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Uric Acid Nephrolithiasis

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41. Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. (PubMed)

Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. Idiopathic uric acid nephrolithiasis is characterized by elevated urinary net acid excretion and insufficient buffering by ammonium, resulting in excessively acidic urine and titration of the relatively soluble urate anion to insoluble uric acid. Patients with type 2 diabetes have similar changes in urinary pH, net acid excretion, and ammonium in 24-h urine (...) collections at baseline, even after controlling for dietary factors, and are at increased risk for uric acid nephrolithiasis. However, not all patients with type 2 diabetes develop kidney stones, suggesting that uric acid stone formers may have additional urinary defects, perhaps not apparent at baseline. We performed a metabolic study of 14 patients with idiopathic uric acid nephrolithiasis, 13 patients with type 2 diabetes, and 8 healthy control subjects of similar body mass index. After equilibration

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2013 American Journal of Physiology. Renal physiology

42. Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study. (PubMed)

and race with incident CKD.In this community-based cohort, nephrolithiasis was not an independent risk factor for incident CKD overall. However, risk of CKD was unexpectedly elevated in participants with stone disease and lower plasma uric acid levels.Copyright © 2015 by the American Society of Nephrology. (...) Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study. Previous studies demonstrated a higher risk of CKD in persons with a history of kidney stones, but these studies examined mostly white populations and did not evaluate important potential interactions such as race and plasma uric acid.In 10,678 Atherosclerosis Risk in Communities (ARIC) study participants free of CKD at baseline (ARIC visit 4 in 1996-1998), we assessed the association between a history

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2015 Clinical Journal of the American Society of Nephrology

43. Differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus. (PubMed)

and multivariable linear regression models were performed, comparing patients with and without DM. A subanalysis of patients with stone analysis data available was performed, comparing the stone composition of patients with and without DM.Of the 1117 patients who comprised the study population, 181 (16%) had DM and 936 (84%) did not have DM at the time of urine analysis. Univariable analysis showed significantly higher total urine volume, citrate, uric acid (UA), sodium, potassium, sulphate, oxalate, chloride (...) Differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus. To examine the differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus (DM) in a large cohort of stone-formers and to examine differences in stone composition between patients with and without DM.A retrospective review of 1117 patients with nephrolithiasis and a 24-h urine analysis was completed. Univariable analysis of 24-h urine profiles

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2015 BJU international

44. The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. (PubMed)

of nephrolithiasis and uric acid stones result from excessively low urine pH. Here we placed 9 healthy volunteers and 10 uric acid stone formers on fixed metabolic diets to study the diurnal pattern of urinary acidification. All showed clear diurnal trends in urinary acidification, but none of the patterns were affected by inhibitors of the gastric proton pump. Uric acid stone formers had similar patterns of change throughout the day but their urine pH was always lower compared to healthy volunteers. Uric acid (...) The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. Many biological functions follow circadian rhythms driven by internal and external cues that synchronize and coordinate organ physiology to diurnal changes in the environment and behavior. Urinary acid-base parameters follow diurnal patterns and it is thought these changes are due to periodic surges in gastric acid secretion. Abnormal urine pH is a risk factor for specific types

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2012 Kidney international

45. Nephrolithiasis (Overview)

of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination with plain (...) , which innervate the intramural ureter and bladder, are responsible for some of the bladder symptoms that often accompany an intramural ureteral calculus. Nephrolithiasis: acute renal colic. Distribution of nerves in the flank. Previous Next: Pathophysiology Formation of stones Urinary tract stone disease is likely caused by two basic phenomena. The first phenomenon is supersaturation of the urine by stone-forming constituents, including calcium, oxalate, and uric acid. Crystals or foreign bodies can

2014 eMedicine.com

46. Nephrolithiasis: Acute Renal Colic (Overview)

and type of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination (...) narcotic analgesics (eg, codeine, morphine sulfate, oxycodone/APAP, hydrocodone/APAP, dilaudid, fentanyl) Alpha blockers (eg, tamsulosin, terazosin) Antiemetics (eg, metoclopramide, ondansetron) Antibiotics (eg, ampicillin, gentamicin, trimethoprim-sulfamethoxazole, ciprofloxacin, levofloxacin, ofloxacin) Stone Prevention/Chemolysis Uricosuric agents (eg, allopurinol) Alkalinizing agents (eg, potassium citrate, sodium bicarbonate): For uric acid and cysteine calculi Thiazide diuretics- helps treat

2014 eMedicine.com

47. Nephrolithiasis (Treatment)

Nephrolithiasis (Treatment) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA (...) == processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus

2014 eMedicine.com

48. Nephrolithiasis: Acute Renal Colic (Treatment)

Nephrolithiasis: Acute Renal Colic (Treatment) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure

2014 eMedicine.com

49. Nephrolithiasis (Follow-up)

Nephrolithiasis (Follow-up) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA (...) == processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus

2014 eMedicine.com

50. Nephrolithiasis: Acute Renal Colic (Follow-up)

Nephrolithiasis: Acute Renal Colic (Follow-up) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure

2014 eMedicine.com

51. Nephrolithiasis (Diagnosis)

of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination with plain (...) , which innervate the intramural ureter and bladder, are responsible for some of the bladder symptoms that often accompany an intramural ureteral calculus. Nephrolithiasis: acute renal colic. Distribution of nerves in the flank. Previous Next: Pathophysiology Formation of stones Urinary tract stone disease is likely caused by two basic phenomena. The first phenomenon is supersaturation of the urine by stone-forming constituents, including calcium, oxalate, and uric acid. Crystals or foreign bodies can

2014 eMedicine.com

52. Nephrolithiasis: Acute Renal Colic (Diagnosis)

and type of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination (...) narcotic analgesics (eg, codeine, morphine sulfate, oxycodone/APAP, hydrocodone/APAP, dilaudid, fentanyl) Alpha blockers (eg, tamsulosin, terazosin) Antiemetics (eg, metoclopramide, ondansetron) Antibiotics (eg, ampicillin, gentamicin, trimethoprim-sulfamethoxazole, ciprofloxacin, levofloxacin, ofloxacin) Stone Prevention/Chemolysis Uricosuric agents (eg, allopurinol) Alkalinizing agents (eg, potassium citrate, sodium bicarbonate): For uric acid and cysteine calculi Thiazide diuretics- helps treat

2014 eMedicine.com

53. Nephrolithiasis/Urolithiasis

junction (UVJ), and the point at which the ureter crosses the iliac vessels. An additional site is on the right side, where the ureter passes through the root of the mesentery. Calcium stones as small as 1-2 mm can be seen. Cystine stones as small as 3-4 mm may be depicted, but uric acid stones are usually not seen unless they have become calcified. Typically, phleboliths are round or oval, and they may demonstrate a central lucency. However, they are often difficult to distinguish from ureteral (...) Nephrolithiasis/Urolithiasis Urinary Calculi (Urolithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzgxOTkzLW92ZXJ2aWV3 processing > Urinary

2014 eMedicine Radiology

54. Ertugliflozin l-pyroglutamic acid / sitagliptin phosphate monohydrate (Steglujan) - Diabetes Mellitus, Type 2

Ertugliflozin l-pyroglutamic acid / sitagliptin phosphate monohydrate (Steglujan) - Diabetes Mellitus, Type 2 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 25 January 2018 EMA/86941/2018 Committee for Medicinal Products (...) Concentration L-PGA L-pyroglutamic acid LS least-squares MACE major adverse cardiovascular event MAR missing at random MNAR missing-not-at-random assumption MCAR missing completely at random MedDRA Medical Dictionary for Regulatory Activities mFAS modified FAS NDA New Drug Application NIR near infrared NMR nuclear magnetic resonance NMT not more than NOEC No Observed Effect Concentration PA polyamide PAR proven acceptable ranges PAT process analytical technology PD pharmacodynamic(s) PDLC pre-defined limit

2018 European Medicines Agency - EPARs

55. Ertugliflozin l-pyroglutamic acid (Steglatro) - Diabetes Mellitus, Type 2

Ertugliflozin l-pyroglutamic acid (Steglatro) - Diabetes Mellitus, Type 2 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 25 January 2018 EMA/86938/2018 Committee for Medicinal Products for Human Use (CHMP) Assessment report (...) of Diabetes ECG electrocardiogram ECHA European Chemicals Agency eGFR estimated glomerular filtration rate ER excluding rescue ERA Environmental risk assessment ESI-MS electrospray positive ionization mass spectra FA Focus area FAS full analysis set FeCl 3 Iron (III) chloride Fpen Market penetration factor FPG fasting plasma glucose GAD glutamic acid decarboxylase GC gas chromatography GMP good manufacturing practice HCTZ hydrochlorothiazide HDL-C high-density lipoprotein-cholesterol HDPE high density

2018 European Medicines Agency - EPARs

56. Ertugliflozin l-pyroglutamic acid / metformin hydrochloride (Segluromet) - Diabetes Mellitus, Type 2

Ertugliflozin l-pyroglutamic acid / metformin hydrochloride (Segluromet) - Diabetes Mellitus, Type 2 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 25 January 2018 EMA/86928/2018 Committee for Medicinal Products for Human Use (...) Ertu/Met ertugliflozin/metformin Ertu/Met pool pooled safety data from placebo-controlled ertugliflozin add-on metformin phase III studies ESFA European Food Safety Authority ESI-MS electrospray positive ionization mass spectra FA Focus area FAS full analysis set Assessment report EMA/86928/2018 Page 5/159 FDA Food and Drug Administration FDC fixed-dose combination FeCl 3 Iron (III) chloride Fpen Market penetration factor FPG fasting plasma glucose GAD glutamic acid decarboxylase GC gas

2018 European Medicines Agency - EPARs

57. Diseases 2.0: Uric acid stones linked to diabetes

Sep;2(5):883-8. Epub 2007 Aug 16.PMID: 17702734 4: Cameron MA, Baker LA, Maalouf NM, Moe OW, Sakhaee K. Circadian variation in urine pH and uric acid nephrolithiasis risk.Nephrol Dial Transplant. 2007 Aug;22(8):2375-8. Epub 2007 May 3. No abstractavailable.PMID: 17478488 5: Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urine composition in type 2 diabetes: predisposition to uric acidnephrolithiasis.J Am Soc Nephrol. 2006 May;17(5):1422-8. Epub 2006 Apr 5.PMID: 16597681 Share: | | One (...) Diseases 2.0: Uric acid stones linked to diabetes Diseases 2.0: Uric acid stones linked to diabetes – Clinical Correlations Search Diseases 2.0: Uric acid stones linked to diabetes July 3, 2008 3 min read Commentary By David Goldfarb, M.D. Professor of Medicine, NYU Medical Center, Chief Nephrology Section VA New York Harbor At the recent meeting of the National Kidney Foundation in Dallas, Dr. Orson Moe reviewed the links between diabetes and uric acid stones . Uric acid stones are most often

2008 Clinical Correlations

58. Investigation of Adipose Tissue Fatty Acid Composition in Men with Uronephrolithiasis and Metabolic Syndrome (PubMed)

Investigation of Adipose Tissue Fatty Acid Composition in Men with Uronephrolithiasis and Metabolic Syndrome BACKGROUND Fatty acids (FA) and their metabolites are closely related to some mechanisms involved in the development of uronephrolithiasis. The aim of this study was to evaluate the relationship between FA composition and type of kidney stones. MATERIAL AND METHODS Abdominal adipose tissue fatty acid methyl esters of 71 men with nephrolithiasis were identified by GC/MS, and the type (...) of kidney stones was identified using FTIR infrared spectroscopy. Patients were divided into groups according to diagnosis of metabolic syndrome (MS) and type of kidney stone. The composition of FA was compared within different groups of patients with different types of kidney stones and between the patients and healthy individuals (control group) (n=100). RESULTS Individuals with nephrolithiasis had a significantly higher level of monounsaturated fatty acids (MUFA) and a lower level of polyunsaturated

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2018 Medical science monitor : international medical journal of experimental and clinical research

59. Body Fat Content and Distribution and Urinary Risk Factors for Nephrolithiasis. (PubMed)

-ray absorptiometry to assess body composition and fat distribution. Urinary risk factors for nephrolithiasis and urine saturation with respect to calcium oxalate and uric acid (assessed as supersaturation index [SI]) were correlated with various measures of adiposity.Study participants included 21 men with a mean age of 52.1 years, mean weight of 91.1 kg, and mean total fat mass of 24.3 kg. Twenty-four-hour urine pH and SI uric acid were more closely correlated with fat mass than with lean mass (...) or total body weight. Both 24-hour urine pH and SI uric acid were also significantly correlated with truncal fat mass but not with leg fat mass. Moreover, there was a significant negative correlation between truncal/leg fat mass and NH4(+)/net acid excretion ratio (R=-0.62; P=0.009). However, there was no significant association between SI calcium oxalate and body weight, lean mass, fat mass, trunk fat mass, or leg fat mass.The association between 24-hour urine pH and SI uric acid and various measures

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2013 Clinical Journal of the American Society of Nephrology

60. Nephrolithiasis and loss of kidney function. (PubMed)

. Across several studies, patients with nephrolithiasis had about a two-fold higher risk for decreased renal function or need for renal replacement therapy. This risk appears to be independent of risk factors for CKD that are common in stone formers such as hypertension and diabetes mellitus. Specific risk factors for CKD in stone formers include recurrent urinary tract infections, struvite and possibly uric acid stone composition, symptomatic stones, solitary kidney, ileal conduit, neurogenic bladder (...) Nephrolithiasis and loss of kidney function. The prevalence of nephrolithiasis has been on the rise over recent decades. There have also been extensive efforts to identify risk factors for chronic kidney disease (CKD). The purpose of this review is to highlight recent evidence on the association of nephrolithiasis with the development of CKD and end-stage renal disease (ESRD).Several epidemiologic studies over the past decade assessed the relationship between history of nephrolithiasis and CKD

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2013 Current Opinion in Nephrology and Hypertension

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