cases with a morphology suggestive of phosphorus deficiency associated with a history of diarrhoea. In 24% of cases, the nucleus contained struvite indicating the presence of urinary tract infection by urease-positive bacteria. The main growth factors of urinary stones were hyperoxaluria and urinary tract infection. In 5 cases, the stones were due to a hereditary lithogenic metabolic disease : cystinuria in 1 case and primary hyperoxaluria in 4 cases.
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PMID:[Etiologic factors of urinary lithiasis in Tunisian children]. 877 1

Considerable progress has been made regarding pathophysiology, diagnosis, and medical prevention of recurrent renal stone formation. The medical approach is not applied widely because of the availability of extracorporeal shockwave lithotripsy and the complexity of medical diagnostic and treatment modalities. In this review, a simplified program for the medical management of stones is described. From analysis of stone risk factors in 24-hour urine specimens, uncomplicated calcium stone disease is separated from other stone diseases. The uncomplicated calcium stone disease, comprising the illness in the majority of patients with recurrent renal calculi, is characterized by normocalcemia, normouricemia, calcium stones, and the absence of urinary tract infection, bowel disease, or marked hyperoxaluria. Uncomplicated calcium stone disease is separated into a hypercalciuric group and a normocalciuric group. In the simplified treatment program, the hypercalciuric group would be offered thiazide plus potassium citrate, whereas the normocalciuric group would receive potassium citrate alone.
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PMID:Southwestern Internal Medicine Conference: medical management of nephrolithiasis--a new, simplified approach for general practice. 909 51

The primary care physician has a responsibility not only to recognize and treat acute stone passage but to ensure that the patient with recurrent stones has metabolic evaluation and appropriate preventive care. Renal colic is typically severe, radiates to the groin, is associated with hematuria, and may cause ileus. About 90% of stones that cause renal colic pass spontaneously. The patient with acute renal colic should be treated with fluids and analgesics and should strain the urine to recover stone for analysis. Highgrade obstruction or failure of oral analgesics to relieve pain may require hospitalization; a urinary tract infection in the setting of an obstruction is a urologic emergency requiring immediate drainage, usually with a ureteral stent. Several approaches are available when stones do not pass spontaneously, including extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and ureteroscopic laser lithotripsy. Calcium stone disease has a lifetime prevalence of 10% in men and causes significant morbidity. Renal failure is unusual. Stone types include calcium oxalate, uric acid, struvite, and cystine. Stone analysis is particularly important when a noncalcareous constituent is identified. The majority of patients with nephrolithiasis will have recurrence, so prevention is a high priority. High fluid intake is a mainstay of prevention. Metabolic evaluation will indicate other appropriate preventive measures, which may include dietary salt and protein restriction, and use of thiazide diuretics, neutral phosphate, potassium citrate, allopurinol, and magnesium salts. Dietary calcium restriction may worsen oxaluria and negative calcium balance (osteoporosis).
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PMID:Nephrolithiasis: acute management and prevention. 965 69

Epidemiologic investigation did not show any special environmental combination causing urinary calculi creation. The disease concerns usually people between 25-50 year old. Most of the urinary calculi are compound of calcium oxalate and phosphate. In contaminated urine more often ammonia-magnesium phosphate. General constitutional factors having influence on urinary stones creation are specific gravidity, crystallization inhibiting factors concentration, hypercalcuria, urine acidity, hyperoxaluria and urinary tract infection. Unilateral, single urine stone is usually the effect of the local factors. Bilateral and multiple urinary stones are usually the effect of the local factors. Bilateral and multiple urinary stones usually are the effect of general constitutional and environmental factors. Complaints depend on the stone localisation, its dimensions and period of the disease. Nowadays most of the urinary calculi localised in the kidneys and ureters are treated with ESWL, PCNL and URS. Staghorn calculi are treated with the combination of PCNL and ESWL or operatively. Urinary stones localised in the bladder can be the consequence of descending ureteral stones, but usually they are created in the bladder as a consequence of the subvesical obstruction. The treatment is based on transurethral lithotripsy with simultaneous obstruction treatment by electrosurgery of the prostate or bladder neck or visual urethrotomy. Large and hard stones can be removed by cysto-lithotomy. Metafilaxis is the recurrences prevention, based first of all on diminution of crystalloid concentration and their solubility in the urine and providing crystallization inhibiting factors. Calculi composed of urine acid can be treated conservatively by their dilution.
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PMID:[Urolithiasis]. 1008 29

Various endo- and exogenous factors play a role in the urinary stones formation tract. The aim of the study was to define the type and frequency of hyperexcretion of lithogenic substances in school children population and to determine an influence of risk factors on hyperexcretion of crystallizing substances. The study included 220 school children. Preurolithiasis state (PS) was found in 30% children. The most frequently hyperoxaluria, hyperuricosuria and hypercalciuria were diagnosed and it may be connected with abnormal nutritional habits, excessive application of multivitamins, vitamin D and calcium, disturbances in drinking water chemical composition (higher amount of calcium, smaller amount of magnesium, abnormal pH). Urinary tract infections, particularly in children with obstructive uropathy are an important risk factor in the examined population. Positive familial history of urolithiasis in 43.3% children may indicate for the important role of the genetic factor in the pathogenesis of the disease.
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PMID:[The role of environmental factors in the formation of kidney calculi]. 1089 97

Urolithiasis often coexists with recurrent urinary tract infections (RUTI). The aim of the study was to determine the correlation of preurolithiasis state (PS) and recurrent urinary tract infections and to establish an effect of the treatment UTI recurrence incidence. PS was found in 202(21.1%) children, most frequently: hyperoxaluria--in 61/202 (30.2%), hypercalciuria--in 32/202 (15.8%), and hyperuricosuria--in 30/202 (14.9%) children. Complex metabolic abnormality was observed in 62/202 (30.7%) patients. Therapeutic management comprised of: antibacterial prophylaxis, high fluid intake, proper diet, correction of urine pH, and pharmacological treatment if necessary. Disappearance of RUTI and PS in 88/202 (43.6%) children, disappearance of RUTI in spite of persistent PS in 36/202 (17.8%), and decrease of RUTI in 54/202 (26.7%) patients were method. In 110/202 (54.5) children PS disappeared.
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PMID:[Results of the treatment of pre-urolithiasis state in children with recurrent urinary tract infections]. 1089 15


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