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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of bilateral urolithiasis and renal insufficiency with a blind-ending branch of the right bifid ureter is presented. The diagnosis was made by retrograde ureterogram which revealed a blind-ending branch originating in the middle third of the right ureter. Stones were treated with phased extracorporeal shock wave lithotripsy after preliminary bilateral JJ stenting. The renal parameters reverted to normal and the patient was stone-free.
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PMID:Urolithiasis with blind-ending ureteral duplication and azotemia treated with shock wave therapy. 826 19

In order to investigate long-term effects of indwelling urinary catheters on renal functions, in 46 patients (27 male and 19 female) with ureterostomy or nephrostomy serum creatinine values were measured periodically. Average age of the patients was 60.6 years old. Duration of catheterization was more than 3 years (average 8.1 years). Renal dysfunction was defined as an elevation of serum creatinine more than 2 mg/dl. It was found that catheterization used more than 15 years evoked renal insufficiency over 50% of such patients. This period, however, was shorten to 11 years in patients with nephrolithiasis or frequent fever. It was concluded that urolithiasis and symptomatic urinary tract infections were two remarkable risk factors for the deterioration of renal functions, and that these risk factors must be avoided in patients on long-term catheterization in the upper urinary tract.
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PMID:[Renal functions of the patients with long-term catheterization in upper urinary tract]. 834 34

The main objective of the urologist treating patients with spinal cord injury is to preserve renal function. In order to minimize morbidity, all attempts must be made to maintain a low bladder pressure, sterile urine, and a non-obstructed drainage system. These patients remain at increased risk of infection and stone formation despite all clinical intervention. Diligence in routine follow-up and careful evaluations will provide the best possible results. In the face of urolithiasis, ESWL, percutaneous nephrolithotomy, and chemolysis are effective means of treatment with acceptable morbidity. With future technologic advancements and implementation of neurostimulators to improve the urodynamic profiles, the incidence of renal insufficiency, urolithiasis, and overall morbidity in patients with spinal cord injury is likely to decrease.
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PMID:Management of urinary stones in the patient with spinal cord injury. 835 69

Primary hyperoxaluria type I may initially manifest as urolithiasis, renal insufficiency, or symptoms of systemic oxalosis. This hereditary disorder was fatal until effective therapies evolved during the past two decades. Difficulty in recognizing and diagnosing this disorder in adults is illustrated in a report of a patient eventually restored to good health by high-flux dialysis and combined renal and hepatic transplantation. I explore the molecular processes of the genetic defect and discuss clinical indicators of primary hyperoxaluria type I, manifestations of oxalosis, the pathogenesis of chronic oxalate nephropathy, and the diagnosis and management of this disease.
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PMID:Initial manifestation of primary hyperoxaluria type I in adults-- recognition, diagnosis, and management. 877 19

Xanthine calculi were found in a 7-month-old male Cavalier King Charles spaniel with urethral obstruction and renal insufficiency. Because the only two other reported cases of naturally occurring xanthine urolithiasis concerned a Cavalier King Charles and a King Charles spaniel the urine of the littermates and parents of the patient were also examined for xanthinuria. Semi-quantitative analysis revealed high urine concentrations of hypoxanthine and xanthine in the patient and his female littermate. Quantitative analysis by high-pressure liquid chromatography (HPLC) of the urine samples from the family of this Cavalier King Charles spaniel and nine control dogs revealed that hypoxanthine and xanthine excretion was 30 and 60 times higher in the affected patient and the female littermate than in the others dogs. The pattern of xanthinuria, which is caused by a deficiency of the enzyme xanthine oxidase, in the relation diagram of this family of Cavalier King Charles Spaniels was consistent with an autosomal recessive mode of inheritance.
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PMID:Xanthinuria in a family of Cavalier King Charles spaniels. 941 15

In a case of typical cystinuria type I with left kidney hypoplasia and bilateral calculosis, calculi were dissolved by means of alpha-mercapto-propionyl-glycine and prophylaxis of the calculosis was performed by the same drug continuously administered in two divided doses (10-4 mg.kg-1.day-1) for 9 years, without urolithiasis. Then, the alpha-mercaptopropionyl-glycine every other day in one dose, 4 mg.kg-1.day-1, for two years was administered without calculosis. The arbitrary discontinuation of the drug by the patient was followed after 6 months from a right ureteral calculosis with transitory renal insufficiency. In our case the administration of a low dose of alpha-mercapto-propionyl-glycine every other day was useful in cystine calculosis prophylaxis.
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PMID:Prophylaxis of cystine calculi by low dose of alpha-mercapto-propionyl-glycine administered every other day. 978 25

A 65-year-old man was admitted to our hospital because of thirstyness and left lower abdominal pain. On admission, he was found to have urolithiasis, renal insufficiency (BUN: 73 mg/dl, Crt: 4.4 mg/dl), and hypercalcemia (13.2 mg/dl). Chest X-ray films and computed tomograms showed enlargement and calcification of the hilar lymph nodes, and thickened interlobar fissures in both lungs. Levels of angiotensin converting enzyme (30.2 IU/l) and 1.25 (OH)2VitD3 (66.4 pg/ml) were elevated. Histologic examination of the specimen obtained from transbronchial lung biopsy showed non-caseous epithelioid cell granulomas. Because the level of parathyroid hormone was normal and no malignancies were detected, a diagnosis of sarcoidosis was made. Treatment with extracorporeal shock wave lithotripsy, transurethral lithotomy, saline infusion, and prednisolone (30 mg/day) alleviated the urolithiasis, renal insufficiency, and hypercalcemia. After discharge, the patient was followed up and given prednisolone therapy. About 1 month after the prednisolone dose had been tapered to 15 mg/day, the patient experienced dyspnea and facial and pedal edema. Because congestive heart failure was diagnosed, he was re-admitted to our hospital for a second time. Although he was then placed on intensive therapy, he died of ventricular tachycardia associated with sarcoidosis of the heart.
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PMID:[Sarcoidosis with hypercalcemia, urolithiasis, renal insufficiency, and heart failure]. 1048 65

The term benign prostatic hyperplasia has traditionally been used to describe a constellation of obstructive and irritative voiding symptoms that occur in men as they age. Such symptomatology may be due to a variety of causes, including prostatic enlargement. Thus, the term lower urinary tract symptoms has replaced BPH to describe this symptom complex. The evaluation and treatment of LUTS continues to be a significant part of urology practice in the United States, as well as a significant component of medical resource utilization. Currently, indication for treatment in patients with LUTS is most often based on subjective measurements of symptom severity and bother. Consequently, imaging does not play a major role in the evaluation of such patients. Recent data suggest that the size of the prostate gland may predict which patients with LUTS will develop progressive symptoms and complications. Moreover, both prostate size and the histologic composition of BPH may help to select patients for specific treatment options. Thus, radiologic imaging may eventually play a larger role in the diagnosis and treatment of LUTS in the future. After review of the literature, it appears that routine upper urinary tract imaging in patients with LUTS or BPH is not warranted. Selective use of such imaging tests in patients with BPH and either hematuria, laboratory evidence of renal insufficiency (elevated BUN or creatinine), or a history of urinary tract infection, urolithiasis, previous urinary tract surgery, or congenital or acquired renal disease remains indicated. Local imaging of the prostate can be performed with either MR imaging or TRUS. Although MR imaging provides excellent resolution of internal prostatic anatomy, information with respect to the ratio of glandular to stromal tissue in the prostate, and an accurate estimate of prostate volume, its use in patients with BPH is limited by its high cost and limited availability. In contrast, TRUS remains an important tool in the evaluation of patients with prostatic disease. Similar to MR imaging, TRUS provides excellent images of internal prostatic anatomy and an accurate estimate of prostate volume prior to treatment. In addition, this imaging modality is noninvasive, cost-efficient, easily adapted to office use, and able to provide guidance for transrectal prostate biopsy.
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PMID:Benign prostatic hyperplasia: clinical overview and value of diagnostic imaging. 1066 65

Evaluation of the risk for developing renal insufficiency is generally not considered during the clinical metabolic workup of the stone-forming patient. This review approaches the problem of the severity of nephrolithiasis by addressing the renal risk. Although renal stones are an infrequent cause of renal failure, some lithiasic forms present a greater risk, such as in hereditary stone diseases (eg, cystinuria, primary hyperoxaluria, Dent's disease), primary struvite stones, and infection-related urolithiasis associated with anatomic and functional urinary tract anomalies and spinal cord injury. Recurrent bouts of obstruction and/or crystal-specific biological effects on tubular epithelial cells and interstitial renal cells may activate the fibrogenic cascade responsible for the loss of renal parenchyma. In clinical terms, frequent stone relapses, episodes of urinary tract infection and obstruction, number of urological interventions, and size of the gravel are all significantly associated with the risk for renal failure. Percutaneous and extracorporeal urological methods for the treatment of renal stones may also lead to some chronic deterioration of renal function, particularly in recurrent stone formers treated with multiple therapeutic sessions. Although still speculative, concerns exist about the effect of extracorporeal shock wave lithotripsy on small or pathological kidneys. Without doubt, the medical prevention of stones would be more sensible.
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PMID:Risk for renal failure in nephrolithiasis. 1115 64

Acute renal insufficiency (ARI) complicated the course of the underlying process, including primary and secondary glomerulonephritis, interstitial nephritis, pyelonephritis, dysmetabolic nephropathies, urolithiasis, tubulopathies, renal congenitae defects and injuries in 136 of 1695 children with nephrological diseases hospitalized at Republican Pediatric Renal Center during the last decade. In 69.1% cases ARI developed by the renal type, in 23.5% cases was caused by prerenal factors, and rarely (in 7.4% cases) by postrenal factors. Renal ARI in children was caused by 5 causes, including glomerulonephritis (47%), acute tubular necrosis (19%), interstitial nephritis (14%), vascular disorders (11%) resultant from vasculitis, renal vein thrombosis, and acute crystalluria (9%) which developed in the presence of grave dysmetabolic nephropathy. Among three clinical variants of ARI the most severe was observed in renal ARI leading to grave endogenous intoxication and pronounced decompensation of renal function. More benign course of renal ARI caused by acute tubular necrosis or acute crystalluria differed significantly from prerenal ARI by a more pronounced endogenous intoxication, increased fractionated sodium excretion, and renal insufficiency index higher than 1.
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PMID:[Diagnosis of acute renal failure in pediatric nephrology]. 1133 30


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