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

After discovering juvenile rheumatoid arthritis (JRA), hematuria, and urolithiasis associated with hypercalciuria in two children, urinary calcium excretion was examined in 38 patients with JRA. Fasting urine calcium/creatinine (mg/mg) (UCa/UCr) ratios were increased (greater than 0.21) in 12 patients, who had a mean UCa/UCr ratio of 0.34 +/- 0.14, compared with 0.09 +/- 0.06 in 26 normocalciuric patients with JRA. Increased UCa/UCr ratios were found more frequently in patients with systemic JRA (P less than 0.05); however, no relationship between UCa/UCr ratios and either functional classification or drug therapy was observed. Four children with increased urine calcium to creatinine ratios were examined more extensively. Twenty-four-hour urine calcium excretion ranged from 4.0 to 7.2 mg/kg/24 hours. An orally administered calcium loading test demonstrated fasting hypercalciuria after dietary calcium restriction in these four patients. Serum calcium, bicarbonate, phosphorus, and parathyroid hormone values were normal. Hematuria was found in six of 12 hypercalciuric patients with JRA but in only three of 26 normocalciuric patients (P less than 0.016). We conclude that urinary calcium excretion is frequently increased in patients with JRA and that hypercalciuria may be related to the pathogenesis of hematuria in some of them.
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PMID:Hypercalciuria in children with juvenile rheumatoid arthritis: association with hematuria. 402 May 46

Urinary excretion of N-acetyl-beta-glucosaminidase (NAG), a lysosomal enzyme, was examined in 33 children with hypercalciuria. Urinary NAG excretion in 13 healthy children was 5.84 +/- 9.35 nmole/hr/mg of creatinine (NAG/Cr) (mean +/- SD) compared with 35.61 +/- 42.04 nmole/hr/mg of creatinine in 23 children with renal hypercalciuria, and 28.99 +/- 13.69 nmole/hr/mg of creatinine in ten children with absorptive hypercalciuria. In children with renal hypercalciuria, NAG/Cr excretion was not statistically different between children with either urolithiasis or hematuria without calculi. In six children with renal hypercalciuria, no significant change in NAG/Cr excretion occurred after a mean duration of 25 weeks of hydrochlorothiazide therapy although urinary calcium to creatinine ratios (UCa/Cr) decreased from 0.24 +/- 0.11 to 0.16 +/- 0.11. We conclude that increased urinary calcium excretion produces renal tubular injury and that the renal injury may not be reversed by short-term alterations in urinary calcium excretion.
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PMID:Increased urinary excretion of renal N-acetyl-beta-glucosaminidase in hypercalciuria. 403 32

The urinary calcium/creatinine ratio, during a low-calcium diet and after an oral calcium load, was determined in 128 members of 29 families. No differences were observed between subjects of different sexes, ages and ethnic origins. Our data allow characterization of hypercalciuria in Israeli patients with urolithiasis.
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PMID:Urinary calcium/creatinine ratio following calcium deprivation and calcium loading in an Israeli population. 407 85

24 h urine compositions of male stone formers with idiopathic hypercalciuria prior to treatment were compared with those of male general practitioners without urolithiasis. Urinary urate was slightly higher in the stone formers than in the normals but this was not statistically significant. Furthermore, when results were corrected for the higher creatinine excretions of the stone formers then the reverse was true and statistically significant. All subjects with urinary urate over 7.0 mmol/24 h were separately studied. In these groups the normals had higher urate and creatinine excretions than the stone formers but when results were corrected for creatinine the difference in the urate excretions disappeared. In long term follow up studies urinary calcium was lowered by diet and more so by diet supplemented with either Bendrofluazide or cellulose phosphate. Each drug raised urinary oxalate slightly and this was statistically significant, while both drugs together caused an even bigger rise in oxalate excretion. An unexpected finding was a rise in urinary urate with cellulose phosphate.
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PMID:Idiopathic hypercalciuria. Urate and other ions in urine before and on various long term treatments. 409 26

The risk of calcium crystallization (CaOx-CR) in urine was analyzed by means of crystal counting following standardized addition of oxalate. CaOx-CR was determined in 24 h urine samples from 21 stone formers and 26 normal subjects following dilution of urine to a creatinine concentration of 5 mumol per ml. The mean (+/- SD) CaOx-CR was in stone formers 1.42 +/- 0.57 and in normal subjects 1.29 +/- 0.40. CaOx-CR was also analyzed in 16 fresh urine samples diluted to 80 per cent of the original concentration whereby values between 0.36 and 3.6 were recorded. There was a good correlation between CaOx-CR and estimates of the ion-activity product of CaOx, both in urine diluted to 5 mumol of creatinine per ml and in 80 per cent diluted urine. It ist suggested that the method described is of value for evaluation and follow up of patients with CaOx urolithiasis.
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PMID:Measurement of the risk of calcium oxalate crystallization in urine. 409 29

The urinary excretion of various substances involved in kidney stone formation was evaluated in 67 patients with hypercalciuric lithiasis (HCl), 36 lithiasis patients with normal calciuria (NCl) and 21 controls without urinary stones. All subjects were hospitalized for 3 days and given a calcium, phosphorous and sodium-controlled diet. The 24-hour urine volume was significantly larger in the HCl and NCl groups than in controls. The 24-hour Ca, Na and uric acid excretion was significantly greater in the HCl group than in the NCl and control groups. Oxalate and pyrophosphate excretion was the same in all three groups. Urinary Ca correlated with urinary creatinine in the HCl and control groups, but the slope and ordinate of the regression line were significantly higher in the former group. Similarly, urinary Na correlated with urinary creatinine in the HCl and control groups with a significantly steeper slope in the HCl group. These data are suggestive of abnormalities in the tubular reabsorption of Ca and Na in HCl patients. Finally, there was no correlation between the values obtained and the activity of the disease, as evaluated by the finding of at least 3 urinary stones or one staghorn calculus during the 5 years preceding the study. It is concluded that measurements of Ca, Na, uric acid, creatine, oxalates and phosphates during a stay in hospital provide pathophysiological information but cannot be taken as indices of urolithiasis activity.
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PMID:[Urinary excretion of lithogenic substances in hospitalized patients with calcium lithiasis. Physiopathologic meaning and prognostic value]. 622 Feb 70

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

We studied 44 patients with calcium urolithiasis on high (900 mg. daily) and low (400 mg. daily) calcium diets. With 24-hour urinary data, we categorized the patients as normocalciuric or hypercalciuric and subdivided the hypercalciuric patients into absorptive and renal types. Abbreviated tests, including the 2-hour fasting urinary calcium-to-creatinine ratio and 24-hour urinary (nephrogenous) cyclic adenosine monophosphate, did not predict accurately whether hypercalciuria was of the idiopathic, absorptive or renal type. However, 24-hour urinary calcium excretions on the low calcium diet had a sensitivity and specificity of more than 90 per cent for reproducing the categorized diagnoses.
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PMID:Potential pitfalls of the 2-hour calcium-to-creatinine ratio and urinary cyclic adenosine monophosphate excretion in the differential diagnosis of idiopathic hypercalciuria. 632 73

A group of 121 patients with a history of multiple or complicated calcium urolithiasis were divided into three subgroups: normal, absorptive and renal/resorptive calciuria by means of a calcium-loading test. Patients with renal hypercalciuria had lower bone mineral content (BMC) than the other groups but did not differ in amount of bone or TmPO4/GFR. The 24-hour urine calcium excretion was elevated in patients with renal and absorptive type of hypercalciuria but not in patients with normal calcium-loading test and there was no correlation to BMC. The c-AMP/creatinine seemed to discriminate patients with resorptive calciuria from patients with renal calciuria. It is suggested that only patients with renal hypercalciuria should be treated with calcium-retaining drugs such as thiazides.
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PMID:Calcium-loading test and bone disease in patients with urolithiasis. 665 69

The urinary excretion of oxalate, calcium, citrate, magnesium, urate and creatinine and the inhibition of calcium oxalate crystal growth were determined in 30 patients operated with three different types of jejunoileal bypass. In addition the ion-activity products of calcium oxalate and calcium oxalate saturation were calculated. 15 of the patients had formed urolithiasis postoperatively. The patients were investigated on an out-patient basis with their ordinary diet. All patients had hyperoxaluria. The oxalate excretion did not seem to decrease with time after operation. The patients operated with a biliointestinal shunt had a significantly higher excretion of oxalate than those with the other two types of operation, indicating that variations in the anatomy of the small intestine after jejunoileal bypass might result in different absorption of oxalate or oxalate precursors. Urinary oxalate, calcium oxalate saturation and ion-activity products were higher whereas the excretion of calcium, magnesium and citrate was lower in patients than in controls. The urine volumes, excretion of creatinine and urate and inhibition of calcium oxalate crystal growth were equal in patients and controls. Analogous urine composition was found in patients both with and without urolithiasis with the exception of a higher magnesium excretion observed in stone formers.
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PMID:Urine composition following jejunoileal bypass. 682 41


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