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

The authors considered an important problem of in vivo verification of urolith composition as specifying the choice of drug treatment and prevention of urolithiasis. 84 nephrolithiasis patients were allocated to 4 groups according to their concrement compositions (after spontaneous or surgical removal): 23 patients with urate calculus, 19 with oxalate, 20 with phosphate and 22 with oxalate-phosphate concrements. Polarizing microscopy, x-ray structural analysis and infrared spectrophotometry were employed for verification of calculi composition. Biochemical assay was used for the assessment of serum and circadian excretion of calcium, phosphates, sodium, potassium, uric acid, oxalates and uroacidimetric values. The findings were subjected to discriminant computed analysis which resulted in 6 linear computable functions defining 4 selective groups with regard to biochemical blood and urine data. The aforementioned functions were used in diagnostic routine for the in vivo assessment of calculous composition in 26 controls. In 61.5 per cent of the patients the diagnosis was confirmed, in 34.6 per cent it was verified, and only in 3.9 per cent the diagnosis turned to be erroneous.
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PMID:[Determination of the composition of the concretions in patients with nephrolithiasis by metabolic indices]. 267 29

Urinary volume in 24-hour urine collections was examined in 50 children with hypercalciuria and urolithiasis or hematuria, 12 with idiopathic calcium oxalate urolithiasis and 36 healthy children. Urinary volume was 22.2 +/- 2.0 ml. per kg. per day in healthy children and 25.4 +/- 2.0 ml. per kg. per day in children with hypercalciuria, and it was similar in children with absorptive and renal hypercalciuria, and significantly lower in children with idiopathic calcium oxalate urolithiasis (12.2 +/- 1.4 ml. per kg. per day, p less than 0.001 from controls and children with hypercalciuria). Volume was not statistically different in hypercalciuric children with and without urolithiasis. Urinary sodium excretion in children with idiopathic calculi was not statistically different from controls. Urine osmolality was similar among the groups. Urinary volume represents a risk factor in children with idiopathic calcium oxalate urolithiasis, and increased fluid intake should be emphasized in such patients.
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PMID:Urinary volume in children with urolithiasis. 292 90

Abnormalities in renal tubular function have been reported in adult patients with idiopathic renal hypercalciuria. To determine if such abnormalities are present early in the natural history of renal hypercalciuria, we evaluated renal tubular function in ten children with idiopathic renal hypercalciuria, aged 5-17 years. Seven of the children presented with urolithiasis and three with hematuria. Urinary calcium excretion ranged from 4 to 9 mg/kg per day, (5.2 +/- 0.5, mean +/- SEM) with a mean fasting urinary calcium to creatinine ration of 0.31 +/- 0.03. Studies described in this report were performed after 1 week of ingesting a diet containing 1,000 mg calcium, 3,000 mg sodium, and 100 mg purine. Clearance of creatinine ranged from 84 to 159 ml/min per 1.73 m2. Tm phosphate (mg/100 ml GFR) was normal in each child (mean 4.66 +/- 0.06 mg/100 ml GFR). Fractional excretion of uric acid, sodium and beta-2-microglobulin were also normal in each child. Serum bicarbonate concentrations ranged from 21.5 to 27 mEq/l with a mean of 24.4 +/- 0.5 mEq/l and all patients lowered urinary pH to less than 5.5. Hypotonic diuresis demonstrated normal free water clearance with a mean of 12.8 ml/min per 100 ml Cin. Distal sodium delivery and fractional distal sodium reabsorption were normal with a mean of 13.6 +/- 1.2% and 92.7 +/- 0.5%, respectively. Water deprivation studies demonstrated a range of maximum urinary osmolality from 711 to 1,020 mosmol/kg H2O with a mean of 864 +/- 34 mosmol/kg H2O. Seven healthy children, ingesting an identical study diet, concentrated their urine to a mean of 1,059 +/- 31 mosmol/kg h2O.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal function in children with idiopathic hypercalciuria. 315 15

Plasma cortisol and urinary excretion of water, sodium, potassium, calcium and magnesium have been studied in the rat after application of heat stress. There was a significant increase in plasma cortisol level after exposure to heat. During heat stress complete cessation of urine formation was observed. In the next 30 min there was statistically significant increase in the urinary excretion of water, sodium and calcium but not of potassium and magnesium. Urinary calcium/magnesium ratio was also significantly elevated. The increase in urinary water and electrolyte excretion seemed to be mediated through prostaglandins since it could be abolished by administration of indomethacin prior to the application of heat stress. On the basis of these results, the possible role of heat stress in the genesis of urolithiasis has been discussed.
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PMID:Effect of acute environmental heat stress on urinary water and electrolyte excretion in the rat. 318 59

1. Because urinary prostaglandin excretion could play a role in idiopathic hypercalciuria (IH), we studied the excretion of prostaglandin E (PGE), calcium and sodium at various urine flows in 21 patients (14 males) with urolithiasis and IH, seven stone formers (five males) with normal calciuria and 20 controls (11 males). Dietary composition was comparable and sodium intake was restricted to 100-120 mmol/day. 2. Analyses were performed on 30 min urine collections obtained after overnight water deprivation and during water diuresis. Male IH patients had increased levels of urinary PGE at all ranges of urine flow. PGE excretion correlated directly with urine flow in patients and controls, but the slope of this relationship in individual IH male patients was steeper than in controls (P less than 0.01). Calciuria correlated directly with urine output in patients with IH but not in controls. Calcium and sodium excretion were directly correlated (P less than 0.0001) in patients and controls. There were no significant differences between absorptive IH (seven patients) and renal IH (eight patients). There were no significant differences between stone formers with normocalciuria and control subjects. 3. The findings suggest that increased urinary PGE could play a role in the hypercalciuria syndrome, possibly by promoting natriuresis.
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PMID:Increased urinary excretion of prostaglandin E in patients with idiopathic hypercalciuria. 320 91

Relationship between urinary sodium excretion and urinary excretion of calcium, uric acid, oxalate, phosphate and magnesium was analyzed in 93 ambulatory patients with urolithiasis. There was a significant correlationship between urinary sodium excretion and urinary excretion of calcium, uric acid, oxalate (only in male stone formers), phosphate and magnesium, respectively. Under a salt restricted diet (NaCl 3-5 gm/day) for 3 days, urinary sodium excretion of 16 inpatients with urolithiasis was reduced remarkably together with significant reduction of urinary excretion of calcium, uric acid and oxalate. Urinary excretion of phosphate and magnesium showed no change. From these findings we conclude that restriction of sodium intake is an effective treatment for prevention of stone recurrence.
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PMID:[Clinical studies of the recurrence of urolithiasis (3). Influence of sodium intake on urinary excretion of calcium, uric acid, oxalate, phosphate and magnesium]. 321 89

Plasma Cortisol and urinary excretion of water, sodium, potassium, calcium and magnesium have been studied in the rat after application of 2 types of neurogenic stress:--(a) tight rubber band tourniquet and (b) electric shock. Plasma cortisol levels increased significantly after application of either type of stress. During both type of stress, there was statistically significant increase in the urinary excretion of water, sodium and calcium but not of potassium and magnesium. Urinary calcium/magnesium ratio was also significantly elevated. The results suggest that stress may be one of the factors involved in the genesis of urolithiasis.
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PMID:Acute effects of neurogenic stress on urinary electrolyte excretion. 342 32

The etiopathogenesis of uric acid, sodium acid urate, and ammonium acid urate uroliths in non-Dalmatian dogs appears to be a complex phenomenon. It may involve one or more pathologic and/or physiologic processes acting independently or in concert to increase urinary concentration of lithogenic substances that result in initiation, growth, and retention of urate uroliths. Increased urine uric acid concentration and/or urinary excretion of uric acid appear to be primary predisposing factors in urate lithogenesis. Specific disorders resulting in hyperuricuria may involve abnormalities of increased synthesis, diminished biodegradation, and/or enhance excretion of uric acid. In addition, ammonium ion, hydrogen ion, and other organic and inorganic urine constituents appear to have major influences on urate urolith formation. Unfortunately, many specific disorders of uric acid metabolism and other factors promoting or inhibiting urate urolith formation remain poorly characterized in the majority of non-Dalmatian dogs with urate urolithiasis. Growing awareness of the significance of urate uroliths in non-Dalmatian dogs should encourage further investigation into the identification, characterization, and quantitation of parameters influencing urate lithogenesis. Results of such studies are required for development of practical and effective strategies for treatment and prevention of canine urate urolithiasis.
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PMID:Etiopathogenesis of uric acid and ammonium urate uroliths in non-Dalmatian dogs. 351 3

Considerable progress has been made regarding pathogenesis, diagnosis and conservative management of urolithiasis. The cause of the disease can now be determined in nearly 80% of the patients. New stone formation may be prevented in the majority of patients by selective medical treatment. The metabolic, physicochemical and clinical effects of diet, thiazides, allopurinol, sodium cellulose phosphate and potassium-sodium citrate (Oxalyt-C) are described in detail. Intrinsic problems involved in clinical trial with recurrent stone formers are discussed.
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PMID:Rational prevention of calcium urolithiasis. 354 40

Between 1981 and 1983, 49 children aged 2 to 15 years were diagnosed as having idiopathic hypercalciuria (IH). They were divided into 3 groups based on their response to dietary manipulation: group I (32/49) had absorptive hypercalciuria; group II (8/49) had renal hypercalciuria and group III (6/49) had sodium-dependent hypercalciuria. Response to diet was more reliable than Pak's test in differentiating between the three groups. A control group (CG) of 45 healthy, age matched children determined baseline levels for all metabolic parameters. At the time of presentation IH children did not differ from the CG in height or weight. Fifty percent of IH children had first degree relatives with urolithiasis. Yet, only 16% of the IH children had urolithiasis, the majority presenting with gross hematuria and urinary tract infections (UTI). With few exceptions the clinical symptoms resolved when urine calcium excretion was controlled. Severe calcium restriction in a few patients produced osteoporosis and delayed bone age although growth velocity was unaffected. Thiazide therapy in a few patients produced some metabolic derangements. The authors conclude that IH in childhood is a benign disease which may present with UTI or hematuria. They further propose a new classification method based on response to dietary manipulation.
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PMID:Idiopathic hypercalciuria in children. Classification, clinical manifestations and outcome. 359 Dec 93


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