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Uric Acid Nephrolithiasis

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1. Renal and ureteric stones: assessment and management

agreed that ureteric stones can be extremely painful and if left untreated can lead to a loss of kidney function. Surgical treatment should be offered within 48 hours of diagnosis or readmission, to people presenting with ureteric stones and renal colic, if the pain is ongoing and not tolerated or the stone is unlikely to pass. Although the evidence was from people with stones less than 20 mm, the committee agreed that Renal and ureteric stones: assessment and management (NG118) © NICE 2019. All (...) Renal and ureteric stones: assessment and management Renal and ureteric stones: assessment Renal and ureteric stones: assessment and management and management NICE guideline Published: 8 January 2019 nice.org.uk/guidance/ng118 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

2. StoneChecker for kidney stone evaluation

in this briefing are from 3 observational studies in the UK and China. The results of these studies suggest that CT texture analysis using StoneChecker can differentiate uric acid from non-uric stones on unenhanced CT. This may make it possible to predict the number of shocks needed to treat kidney stones. K Ke ey uncertainties y uncertainties around the evidence or technology are that the evidence is limited in quality and quantity. All studies had small sample sizes. One study was experimental (...) evidence, and its strengths and limitations. Overall assessment of the evidence The studies included in table 1 examine the accuracy of CT texture analysis (CTTA) software for distinguishing uric acid (UA) and non-UA stones and predicting shockwave lithotripsy outcomes. Studies report that CTTA in vivo and ex vivo using unenhanced CT images can accurately differentiate UA stones from non-UA stones, and can also help to predict number of shocks needed when using shock wave lithotripsy to treat kidney

2019 National Institute for Health and Clinical Excellence - Advice

3. The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis. Full Text available with Trip Pro

The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis. To determine the influence of serum uric acid (UA) levels on renal impairment in patients with UA stone.We retrospectively analyzed 463 patients with calcium oxalate and/or calcium phosphate stones (CaOx/CaP), and 139 patients with UA stones. The subjects were divided into the serum UA-high (UA ≥ 7.0 mg/dL) or the UA-low group (UA < 7.0 mg/dL). The control group comprised (...) 3082 community-dwelling individuals that were pair-matched according to age, sex, body mass index, comorbidities, hemoglobin, serum albumin, and serum UA using propensity score matching. We compared renal function between controls and patients with UA stone (analysis 1), and between patients with CaOx/CaP and with UA stone (analysis 2). Logistic regression analysis was used to evaluate the impact of the hyperuricemia on the development of stage 3 and 3B chronic kidney disease (CKD) (analysis 3

2017 PLoS ONE

4. Guideline on the evaluation and medical management of the kidney stone patient - 2016 update

, Sakhaee K, Skurla C, et al. Prevention of recurrent calcium stone formation with potassium citrate therapy in patients with distal renal tubular acidosis. J Urol 1985;134:20-3. 123. Fabris A, Lupo A, Bernich P, et al. Long-term treatment with potassium citrate and renal stones in medullary sponge kidney. Clin J Am Soc Nephrol 2010;5:1663-8. http://dx.doi.org/10.2215/CJN.00220110 124. Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am 2007;34:335-46. http://dx.doi. org/10.1016/j.ucl (...) of patients with “pure” uric acid nephrolithiasis compared with “pure” calcium oxalate stone-formers. Urol Res 2007;35:247-51. http:// dx.doi.org/10.1007/s00240-007-0109-1 128. Trinchieri A, Esposito N, Castelnuovo C. Dissolution of radiolucent renal stones by oral alkalinization with potassium citrate/potassium bicarbonate. Arch Ital Urol Androl 2009;81:188-91. 129. Pak CY, Sakhaee K, Fuller C. Successful management of uric acid nephrolithiasis with potassium citrate. Kidney Int 1986;30:422-8. http

2017 CPG Infobase

5. Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones. Full Text available with Trip Pro

. Infrared (IR) spectroscopes, X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to confirm the bulk mineral composition in the thin section stones. Observations revealed differences in the micro-morphology of the kidney stones with similar composition in the internal 3-D structure. Calcium oxalate monohydrate stones showed well-organised layering patterns, while uric acid stones showed lower absorption signals with homogenous inner structure. Distinct mineral phases in the mixed (...) Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones. Understanding the mechanisms of kidney stone formation, development patterns and associated pathological features are gaining importance due to an increase in the prevalence of the disease and diversity in the presentation of the stone composition. Based on the microstructural characteristics of kidney stones, it may

2019 PLoS ONE

6. CUA guideline on the evaluation and medical management of the kidney stone patient

. Prevention of recurrent calcium stone formation with potassium citrate therapy in patients with distal renal tubular acidosis. J Urol 1985;134:20-3. 123. Fabris A, Lupo A, Bernich P, et al. Long-term treatment with potassium citrate and renal stones in medullary sponge kidney. Clin J Am Soc Nephrol 2010;5:1663-8. http://dx.doi.org/10.2215/CJN.00220110 124. Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am 2007;34:335-46. http://dx.doi. org/10.1016/j.ucl.2007.05.001 125. Reichard C (...) ” uric acid nephrolithiasis compared with “pure” calcium oxalate stone-formers. Urol Res 2007;35:247-51. http:// dx.doi.org/10.1007/s00240-007-0109-1 128. Trinchieri A, Esposito N, Castelnuovo C. Dissolution of radiolucent renal stones by oral alkalinization with potassium citrate/potassium bicarbonate. Arch Ital Urol Androl 2009;81:188-91. 129. Pak CY, Sakhaee K, Fuller C. Successful management of uric acid nephrolithiasis with potassium citrate. Kidney Int 1986;30:422-8. http://dx.doi.org/10.1038

2016 Canadian Urological Association

7. Incidence and characteristics of kidney stones in patients with horseshoe kidney: A systematic review and meta-analysis. Full Text available with Trip Pro

Incidence and characteristics of kidney stones in patients with horseshoe kidney: A systematic review and meta-analysis. The horseshoe kidney (HSK) is the most common type of renal fusion anomaly. The incidence and characteristics of kidney stones in patients with HSK are not well studied. The aim of this meta-analysis was to evaluate the incidence and types of kidney stones in patients with HSK.A systematic literature search was performed using MEDLINE, EMBASE, and Cochrane Database (...) incidence of kidney stones was 36% (95% confidence interval [CI], 15%-59%) in adults with the HSK. Kidney stones were less common in pediatric patients with HSK with an estimated pooled incidence of 3% (95% CI, 2%-5%). The mean age of adult stone formers with HSK was 44.9 ± 6.2 years, and 75% were males. Within reported studies, 89.2% of kidney stones were calcium-based stones (64.2% calcium oxalate [CaOx], 18.8% calcium phosphate [CaP], and 6.2% mixed CaOx/CaP), followed by struvite stones (4.2%), uric

2018 Urology annals

8. Raman chemical imaging, a new tool in kidney stone structure analysis: Case-study and comparison to Fourier Transform Infrared spectroscopy. Full Text available with Trip Pro

Raman chemical imaging, a new tool in kidney stone structure analysis: Case-study and comparison to Fourier Transform Infrared spectroscopy. The kidney stone's structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two-dimension maps of the constituents' distribution in samples. We aimed at determining the use of Raman chemical imaging in urinary stone analysis.Fourteen calculi were analyzed (...) monohydrate and dihydrate calcium oxalate, anhydrous and dihydrate uric acid, apatite, struvite, brushite, and rare chemicals like whitlockite, ammonium urate and drugs. However, proteins couldn't be detected because of the huge autofluorescence background and the small concentration of these poor Raman scatterers. Carbapatite and calcium oxalate were correctly detected even when they represented less than 5 percent of the whole stones. Moreover, Raman chemical imaging provided the distribution

2018 PLoS ONE

9. Prevention of Recurrent Kidney Stones

with residual or recurrent struvite stones in whom surgical options have been exhausted, AUA cites acetohydroxamic acid as a treatment option. AUA recommends potassium citrate for patients with uric acid and cystine stones in order to raise urinary pH to an optimal level. Prevention of Recurrent Kidney Stones ACP (2014) Recommendation 1 : The ACP recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis. ( Grade (...) have an account? The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. For additional information, read our . Guideline Synthesis Prevention of Recurrent Kidney Stones Guidelines Being Compared: American College of Physicians (ACP) Dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: a clinical practice

2015 National Guideline Clearinghouse (partial archive)

10. Temporal Changes in Kidney Stone Composition and in Risk Factors Predisposing to Stone Formation. Full Text available with Trip Pro

patients diagnosed with either calcium or uric acid stones at an initial visit to a university kidney stone clinic from 1980 to 2015.From 1980 to 2015, the proportion of uric acid stones in all stone formers increased from 7% to 14%. While age and body mass index increased with time in both uric acid and calcium stone formers, uric acid stone formers were consistently older and had a higher body mass index and lower urinary pH than calcium stone formers. The proportion of females with stones has (...) increased over time but the increase in female gender was more prominent among calcium stone formers. Urinary pH, phosphorus, oxalate and sodium increased with time in calcium stone formers but remained unchanged in uric acid stone formers. After accounting for various parameters of stone risk, the strongest clinical discriminant of uric acid vs calcium stones was urinary pH. Limitations of this study include the retrospective single center design and the available number of patients with stone

2017 Journal of Urology

11. Net Acid Excretion and Urinary Organic Anions in Idiopathic Uric Acid Nephrolithiasis. Full Text available with Trip Pro

relative to net acid excretion, resulting in low urine pH over a wide body mass index range. Urinary metabolomics was performed to attempt to identify excess organic acids presented to the kidney in idiopathic uric acid nephrolithiasis. Among the tricarboxylic acid cycle intermediates and amino acid and lipid metabolites analyzed, 26 organic anions with acid dissociation constants values in the range of urine pH showed greater protonation. However, protons carried by the identified organic acids did (...) Net Acid Excretion and Urinary Organic Anions in Idiopathic Uric Acid Nephrolithiasis. Idiopathic uric acid nephrolithiasis, which is closely associated with obesity and the metabolic syndrome, is increasing in prevalence. Unduly acidic urine pH, the quintessential pathophysiologic feature of this disease, is in part explained by inadequate excretion of the principal urinary buffer ammonium. The role of net acid excretion in the pathogenesis of uric acid nephrolithiasis is incompletely

2019 Clinical Journal of the American Society of Nephrology

12. Circadian Periodicity of Circulating Plasma Lipid Peroxides, Uric Acid and Ascorbic Acid in Renal Stone Formers Full Text available with Trip Pro

Circadian Periodicity of Circulating Plasma Lipid Peroxides, Uric Acid and Ascorbic Acid in Renal Stone Formers Circadian periodicity of plasma lipid peroxides and serum ascorbic acid and uric acid levels were studied in one hundred renal stone formers (55 women and 45 men; age 20-60 years) and 50 clinically healthy volunteers (21 women and 29 men; age 21-45 years) with diurnal activity from 06:00 to 22:00 and nocturnal rest. A marked circadian variation was demonstrated by population-mean (...) -cosinor for all studied variables in stone formers and healthy subjects. By comparison to the healthy controls, parameter tests indicate that the stone formers had a higher MESOR (±SE) of MDA (2.90 ± 0.03 vs. 2.28 ± 0.06; F = 94.929, p < 0.001), a lower MESOR of serum ascorbic acid (0.722 ± 0.010 vs. 0.839 ± 0.10; F = 32.083, p < 0.001), and a similar MESOR of serum uric acid. Furthermore, the patients also differed from the healthy subjects in terms of their circadian amplitude and acrophase (tested

2016 Indian Journal of Clinical Biochemistry

13. Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis. Full Text available with Trip Pro

males. 67% of kidney stones were calcium-based stones (30% mixed CaOx/CaP, 27%CaOx and 10%CaP), followed by struvite stones (20%) and uric acid stones (13%).The estimated incidence of kidney stones in patients after kidney transplantation is 1.0%. Although calcium based stones are the most common kidney stones after transplantation, struvite stones (also known as "infection stones") are not uncommon in kidney transplant recipients. These findings may impact the prevention and clinical management (...) Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis. To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients.A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a random-effects model to estimate

2017 World journal of transplantation

14. Predictors of Symptomatic Kidney Stone Recurrence After the First and Subsequent Episodes. Full Text available with Trip Pro

; family history of stones; pregnancy; incident asymptomatic stone on imaging before the first episode; suspected stone episode before the first episode; history of a brushite, struvite, or uric acid stone; no history of calcium oxalate monohydrate stone; kidney pelvic or lower pole stone on imaging; no ureterovesical junction stone on imaging; number of kidney stones on imaging; and diameter of the largest kidney stone on imaging. The model had a C-index corrected for optimism of 0.681 and was used (...) Predictors of Symptomatic Kidney Stone Recurrence After the First and Subsequent Episodes. To predict symptomatic recurrence among community stone formers with one or more previous stone episodes.A random sample of incident symptomatic kidney stone formers in Olmsted County, Minnesota, was followed for all symptomatic stone episodes resulting in clinical care from January 1, 1984, through January 31, 2017. Clinical and radiographic characteristics at each stone episode predictive of subsequent

2018 Mayo Clinic Proceedings

15. Fourier transform infrared spectroscopy for analysis of kidney stones Full Text available with Trip Pro

apatite (n=1) in five stones, while uric acid crystals were detected (n=13) by FT-IR. While chemical analysis identified 3 stones as uric acid and the rest as calcium oxalate only. Agreement between the two methods was moderate, with a kappa statistic of 0.57 (95% confidence interval, 0.5-0.64). Disagreement was noted in the analysis of 77 stones.FT-IR analysis of kidney stones can overcome many limitations associated with chemical analysis. (...) aged <2 years. The male to female ratio was 4.6. In adults, the calcium oxalate stone type, calcium oxalate monohydrate (COM, n=224), was the most common crystal, followed by uric acid and calcium oxalate dihydrate (COD, n=83). In children, the most frequently occurring type was predominantly COD (n=21), followed by COM (n=11), ammonium urate (n=10), carbonate apatite (n=6), uric acid (n=4), and cystine (n=1). Core composition in 22 stones showed ammonium urate (n=2), COM (n=2), and carbonate

2018 Investigative and clinical urology

16. Menopause and Risk of Kidney Stones. Full Text available with Trip Pro

menopause was 1.27 (95% CI 1.09-1.48) and 1.43 (95% CI 1.19-1.73), respectively. Among the 74,505 postmenopausal participants there was a total of 1,041 incident stone events. Compared with no hormone therapy neither current nor past use was significantly associated with kidney stone risk. Compared with premenopause the postmenopausal urine collections had lower mean calcium, citrate, phosphorus and uric acid, and higher mean volume.Postmenopausal status is associated with a higher risk of incident (...) Menopause and Risk of Kidney Stones. Metabolic changes due to menopause may alter urine composition and kidney stone risk but results of prior work on this association have been mixed. We examined menopause and the risk of incident kidney stones, and changes in 24-hour urine composition in the NHS (Nurses' Health Study) II.Using multivariate adjusted Cox proportional hazards models we prospectively analyzed 108,639 NHS II participants who provided information on menopause and kidney stones. We

2018 Journal of Urology

17. Fructose increases risk for kidney stones: potential role in metabolic syndrome and heat stress. Full Text available with Trip Pro

Fructose increases risk for kidney stones: potential role in metabolic syndrome and heat stress. Fructose intake, mainly as table sugar or high fructose corn syrup, has increased in recent decades and is associated with increased risk for kidney stones. We hypothesized that fructose intake alters serum and urinary components involved in stone formation.We analyzed a previously published randomized controlled study that included 33 healthy male adults (40-65 years of age) who ingested 200 g (...) of fructose (supplied in a 2-L volume of 10% fructose in water) daily for 2 weeks. Participants were evaluated at the Unit of Nephrology of the Mateo Orfila Hospital in Menorca. Changes in serum levels of magnesium, calcium, uric acid, phosphorus, vitamin D, and intact PTH levels were evaluated. Urine magnesium, calcium, uric acid, phosphorus, citrate, oxalate, sodium, potassium, as well as urinary pH, were measured.Ingestion of fructose was associated with an increased serum level of uric acid (p < 0.001

2018 BMC Nephrology Controlled trial quality: uncertain

18. Short term changes in urinary relative supersaturation predict recurrence of kidney stones: a tool to guide preventive measures in urolithiasis. (Abstract)

treatment.We performed a post hoc analysis of data from a previously published randomized controlled trial comparing the effect of 2 diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Baseline and followup 24-hour urine parameters were used to calculate the relative supersaturation of calcium oxalate, calcium phosphate and uric acid using the EQUIL2, JESS and LithoRisk computer programs. Cox models were used to calculate the estimated association between each baseline relative (...) Short term changes in urinary relative supersaturation predict recurrence of kidney stones: a tool to guide preventive measures in urolithiasis. Kidney stone disease is characterized by a relatively high rate of recurrence. In our study we analyzed the association between relative supersaturation and the risk of stone recurrence. Additionally, we examined the association between the risk of recurrence and changes in relative supersaturation and urinary composition after 1 week of medical

2018 Journal of Urology

19. Medical Management of Kidney Stones

and prostate, the pathophysiology related to stone formation differs according to the site of origin. The focus of this Guideline is on renal calculi as these stones are the main source of morbidity, cost and resource utilization associated with urinary tract calculi. Kidney stone disease is a common condition. According to the most recent National Health and Nutrition Examination Survey (NHANES), the overall prevalence of self-reported kidney stones in the period 2007-2010 was 8.8%, with a higher (...) × Discussion Stone composition of uric acid, cystine or struvite implicates specific metabolic or genetic abnormalities, and knowledge of stone composition may help direct preventive measures. 44, 45 Calcium phosphate stone composition is more likely to be associated with certain medical conditions or medications, such as RTA Type 1, primary hyperparathyroidism, medullary sponge kidney and the use of carbonic anhydrase inhibitors. 44, 45 Close Guideline Statement 4 Clinicians should obtain and review

2014 American Urological Association

20. Detection and Characterization of Renal Stones by Using Photon-Counting-based CT. Full Text available with Trip Pro

the same radiation dose (as represented by volumetric CT dose index). Two radiologists were tasked with detection of stones, which were later characterized as uric acid or non-uric acid by using a commercial dual-energy CT analysis package. Stone size and contrast-to-noise ratio were additionally calculated. McNemar odds ratios and Cohen k were calculated separately for all stones and small stones (≤3 mm). Results One-hundred sixty renal stones (91 stones that were ≤ 3 mm in axial length) were visually (...) Detection and Characterization of Renal Stones by Using Photon-Counting-based CT. Purpose To compare a research photon-counting-detector (PCD) CT scanner to a dual-source, dual-energy CT scanner for the detection and characterization of renal stones in human participants with known stones. Materials and Methods Thirty study participants (median age, 61 years; 10 women) underwent a clinical renal stone characterization scan by using dual-energy CT and a subsequent research PCD CT scan by using

2018 Radiology

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