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Uric Acid Nephrolithiasis

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181. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

8.1.2 Valvular heart disease (including planned transcatheter aortic valve implantation) 44 8.1.3 After heart transplantation 44 8.2 Non-cardiovascular comorbidities 45 8.2.1 Cancer 45 8.2.2 Diabetes mellitus 45 8.2.3 Chronic kidney disease 46 8.2.4 Elderly 46 8.3 Sex 46 8.4 Patients with refractory angina 47 9. Key messages 48 10. Gaps in the evidence 49 10.1 Diagnosis and assessment 49 10.2 Assessment of risk 49 10.3 Lifestyle management 49 10.4 Pharmacological management 49 10.5 Revascularization (...) Recommendations for investigations in patients with suspected vasospastic angina 42 Recommendations for screening for coronary artery disease in asymptomatic subjects 43 Recommendations for hypertension treatment in chronic coronary syndromes 44 Recommendations for valvular disease in chronic coronary syndromes 44 Recommendations for active cancer in chronic coronary syndromes 45 Recommendations for diabetes mellitus in chronic coronary syndromes 45 Recommendations for chronic kidney disease in chronic

2019 European Society of Cardiology

182. Gout — achieving the management goal

Drink plenty of fluids (at least 2 litres a day), unless under fluid restriction The following diet can help to prevent gout attacks: Avoid Include more of Other problems (complications) can develop if gout is not treated: Collection of uric acid crystals, forming lumps around joints (tophi) Kidney or bladder stones Joint damage Uric acid crystals trigger painful gout attacks Uric acid forms crystalsUrate-lowering therapy (ULT) is an effective treatment for gout. However, severe cutaneous adverse (...) , such as urate nephrolithiasis or chronic nephropathy may develop. As renal impairment is also a known risk factor for gout, the relationship between the two is bidirectional. Besides renal impairment, patients with gout often have multiple comorbidities, including obesity, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. The increasing prevalence of gout, related complications, and comorbidities call for improved long-term management of gout—as a chronic condition with ongoing

2020 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

183. KDOQI Clinical Practice Guidelines for Nutrition in CKD

kinase CKD Chronic kidney disease CRP C-reactive protein CVD Cardiovascular disease DBP Diastolic blood pressure DEXA Dual-energy X-ray absorptiometry eGFR Estimated glomerular filtration rate EAAs Essential amino acids ESRD End-stage renal disease FM Fat mass FFM Fat free mass FSA Four-site skinfold anthropometry GFR Glomerular filtration rate GNRI Geriatric Nutrition Risk Index GRADE Grades of Recommendation Assessment, Development, and Evaluation HD Hemodialysis HDL-C High-density lipoprotein (...) acid production NHANES National Health and Nutrition Examination Survey NIS Nutrition Impact Symptoms NKF National Kidney Foundation NRCT Non-randomized controlled trial nPCR Normalized protein catabolic rate nPNA Normalized protein nitrogen appearance NST Nutrition Screening Tool ONS Oral nutritional supplements PCR Protein catabolic diet PD Peritoneal dialysis PEW Protein energy wasting PNA Protein nitrogen appearance PNI Protein Nutrition Index RCTs Randomized controlled trials RDN Registered

2020 National Kidney Foundation

184. Febuxostat - hyperuricaemia

in the joints) or tophi (‘stones’, larger deposits of urate crystals that can cause joint and bone damage). Febuxostat Krka is also used to treat and prevent high levels of uric acid in the blood in adults with blood cancers who are receiving chemotherapy (medicines to treat cancer) and at risk of tumour lysis syndrome (a complication due to the breakdown of cancer cells causing a sudden rise of uric acid in the blood which can cause damage to the kidneys). Febuxostat Krka contains the active substance (...) it is authorised in the EU What is Febuxostat Krka and what is it used for? Febuxostat Krka is a medicine used to treat adults with long-term hyperuricaemia (high levels of uric acid or ‘urate’ in the blood). Hyperuricaemia can lead to urate crystals forming and building up in the joints and the kidneys. When this happens in the joints and causes pain, it is known as ‘gout’. Febuxostat Krka is used in patients who have signs of a build-up of crystals, including gouty arthritis (pain and inflammation

2019 European Medicines Agency - EPARs

185. Guidelines For Professional Ultrasound Practice

AND SCROTUM 76 2.9.1 Ultrasound examination of the kidneys 76 2.9.2 Ultrasound examination of the testes and scrotum 79 2.10 ULTRASOUND EXAMINATION OF THE ADULT HEAD AND NECK 82 2.11 PAEDIATRIC ULTRASOUND EXAMINATIONS 86 2.11.1 Paediatric liver and biliary system 86 2.11.2 Paediatric Urinary system 90 2.11.3 Paediatric gastro-intestinal tract 91 2.11.4 Neonatal hip 92 2.11.5 Neonatal intracranial ultrasound 93 2.12 MUSCULOSKELETAL ULTRASOUND EXAMINATIONS 95 SCoR/BMUS Guidelines for Professional Ultrasound (...) . ISAS, GDPR and marketing/advertising codes added 2.6 BMUS statement on ultrasound imaging reporting added. 2.7 Revised and updated gynaecology section 2.8.6 Advice on imaging and reporting of thoracolumbar aortic aneurysms (safety critical) 2. 9 Updated renal imaging section 2. 9 Updated scrotal imaging section 2.15 Link to HEE Advanced Clinical Practice Framework added. 2.16 Patient Group Directions section updated 2.6 RCR actionable report audit added 2.14 Reference to ‘Medicine Matters’ added

2019 British Medical Ultrasound Society

186. American College of Rheumatology Guideline for the Management of Gout

of renal disease (31). Similarly, patients with markedly elevated SU concentrations (>9 mg/dl) are more likely to experience gout progression (26,32). For patients with a history of urolithiasis, allopurinol and febuxostat provide benefit, as both medications lower 24- hour urinary uric acid excretion more than placebo (33). Among patients with calcium oxalate stones and hyperuricosu- ria, allopurinol (300 mg/day) is superior to placebo in reducing the 3- year incidence of stone- related events (34 (...) kidney disease: systematic review and meta- analysis. BMC Nephrol 2015;16:58. 32. Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperurice- mia: risks and consequences in the Normative Aging Study. Am J Med 1987;82:421–6. 33. Goldfarb DS, MacDonald PA, Gunawardhana L, Chefo S, McLean L. Randomized controlled trial of febuxostat versus allopurinol or placebo in individuals with higher urinary uric acid excretion and calcium stones. Clin J Am Soc Nephrol 2013;8:1960–7. 34. Ettinger B, Tang A, Citron

2020 American College of Rheumatology

187. Lesch-Nyhan disease

originally diagnosed with cerebral palsy were later recognised as suffering from a previously undescribed inherited metabolic disease because of the familial occurrence and unusual clinical features. Lesch M, Nyhan WL. A familial disorder of uric acid metabolism and central nervous system function. Am J Med. 1964;36:561-570. HPRT deficiency causes overproduction of uric acid, which may lead to hyperuricaemia, nephrolithiasis, gouty (...) movement disorder dominated by dystonia, attentional deficits, and behavioural disturbances with self-injury. Should be considered when delayed development is accompanied by a hyperkinetic movement disorder, including dystonia, particularly when routine brain MRI is normal. Should be suspected if a delayed development is accompanied by self-injurious behaviour or evidence of excessive production of uric acid. Diagnosis is based on HPRT enzyme activity, preferably measured in live cells such as cultured

2018 BMJ Best Practice

188. Narrow Versus Wide Focal Zones for Shock Wave Lithotripsy of Renal Calculi

, and located within the renal collecting system. Patients must have had a CT scan within the past 30 days. Stones must be solitary, between 5 and 15 mm in maximal diameter. Patient must consent to the trial and be willing to return to their respective lithotripsy unit at 2 weeks and 3 months for follow-up. Patients must be treated on the Storz Modulith SLX-F2 machine Exclusion Criteria: More than one renal calculus on the treated side. Radiolucent stones (uric acid, indinavir) or cystine stones. Stone size (...) of Western Ontario, Canada More Information Go to Layout table for additonal information Responsible Party: St. Michael's Hospital, Toronto Identifier: Other Study ID Numbers: 10-225 First Posted: October 22, 2010 Last Update Posted: October 6, 2017 Last Verified: October 2017 Keywords provided by St. Michael's Hospital, Toronto: SWL kidney stones renal calculi Additional relevant MeSH terms: Layout table for MeSH terms Kidney Calculi Nephrolithiasis Calculi Kidney Diseases Urologic

2010 Clinical Trials

189. Allopurinol / lesinurad (Duzallo) - Gout

increase excretion of uric acid into the urine, by inhibition of transporters mediating reabsorption of uric acid by the kidney. Lesinurad also belongs to the oral uricosuric agents. c) intravenous pegloticase, a pegylated recombinant uricase. Uricase is an enzyme which converts uric acid to more soluble allantoin for renal excretion. Initiation of ULT could actually induce an arthritis gout attack, as instability of crystals deposits due to a sudden drop of Serum uric acid (sUA, also referred (...) and lesinurad, targets both excretion and production of uric acid, thus providing a dual-mechanism approach to lower sUA levels. Lesinurad is a selective uric acid reabsorption inhibitor (SURI) that inhibits the uric acid transporter 1 (URAT1) in the proximal tubule of the kidney. URAT1 is responsible for the majority of the reabsorption of filtered uric acid from the renal tubular lumen. By inhibiting URAT1, lesinurad increases uric acid excretion and thereby lowers serum uric acid. Lesinurad also inhibits

2018 European Medicines Agency - EPARs

191. Adalimumab (Hyrimoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Papulosquamous Skin Diseases, Hidradenitis Suppurativa, Ankylosing Spondylitis, Uveitis

populations Elderly No dose adjustment is required. Renal and / or hepatic impairment Adalimumab has not been studied in these patient populations. No dose recommendations can be made. Paediatric population Hyrimoz is only available as 40 mg pre-filled syringe / pre-filled pen. Thus, it is not possible to administer Hyrimoz to paediatric patients that require less than a full 40 mg dose. If an alternate dose is required, other adalimumab products offering such an option should be used. Juvenile idiopathic (...) effect on adalimumab clearance. The serum levels of free adalimumab (not bound to anti-adalimumab antibodies, AAA) were observed to be lower in patients with measurable AAA. Hepatic or renal impairment Adalimumab has not been studied in patients with hepatic or renal impairment. 5.3 Preclinical safety data Non-clinical data reveal no special hazard for humans based on studies of single dose toxicity, repeated dose toxicity, and genotoxicity. An embryo-foetal developmental toxicity / perinatal

2018 European Medicines Agency - EPARs

192. Cardiovascular Disease: Secondary Prevention

Metoprolol LA 12.5–25 mg daily 200 mg daily is maximum dose. 12 Medication Monitoring Table 7. Medication monitoring Eligible population Recommended tests Recommended frequency Patients on statin Non-fasting lipoprotein panel 4–6 weeks after initiating therapy Patients on niacin ALT/AST and Fasting blood glucose or HbA1c and Uric acid At baseline and 2–4 weeks after increasing dose and Every 6 months Patients on bile acid sequestrant Non-fasting lipoprotein panel At baseline and 3 months after initiating (...) Organization diagnostic criteria—who have failed to achieve an LDL 400 mg/dL. Bile acid sequestrants should be avoided for patients with TG = 300 mg/dL. • Cholestyramine has many drug interactions due to its ability to reduce absorption of other medications. Other drugs should be administered at least 1 hour before or 4–6 hours after cholestyramine. 9 ACE Inhibitor or ARB Therapy Table 3. ACE inhibitor or ARB therapy for secondary prevention of ASCVD Line Medication Initial dose Maximum dose 1 st ACE

2018 Kaiser Permanente Clinical Guidelines

193. ESC/ESH Management of Arterial Hypertension Full Text available with Trip Pro

influencing cardiovascular risk in patients with hypertension Demographic characteristics and laboratory parameters Sex (men >women) Age Smoking (current or past history) Total cholesterol and HDL-C Uric acid Diabetes Overweight or obesity Family history of premature CVD (men aged <55 years and women aged <65 years) Family or parental history of early-onset hypertension Early-onset menopause Sedentary lifestyle Psychosocial and socioeconomic factors Heart rate (resting values >80 beats/min) Asymptomatic (...) Peripheral artery disease Atrial fibrillation Demographic characteristics and laboratory parameters Sex (men >women) Age Smoking (current or past history) Total cholesterol and HDL-C Uric acid Diabetes Overweight or obesity Family history of premature CVD (men aged <55 years and women aged <65 years) Family or parental history of early-onset hypertension Early-onset menopause Sedentary lifestyle Psychosocial and socioeconomic factors Heart rate (resting values >80 beats/min) Asymptomatic HMOD Arterial

2018 European Society of Cardiology

195. Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk Full Text available with Trip Pro

available definitions of the metabolic syndrome are not yet fully validated as quantifiable predictors of risk, and more studies are necessary to test their ability to predict ASCVD and T2DM, these definitions can be used to identify more susceptible populations for more intensive screening ( ). Many different biomarkers of ASCVD and/or T2DM risk have been identified in addition to the five “classic” components of metabolic syndrome, including uric acid, apolipoprotein B, lipoprotein(a), adiponectin (...) causes of hyperlipidemia. If a secondary cause can be excluded, primary hyperlipidemia should be suspected. (1∣⊕⊕⊕○) Technical remark: Examples of secondary causes of hyperlipidemia include untreated hypothyroidism, nephrotic syndrome, renal failure, cholestasis, acute pancreatitis, pregnancy, polycystic ovarian disease, excess alcohol use, treatment with estrogens/oral contraceptives, antipsychotic agents, glucocorticoids, cyclosporine, protease inhibitors, retinoids, and beta blockers. Cholesterol

2019 The Endocrine Society

196. Heart Disease and Stroke Statistics Full Text available with Trip Pro

on the definition used. In addition to well-established associations with poor CVD outcomes and all-cause mortality, the presence of metabolic syndrome also has been shown to be associated with poorer cancer outcomes, including increased risk of cancer recurrence, cancer-related mortality, and overall mortality. Kidney Disease (Chapter 11) According to the United States Renal Data System, the overall prevalence of chronic kidney disease in the United States among NHANES participants ≥20 years of age was 14.8 (...) status, particularly income, was associated with a higher prevalence of chronic kidney disease and faster progression to end-stage renal disease. This association was observed in higher- versus lower- or middle-income countries and was more pronounced in the United States, relative to Europe. Sleep (Chapter 12) Data from the Centers for Disease Control and Prevention indicated that the age-adjusted prevalence of healthy sleep duration (≥7 hours) was 65.2% for all Americans and was lower among Native

2019 American Heart Association

197. Bladder Stones

stones still kill? An analysis of death from stone disease 1999-2013 in England and Wales. BJU Int, 2016. 118: 140. 11. Ramello, A., et al. Epidemiology of nephrolithiasis. J Nephrol, 2000. 13 Suppl 3: S45. 12. Halstead, S.B. Epidemiology of bladder stone of children: precipitating events. Urolithiasis, 2016. 44: 101. 13. Takasaki, E., et al. Chemical compositions of 300 lower urinary tract calculi and associated disorders in the urinary tract. Urol Int, 1995. 54: 89. 14. Naqvi, S.A., et al. Bladder (...) then serve as a nidus for bladder stone growth; patients with bladder calculi are more likely to have a renal stone history and other risk factors for renal stone formation [ ]. A wide range of metabolic urinary abnormalities can predispose to calculi anywhere in the urinary tract, a topic which is covered in more detail in the EAU Urolithiasis Guideline [ ]. There is a paucity of evidence as to which specific metabolic abnormalities predispose to bladder stones. Hypocitraturia and a low urine volume

2019 European Association of Urology

199. Urolithiasis

tomography of the kidneys, ureters and bladder for urolithiasis. J Med Imaging Radiat Oncol, 2017. 61: 582. 52. Poletti, P.A., et al. Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. AJR Am J Roentgenol, 2007. 188: 927. 53. Zheng, X., et al. Dual-energy computed tomography for characterizing urinary calcified calculi and uric acid calculi: A meta-analysis. Eur J Radiol, 2016. 85: 1843. 54. Niemann, T., et al. Diagnostic performance of low-dose CT (...) Urol, 2007. 177: 565. 26. Gonzalez, R.D., et al. Kidney stone risk following modern bariatric surgery. Curr Urol Rep, 2014. 15: 401. 27. Rendina, D., et al. Metabolic syndrome and nephrolithiasis: a systematic review and meta-analysis of the scientific evidence. J Nephrol, 2014. 27: 371. 28. Dell’Orto, V.G., et al. Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review. Br J Clin Pharmacol, 2014. 77: 958. 29. Mufti, U.B., et al. Nephrolithiasis

2019 European Association of Urology

200. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

Complementary and Alternative Medicine for Diabetes Loren D. Grossman MD, FRCPC, FACP, Robert Roscoe BScPharm, ACPR, CDE, CPT, Anita R. Shack BFA, DC, FATA Macrovascular and Microvascular Complications S162 Cardiovascular Protection in People With Diabetes James A. Stone MD, PhD, FRCPC, Robyn L. Houlden MD, FRCPC, Peter Lin MD, CCFP, Jacob A. Udell MD, MPH, FRCPC, Subodh Verma MD, PhD, FRCSC, FAHA S170 Screening for the Presence of Cardiovascular Disease Paul Poirier MD, PhD, FRCPC, FCCS, FACC, FAHA (...) . Prebtani MD, FRCPC, Vincent Woo MD, FRCPC S190 Management of Acute Coronary Syndromes Jean-Claude Tardif MD, FRCPC, FACC, FCAHS, Phillipe L. L'Allier MD, David H. Fitchett MD, FRCPCCONTENTS (continued): April 2018 Volume 42 Supplement 1 S196 Treatment of Diabetes in People With Heart Failure Kim A. Connelly MBBS, PhD, FCCS, Richard E. Gilbert MBBS, PhD, Peter Liu MD, FRCPC, FACC S201 Chronic Kidney Disease in Diabetes Philip McFarlane MD, PhD, FRCPC, David Cherney MD, PhD, FRCPC, Richard E. Gilbert

2018 Diabetes Canada

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