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

Oral calcium tolerance and urinary cyclic AMP testing was used in the evaluation of 61 unselected patients with stones. The oral calcium tolerance test was easy to perform and was useful in defining several distinct metabolic abnormalities contributing to calculous formation. Oral calcium tolerance testing is more precise than twenty-four-hour urinary calcium determination and should provide a means of determining proper medical treatment of urolithiasis. Urinary cyclic AMP was disappointing as a measure of parathormone activity.
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PMID:Oral calcium tolerance and urinary cyclic AMP in urolithiasis. 21 23

About 7% of patients with calcium urolithiasis suffer from primary hyperparathyroidism. A systematic search for this diagnosis is therefore mandatory in such patients. Because hypercalcemia is often discrete or intermittent, determinations of calcium levels should be repeated at least thrice. Measurement of ionized calcium levels improves the detection of hypercalcemia. The biological diagnosis is based on the presence of hypercalcemia together with an increased plasma level of 1-84 intact parathormone (PTH). A PTH value still in the normal range but inappropriately elevated in the context of hypercalcemia could be sufficient for the diagnosis of primary hyperparathyroidism.
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PMID:[Should the parathyroid function be evaluated in a patient with calcium kidney stones? If so, when and why?]. 194 59

Ninety-seven male patients with idiopathic calcium urolithiasis and 17 normal male subjects were studied to evaluate the mechanism of idiopathic hypercalciuria with an oral calcium tolerance test, which has been useful in differentiating hypercalciuria. The changes in parathyroid function, such as parathormone and urinary cyclic AMP, and calcium after calcium load differed between absorptive hypercalciuria and renal hypercalciuria. We have confirmed that the change in serum calcitonin after calcium load was also different in these two hypercalciurias. The increase in serum calcium was sufficient to reduce parathyroid function but serum calcitonin was unchanged after calcium load in the control group, in patients with normocalciuria, and those with renal hypercalciuria. Although serum and urinary calcium were more elevated in absorptive hypercalciuria than in the other three groups, parathyroid function was not significantly reduced after loading in absorptive hypercalciuria. In this group only, the serum calcitonin was significantly elevated after calcium load. It is reasonable to suggest that, in this group, because parathyroid function is usually suppressed by intestinal hyperabsorption of calcium, parathyroid function may not be further suppressed by even calcium load. Possibly the significant stimulation of calcitonin may compensate for the lack of suppression of parathyroid function and maintain normal serum calcium levels in absorptive hypercalciuria. These results suggest that the change in serum calcitonin is also useful to differentiate abnormalities of calcium metabolism in patients with hypercalciuria.
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PMID:Oral calcium tolerance test and serum calcitonin in calcium stone formers. 630 68

The review of 340 own cases of hyperparathyroidism surgery shows, that only the concentrations of calcium and parathormone in serum are of interest for the diagnosis. Further biochemical analyses and function tests are not specific enough to serve as indicators for hyperparathyroidism and serve only as secondary reinforcements of the diagnosis. There are many methods for the preoperative localisation but only the computer tomography with simultaneously given contrast medium or a refined sonography seem to be reproducible. 94% of the cases are cured by surgery. The further development of urolithiasis is certainly reduced after the successful operation, however, in about one third of the cases with normocalcemia, a recurrent and marked increase in size of the stones present was observed postoperatively. The possibility of such a continuous growth gives reason to observe closely the development of urolithiasis in order to be able to react promptly by means of lithotomy.
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PMID:[Problems of hyperparathyroidism in urology (author's transl)]. 720 98

The different subgroups of hypercalciuria cannot be separated clearly by the Pak calcium-load test. To improve the diagnosis and therapy we examined all relevant parameters of calcium metabolism in 32 patients with calcium urolithiasis and hypercalciuria (> 6.25 mmol/day). We also conducted bone mineral density measurements as well as the Pak calcium-load test. In most cases the pathophysiological constellations which Pak takes as the basis for his classification of hypercalciuria could not be shown. To date, diagnostics only insufficiently explains the genesis of hypercalciuria (except pHPT). As a consequence, a therapeutic problem arises: a low-calcium diet should not be generally recommended, since some patients may develop osteopenia. From our investigation the following diagnostic and therapeutic conclusions can be drawn: (1) Hypercalciuria in primary hyperparathyroidism should be treated by surgical removal of the adenoma. (2) The parathormone-independent osteogenic form should be treated with thiazides. (3) Hypercalciuria with increased 1.25-dihydroxyvitamin D should be treated by low-calcium diet.
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PMID:[Studies of calcium metabolism in patients with hypercalciuria]. 899 31

Primary hyperparathyroidism in children is very rare. It is caused by overproduction of parathormone by a pathologically changed parathyroid gland. We carried out a retrospective study in 10 patients (age 10-17 years) who had surgical treatment between 1996 and 2007. The main signs of primary hyperparathyroidism were urolithiasis, nephrolithiasis, nephrocalcinosis and bone resorption, as well as non-specific signs such as fatigue, torpidness and muscle weakness. Patients were examined using sonography, MIBI-scintigraphy, CT and MRI. Calcium was measured before and after surgery; parathormone was monitored postoperatively. Surgery was curative in nine patients; reoperation was necessary in one patient because an ectopic parathyroid gland was not detected during the primary operation. Other major complications were not observed. Removal of pathologically changed parathyroid glands offers definitive and safe treatment of primary hyperparathyroidism in children. Special care should be taken if an ectopic parathyroid gland is suspected.
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PMID:Surgical treatment of primary hyperparathyroidism in children: report of 10 cases. 1851 6