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Query: UMLS:C0392525 (nephrolithiasis)
 2,669 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The occupational risks for nephrolithiasis have not been widely studied. The published literature focuses on exposure to heat stress and toxic substances, not on the equally important behavioral risk factor of limited water consumption over many years. Urologic morbidity has been associated with suppressing the need to drink or void under restrictive work environments; however, no such studies link work related behavioral change with the development of kidney stones. This case report is the first to associate a restrictive work environment with limited fluid consumption, resulting in the development of nephrolithiasis.
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PMID:Occupational risk for nephrolithiasis and bladder dysfunction in a chauffeur. 1457 63

Nutrition plays a major role in the pathogenesis of the most widespread forms of nephrolithiasis, i.e. calcium (calcium oxalate and phosphate) and uric acid stone disease. For this reason, dietary measures are the first level of intervention in primary prevention, as well as in secondary prevention of recurrences. An unbalanced diet or particular sensitivity to various foods in stone formers can lead to urinary alterations such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and an excessively acid urinary pH. Over the course of time, these conditions contribute to the formation or recurrence of kidney stones, due to the effect they exert on the lithogenous salt profile. The fundamental aspects of the nutritional approach to the treatment of idiopathic nephrolithiasis are body weight, diet and water intake. This paper will present data resulting from our own investigations and the most significant evidence in literature.
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PMID:Body weight, diet and water intake in preventing stone disease. 1513 30

Ethylene glycol (EG) consumption is commonly employed as an experimental regimen to induce hyperoxaluria in animal models of calcium oxalate nephrolithiasis. This approach has, however, been criticized because EG overdose induces metabolic acidosis in humans. We tested the hypothesis that EG consumption (0.75% in drinking water for 4 wk) induces metabolic acidosis by comparing arterial blood gases, serum electrolytes, and urinary chemistries in five groups of Sprague-Dawley rats: normal controls (CON), those made hyperoxaluric (HYP) with EG administration, unilaterally nephrectomized controls (UNI), unilaterally nephrectomized rats fed EG (HRF), and a metabolic acidosis (MA) reference group imbibing sweetened drinking water (5% sucrose) containing 0.28 M NH4Cl. Arterial pH, plasma bicarbonate concentrations, anion gap, urinary pH, and the excretion of titratable acid, ammonium, phosphate, citrate, and calcium in HYP rats were not significantly different from CON rats, indicating that metabolic acidosis did not develop in HYP rats with two kidneys. Unilateral nephrectomy alone (UNI group) did not significantly affect arterial pH, plasma bicarbonate, anion gap, or urinary pH compared with CON rats; however, HRF rats exhibited some signs of a nascent acidosis in having an elevated anion gap, higher phosphate excretion, lower urinary pH, and an increase in titratable acid. Frank metabolic acidosis was observed in the MA rats: decreased arterial pH and plasma HCO3(-) concentration with lower urinary pH and citrate excretion with elevated excretion of ammonium, phosphate and, hence, titratable acid. We conclude that metabolic acidosis does not develop in conventional EG treatments but may ensue with renal insufficiency resulting from an oxalate load.
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PMID:Ethylene glycol induces hyperoxaluria without metabolic acidosis in rats. 1585 60

Nephrolithiasis is a frequent disease that affects about 10% of people in western countries. The prevalence of calcium oxalate stones has been constantly increasing during the past fifty years in France as well as in other industrialized countries. Stone composition varies depending to gender and age of patients and also underlines the role of other risk factors and associated pathologies such as body mass index and diabetes mellitus. The decrease in struvite frequency in female patients is the result of a significantly improved diagnostic and treatment of urinary tract infections by urea-splitting bacteria. In contrast, the increasing occurrence of weddellite calculi in stone forming women aged more than 50 years could be the consequence of post-menopausal therapy. A high prevalence of uric acid was found in overweight and obese stone formers and in diabetic ones as well. Another important finding was the increased occurrence with time of calcium oxalate stones formed from papillary Randall's plaques, especially in young patients. Nutritional risk factors for stone disease are well known: they include excessive consumption of animal proteins, sodium chloride and rapidly absorbed glucides, and insufficient dietary intake of fruits and potassium-rich vegetables, which provide an alkaline load. As a consequence, an excessive production of hydrogen ions may induce several urinary disorders including low urine pH, high urine calcium and uric acid excretion and low urine citrate excretion. Excess in calorie intake, high chocolate consumption inducing hyperoxaluria and low water intake are other factors, which favour excessive urine concentration of solutes. Restoring the dietary balance is the first advice to prevent stone recurrence. However, the striking increase of some types of calculi, such as calcium oxalate stones developed from Randall's plaque, should alert to peculiar lithogenetic risk factors and suggests that specific advices should be given to prevent stone formation.
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PMID:[Epidemiology of nephrolithiasis in France]. 1642 40

Environment and diet have a major role in calcium nephrolithiasis by affecting urine saturation, but this is not enough to cause lithogenesis; the crystals must adhere to the tubular epithelium (TE), but it is hard to say how environment and nutrition may be involved in this step. The hypothesis that TE damage (known to enhance crystal attachment) is lithogenic in mild hyperoxaluria was tested. Mild hyperoxaluria was induced in male Wistar rats using ethylene glycol (EG; 0.5% in water) for 21 d, and TE damage was induced by intraperitoneal administration of hexachloro-1:3-butadiene (HCBD; an industrial nephrotoxin) at 10, 25, and 50 mg/kg body wt on days 7 and 14. These EG and HCBD concentrations were chosen to span from suboptimal to very low doses as far as effects on crystalluria and TE damage are concerned. Enzymuria, proteinuria, oxaluria, crystalluria, and renal pathology were investigated. All HCBD dosages induced crystalluria in mildly hyperoxaluric rats, but no intrarenal crystals were found. EG alone induced very mild hyperoxaluria but no damage to the renal tubule observable on transmission electron microscopy, and it did not cause crystalluria or intrarenal crystals. HCBD with the concomitant administration of EG caused apoptosis of the TE at the two highest dosages after the second injection. Apoptosis did not correlate with crystalluria. A TE toxin is needed for crystallogenesis to occur in borderline metabolic conditions. It may take more than just a metabolic predisposition for calcium nephrolithiasis to occur, and the second hit could come from an environmental pollutant such as HCBD.
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PMID:Mild tubular damage induces calcium oxalate crystalluria in a model of subtle hyperoxaluria: Evidence that a second hit is necessary for renal lithogenesis. 1679 May 10

Like other diseases striking predominantly the affluent societies, idiopathic nephrolithiasis is increasing in rich countries and appears to be closely related to dietary habits. In this review we summarize the latest evidence about the efficacy of dietary treatment for idiopathic calcium and uric acid stones, dealing especially with its effect on the urinary stone risk factors, stone recurrences, and clinical limitations. After a short introduction on epidemiology and pathogenesis, we review the role of the most important foods and nutrients in stone formation and protection: water and other fluids, proteins, carbohydrates, fats, salt, milk and dairy products, fruits and vegetables, and vitamins. The final part of the paper will provide practical guidelines for pursuing an anti-lithogenic diet in idiopathic calcium and uric acid stones.
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PMID:Dietary therapy in idiopathic nephrolithiasis. 1691 Feb 18

We have studied the influence of the Plaferon on the stimulation of restoration of a kidney function in patients with nephrolithiasis of the only kidney. The researches were performed in 42 patients with nephrolithiasis of the only kidney (control group-23; group accepted Plaferon-19 patients). In group of the patients, which accepted Plaferon, the creatinine clearance after two weeks from the operation was increased (58.1+/-5.9 ml/min) and achieve statistically main differs from those in control group (40.1+/-4.2 ml/min; p<0.05). There was detected correlation between "osmolar free" water reabsorption in each nephron and mass of the active nephrons. In control group these correlations are weak and couldn't be evaluated as positive one. In both groups we couldn't detect correlation between excretion fraction of filtered Natrium and reabsorption of "osmolar free" water. Plaferon positively influences process of stimulation of restoration of a renal function at post-operative period in patients with nephrolithiasis of the only kidney and to restoration of the urine passage. After using Plaferon at post-operative period we can detect the better function of the glomerular filtration and other investigated parameters, which differs from those in control group. Plaferon should be used in patients with nephrolithiasis of the only kidney for stimulation of restoration of a renal function at postoperative period.
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PMID:[Using plaferon in patients with nephrolithiasis of the only kidney]. 1740 45

The article covers theoretical and practical matters on prevalence, incidence of nephrolithiasis in Moscow region and influencing ecological hazards. Predictive role of those matters is evaluated. The author presented features of drinkable water in Moscow region and revealed changes in nephrolithiasis prevalence in accordance with antropogenous load. Correlation between the nephrolithiasis prevalence and the microelements ratio in drinkable water is established.
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PMID:[Relationship between microelements content of drinkable water and nephrolithiasis formation in Moscow region residents]. 1743 54

Bangladesh is one of the densely populated countries, a nation of 128 million people, 75% of whom lives in rural areas and the annual per capita gross national product (GNP) is US$ 380.00. The health care budget is 1.2% of GNP and the priority areas are population control, provision of clean drinking water and eradication of communicable diseases. The country has a small number of nephrologists and renal care is available in large cities only. The causes of renal diseases include glomerulonephritis, diabetes, hypertension, nephrolithiasis, obstructive uropathy and interstitial nephropathy. The incidence of end-stage renal disease is not known, but would be much higher than in developed countries because of high incidence of infection and environmental pollution. The treatment of ESRD has low priority in Bangladesh because of the government health policy and high cost of treatment. As a result, less than 10% of ESRD patients are able to maintain dialysis in private hospitals and governmental dialysis centers that are already overcrowded. The vast majority of patients who are started on dialysis die or stop treatment within the first three months. Renal transplantation is not as expensive as dialysis and is less costly in the university hospital than in private hospitals. Cyclosporine is usually replaced by azathioprine after six months of transplantation. Although organ act law is effective since 1998, cadaveric transplant has not picked up due to lack of infrastructure, facility and orientation regarding cadaveric transplantation. Preventive measures of renal disease can not be overemphasized.
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PMID:Health delivery system for renal disease care in bangladesh. 1764 75

Foods that are high in citrate content generally are assumed to deliver alkali load when consumed irrespective of the accompanying cation. The object of this randomized, crossover study was to compare the effects of orange juice with those of lemonade on acid-base profile and urinary stone risks under controlled metabolic conditions. Thirteen volunteers (nine healthy subjects and four stone formers) sequentially received distilled water, orange juice, or lemonade while on constant metabolic diet. Twenty-four-hour urine samples were collected for acid-base parameters and stone risk analysis. Orange juice but not lemonade provided alkali as evidenced by higher net gastrointestinal alkali absorption and higher urinary pH and citrate compared with control. Urinary calcium was not significantly different, but urinary oxalate was higher during the orange juice phase. The calculated supersaturation of calcium oxalate was lower in the orange juice phase compared with control. Calculated undissociated uric acid was lower in the orange juice phase compared with both control and lemonade phases. The calculated supersaturation of brushite was significantly higher in the orange juice phase compared with both control and lemonade phases. Despite comparable citrate content, this study showed that orange juice has greater alkalinizing and citraturic effects than lemonade. Consumption of orange juice was associated with lower calculated calcium oxalate supersaturation and lower calculated undissociated uric acid. This short-term study suggests that orange juice consumption could result in biochemical modification of stone risk factors; however, additional studies are needed to evaluate its role in long-term prevention of recurrent nephrolithiasis.
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PMID:Comparative value of orange juice versus lemonade in reducing stone-forming risk. 1769 58


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